Largely unheard of a generation or two ago, attention deficit hyperactivity disorder (ADHD) is now a common diagnosis for school children, especially boys. Recently, however, researchers have discovered that 4% to 8% of adult women may have ADHD—yet most of them have never been diagnosed.
ADHD (also formerly known as attention deficit disorder, or ADD) is a neurological condition that interferes with a person's ability to concentrate, organize daily life and manage time. It can wreak havoc on all areas of life, including health. Unlike a man, a woman may develop worsening symptoms in midlife and beyond due to hormonal changes.
Fortunately, help is available. Once a woman with ADHD is diagnosed and treated, her life tends to improve dramatically.
Signs Of ADHD
While everyone feels frazzled at times, the typical woman with ADHD feels almost constantly overwhelmed. Far more often than average, she...
- Feels rushed. arrives late...inclined to miss deadlines.
- Procrastinates...gets distracted...feels like she works frantically all day long but accomplishes little.
- Has difficulty concentrating and following directions.
- Is easily bored...or becomes so engrossed in an activity that she tends to neglect other responsibilities.
- Acts impulsively...blurts out inappropriate remarks...makes hasty decisions.
- Misplaces things...forgets errands. .Overspends...pays bills late.
- Has short-lived friendships and failed marriages.
- Is moody...feels ashamed...feels different" from other women.
ADHD can be costly in myriad ways. A woman suffers financially if she impulsively buys things she can't afford. She suffers professionally due to her scattershot performance-a recent study found that, in terms of productivity, employees with ADHD do the equivalent of 22 fewer days of work per year than other employees. She suffers socially if friends and family get fed up...and psychologically if her inability to cope erodes her self-esteem.
Her physical health also is at risk--for instance, she may forget her medication or mammogram appointment. Constant stress elevates levels of the hormone cortisol, which can weaken the immune system and contribute to heart disease, digestive disorders, respiratory problems, infertility and fibromyalgia (widespread muscle and joint pain). ADHD even may increase her risk for depression, addiction and/or eating disorders.
What’s Worse For Women
Because girls with ADHD generally are not as disruptive as boys, pediatricians may overlook the disorder in girls. When these girls reach adulthood, their symptoms often are wrongly attributed to depression or anxiety-misdiagnoses that are less common among men.
Gender bias plays a role, too. Women typically are expected to be the family organizers --to plan meals, put away clutter, keep track of everyone's schedule. These tasks are difficult for women with ADHD, in whom the brain's organizational functions are compromised.
Midlife's hormonal changes can worsen a woman's symptoms significantly.
Reason: As estrogen production declines, the brain's receptors for dopamine-a brain chemical associated with happy feelings-become less receptive.
Result: Women who used to manage their ADHD fairly well may have more trouble coping during and after menopause.
Treatment can help—but that requires a diagnosis. There is no definitive test for ADHD, SO diagnosis is based on three criteria…
- Symptoms began many years ago.
- You have at least several of the symptoms above.
- Symptoms are severe enough to significantly affect at least two of the three main areas of life-home, work, social aspects.
What to do: If you suspect that you have ADHD, consult a mental health professional who works with adult ADHD patients.
Referrals: Children and adults with Attention Deficit/Hyperactivity Disorder, 301-3067070, www.chadd.org.
How To Cope
The following strategies make it much easier to live with ADHD…
- Join a support group. The Center, A Resource for Women and Girls with AD/HD (888238-8588, www.ncgiadd.org) or find an online group through www.chadd.org.
- Hire a professional organizer to create systems for you for filing paperwork and storing belongings.
Referrals: National Association of Professional Organizers, 856-380-6828, www.napo, net/referral
- Set up an automatic bill paying system for regular expenses, such as mortgages and car loans, through your bank's Web site.
- Avoid food additives. Studies suggest that artificial coloring and preservatives are linked to ADHD.
- Supplement daily with a vitamin B complex and with omega-3 fatty acids (found in fish oil)—these support brain function.
- Stabilize blood sugar. Rapid spikes and plunges in blood sugar levels impair concentration. Include protein at every meal.. avoid simple carbohydrates (white bread, cookies).
- Get enough sleep. Many women with ADHD are sleep-deprived because they get a "second wind" after dinner or lose track of time and stay up too late.
Helpful: Set an alarm to ring each evening to remind you when it's time for bed.
- Practice stress-reduction techniques to clear your mind. If it is hard to sit still for meditation or deep breathing, try yoga or tai chi.
- Try neurofeedback, which trains you to increase the brain-wave patterns associated with improved focus and concentration.
Referrals: The Biofeedback Certification Institute of America, 866-908-8713, www.bcia.org.
If the above strategies are not sufficient to make life manageable, ask your doctor about the pros and cons of medication. ADHD drugs generally work by regulating levels of the brain chemicals dopamine and/or norepinephrine, which affect parts of the brain that control attention. Medication does not cure ADHD—when the drugs are discontinued, symptoms return.
Stimulants, such as amphetamine (Adderall), methylphenidate(Ritalin, Concerta) or lisdexamfetamine (Vyvanse), are most often prescribed. Fluctuations in estrogen levels may influence the effectiveness of stimulants, so women taking these drugs should be closely monitored. Side effects may include dry mouth, restlessness and high blood pressure.
Another option is an antidepressant. Atomoxetine (Strattera) is the first non-stimulant drug approved by the FDA for the treatment of ADHD. Other antidepressants include bupropion (Wellbutrin), venlafaxine (Effexor) and desipramine (Norpramin). Such drugs may be appropriate when anxiety and depression accompany ADHD. Antidepressants often are used in combination with stimulants. Side effects may include nausea, sleep problems and decreased sex drive.
If you are going through menopause and your ADHD symptoms have worsened, hormone therapy may help you by balancing your estrogen levels.
Downside: Increased heart disease and breast cancer risk.
Bottom line: ADHD is a legitimate medical problem, not a character flaw. Remember, the condition does have its benefits. Women with ADHD often have tremendous energy are very creative...and have an adventurous nature that makes them great fun to be with.