6 Urgent Questions About Adult ADHD, Answered.
by Marissa Pomerance
Most of us think of ADHD as being something that overly energetic, easily distractable, little kids have. But 12 million adults experience ADHD, and for many women, it goes completely undiagnosed.
So we spoke to psychotherapist and ADHD expert, Sari Solden, who has written multiple pioneering books about ADHD, and is one of the go-to experts in studying ADHD in women, specifically. And she gave us answers to the most rarely-discussed questions about ADHD.
1. So ADHD isn’t actually just about hyperactivity?
That’s a huge misconception— that ADHD describes hyperactive, impulsive, trouble-making little boys. And if you are quiet, inactive, a people pleaser, inattentive, went to college, or are successful, you don’t have ADHD! Which just isn’t true.
Another misconception is related to this idea of “twice exceptional.” People who are “twice exceptional” might have learning disabilities and/or ADHD, but they are also gifted or highly intelligent. This creates confusion, because their gifts might shield others from noticing their diagnoses, and their diagnoses might prevent them from fully utilizing their gifts.
When an individual has these great gifts or talents, but also has great difficulty organizing their thoughts or actions to manifest their abilities in the world, this can lead to demoralization and avoidance, which further exacerbates their problems.
There are a lot of lesser known signs and symptoms of ADHD, and they occur commonly for both men and women:
Difficulty moving from thought to action— i.e., activating themselves.
Prioritizing or coordinating and organizing daily life.
Filtering out distractions in their environment or from their internal thoughts.
Working memory problems.
Emotional regulation.
Short term memory.
2. Why is ADHD under-diagnosed in women?
If you are smart and had support or structure as a girl, and if you didn’t match the hyperactive stereotype described above, your symptoms were often masked until later when the demands of college, independent living, working, or marriage exceeded your executive function abilities in some areas.
Because they don’t get diagnosed early enough to understand their experiences, neuro-diverse women’s self-concepts often become conflated with their unique brain wiring. This can lead to withdrawal, hiding, or pretending, which prevents them from leading a fulfilling life or having close relationships.
Many women with ADHD may be diagnosed with depression or anxiety because of their masked ADHD symptoms, but these may be secondary to a missed diagnosis of inattentive ADHD.
3. Why do people with ADHD struggle with emotional dysregulation?
Women with ADHD are already coping with a great amount of sensory overload, because of their inability to filter out incoming stimuli, as well as their general sensitivity and a tendency to be wounded easily because of their lack of early diagnosis, and resultant negative attributions from other people.
A common component of ADHD is called “Rejection Sensitive Dysphoria,” which is a condition that makes rejection and criticism almost impossible to stomach, leading to extreme emotional reactions, or more commonly for women, withdrawl and passivity.
Because their daily lives are more difficult to manage in general, and because they get emotionally flooded easily, their emotional reactions are easily triggered.
4. How do we remove shame from the ADHD equation?
When women with ADHD devalue themselves, they collude with others’ negative attributions and allow themselves to be treated in a demeaning or critical way. It is easy for them to believe the misattributions ascribed to their executive function challenges, ie. that they are immature, irresponsible, lazy, careless, or selfish. This leads to shame and more reactivity and disempowerment, especially in relationships.
Women have to go through a process of untangling who they are at their core from their executive function struggles. When they do this, their shame will begin to decrease, so that they can participate in mutually respectful relationships.
When women value themselves and know what kind of help they need and can ask for that in a direct way, they no longer allow themselves to tolerate and absorb toxic messages about their difficulties.
5. How can someone with ADHD better manage their emotional reactions, especially in the context of their relationships?
Women with ADHD continue to internalize and idealize gender role expectations for what a women should be able to do easily. These images that they continually take in from the general culture— that they should be able to “do it all,” for example— run counter to their executive function capabilities. This often puts them in a difficult position when it comes to navigating relationships. When they feel shame and isolation, they move away from meaningful relationships to hide their difficulty.
And women with ADHD are often looked at as the person causing the problems in relationships. It is critical for the woman to accept herself and become aware of her own value, even with her difficulties. These women need to be able to see themselves as worthwhile partners, friends, family members, colleagues, or employees.
So when women find themselves becoming flooded with emotions, they can learn to move away from the conversation or situation temporarily so that they have a way to calm down and get back to a centered position from which to continue communication. This will allow them to stay in relationship, but to protect themselves in a healthy way. They can learn to take a pause to honor their processing speed so they can keep calm when talking with someone who may have a faster processing speed.
Women with ADHD have to learn to set boundaries so they can feel safe. They can take responsibility if they have inconvenienced others, but they can stop over-apologizing for who they are and putting themselves in a less powerful position in a relationship because of their difficulties or challenges. The goal is to move to a mutual problem-solving mode where each person’s feelings are validated.
6. How can mental health professionals better address the needs of women with ADHD, specifically?
Mental health professionals need to move away from viewing a woman with ADHD through a pathological lens and instead help a women to see herself as a whole person with strengths, difficulties, and enduring core traits.
Instead of the mental health professional exclusively using tips, tools, and strategies to “fix” the client, they instead can look through a healing lens for women who have lived most of their lives with the confusion and frustration of undiagnosed and untreated ADHD.
Mental health professionals can help address chronic brain wiring challenges with strategies, medication, and support, but the parallel track has to be about the woman and her core sense of self in order to help her move toward a fulfilling life with meaningful relationships, even if, and when, she continues to struggle with ADHD. In other words, the goal can’t be for her to wait to live her life until she gets over her difficulties or to define herself or measure her worth by this yardstick.
Bonus: these are the newest, most modern ADHD resources.
And because what’s the point of all this without clear cut action items, here are some modern resources for understanding and managing ADHD:
For better understanding ADHD in women, you can read Sari Solden’s book, A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, and Break Through Barriers
For managing ADHD in relationships, try this online course by expert Melissa Orlov.
For access to mental health experts and ADHD medication, try Ahead.
To manage your career and life, consider getting an ADHD coach, who helps with planning and time management skills.
If you just want some lighthearted, relatable ADHD content, follow this Instagram account. Is it a bit cutesy? Yes. Do we still love it? Also yes.
Marissa Pomerance is the Managing Editor of The Candidly. She’s a Los Angeles native and lover of all things food, style, beauty, and wellness. You can find more of her articles here.
