ADHD: It's Not Just a Guy Thing
When you hear the term ADHD, a picture of a rambunctious little boy probably pops up in your mind. He’s a well meaning bundle of energy who leaves a trail of destruction and flustered adults in his wake. We don’t often associate ADHD with girls though. Why is that? The ratio of boys to girls identified as having ADHD is 3:1, at least in childhood. So, that may be a factor. But we should also consider how ADHD shows up in our girls, because it is often masked as something else.
Under the umbrella of ADHD, there are 3 distinct types, according to the DSM IV. Kids with ADHD present as either Predominantly Inattentive, Predominantly Hyperactive/Impulsive or Combined Type. Needless to say, it’s much easier to spot the Predominantly Hyperactive/Impulsive type than the Predominantly Inattentive Type. So let’s just start there.
Symptoms of hyperactivity and impulsivity start to emerge at a young age, between 3 and 6 years, according to Dr. Russell Barkley, a prominent researcher in the field. Parents might question whether their child’s level of activity and lack of social skills warrants a closer look and, indeed many will advise that they may just grow out of it. Given the ratio between boys and girls cited above, it’s much more likely that we’re talking about a little boy in this scenario. If we consider our social norms, we are more likely to view an overactive boy as being “normal” because well, he’s just being a boy, right? A little girl? I think it’s far more likely that her parents or teachers would start looking into a possible cause and some strategies to support her at this young age.
But what if I told you that some studies have shown girls to be more likely to have the inattentive type of ADHD than the impulsive type? And that symptoms of inattention show up a little later-during middle to late childhood? Now we’re looking at a different story. Let’s keep in mind those social norms I mentioned. Whether it’s right or wrong, girls have historically been rewarded for being “good” or “nice” or “fitting in” and they want to please others. I think this has started to change, however we have a long way to go.
This leads me to believe that our girls with ADHD are much more likely to try to hide it, without knowing what they’re actually hiding. They may seem to others to be lazy or dreamy or just plain stubborn. They may be super students too. A parent recently told me that her daughter wasn’t diagnosed until she reached college and felt so frustrated that she didn’t get help sooner. This young lady earned her way into a very prestigious and selective university so she obviously worked hard to get over the many hurdles of ADHD. And, as she probably knows, suffering in silence, so to speak, has its’ price. Anyone who has ADHD is more likely to have secondary issues like low self esteem, depression and anxiety, but if the ADHD goes undiagnosed, those secondary issues can be misinterpreted as the primary issues and treatment falls short of being effective.
Michele Nelson, Assistant Clinical Professor of Psychiatry at University of California, Riverside School of Medicine, was quoted in an article that addresses just this phenomenon. In regard to the girls and women who come to her clinic she states “… they have this underlying condition, in this case, ADHD, but they're presenting with all these features of depression just because they're struggling with poor self-esteem. They just can't get their work done. They say, ‘No, I just can't do this. I'm just not good enough. I don't know what's wrong with me.”
The point I’m trying to make here is that our girls who struggle with low self esteem, depression and anxiety may actually be struggling with ADHD, without knowing it and subsequently without getting the treatment they need. Of course this isn’t strictly an issue of gender. My advice for boys and men is the same. If you struggle with mental health issues, it’s worth taking a look for ADHD. Obviously, ADHD isn’t always at the root of depression, anxiety and low self esteem, but in my opinion, it’s worth taking a look.
Suzanne Leon is a Certified Professional Coach who works with people affected by ADHD/ADD. Visit her website to learn more about the services she provides.
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