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The Good, The Bad and the Ugly on ADHD in Girls and Women

A few decades ago, it was believed that ADHD occurred only in boys. Back then, girls with ADHD were labeled tomboys, day-dreamers, social butterflies. They were said to talk too much in class and their teachers were known to keep saying, "She's a smart girl, she's just not applying herself.

Today, we've come a long way in recognizing and identifying the gender-specific and often more subtle manifestations of ADHD in girls and women; but we still have a long way to go. Teachers continue to identify many more males than females; mainly because they are more disruptive. They fail to see other behaviors, like hyper-talkativeness, blurting out answers, social withdrawal, misunderstanding directions, messiness, disorganization, test anxiety, late or missing assignments and forgetfulness as linked to ADHD.

Parents also do not connect the following symptoms with ADHD:

*School phobia/avoidance

*Low self-esteem

*Low academic performance, despite high IQ/creativity

*Poor organizational skills/messiness

*Sleep problems

*Shyness/poor social skills

*Disheveled appearance/grooming problems

*Withdrawal in the classroom.

Additionally, whereas boys generally act out and blame others for their difficulties, girls with ADHD tend to internalize their struggles. As opposed to hyperactivity, impulsivity and inattention, this impacts girls in ways that may not easily be observed by others.

ADHD has come to be viewed as a "foundational disorder", a basis that sets the stage for other conditions to develop, such as: *anxiety

*mood disorders

*various learning disorders (reading and written language difficulties)

*substance abuse

*eating disorders

How else does ADHD in girls differ from in boys?

Hyperactivity is more "hyper-talking" and emotional excitability/reactivity. It could be hyperactive thoughts, causing inablity to focus and sleep issues.

Social challenges look different than in boys with ADHD. We see:

*Verbal as opposed to physical aggression - gossip and social exclusion of others.

* Social rejection of hyperactive/impulsive type girls.

*Social neglect of inattentive type (ADD) girls - being ignored and left out.

These girls have more self-esteem problems than their boy counterparts because of the shame and self-blame they internalize.

Hormonal changes at puberty affect impulsivity and mood swings and there is generally more related depression and anxiety among girls with ADHD.

The good news is that early identification and effective interventions can greatly reduce some of these negative symptoms and coexisting conditions. Some successful interventions include:

*Positive parenting

*Brain-healthy habits like sleep, exercise, good nutrition and stress reduction


ADHD coaching for increasing structure and support in the school environment

*Therapy or coaching for addressing underlying emotional distress linked to low self-esteem .

It has become my passion to work with ADHD girls and women on these structural supports (view them like eye-glasses for the visually impaired, or like insulin shots for diabetics), as well as to help them identify their strengths, build their self esteem and empower them to feel in control of their lives. It is a mission of mine to help these girls reframe their ADHD condition and to encourage them to view it as a different but equal brain bake-up; one that is perhaps simply not suited to the traditional classroom. For example; day-dreamers have great imaginations, out-of-the-box thinkers are great problem-solvers, energetic personalities can pursue causes with tireless dedication.

Early identification and intervention can help these girls not only function well in daily life, but also access their strengths and utilize them to overcome their difficulties.

This article is based on the first chapter of the book Understanding Girls with ADHD.

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