Illustration: Zoe Maxwell
February 19, 2021
I was 7-years-old when I began hating school, or as I felt, school began hating me. I would get so stressed and overwhelmed, my second grade schoolwork would routinely bring me to tears. I was a smart kid who loved to learn–why was it all so hard?
My parents brought their concerns to my second grade parent-teacher conference. My teacher saw no issues. She told my parents I was good in class. I was not disruptive, and I performed well. She told them nothing was wrong. She didn’t see I was incapable of paying attention, spent hours upon hours trying to complete her weekly vocabulary word-searches, and my meltdowns over my inability to control my own brain.
Next, my parents spoke to my pediatrician. They told him I was smart, interested, and social, yet I dreaded going to school each day. We asked if it was possible I had ADHD.
My doctor then took to asking the questions. He asked about my grades. They were good. He asked if I had difficulty sitting still. I did not. He asked if I was disruptive at home or in school. I was not. He told my parents and me it was unlikely I had ADHD, and even if I did, it was not a problem, so he was not concerned. We trusted my doctor, and let it go.
I continued to struggle with organization, focus, and anxiety. I was working harder than others to get what needed to be done, but I was staying afloat. This was up until my sophomore year of high school when it all came crashing down. My classes were more academically challenging than anything I had previously faced, and my hard work was no longer enough to get by.
No matter how hard I tried, I was incapable of paying attention in class. To compensate, I spent hours every day teaching myself the lessons that I was supposed to have learned in school. I would spend upwards of six hours a night trying to complete my homework. It didn’t matter if I had three essays and a test to study for or a mere science worksheet–I could never get it done on time. I couldn’t focus. I found myself sitting at my desk for hours staring out my window, counting the bubbles in my seltzer, or getting lost in the depths of the internet. When I looked up and my chromebook screen read 11 p.m., I had none of my homework done–so I stayed up to finish it. By 1 a.m. I’d go to bed completely exhausted, unbelievably stressed, and dreading the day ahead of me.
Each day, this vicious cycle repeated itself. I would show up to school exhausted, overwhelmed, and consequently, my inability to focus was heightened. Each new assignment added to the endless tower of overdue ones. I stopped sleeping and I stopped having a social life. I was drowning.
I hated myself. Everyone else could get it done, why couldn’t I? I was working 10 times harder than everyone else, yet I was falling farther and farther behind. I felt broken.
“I feel like my brain is flipping through one hundred channels, and someone else has the remote,” I wrote in my journal, dated November 1, 2018. “Why is my brain broken? What is wrong with me?”
We went back to my doctor to once again ask about ADHD. We were asked the same initial questions about my grades and whether I was disruptive. But this time, we insisted that I get tested. When I was, it was clear that I did, in fact, have ADHD.
After my diagnosis, things finally started to change. I was at last able to understand why my brain worked the way it did. For the first time in my life, I had a legitimate medical diagnosis to tell me it wasn’t because I was not working hard enough or too stupid. Doors opened up allowing me to seek medication and treatment. It was liberating.
The signs weren’t new. Why had it taken 15 years to finally get diagnosed?
The answer is simple: I am a girl.
My story is unbelievably common. According to the Centers for Disease Control and Prevention, boys are three times more likely to receive an ADHD diagnosis than girls, despite the disorder affecting both genders nearly equally. Why? Because ADHD in girls manifests itself in less visible ways. Boys are more likely to have hyperactive-impulsive ADHD and show externalized symptoms, whereas girls are more likely to have inattentive ADHD where symptoms are more internal.
Since girls with ADHD often display fewer behavioral issues and less noticeable symptoms, their struggles are frequently overlooked or dismissed. My family insisted on a medical reevaluation because my father has ADHD and we were familiar with the signs. This is not the case for most–without even bringing in the myriad of other barriers preventing so many from accessing healthcare and treatment. Countless girls are like me and have problems that are internal, and were not diagnosed until later in life, or worse, not at all.
Undiagnosed ADHD is crippling. I was fortunate enough to be diagnosed at all, but had I received a diagnosis in second grade when we had initially gone to my doctor, I could have accessed treatment and learned coping mechanisms earlier. I could have avoided years of not understanding and hating my brain.
For doctors, teachers, parents, and everybody in between, we need to understand that girls have ADHD too. We can’t just see the hyperactive boys blurting out in class, but also the girl who is severely struggling but works 10 times as hard to compensate. When a girl says she is struggling, listen. Do not dismiss her struggles because she is getting the grades and behaves.
And for any girls who see themselves in my story, know that you are not stupid, lazy, or broken. I know it is hard to say you are struggling–but it is so important to name your struggle. Do not let yourself be invisible. Be loud, and when you are dismissed, be prepared to be louder.
Girls have ADHD, and it is time we recognize it.
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Anne • Feb 28, 2021 at 6:45 pm
This is me, except the problem went on much much longer without being recognised. It has resulted in a very different life to what I might of had. There have been tragic consequences.
I was not diagnosed with ADHD and ASD until last year at the age of 54. It is now believed these are both developmental disorder you are born with the genetic potential to develop. I actually also have epilepsy diagnosed at 12 years old, so does my brother… these 3 conditions are commonly comorbid (about 30% of people with ASD have epilepsy, similarly about 30-40% have ADHD).
ASD and ADHD are still not well recognised in girls, as we tend to not be disruptive, or show the signs that outsiders can see or are traditionally associated with ADHD or ASD. Often we appear higher functioning, and with a lot of effort appear to be coping. But the effort involved in coping, and the failure to recognise and treat, often leads to a lot of damage to self image. Relationship problems can occur in the wake. In girls the first sign of problems picked up by medical professionals can be psychological or psychiatric.
When I grew up the situation was even worse, ADHD was rarely diagnosed in boys and girls. The situation was the same for ASD (Autism spectrum disorder). Much of the time the boy was naughty… a troublemaker, and girls very shy or daydreamers. Many medical professionals even questioned if ADHD was even real… just an excuse for bad behaviour or poor parenting. Many now still believe ASD is overdiagnosed, or in high functioning people does not have a great impact.
In girls and women the presentation of both ASD and ADHD is often very different, internalized, and masked because we are pretty good at trying to fit in and seem more engineered to be social. This means many were and are not helped, they suffered more, the resulting poor self image problemswere deemed to have no physical basis. Both condition often leading to difficulty making and keeping friends. Not having social support often leads to anxiety, depression, more feelings of being broken. When this goes on long enough it can lead to psychiatric problems or even death by suicide. A psychiatric diagnosis, is often the first diagnosis made by medical professionals… it is really stigmatising, and often taints medical opinions and diagnoses. As the core of the problem is not recognised or treated, it is often not helped by psychiatric treatment. A psychologist may help you cope, and not blame yourself as much for your messvof a life though. Because of the era I grew up in, and my avoiding psychiatric treatment for 20 years after my bad experiences, I was not introduced to psychological help until I was about 50 years old. I again sought help because of the mess my life was in, financially, socially and physically. I had lost the one thing that had consistently helped me, and the only real source of pride… my cognitive ability. It was damaged to the point I could no longer compensate for problems related to ADHD or ASD. It is believed I now have a mild cognitive deficit through he effects of epilepsy, sepsis and chemotherapy after treatment for breast cancer 18 years earlier. Short term memory problems, and a massive slowing of thought processes made functioning with ADHD or ASD nearly impossible. I was at the end my tether and just wanted to escape the struggle and psychological and physical pain by dying… All my efforts to improve my life just made things worse.
In my case I did build up a bundle of psychiatric diagnoses, which frankly made my situation a whole lot worse.
I was sure I had ADHD from my early 20s, I have always had great difficulty organising myself, and was extremely distractable. Time management, and temporal memory and awareness were the problems I noticed most, and felt the consequences of it a lot as a young women… missing appointments, chronically running late would enhance the chaos of my life, and make me feel worse about myself. I was very very intelligent, excelling in at subjects I was interested, they were easy and effortless… I would travel down hyperfocussed wormholes for pleasure, and learn a lot more than any course material would teach. I loved the sciences and maths. However, any subject I was not passionate about (like English/language) I really struggled with. It took a lot of effort for mediocre or good results. At high school I was known as an absent minded professor, and topped science every year without trying, and maths most years (this took more effort). I was dux of the school, and 15th in the state, but really had no close friends, and was miserable. I felt alien and broken. However as I got older and life held more responsibilities and management… I failed miserably. I started 5 degrees… did well in many subjects, but not finish one degree. I was hopeless at housework, and keeping my living areas organised. My relationship with my husband and others suffered. I would hyperfocus and excel in one aspect o my life, while every else fell apart. Often after a couple of years I could not even sustain what I was focussing on and my world would call apart. Aspects of ASD would compound my struggles, and sometimes were the primary reason I would crash. ASD and ADHD together… I felt completely broken, I blamed myself for everything… my inadequacy, my pathetic efforts, my selfishness and inherent badness… I felt there was no place for me in this world… I was suffering, causing others to suffer… I felt useless, hopeless, a burden and frequently suicidal. This has become a lifelong pattern. I had my first suicide attempt at 13, I developed an eating disorder at 16, I struggled with self harming and parasuicidal behaviour. Though I no longer act on suicidal and self harming urges I still struggle with these thoughts and feelings everyday and I have developed PTSD.
Like you, I also have a family history… not diagnosed in my parents or siblings, though I think both of them are somewhat affected.
Both my sibling’s children have been diagnosed as being on the Autistic spectrum, and half with ADHD (I had no children myself).
Now I am on disabilty and ADHD medication. I am damaged, my life is not normal. My 30 year marriage is broken, I have gone from being more than financially secure, to poverty, but with help I am more able to function and life is more livable. Most all, with my new diagnoses I do not blame myself as much for my situation, I don’t feel nearly as badly about myself as I have for decades.
Heather DeLeone • Feb 19, 2021 at 8:58 pm
Thank you for having the courage to write this and I hope your generation can be not only properly treated for ADHD but also celebrated for the gifts of neurodiversity. After 20 years of working as an educator I read an article on ADHD in girls which brought me to tears, and to the door of a psychiatrist for ADHD testing. Adderall has had a tremendous impact on my life but like many adults diagnosed with ADHD, I mourn for who I might have been. This includes sadness about the relationships and opportunities lost due to being undiagnosed and struggling with overwhelm and self doubt despite my achievements and successes.
My mother also pushed that something wasn’t right but was assured I was fine because my grades were good and I wasn’t “diffficult”. Many women in my generation with ADHD who were highly functional (adept at developing coping mechanisms) had parents who’s concerns were ignored. During their teens and twenties they were sent through the conveyor belt of doctors and diagnosed with depression, anxiety or OCD, and ultimately left feeling like broken people incapable of being happy, and feeling painfully different. Then the kicker at midlife is being told it is just “hormones”.
Recent research has linked illnesses such as Fibromyalgia and autoimmune disorders to ADHD in women. More recognition and research into ADHD in girls can allow for a future of greater empowerment, appropriate medical care, and the celebration of the unique gifts these women have to share instead of lives filled with loneliness and shame.
Margaret Ray • Feb 19, 2021 at 3:16 pm
Thanks for shedding light on a problem that so many are dealing with and do not understand it all. You are very brave and have now shown the light in a way that others will be able to get help that they need.