It was early 2012 the first time someone said the words attention deficit hyperactivity disorder about me. I was nineteen years old, a sophomore in college, and had just started seeing a therapist for treatment for (what I thought were) unrelated anxiety issues I was experiencing in many aspects of my life.
As I was talking about how difficult it was for me to keep up with basic human functions, such as doing the dishes, taking a shower, and vacuuming my apartment, my therapist interjected: “I think you have ADHD, Sarah. I’d love to have you take some assessments to see.”
It Came As A Shock: My ADHD Diagnosis Story
At first, I wanted to laugh at her. How could I have ADHD? I had a solid 3.8 GPA throughout high school and was sitting at a 3.9 in college thus far. I had always taken advanced classes and had done exceptionally well- the kids I had known in school with ADHD were all rowdy boys who couldn’t sit still, who caused trouble with the teacher, and were notoriously difficult to get along with. That didn’t fit me even a little bit!
However, I humored her. “Sure, I’ll take some assessments.” Can’t hurt, right?
She said she would set them up for the following week. Instead, she went on maternity leave and I never saw her again. Oh well, I thought. No harm, no foul. She was probably mistaken, anyway.
I didn’t think about ADHD again until 2017, now a graduate student about to start the first year of my PhD program. My then-psychiatrist’s approach was therapeutic in nature, with our sessions going much more in-depth versus a traditional medication check. As I was talking about my childhood and how I was a constant fidgeter, nails ripping at my own skin, legs tapping out of impatience, and age-inappropriate interrupting, my psychiatrist interjected: “I think you have ADHD, Sarah. If you’re interested, you could try some stimulants to see if they help with your anxiety.”
I wanted to laugh at her. How could I have ADHD? But then, my therapist visit back in 2012 popped into my brain like a scene from a familiar movie. If two different professionals from different parts of the country with no relation to each other both thought I had ADHD, there’s no way they were fooling me, right?
My psychiatrist must have noticed the hesitation on my face. “ADHD presents much different in girls than in boys. All the symptoms you’ve been describing to me over the past few months are pretty spot on for what ADHD looks like in girls, and especially in adult women.”
I picked up a prescription for Ritalin the next day. I never took it, allowing it instead to sit in my drawer and expire due to my own fears that it would cause an increase in anxiety. I did, however, dive deep into what ADHD looks like in both girls and women, trying to determine if maybe this was the missing puzzle piece of my now-decades long mental health journey.
ADHD Versus ADD: What’s The Difference?
The first thing I learned was what the heck ADHD even was! ADHD stands for attention deficit hyperactivity disorder and is considered to be a neuropsychological disorder that is present from birth. Although it is sometimes categorized as a mental illness, it’s actually more closely related to autism spectrum disorder, dyslexia, and other learning disabilities than other mental illnesses like depression and anxiety disorders.
It is a chronic condition that can cause symptoms of inattentiveness, hyperactivity, emotionality, and impulsiveness. While most people deal with bouts of these symptoms, those with ADHD have them on a constant basis and they interfere with normal day-to-day functioning.
ADHD comes in, what I like to call, three different flavors. There are two different subcategories of symptoms, the hyperactive ones and the inattentive ones. The first is ADHD- hyperactive subtype, where the individual’s symptoms primarily fall into the hyperactive category.
The second is ADHD- inattentive subtype, where the individual’s symptoms primarily fall into the inattentive category. The third is ADHD- combined subtype where, you guessed it!, the individual’s symptoms fall into both categories. I personally have the combined subtype, in which my hyperactivity can appear as restlessness, skin picking, and fidgeting and my inattentiveness can appear as zoning out, brain fog, and inability to start tasks.
But wait a minute- what about ADD? Is that something completely different? Because mental health and psychology are ever-evolving fields of study, a few decades ago the categories had different diagnoses all together! ADHD- hyperactive subtype was strictly called ADHD, while ADHD- inattentive subtype was called ADD, attention deficit disorder. If you had the combined type, it was possible to be diagnosed with both.
A little confusing, right?! Since then, the ADD diagnosis has disappeared and clinicians have expanded on the ADHD subtypes to be able to group them all together for easier understanding. Phew! It’s a lot to take in, especially for someone trying to navigate their “new” diagnosis. I knew I couldn’t do it alone.
“Hey, Tara!” I remember calling across our Washington D.C. studio apartment to my then-girlfriend (now fiancée). “Can I tell you what I’ve learned about ADHD? Maybe you can help me understand why it keeps being brought up.”
She nodded and pulled up a chair beside me.
ADHD Is Wildly Undiagnosed In Girls And Women
What most people think of when they hear ADHD is exactly what I did- young (mostly boys) who talk out of turn, jump up from their desks at school, run around the playground like they’ve only consumed caffeine and sugar that day, and are a teacher’s worst nightmare. Not only is that often incorrect for young boys with ADHD (a pretty frustrating stereotype for all genders), my psychiatrist was (of course) absolutely right: ADHD is vastly different for most girls.
The symptoms of ADHD in young girls can often be mistaken for anxiety, depression, or other mental illnesses. Many girls care about school, have above average intelligence, and are placed in advanced or gifted classes. They may excessively daydream, get frustrated and cry easily, have difficulties starting tasks or projects that they believe to be hard, struggle with forgetfulness, and work too quickly on assignments and exams, which can result in making careless mistakes.
Paying attention may not come easily, but it often isn’t as obvious as it is with boys. They may be outgoing with their friends, but feel out of place among strangers or anyone who doesn’t quite get them, causing intense feelings of jealousy and competitiveness. Girls with ADHD often internalize their symptoms rather than externalize them, like the stereotype would suggest, which is one of the reasons that it is now believed to be wildly underdiagnosed in girls.
(It’s not only cis boys and cis girls that have ADHD. Many transgender, non-binary, and gender non-conforming individuals have ADHD, too. Unfortunately, the research has not caught up to the lived realities of people, and it is hypothesized that more transgender people are misdiagnosed or undiagnosed than cis girls!)
The most important diagnostic criteria for ADHD is that, because it is a neuropsychological disorder, it needs to have been present since childhood. I was diagnosed with “childhood anxiety” when I was five years old, and have been labeled with many other diagnoses since, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and symptoms of depression.
Recently, I had two therapy sessions with my mom present and we were able to deeply understand that all of those struggles from my childhood were, most definitely, ADHD in disguise (and obsessive-compulsive disorder… but that’s a topic for another day).
Even more crucial than recognizing and understanding my childhood was to recognize and understand my adulthood. After all, professionals had only noticed my ADHD when I was in my 20s, not when I was in elementary school. So what does ADHD look like in adults, especially in adult women?
Many Women Are First Diagnosed In Adulthood
There are some people who outgrow their ADHD symptoms as they age. They still have the disorder, of course, but they either develop coping mechanisms that work for them, or the severity decreases over time. Many people, however, find their problems get worse as they get older. This is especially true in women, and I certainly fall into the latter category.
Much like in childhood, the symptoms of adult ADHD in women can often be mistaken for anxiety, depression, bipolar disorder, or borderline personality disorder. Many people have experiences with misdiagnosis before learning that it’s been ADHD all along. I was actually misdiagnosed with borderline personality disorder before my D.C. psychiatrist was able to sort through my symptoms and put the pieces together.
Workplaces Are Hard To Keep Clean
Many women with ADHD tend to have a difficult time keeping their work spaces organized, no matter how hard they try. Papers pile up, documents go missing, and her work performance can be severely impacted. It may be difficult to give someone her full and undivided attention, as she may be easily distracted and her mind may drift away to all the unfinished tasks she has at home and at work.
Chores Go Undone
Chores may go undone because the idea of starting them is too overwhelming. She may be hyper-emotional and have difficult and complicated personal relationships due to a phenomenon called rejection sensitive dysphoria. Anything that she doesn’t find interesting goes untouched, but tasks and projects that interest her are narrowed in on with intense hyperfocus. This hyperfixation can become overwhelming to the point of not doing anything- not sleeping, not eating, not taking care of personal hygiene- until the task is done.
She May Interrupt (A Lot)
She may talk a lot, interrupting other people, but also have feelings of crippling shyness because everyone else seems to have their lives together far more than she does. All of these symptoms, and others, impact her to the point of causing distress and lowering her overall quality of life.
No Longer A Shock: ADHD Acceptance
Because even professionals have embraced the young boy ADHD stereotype, it has become much more common for women to first be diagnosed well beyond childhood. I’ve heard stories of women in their 60s and 70s finally getting their diagnosis and it being life-changing! I certainly felt that way when I finally took the time to accept my own diagnosis, and I was 19 (and then again at 23!). It was like a light switch had turned on in my brain, illuminating a giant neon sign that validated the way I’ve felt my entire life.
I wasn’t weird, I wasn’t damaged, I wasn’t broken- I have ADHD!
I looked up from my list and realized I had been talking Tara’s ear off for well over an hour. Talk about hyperfixating! Tara’s eyebrows were raised, a knowing look in her eye. “You just described yourself to a T,” she said. “I think I’m living with a woman with ADHD, and suddenly, everything makes a lot more sense.”
It’s Not Just School Or Work: ADHD & Relationships
ADHD doesn’t just affect one’s work or school performance. It can play a role in almost any aspect of life. One area that many ADHDers report having difficulties in is interpersonal relationships, especially close friendships and romantic relationships. Because ADHD can affect what’s called executive functioning, basic skills like memory, problem-solving, and self-control, many affected people appear lazy to others around them.
I’ve had plenty of executive dysfunction throughout my life. As a kid, if my mom asked me to clean my room, the task felt so overwhelming that I would simply sit down and cry instead of putting my clothes away. In middle school, if a school assignment gave me any difficulties, I would have a panic attack because it seemed far too impossible to finish. In adulthood, my biggest challenge has been with household chores.
I had a roommate briefly in 2012 and 2013 who moved out because I couldn’t get the dishes done in any sort of timely manner. She thought I was selfish and lazy. I believed her- why else would I be so deficient in basic adult abilities?
These dysfunctions certainly have impacted my relationship with Tara. We have been together for almost 6 years, and have lived together for a little over 5 years. When I lived alone, it didn’t matter if the dishes piled up, or if I didn’t shower for a week, or if there was so much dust in my apartment that I was on the verge of an allergy attack at any moment. But once you add someone else to the mix, these deficits can make or break the relationship.
Before I was confident in my diagnosis and actively sought help with it, I know that Tara struggled with how much I struggled with doing chores. By nature, she would describe herself as more “type A” and thrives when her environment is clean and organized. By comparison, I don’t even notice clutter and mess because I tend to only see one task at a time instead of the greater picture.
This dichotomy has caused considerable tension in our relationship: Tara felt like the burden of all the chores fell on her, and asking me to do something felt like she was nagging me, a feeling she doesn’t enjoy. On the other hand, I desperately wanted her to ask me to do a certain task because the big picture of “doing chores” caused the familiar overwhelming feelings that can make me shut down.
In the fall of 2019, I knew my executive dysfunction issues were out of control. I had accepted my ADHD diagnosis but hadn’t done anything to help myself with it. I was hyper-emotional, always worried that my friends and loved ones were mad at me, and I felt like a failure. Why was I struggling so much to simply exist as an adult human, while everyone else around me was doing fine? Tara begged me to talk to my psychiatrist about it, because not only did I feel bad about it, she was being enormously affected, too.
Your mental health is not your fault, but it is your responsibility.
Your mental health is not your fault, but it is your responsibility. By ignoring my obvious issues, I was not only making my life more difficult for myself, but also for my partner. I knew it was time to seek ADHD treatment. By the beginning of 2020, after careful consideration with both my psychiatrist and my primary care doctor, I started taking stimulants, along with an alpha-agonist hypotensive medication (aka, a high blood pressure pill that also can help with the emotional dysregulation symptoms of ADHD).
Turns out that the stimulants did not make me more anxious- the exact opposite happened! Stimulants are by no means a magic pill and should only be taken under very strict supervision from the prescribing physician.
I also started seeing a therapist who specializes in ADHD. Combining therapy and meds typically yields the best results when it comes to mental health, and ADHD is no exception. My therapist has taught my incredibly valuable skills that have helped me not only with work and school, but with tackling tasks that I have a hard time starting (such as chores), effectively being able to communicate with Tara, and on validating my own experiences without judgment.
Dating A Woman With ADHD? Here’s What To Know
Whether you have ADHD or not, every single person is going to have different needs in relationships. However, through my own experiences both with friends and partners, I’ve figured out what works best for me, and may help someone else who is dealing with their own mental health struggles.
1. Get A Chore Chart
One of the best tools we have implemented is a chore chart. It lists out what chores are expected from both of us every week. The visual reminder helps me to actually think about doing the tasks, and seeing Tara’s chores on there too helps me not to feel like a little kid who needs a chart.
2. Be Open About Therapy
I like to share what I learn in therapy with Tara. She enjoys feeling involved, and she learns alongside me about ways to be a more effective partner.
3. Be specific in your communication.
Be specific in your communication. I have found that it’s effective when Tara asks me to do something very specific. Before, she would wait for me to do the dishes (a chore we both hate that isn’t on the designated chore chart) and then her getting mad at me for not doing them (arguing with someone who has ADHD can be a particular challenge because of emotional dysregulation issues). Instead, she asks me specifically to do the dishes, which works a lot better. It also helps to practice doing things in the moment. If Tara asks me to do the dishes, I’m going to have more success if I get up and do them at that time, rather than waiting until later.
4. Focus On Listening
Pay attention to your partner when they are speaking to you! My mind easily wanders to a million other things when anyone talks to me, and I know it can hurt their feelings when it seems like I don’t care about what they are saying. I’m actively working on setting my phone down and being fully present and engaged when Tara is telling me a story or sharing something with me.
Trust when your partner says they love you. Emotional dysregulation and rejection-sensitive dysphoria are tough, but your partner is with you for a reason. They love you, ADHD brain and all.
It’s not a one-way street, however, and Tara knows that. She has learned a lot about ADHD over the past almost six years, and has had to adjust her own ways of being a partner, roommate, and friend. It hasn’t been easy, but she has been such a champ in trying to change her expectations by meeting me where I am, while still honoring her own wants and needs. She has also been able to share what has worked for her in supporting a partner with ADHD, and has been kind enough to share.
1. Be patient.
Be patient.More than usual. There will be a lot of repeating things, not because your partner doesn’t want to listen, but because it can be exceptionally difficult to sustain focus on one thing.
2. Learn About ADHD
Learn about the disorder. It helps to know where the person is coming from, from a medical or psychological standpoint. This may include reading books, blog posts, watching YouTube videos, or asking professionals questions.
Most issues come from misunderstandings or miscommunications, so it’s better to be clear on the spot. Loving someone with ADHD can be super easy, because they are exceptionally creative and fun people, but communication issues can really get in the way.
4. Compromise & Have Realistic Expectations
Have realistic expectations. If you’re Type A like Tara is, your expectations will need to come down. This isn’t to say your partner will not meet them, it just may take a little extra work from both sides. Compromise is key.
Check-in. Sometimes your partner may be extra sensitive. This has a lot to do with emotional dysregulation, being overwhelmed, and rejection-sensitive dysphoria.
ADHD is not synonymous with being male. It’s also not synonymous with stupid, lazy, or underachieving. ADHD is simply a different way of existing, and that’s okay! With the right therapeutic supports, medication management, and interpersonal relationships, people with ADHD can and do live productive, happy, and fulfilling lives.
Neurodivergency, whether it’s from mental illness or a neuropsychological disorder or both, has plenty of challenges but you don’t have to handle it on your own.
Hopefully with more awareness, discussion, and normalization, having ADHD will no longer be seen as just rowdy young boys who can’t sit still. Instead, society needs to replace the negative stereotypes with lived experiences from boys, girls, non-binary and transgender folks, men, women, and anyone else under the sun to showcase the fun, creative and loving people that ADHDers really are.