Just came across a good article in WebMD about why girls and women are so often missed in diagnosising ADHD. Thought I'd pass it along with a few observations of my own. You can find it at:
http://my.webmd.com/content/Article/95/103354.htm (http://my.webmd.com/content/Article/95/103354.htm)

I've always been a bit confused about how I was so easy to diagnosis before I even entered school (my mom said it was pretty obvious to everyone including two pediatricians and an OB/GYN who treated me) but how I managed to have very few of those "comments" my on report cards that psychologists are always looking for to show evidence of childhood ADHD. The only comment I remember was when my second grade teacher wrote in TALKS and then checked it because that wasn't on the behaviors list she was filling out. And while I was no wiz kid and had to spend a couple of summers doing reading or math catch up I wasn't failing school either.

I just had a conversation with my mom after she saw Dr. Hallowell on the Today show and decided there was something to this ADHD thing after all!:rolleyes: She told me that I was a real people pleaser and worked extremely hard in school. Well, that put together with this makes a lot of sense to me.

Instead of being disruptive, girls with ADHD tend to show their symptoms in more socially appropriate ways, say Patricia A. Pape, PsyD, a psychologist in private practice in Wellington, Fla. She says it's not uncommon for girls with ADHD to become social butterflies. When they feel the need to move around, they usually meet their need by acting as a teacher's helper or monitor.

Girls with ADHD also learn to cover up their syjmptoms, because they are ashamed of them and generally want to please people, say Quinn. "If [girls with ADHD] forget to bring a project into school, they're embarrassed and humiliated by that, so they work hard, or even develop anxiety and worry so that it won't happen again."

Wow, this fits me so well (it looks like it's going to fit my daughter too). I don't really fit into the Inattentive Type of ADD a lot of girls did. I was clearly hyperactive early on but I really did want to be good and please people. I can clearly remember anxiety and depression symptoms as early as sixth grade. Just kind of nice to hear somebody else validate it -- because sometimes I don't feel like I fit in here although, I'm clearly ADHD.

The article goes on to say:

The average woman is already doing more, say Terry Matlen, MSW, author of Survival Tips for Women with ADHD: Beyond Piles, Palms, and Post-its. She says, "If you add the burden of ADHD symptoms -- getting overwhelmed, being forgetful, being hyperactive, or being disorganized -- to deal with that, on top of taking care of children... plus being a wife and handling a job, it's just more than one can imagine."

Afraid I don't have to imagine it -- I live it!:p

Russel Barkley, PhD, professor of psychiatry at the Medical University of South Carolina, say there are no special remedies for women with adult ADHD. He says the disorder has an equally great impact on men and women. Both sexes, he says, will have difficulties with memory, driving, school, the workplace, handling substances, regulating feelings, and managing lifestle factors such as weight.

"Both of them are going to suffer in these domains," say Barkley, noting the differential impact will be in what people choose to emphasize in their lives. Since many women place a premium on their homes, children, and social relationsips, those areas of their lives will likely suffer ..."

We definately need to learn more about how men and women show up in the ADHD world! Anyway, I found this helpful and hoped someone else might as well! :)

Scattered

Felt like I was reading about myself...

It's so true though...we do I think try to cover up our ADHD cause we have been trained to be a certian way...so sad....once again..guys have it easy!!! :)

Scattered,

Excellent question and thanks for the link.

A lot of times it comes down to the old......."squeaky wheel gets the grease" thing.

By and large we're (boys) louder and more annoying (as a rule )...lol.

I do have some hyperactive girls on my caseload though.

Having said that, it's also been discussed that the symptoms are more heavily weighted towards boys.


P.S.

Here's an "unofficial" ADHD boys degree of annoyance level question.....

Ask their sisters if they have post traumatic flashbacks when the 3 Stooges come on? :)

I was,and still am the complete opposite to what they say is the typical female AD/HDer.I'm-hyper,impulsive disruptive and all the usual male associated traits,I was on formal report,detention and head teacher visits constantly,and my parents were often called in,yet I was never assessed for anything,i'm still searching for a reason why I would be missed. :(

Scattered,
A lot of times it comes down to the old......."squeaky wheel gets the grease" thing.

By and large we're (boys) louder and more annoying (as a rule )...lol.
Yeah, McTavish, but then I was never much of one for following the rule!:D Both my little brother and I are ADHD (he was the quiet good little kid -- I was the other kind who wasn't even allowed to play with my little brother's toys 'cause I might break them!:p ). They were offering my parents Ritalin for me in the early 60's before I even hit school! LOL!

Scattered

That's interesting. I'm in the middle of the process of getting diagnosed (or possibly not diagnosed) and I was looking back at my old report cards. My early report cards have comments like "needs reminders to complete work on time" "needs to put more effort into written work" or my favourite "must learn to try harder with her colouring" (seems bizarre now but I guess it makes sense when you're 6). But my later report cards say things like "a pleasure to teach" and "an excellent helper".

I was never hyperactive though so I guess I wouldn't have drawn attention to myself. I remember around grade 4ish (whenever it was when Chrissy on the show 'growing pains' had an imaginary friend), I invented an imaginary character named Mikey who would run around the classroom playing with everything, climb to the top of the book shelves, make faces at the teacher, and generally entertain me when I was bored. He definately would have been noticed....I mean if he wasn't invisible that is.

I remember alot of humiliation!Teachers getting angry at me and holding grudges.I learned to shut down and just wing it.
Once I had kids I couldnt shut down or wing it anymore!It was time to face it head on!
I had always been a people pleaser and then I hit my teens and I became anti social and against the powers that be!Even though I had no idea what or who they were!LOL!!!!!
One extreme to the other!

I think I was passed over because I learned to lay low.It was embarrasing,I had no idea what was wrong.I thought it was just the way I was.
Thank God I found out diffrent and now life is much sweeter and so am I!LOL!!!!

Well Brandilyn, you were right on schedule -- teen girls generally start having a lot more troubles and begin more closely approximating behaviors seen in boys or so I've read. Not me! The little preschool hellion that gave the boys a run for their money was the sweetest, most compliant little teenager you ever saw! :D Got to keep them guessing, I suppose!:p

Glad life is much sweeter now for you!:) I think I'm finally hitting all those bumps I managed to avoid as a teenager.:eyebrow:

Scattered

Scattered,

Excellent question and thanks for the link.

A lot of times it comes down to the old......."squeaky wheel gets the grease" thing.

By and large we're (boys) louder and more annoying (as a rule )...lol.
You are correct. There is a double standard between boys and girls when it comes to classroom disipline. Boys that act out are usually threatened with a tone of voice that enforces that threat. Girls that act out are more likely to be brought back into group with a easier tone of voice.

Since females are "talkers" by nature, hyperactivity might be exhibited by being overly talkative. Since males have all that testosterone (sp), their hyperactivity is exhibited by not sitting still. I read some where that a new classification, ADHD / talkative, might be considered. Anyone hear anything?

I also think girls with ADHD could eventually get excluded from their established "clique", because of the above reason. Their hyperfocus could be anything. But I can see where reading would be an area of hyperfocus, which falls into the arena of academics. I also see the comorbids of anxiety, depression and low self-esteem/self-image being very high with females.

You think boys can be mean, they just roll around on the ground and beat each other up and then go play with Hot Wheels 5 min. later. Girls can be down right evil to each other and stay that way. :eek:

I agree,why is that?Is it competion?Something learned?Passed on from generation to generation?
Women do seem eager to to come down hard on theyre equals.Women should protect and defend each other!I think its very important to teach our young women that.They dont have to compete with each other.

My mom always told me growing up,"there is always gonna be someone prettier or smarter than the one before."
As a young woman it sounded harsh and then as I got older I understood what she meant.
We shouldnt focus so much on our flaws,everyone is diffrent and beautiful in there own way.
Looks fade with time,but love and understanding and kindness is a wonderful trait to have!

I don't know anything about talkativeness being included in the next DSM, but it would sure make sense to me. Hyperactive girls frequently talk too loud, too fast, and too much. (They frequently eat the same way too!). I know mine will also talk to any one they meet and give out all kinds of personal information, so too indiscriminately probably also applies. It would fit with the overall picture of a behavior inhibition disorder (a much more accurate description, than ADHD). And your right Tim, talking is definately a behavior girls probably have more need to inhibit than most boys (although judging from your 4th grade teacher's comment -- you kept up with us just fine!:p ).

As far as girls being more vicious than boys -- that's a fact, although I would suspect ADHD girls are less so than most. Like any ADHDer they aren't particularly good at keeping secrets, forget what they are mad about pretty quickly, and have trouble covering up their true feelings. I was a very easy mark for other girls to dupe, so most of my friends were boys in elementary and high school.

Scattered

I'm 41 and Female...and an ADDer

I've had a difficult Life ; From a young age, i was told off a lot ; For butting into adult conversations, Touching things i shouldn't!, Breaking things, Being noisy, Picking on my older sister!, Being moody in the mornings, Stealing sweets from shops, Not concentrating in the Classroom,Talking when i shouldn't be, Being cheeky... blah blah blah...

My Teenage + years got worse!.. I felt i didn't fit in anywhere and i didn't understand the school work, I didn't do any homework, Truanted school, Had an older boyfriend, Rode Motorbikes illegally, Had under-age sex, Stayed out late, Lied, Cheated, Dyed my hair blue, Stole money from parents, Stole 'things' from other people, Drank alcohol, Smoked cigarettes, Had a fling with my best friends boyfriend behind her back, Lost all my friends, Impulsive behavior that caused me to say and do some nasty things!, Had relationships with many different boys at a time as i got bored easily.. blah blah blah...

Twenties + >>> Had One-Night stands!, I tried to stick to a serious relationship but it didn't work!, I couldn't hold down a job, I was lazy, Smoked Cigarettes, Tried SPEED, Ate too much, Got drunk a lot!, Found great excitement from seeing guys that were already in a relationship, Had 4 children with a man that didn't love me, Made New friends and Lost them.

Thirties + Forties... Got married, abused, had a baby for my husband, Divorced, Made new friends and lost them, Gave up smoking Cigarettes, Had short relationships as i got bored easily, Huge disagreements with neighbours, I Recieve both physical and mental abuse off my 16 year old son, Met the Man of My Dreams, Diagnosed with ADHD(hooray!)...

My Future? (In the making).

And why didn't i get Diagnosed with ADHD before the age of 41?.. Because i was a NAUGHTY CHILD!... NOT!!

My Daughter is 12 and She is struggling at school, she can't concentrate on anything at home or school.. she used to get 'SEN' at her junior school, as her abilities are well below other children of her age, but since she has started secondary school,this september, no help has been set up as yet!... Meetings are being arranged!!!

I know my daughter has ADD, but unlike 3 of her 4 brothers, that are already diagnosed with ADHD, she isn't Hyperactive, she is quite the opposite in some ways ; She shuts off from the world, into Daydream land.. but i feel sorry for the one that intrudes on her Daydream world! > She has a quick temper!!, She has a terrible memory and is either losing/breaking things or forgetting things etc etc


She used to count steps when walking up and down stairs and avoid cracked paving slabs... she did this as a serious issue, Not a game!
She says she doesn't do it anymore:eyebrow: , but doesn't her past behavior, show a form of compulsive behavior, which could be linked to her undiagnosed AD/HD?

I'm led to believe, that AD/HD is more noticeable in Girls, at Puberty?
Looking back on My Life, My Teenage Years were Very Difficult, but then, so was the years before and after that :eyebrow:

My daughter is approaching her Puberty and i'm seeing it in her Impulsive Behavior... I'm scared, that My Daughter is going to go through her Life, like myself... and not getting Diagnosed and getting the help She needs, until it's too late.

Late diagnosis of ADHD, of my 3 diagnosed sons has come too late for the healthy growth of the self esteem and qualifications, not been accepted by their peers(because they are immature)... etc etc

I don't want the same to happen to My Daughter and My 5 year old Son.. both have many/most ADDer traits!!



Karen :)

Thanks for sharing your life synopsis with us. Wow! You have come along way.

I have noticed from the postings on the forum, that those with ADHD can literally be from end to end on the spectrum of behavior, education and relationships.

Good luck with your daughter. Remember, that knowing is half the battle.

Karennerack,

Like Tim said, wow! You really have survived a lot. I guess it's almost like heart disease and women as far as getting diagnosed -- more women die of it than men, but we are still looking for how the symptoms show up in men and miss it in women. You know part of it is simply knowing what's going on. While you keep looking for someone who can correctly diagnose and treat your daughter you can also help educate her. I don't know if you've read Sari Solden's book Women with Attention Deficit Disorder but it's a good one. Hallowell and Ratey also have a good book called Answers to Distraction with a section on women called "Perchance to Dream" that also has suggestions on non medication tips to use in addition to or independent of medication.

I hope you will be able to get everyone correctly diagnosed and treated. I also hope you know you don't have to take physical abuse -- not even from your son. ADHD is an explanation for behavior, not an excuse for it. As Dr. Barkley says, consequences for problem behavior need to be more immediate and consistent not less, because the he won't learn otherwise and you deserve better! I know it's all much easier said than done -- you take care and keep letting us know how it's going with you and your family.

Scattered

I have noticed from the postings on the forum, that those with ADHD can literally be from end to end on the spectrum of behavior, education and relationships.You're absolutely right, but with a qualifier -- education can certainly range all along the continuium, but as far as behavior and relationships go the frequency of problems may vary, but my experience is that problems (even serious ones) in relationships and behavior do crop up in even "well adjusted" looking ADHDers (otherwise it wouldn't really be ADHD -- no dysfuction, no diagnosis). Some women because of a family support net, higher intelligence or income level, etc have some protective factors that help them cover the "oops" in their lives and regain their footing more quickly. That's probably why so many women ADHDers end up feeling like frauds. Others just don't realize the side they so carefully hide. (Not that I'd know anything about that personally!:rolleyes: ).

Scattered

You're absolutely right, but with a qualifier -- education can certainly range all along the continuium, but as far as behavior and relationships go the frequency of problems may vary, but my experience is that problems (even serious ones) in relationships and behavior do crop up in even "well adjusted" looking ADHDers (otherwise it wouldn't really be ADHD -- no dysfuction, no diagnosis). Some women because of a family support net, higher intelligence or income level, etc have some protective factors that help them cover the "oops" in their lives and regain their footing more quickly. That's probably why so many women ADHDers end up feeling like frauds. Others just don't realize the side they so carefully hide. (Not that I'd know anything about that personally!:rolleyes: ).

Scattered
I'm not gloatting, but I think I was pretty "well adjusted". That is until last year when I "hit the wall". :eek: This would be the whole reason I finally got diagnosed at 33 years old. As usual with adults, my co-morbids also assisted in the diagnosis.

I completely agree with the missed diagnosis because of the external support. This may also be due to the natural guideline that the male is supposed to be strong and self sufficiant, while the female is allowed to rely on the family support structure (this is not meant to be a sovenistic statement).

Scattered. Interesting article. Thanks.

:soapbox: Can I just say though, Grrrr. :mad: I know a lot of people on the forums respect Russell Barkley and his ADHD research, etc., and maybe he's got some good theories and has broken ground for which I should be thankful, but I was not impressed by him according to the comments in this article. Being someone who seems to be primarily inattentive (possibly combined?), I'm also not sure about stuff I've read where he wants to make the inattentive a whole different/separate syndrome. But that's a different issue.

With regard to the article. At first he seems to pooh-pooh the idea that women could be different in their ADHD (ummm hello, historically we've tended to be socialized differently, held different roles, and we have different organs, hormones, body chemistry etc., why wouldn't we be different?), saying that we're all going to have to face equal things. Sure, we're going to have similar generic challenges, but he seems to miss the point about how our roles and socialization may alter how it presents, and how we cope, and so what it "looks" like or how we describe the feelings/experience might be different than they are looking for or expecting.

THEN he seems to fall into stereotyping women as weak and fragile by saying that we're more likely to have anxiety and depression, but men may need help with job, time management and organization.

"Women are more likely to have anxiety and depression so you may see physicians adding antianxiety and antidepressant drugs more often for their female patients," says Barkley. "The guys, on the other hand, you may see much more advice about vocational assessment, time management counseling, and working with an organizational specialist."

Harrumph! I'll grant that he might be referring to the initial problems that lead people to seek out a psychologist who don't suspect ADHD. But, why not just acknowledge that there are co-morbids that go along with ADHD (for men and women) and that because women/girls may present differently then men/boys and be less physically hyper that often it's a co-morbid like anxiety or depression that is discovered and focused on first. If they find ADHD in men first, do they even bother looking for anxiety and depression, especially if finding and treating ADHD helps relieve the anxiety and depression? So how can you really say that women are more likely to have anxiety and depression?

And time management/organization. When women are juggling home, children, and often work or school, you don't think they might benefit from help/treatment regarding time management and organization? Some will say, well if he's referring to what makes you seek treatment, women would be less likely to seek out treatment for this reason because they think they're expected to juggle all these things and would be ashamed to admit they can't do what they see other women doing. Well he mentions men getting help for vocation, organization, time management - if they think they're supposed to be a "provider" and successful, then you'd think men wouldn't want to seek out help either for the same reason, feeling shame that they can't do what they think is expected of them.

Anyway, I guess this just struck a nerve with me as I look back and try to figure out ways in which ADD has been part of/influencing my life, behavior, actions, choices. How does it present in me as both an adult and a woman, and why is it that I was never aware that this was a possible issue for over 30 years of my life. (Heh, and I guess there's a little more anger in that grief cycle of mine than I thought there was. :D )

Peace, bythesea

In the classroom I see groupings of ADHD girls. One group are girls who are very loud, rude, and obnoxious. They can "turn" a classroom within a few minutes. The second group are friendly yet hyperactive. The third group is quiet, the inattentive group. There are some who straddle groups.

Group number one gets identified early because they are so disruptive. The other two may get missed, especially if they are intelligent and can compensate for weaknesses.

Scuro - I thought something like that might be happening. Thanks for the affirmation and real-world observation!

Nadeau lists them as: 1) Tomboy (Hyper), 2) Chatty Kathy (Combined, not as active as tomboy or as inactive as daydreamer, may be hyper-talkative rather than hyperactive), and 3) Daydreamer (Inattentive).

http://www.ldonline.org/ld_indepth/add_adhd/nadeau.html (http://www.ldonline.org/ld_indepth/add_adhd/nadeau.html)

Now mostly inattentive, but I have a few I usually mark under hyper/impulsive, including being talkative. So we have been going with me as inattentive. But reading the Chatty Kathy description today gave me flashbacks, and I did active things like climb trees, etc. So maybe I'm more combined that I thought, or I've shifted toward more inattentive as I grew older. Is that possible? :confused:

My 2nd grade teacher called me a "chatterbox" all the time. I can remember my best friend and I being allowed to do homework under a table in the classroom, almost like being in a fort. But at some point the teacher became exasperated by our talking and took away those privilages and tried to separate us, they even put us in different classes the next year (didn't work - we're still friends :D ). In fact I saw someone from elementary school at my 20-year reunion this summer and he brought up the fact that he could remember how upset we were when they tried to separate us.

I had my mom look up reportcards a while back.

A third-grade report card:

Bythesea is a fine student and a happy, talkative youngster. She enjoys school very much and is displaying much capability in most areas. She needs to work on her handwriting and on her active participation in class discussion. She enjoys talking very much, but not in front of a group of attentive listeners. Bythesea is a pleasure to have in class.

And a 6th-grade report card:

Bythesea is an exceptional student and a pleasure to have in class. She is capable and willing to work, but needs a quieter environment for concentration. She is talking less to her friends and I am finding steady improvement.

~~bythesea

....She enjoys talking very much, but not in front of a group of attentive listeners.

That one just cracked me up. I'm still laughing. I have my grade 6 teacher's remarks in my signature which I usually erase. Hope you like my teacher's comment, in particular,"..his refusal to accept responsibility for his deeds".

Wow...I'm making similar observations to a bigwig PHD. ;)

ADHD is a developmental disorder. There is debate if the natural progression of the disorder is from hyperactive to combo to I guess inattentive. As least as it is defined in the DSM4.

Scuro: WOW! :faint: I sure am glad I didn't have your 6th grade teacher!

Thanks for sharing, and glad I could give you a chuckle. ;)

~~bythesea

Ditto on the Chatty Kathy syndrome! Looking back, I'm actually surprised I was never diagnosed. I was in trouble *every single day* for acting up, talking too much, etc. I was separated from the other students, put in the hall for time outs, but my parents were never called; that's always bothered me. I was in a private school with no more than 15 students in my class any given year and yet not one teacher, my parents or my dr ever figure out I had ADD. I did get detention once in 5th grade and sent to the principal's office once the next year for sassin' a teacher. My parents knew I had an excessive talking problem; they got permission from the pediatrician to drug me with dramamine on road trips so they could have a break. LOL

I don't remember if I was hyper or not; I remember having a lot of energy, but I also had a lot of medical problems (severe allergies and undiagnosed asthma) so I was sick a lot as well. When I was active though... watch out! I was so stinkin' accident prone. Broke my first bone at 3 playing Superwoman on the back of my mom's cushy rocking chair. Thought I was an olympic gymnast one summer and tried to flip myself out of the jeep and landed under it instead; yet another trip to the emergency room. The list just goes on and on and on.

Felt like I was reading about myself...

It's so true though...we do I think try to cover up our ADHD cause we have been trained to be a certian way...so sad....once again..guys have it easy!!! :)
ditto