The double challenge of being a woman and suffering from ADHD

The double challenge of being a woman and suffering from ADHD

The most common symptoms are absent-mindedness, inattention, disorganization, procrastination or frequently losing things. If you feel identified, consult a specialist to rule out that you suffer from ADHD

ADHD in women and girls is rarely diagnosed since the symptomatology according to each gender manifests itself differently and in women it tends to go unnoticed. According to the experts consulted, there is a gender bias in the detection of the disorder.

In many cases, not detecting ADHD early can lead to depression and anxiety problems, low self-esteem , difficulties in personal relationships, and work problems.

Many women believe that the treatment has changed their lives and find meaning in many of their problems after learning of the diagnosis.

what is ADHD
ADHD is a neurodevelopmental disorder. This means that there are some difficulties from birth itself – and even from the development of the fetus – that will have some main symptoms that are: the ability to sustain attention, and high levels of impulsivity and, in some cases, motor hyperactivity. It is part of mental disorders, specifically neurodevelopmental disorders, such as autism, Tourette’s syndrome or dyslexia.

The double challenge of being a woman and suffering from ADHD. Photo: EFE
The double challenge of being a woman and suffering from ADHD. Photo: EFE

Living with ADHD: the woman’s experience Ada Soto is a 36-year-old woman who was diagnosed with ADHD just two years ago, when she was 34.

He states that ADHD was "masked" in his two main symptoms: depression and anxiety, for which he had gone to therapy multiple times in search of help.

“Depression and anxiety were a consequence of not having a diagnosis in time”, and it is that, once he comes to know that he suffers from this disorder, it is when he begins to “find logic to everything that happened to him”, relates the affected.

In her childhood and youth, she defines herself as a good student. She was good at school and has done well professionally, but motivation and organization presented obstacles in her day-to-day life. In class he noticed that it was "very difficult for him to maintain sustained concentration" and that he easily lost himself in his thoughts.

The job presented itself as an even bigger bump and the ADHD became that much harder to deal with. She found herself with more and more difficulties and did not understand why the rest of the people did not find themselves with the same potholes as her: lack of motivation, distractions, continuous forgetfulness… This led her, like many women in her situation, to enter into a spiral of depression and anxiety that he was unable to treat until he discovered that the main problem was that he suffered from ADHD.

"The first time I took the medicine I felt much more energy, I noticed how I could concentrate on certain things." He told his psychiatrist “hey, why didn’t you give me this before”. He has no hesitation in stating that the medication, along with the therapy, have changed his life.

She is not the only woman who finds herself facing an abysmal change in her life after starting ADHD treatment.

anonymous testimony
"The change is so great that it seems to have no logic," declared another of the women affected by the disorder, who has preferred to remain anonymous for fear of labor reprisals. He considers that mental illnesses, such as ADHD, have too many stigmas, and that "people are not prepared to understand that thanks to treatment I can have the same capacity as any other person."

The medication helped him get a steady job after numerous layoffs. This job instability turned into emotional instability that ended up leading to many depressive processes.

He was diagnosed with ADHD at the age of 34 and, five months after starting the medication, he got his first promotion. The change was so radical that he managed to get another five promotions in a period of less than a year.

For her, living without the diagnosis "was horrific." "Not understanding why nothing works in your life is a huge frustration," he declared. He considers that girls, in general, show a tendency to "overcompensate" for this problem by investing much more time and effort in doing any type of work, whether in the workplace, education, or within their own home.

The detection of the disorder meant very long periods of therapy in which he treated depressive periods. It wasn’t until she lied to her GP that she had been told by a psychologist that she had ADHD that she was referred to a psychiatrist. She was referred to a psychiatrist, whom she defines as the greatest specialist in ADHD in Madrid, who diagnosed her with the disorder 10 minutes after starting the consultation.

Not knowing that he suffered from this disorder, and consequently, the lack of treatment for it, especially affected his personal life. She confesses that impulsiveness and instability led her to lose her relationship and some of her friendships.

ADHD woman
Photo EFE/Mario Ruiz
Adriana: "I felt like I didn’t fit in anywhere"
Adriana Escobar is another woman who was diagnosed with ADHD as an adult, specifically when she was 40 years old.

All his life he had a feeling “I didn’t fit in anywhere, I wasn’t right. I had the feeling that it was broken,” he says. Although he has many symptoms, he defines the search for a diagnosis as a "show".

She found out she had ADHD while searching for a diagnosis for her son. He realized at that moment that her problems were similar to his.

She tried to obtain treatment for herself, but says that through public health it has been impossible.

The approach to mental health in the National Health System, in his opinion, "is generally fatal" and there is a stigma within the professionals themselves, so it is very difficult to find someone who is up to date, and "if you pull gender bias, even more so.”

For Adriana, within the very difficulty posed by this disorder, for women it is an even greater difficulty since “as a woman they ask you for more demanding behavior and standards”. "We are supposed to be perfect," he declares and that reality is far from this. For this reason, she considers that “it is very important that there is a gender perspective, because in the end, within everything, women end up being the most badly off”.

He went to a private psychiatrist and was immediately confirmed that he had ADHD. It’s only been three months since she was diagnosed.

He requested the medication because he needed something to help him get better because he was looking for support to be able to help his son and "said and done", he says.

On the first day, two hours after starting the medication, he noticed a dramatic change: “There is a lot of noise in my head and the medication is as if they put earplugs in me and I didn’t hear anything”.

Adriana had also gone to therapy numerous times but believes that "she has had bad luck with Social Security."

He has an eating disorder associated with ADHD, something common among people who suffer from this disorder, and complains that for doctors, the greatest concern was always that he lose weight, ignoring his disorder.

The woman with ADHD suffers a change of life after knowing her diagnosis. And it is that, living with a disease that you do not know you have is very frustrating for everyone, but especially if no one realizes for years that this disease is making life much more difficult for you than for others.

The appearance of the diagnosis and, consequently, of the treatment, is something that has suddenly improved the lives of these women. They all recognize an abysmal change regarding the functioning of their brain from the first day they start medical treatment.

It is only a matter of a moment for their lives to change completely. So that they begin to understand many things in their life, but, above all, so that they begin to understand and forgive themselves for many past situations.

Experts are clear: there is a gender bias
We spoke with Dr. Josep Antoni Ramos Quiroga, Dr. Mercedes Sánchez (both psychiatrists specialized in ADHD) and Ana Gómez, a teacher specialized in ADHD. Their testimonies agree that ADHD goes unnoticed in women and is often camouflaged in problems of depression and anxiety.

"In boys, symptoms of hyperactivity predominate more and in girls, more symptoms of attention deficit predominate, so they can go unnoticed and be diagnosed later," explains Dr. Mercedes Sánchez.

According to data from the doctor, the prevalence figures (which is the percentage per inhabitant), show that between 5% and 7% of children suffer from ADHD. In adults, it is estimated that the figure is close to half, "although there is always talk of underdiagnosis."

When we talk about girls, in cases where only attention deficit (without hyperactivity) is manifested, it is much more difficult to diagnose.

To identify these cases, we need to look at whether girls take a long time to do their homework, whether their study time matches their grades, and whether they skip questions or repeat silly mistakes.

Women are often labeled as lazy, lazy, forgetful, absent-minded… without associating these behaviors with ADHD. This is due, in part, to the fact that ADHD in adults is, in a certain way, invisible "in 2015 the catalogs of ADHD in adults came out, but before it did not exist", indicates the specialist.

For women who have spent their entire lives without being detected with this disorder, "a diagnosis by itself is therapeutic," says the doctor, maintaining that it significantly improves the daily life of patients.

Being pigeonholed as lazy, lazy, clueless and disorganized people is a rejection and a stigma both by the family and by society, so when they reach adulthood and someone finally tells them what they have, it is a relief for them .

This disorder is detected with a clinical interview that is based on the interview with the patient and, in some cases, also with their relatives and their treatment is individualized.

It is a multimodal treatment: a combination of psychological, cognitive-behavioural, psychoeducational and pharmacological therapies. The reality though is that most people can’t afford all of these options and treat you only with medication.

The psychiatrist affirms that "the treatment gives them life" and that the drug itself is more effective than all psychological therapies. The most effective are stimulants, although there are also non-stimulant treatments, "despite their bad reputation, stimulants are safe, effective and well-tolerated drugs."

For Mercedes Sánchez, women with ADHD are "extremely vulnerable people" and are more associated with abuse, harassment and even gender violence. "This problem is affected by gender roles, since different things are still expected from women than from men, and many women with ADHD cannot meet the expectations that are expected of them."

As for adults in general, he talks about underdiagnosis and wants to highlight the group of children born in the 60s, 70s and 80s, since they were years when ADHD was not diagnosed.
-even with behavior problems, addictions, or school failures- since at that time "they put you to work and didn’t take you to the psychiatrist". Because of this, it is likely that many of the children and adults of this era have not been diagnosed.

resilience teachers
ADHD is harder to diagnose in girls, experts say. EFE / Ismael Herrero
Ramos-Quiroga: Greater symptoms in girls
For his part, the psychiatrist Josep Antoni Ramos-Quiroga agrees in stating that "there is a detection bias", and that there are twice as many children diagnosed and "even triple in some statistics".

But this does not mean that the disorder occurs two or three times more in boys than in girls, but rather that there is a greater detection of the syndrome in males than in females.

He maintains that since girls or women present greater symptoms of attention – as opposed to hyperactivity in boys – in some way “it goes unnoticed clinically or is confused with other disorders such as anxiety or depression”.

The expert indicates that mental illnesses are diagnosed clinically: "Today we do not have complementary tests that have sufficient specificity and sensitivity to detect these disorders", although the specific genetic causes that are related to the different diseases are becoming more and more known. mental.

The genetic makeup of ADHD
Many times, this disorder is diagnosed in adulthood coinciding with the diagnosis of one of the children. During the evaluation of the child, they realize that what happens to the son is the same as what happened to her.

ADHD has a very high genetic load. "If you take 100% of the reasons why a person has ADHD, 76% have to do with our genetic endowment," explains Dr. Quiroga.

These same genes also confer a higher risk of having other diseases that are often associated with ADHD, such as addictions, obesity, migraines and depression.

"We must not fall into genetic determinism," he warns.

"We know that genetic bases play a prominent role, but we must always keep in mind that gene expression also depends on the interaction we have with the environment." This means that if the environment is protective and favorable, the risk of the expression and severity of ADHD decreases markedly.

Ana Gómez: teacher, patient and in associationism
Ana Gómez is a teacher and has a postgraduate degree in ADHD and behavioral disorder and another in neuroscience and education. In turn, it is part of the Madrid Association of Adults with Attention Deficit and Hyperactivity (AMATDAH).

AMATDAH is an association made up of people with attention deficit disorder, which is complicated, as he explains to us, since the paperwork is “a horror” for them and “meetings are lost or forgotten”.

Ana also suffers from ADHD, and discovered it when she found out that her daughter suffered from it. “I began to read all the symptoms well and I began to cry. It’s me," he commented. After this, he began to call psychologists and psychiatrists in search of a diagnosis and found all kinds of situations "they told me that it did not exist, that it was a lack of maturity."

His life changed after learning of the diagnosis. "You forgive yourself a lot of things," she explains. Like many other women, before learning she had ADHD, she experienced long periods of depression and anxiety.

He decided to specialize in it because it interested him “very much” at an educational level.

He explains that "if the girl does not bother" the disorder is difficult to detect since they go unnoticed in schools and that, in general, "girls do a lot of masking", that is, they try to keep appearances much more than men. children, "don’t let them be noticed". "Society tells them what to do and how to behave, so they are more restrained," he explains.

He believes that this condition does not disappear in adulthood. "There are many women who have everything spotless or who arrive an hour earlier to the sites simply for compensation," she says.

Others, as is her case, realize that they suffer from this disorder when they are mothers, but that it continues to be masked because “if you don’t seem like a bad mother”. There are even cases of women who develop OCD: “you are so afraid to relax that you don’t allow it”, she explains.

Agreeing with many women in her situation, she also believes that "it is essential that jobs adapt to people with ADHD" and that these adaptations would be "very simple" and would make life much easier for all those people who suffer from this. disorder.

As for the consequences of living without a diagnosis, the answers of the experts coincide again. A person with ADHD finds himself with consequences such as anxiety, depression, and low self-esteem.

In addition, people with ADHD find it difficult to face new jobs and are more likely to generate addictive behaviors (to substances, food, the Internet, compulsive purchases, or even sex). Drug use is often higher in people with undiagnosed ADHD as it unconsciously serves as a treatment for the disorder.

Not only this, personal relationships – as we have seen – are complicated. Due to impulsiveness, difficulties are often found when it comes to maintaining both a stable romantic relationship and a friendship relationship. Also, they are more prone to accidents.

In general, and bearing in mind that each case is always particular, the symptoms presented by ADHD are frequently common. We must attend to all those alerts focused on inattention and see if they are frequent.

If you are a woman or a man who identifies with these stories, who share many of the symptoms of ADHD that have been mentioned, and who have been thinking for years that something is wrong in your life, perhaps you also suffer from this disorder. Pay attention to all the warnings of the experts and, in case of doubt, go to a specialist. Who knows, maybe your life could be a little better too.