No One Believes You Have ADHD, Especially If You're a Girl
ADHD is most commonly associated with hyperactive young boys. But because of stigma and frequent misdiagnosis, girls and women suffering from the disorder aren't getting the help they need.
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Margaux Joffe, 31, gets stressed out about Ikea. While the experience of shopping in the giant home goods store can be overwhelming for anyone, for Joffe—and 4.4 percent of Americans living with ADHD—it is unequivocally too much. Even though, in a way, Joffe also has the labyrinth of Scandinavian design to thank for finally being properly diagnosed with the condition.
"Like many other women with ADHD, I had struggled silently for years with periods of depression, anxiety, and sensory overload," Joffe tells me over the phone. "I was misdiagnosed with depression and anxiety when I was 18, but [when I was 29] I took a trip to Ikea. You know how you have to walk through the entire store before you can get out? Well, I was in the store with my mom for a couple hours, and I just hit a point where it was sensory overload." Because people with ADHD don't have the same sensory gating mechanisms as people who are neurotypical, their brains don't automatically filter out extraneous information.
"I told my mom that I had to go and I couldn't be there anymore. My mom, being very perceptive, called me about a week later and said, 'Margaux, have you ever considered that you might have ADHD?'"
In women, ADHD also manifests itself in ways that defy the stereotypical portrait of the disorder and is often misdiagnosed. According to the CDC, boys are far more likely than girls to receive the diagnosis. A 2005 study published in the Journal of Clinical Psychology posits that because girls' symptoms are "less overt than the disruptive behaviors typically seen among males," ADHD in women is virtually hidden.
There are three types of ADHD. The first, predominantly hyperactive/impulsive, mainly involves stereotypical symptoms of ADHD: hyperactive or impulsive symptoms, few or no inattentive symptoms. The second and third types of the disorder, predominantly inattentive and combined hyperactive-impulsive and inattentive, exhibit mainly inattentive symptoms or a mix of hyperactive and inattentive symptoms. "I went my whole life not knowing, and when I finally went through the process of getting diagnosed I started crying out of recognition and relief," says Joffe.
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ADHD makes a real impact on women's lives. Symptoms include low self-esteem, disorganization, and anxiety. Girls with ADHD are more at risk to self-harm and attempt suicide than their peers.
Because of this, Joffe launched Kaleidoscope Society—a resource for women with attention deficit disorder—last month during ADHD awareness month. Kaleidoscope Society aims to promote visibility for the often invisible demographic.
Joffe's parents are both medical professionals, so she says she was able to receive the proper care as soon as she realized she could possibly have ADHD. But this isn't always the case. In some instances, women are met with disbelief when they attempt to seek treatment for the disorder. Medical professionals have even accused women of faking ADHD to be able to take stimulants for weight-loss.
"It's common for [medical professionals to deny women's ADHD diagnoses]. There's a lack of scientific research and understanding when it comes to ADHD and women," Joffe explains. "That is because a lot of what is known about ADHD is based on studies that were done in the 70s on teenage boys—primarily white teenage boys."
"My dad is a pediatrician and he works with kids who have ADHD, and the fact that my own father didn't see any signs [when I was growing up] is a testament to how little information there was at that time about how ADHD is different in women," she continues.
Dr. Lara Honos-Webb, a psychologist who often writes about ADHD, says that in her practice one girl for every three boys comes in for an ADHD diagnosis. When girls go undiagnosed through adolescence, they often feel like their struggles in school and in life are due to personal failings. "Instead of getting help, girls end up conforming their behavior in certain ways to match society's expectations," says Joffe. When Joffe received a report card in the second grade with the note that she "needed to control her enthusiasm" all she saw was the message that she should shine less brightly.
To combat this, Kaleidoscope Society invites women to open up about what it's actually like to live with ADHD and promote a positive image of the disorder. "I want women with attention deficit disorder to know that they're not alone," says Joffe—right before she, needlessly, apologized for going on an ADHD tangent.