What is ADHD?
author/ amanda/ august 11, 2023
(As of 2023, the most up-to-date text regarding this topic is The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR.) The DSM-5 is what will be referenced as there have been some recent updates and changes to the text regarding criteria, diagnoses, and more.)
A General Overview of ADHD:
Attention Deficit Hyperactivity Disorder is more commonly known in short as ADHD. It is a neurodevelopmental disorder. This means that it primarily affects the way someone’s brain works. This may influence how they pay attention and/or control their behavior. It is important to note that there are three different types of ADHD and that it can affect people differently and present in diverse ways. The outward symptoms of ADHD are wide ranging and can be quite different in presentation. Unfortunately, throughout history, girls and women have regularly flown under the radar regarding ADHD diagnoses and often go undiagnosed when their outward symptoms appear to be less prevalent. This is not to diminish their struggles however, as girls with more inward facing symptoms can still possess significant struggles, unbeknownst to those around them, until their internal cup holding them together runneth over.
Regarding resources for those with ADHD, they are often easily attainable in childhood through public schools and established community programs, but adult services and accommodations are harder to come by. There is a bit of a misconception that ADHD is something that is grown out of as children age, but this is not a true statement. Adults everyday, all over the world, suffer with ADHD and it is improper to dismiss their personal experiences.
For everyone with ADHD, it is often difficult to relax, to truly relax. Oftentimes, the brain is too active, excessively thinking and unable to chill. People with ADHD tend to be overthinkers who think too much about everything they need to do or complete. This leaves them paralyzed, unable to do any task, regardless if they want to complete the task or not. This causes immense guilt, stress, and anxiety. They feel guilty for not doing the task they need or want to do. They feel stressed and anxious about not being able to do the task as intended. It is a vicious cycle and is far more frustrating than neurotypicals will ever realize. Usually, they know exactly what tasks need to be completed, when they need to be completed by, and how they are actually completed. Regardless of having all the information and abilities to do the task, they still can’t, no matter how badly they’d like to. Instead, they sit or lay, suffering mentally, and using an immense amount of energy just trying to convince themselves to do the task. The act of doing nothing when they desperately want to do something is nightmarish and it may feel as though they are trapped inside their own bodies. This is called ADHD paralysis.
60%―80%
of people with ADHD also have a
co-occurring condition.
Unfortunately, there is a gender bias in the world of ADHD. More external, observable symptoms of ADHD such as hyperactivity, fidgeting, and inappropriate social behaviors were primarily seen in boys. This stereotypical image of ADHD became known as a disorder that is only found in boys. This means that the diagnostic criteria was created only through the observations of boys. Therefore, the symptoms and diagnostic criteria were unable to capture the unique symptom presentation in girls and women. This did girls and women a huge disservice because they did not necessarily meet the traditional criteria for diagnosis, further contributing to their underdiagnoses. Typically, girls and women may exhibit different symptoms and behaviors that are less visible or are more likely to conform to societal expectations. They may be less hyperactive and more likely to internalize their struggles, leading to their symptoms being overlooked or attributed to other factors/conditions. Basically, the symptoms of ADHD in girls and women were (and still are) more likely to be considered personality traits rather than an actual disorder. For example, social withdrawal may be considered shyness while impulsive, risk-taking actions may be considered extroverted and “wild.” Girls and women tend to be diagnosed with mood disorders and other conditions instead of or prior to an ADHD diagnosis. Recognizing and addressing this gender bias is crucial for ensuring that girls and women with ADHD receive proper support. It’s important to promote awareness, acceptance, and have an understanding of how ADHD can manifest differently in girls and women.
What are the Three Types of ADHD?
There are three different types of ADHD. This includes the inattentive type, the hyperactive and impulsive type, and the combined type. This is simply a way to differentiate between the various symptoms that individuals with ADHD have. Everyone loves a good label.
Girls and women with inattentive ADHD may struggle with attention and focus. They may present as daydreamers with their heads in the clouds. They may be unable to focus for long periods of time, struggle to finish tasks, and become distracted by their environment or even their own thoughts. Struggling with organizational skills, cleaning, task completion, as well as regular forgetfulness, are often signs of someone with inattentive ADHD. They may struggle to listen to others by either thinking about what they themselves are going to say in response, or because they are thinking of something else entirely. This may cause them to appear aloof and uninterested in what another person is saying, though this is usually not intentional. Because of this, it can be difficult for girls and women with inattentive ADHD to make friends and she may wonder why other girls don’t want to be friends with her. They may also struggle with time management. She may be running too early due to anxiety, especially when going somewhere new, or she may be running late, unaware of how quickly time is passing and thinking she had more time before leaving. She may have many alarms on her phone, an extremely full email inbox, and can be rather procrastinative. Also, girls and women with inattentive ADHD may struggle to respond back to messages either because she is unsure of how to answer and put it off, because it was too stressful to respond to in the moment, or because she answered it in her head already and moved on.
For girls and women with inattentive ADHD, it takes a significant amount of energy to stay focused and “on” all the time. On the outside, this can easily go unseen by others, but the stress and pressure building up inside her is so strong it’s nearly palpable. This can be extremely exhausting and upsetting because she may be frustrated by small tasks that appear to come easily to others but are difficult for her to take on. Over time, she may come to doubt herself and her abilities, thinking herself incapable or unintelligent. It should be noted that girls and women with ADHD do not always lack focus as they are also known to “hyper-focus” on certain ideas/topics/etc. When hyper-focused, all other tasks, necessary or not, may go unfinished.
Some other traits had by inattentive ADHD girlies may also include: a variety of unfinished hobbies, many books with bookmarks partway through, and missing items such as keys, phone chargers, and glasses. Also, girls and women may put off difficult tasks for days, weeks, and months, building up immense amounts of stress and anxiety, only to find that the task took five minutes to complete and they can breathe again. This cycle often continues again and again despite the building, anticipatory stress and anxiety. They often struggle to “turn off” their brain as it is constantly thinking and turning. This may cause them to miss important memos and information, and forget to drink water during the day, but it may also cause them to lose out on sleep at night. Because their brains are constantly turning over ideas, conversations, and events from the past, present, AND future, they may struggle to fall asleep and stay asleep due to their active brains and powerful internal world.
(According to the DSM-5, there are nine different behavioral symptoms for the inattentive type of ADHD. The over 17 year old girlies must meet at least five of the criteria.)
Girls and women with hyperactive and impulsive ADHD may struggle with sitting still for long periods of time as they work to fight through their restlessness and need to fidget and move. They are often busy and talkative. They may need to move while they work in order to focus. Also, girls and women with hyperactive and impulsive ADHD may be impatient when they are driving, standing in line, waiting for an email, etc. These are the pen clicking, leg shaking, and active girlies. They may have a tendency to trip over their words as their brain is thinking faster than their mouth can move. This may cause them to change the subject, revert back to previous topics, and/or get confused mid sentence. In conversation, they have a tendency to blurt out, cut off others mid-sentence, overshare, and direct the conversation towards themselves. Though they may see themselves as friendly, outgoing, and conversational, others may take this behavior as rude, self-centered, and commandeering. This is confusing for the hyperactive and impulsive ADHD girlie because in her mind, she was engaging, extroverted, and had the best of intentions.
With this type of ADHD, girls and women may also struggle with impulsivity. This means that they often do not think through thoughts and actions before enacting them. Because of this, they may not think through the consequences of their actions until it’s already too late. This can translate into risk-taking and getting involved in dangerous actions/situations.
Though all of the above may be true for some girls with hyperactive and impulsive ADHD, most primarily have a tendency to appear hyperactive and impulsive internally/mentally. Girls and women with hyperactive and impulsive ADHD may have emotional impulsivity and may have difficulty regulating and managing their intense emotions in an effective and healthy way. Internal impulsivity also includes rumination. They may overthink, repeat old conversations in their head, and obsess over certain thoughts or actions. These are the girlies that may go out drinking/bar hopping the night of a bad breakup and/or text their ex(s.) Also, these girlies may have a tendency to overspend and have less control of their finances. Due to the stress of this internal world and their nervous system, girls and women with this ADHD type may experience excessive headaches and/or stomach issues. It’s important to remember that each individual is unique, and not all girls and women with ADHD will show the same hyperactive and/or impulsive symptoms.
(According to the DSM-5, there are nine different behavioral symptoms for the hyperactive and impulsive type of ADHD. The over 17 year old girlies must meet at least five of the criteria.)
For the combined type of ADHD, girls must meet both the criteria for both inattentive ADHD as well as hyperactive and impulsive ADHD. That’s it. Period <3
For information regarding the diagnostic criteria for Attention Deficit Hyperactivity Disorder, please refer to page 59 of the following PDF of the DSM-5: