this post was submitted on 08 Aug 2024
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ADHD manifests differently in girls and they’re usually able to mask it more.
I’m not sure to what extent it’s actually manifesting differently or being masked better than institutional bias against the idea of women having ADHD - diagnoses are about 3x more rare for women…
If I've understood what I've read over the years correctly, a large percentage of girls with it get diagnosed bipolar, completely missing the underlying ADHD cause of the depression/anxiety. This can turn into an absolute horrid experience as they get prescribed strong drugs that can really mess you up if you don't need them, and they most likely don't.
I think it is at least in part due to it manifesting differently. This is slightly different because it pertains to autism, but a while back I read about how one of the theories of why autism seems to be lower prevalence is girls is because the social norms of girls/boys are different. For example, young boys tend to socialise with team sports, which can be highly reliant on non-verbal communication. In contrast, because neurotypical girls are (implicitly and explicitly) taught to take on caring roles, an autistic girl is more likely to be "taken under the wing" of a neurotypical girl, providing more opportunities to develop social skills via social mimicry.
I'm just one autistic woman, but this certainly scanned with my lived experience. As a result of this, I wasn't diagnosed until my teens, after a full on mental breakdown led to a psych eval.
I agree with you that institutional bias plays a huge role: I had a partner who had ADHD and was diagnosed quite young. When we discussed our experiences of the early years of school, I was struck by how similar our experiences were in terms of our behaviour, but how he was read as being a naughty boy (which is what led to his much earlier diagnosis) whereas my distractibility and fidgeting was seen as either me being unstimulated in class, or anxious. I think I'd have probably been diagnosed way sooner if I were a boy acting as I did.
But what's really interesting to speculate on is the way that my behaviour and understanding of my self changed over the years, as a result of that institutional bias. I think that there's a self reinforcing cycle at play, where an institutional bias leads to women and girls with ADHD (and/or autism) developing a particular set of masking skills that makes them further illegible to the systems that dispense diagnoses (which then reinforces said institutional bias).
That being said, I've noticed a lot of progress in recent years on this front, especially in the community. My friend is a high school teacher who almost certainly has ADHD but is on the very long waitlist for an actual diagnosis. Despite not having a diagnosis, understanding herself better has helped her to cope better in her life, and through community and solidarity, feels that she is better equipped to understand and support neurodivergent students in her classroom. People like my friend are one of the ways that the reinforcing cycle of institutional bias, even if progress on that front is slow.
It can manifest itself in the same way for men but it is usually then never discovered untill maybe much late in life when you have someone with depression and anxiety coming to the doctor's who may also miss the fact that it could be ADHD
Literally me
Tried a bunch of anxiety meds that didn't work, tried some antidepressants that didn't work, got a different doctor and they were like "I think you might have ADHD".
8 months later got an appointment and talked to the doc for an hour and got a new prescription for ADHD meds, and my life has massively improved since.
NGL I think getting that diagnosis may have been one of the best things to have happened in my life. I just wish I didn't have to wait I til I was 29 to get it.
You just described my situation almost exactly. Huge life changer for me to get medication. My mood is so much better and my confidence in myself at work is better than ever. I can finally trust myself and my skills and push complex projects like never before because the depressive anxiety and constant stream og garbage noisy adhd thoughts isn't holding me back anymore. I track my mood on an app every single day from 0-6 and you can se on the graph exact what day i started the medication because it went from the average hovering around 3 to now hovering around 5 which is just such a good feeling. Best of luck to you and I'm happy to hear you found help as well.
Edit, the app i use to track my mood is called daylio and works pretty good. Giving me good insight on my own mental health.
I'm really happy for you. Big props to the doc who suggested it as a possibility, and for you for persevering long enough to get the diagnosis — it is unfair that you had to struggle for so long, but I am glad that you are now afforded the opportunity to learn how to work with your brain, rather than against it.
What domain of your life did ADHD meds most help with?
Yeah it was a struggle for sure, especially when I found out from my parents that they didn't think it was real and that my teachers had told them for years to get me evaluated.
The biggest impact is honestly hard to put my finger on because of the massive impact it's had on my life overall.
I suddenly found myself with time. I no longer had to get up for work at 8am to make it to work by 1pm and was still barely making it some days.
I'm more consistent about things in almost every aspect of my life. I still have my rotating rogues gallery of hobbies but that keeps them fresh for me.
My PTSD is so much easier to deal with that it's mind blowing. Though my brain will still serve me up a heaping pile of memories sometimes it's easier to focus on the task at hand rather than just spiral into a pit.
My relationships have improved. My friends have been able to make plans with me and I've been making plans as well and it's not even that stressful. It was at first because I was so afraid of ruining it but as my confidence grew it quickly paid off.
Shit I even got a promotion at work lol
Honestly it's gone so well overall that it blows my mind.
Raises hand
Able to, forced to, I mean what’s the difference amirite? This coming from a dude who has often felt like people treat me worse for it but has seen just how nasty people can get with women for the same thing.
IMO everyone is forced to, but some are able to do it while others can’t, no matter how hard they try. I’m definitely in the second category.
My analogy that I like to use for this is being able to fit in a box that society has produced for you. Most people can fit in the box and I spent years attempting to fit myself into it. I contorted myself into painful shapes in a desperate attempt to please the world and even when I thought I was doing it right, it was never enough. Properly acknowledging that I will never fit in that box was immensely liberating in the long run.
Sometimes I see people who can fit in the box, but not comfortably, and I experience a mix of pity, and relief. I reflect on how grim my life would've been if I had been successful in carving myself into a shape that would fit what had been demanded of me — just because someone can fit in doesn't mean that that's good for them. Certainly, it denies one the ability to grow if you've already had to cut off parts of yourself to be palatable to the world.
In this light, I feel an odd sense of privilege for having found myself in the people who can't blend in, despite trying. "Privilege" is definitely the wrong word for this, but I struggle to articulate it otherwise. I think mostly, I'm just glad to finally be free of wasting what little energy I have trying. Even if it changes little in how the world regards me, I'm just glad to no longer think of myself as a broken neurotypical. I don't know what it means to be a functioning neurodivergent person, but I'm sort of excited to be a part of building that, alongside people like you and many others on this thread and this site.
I completely agree with that perspective.
Personally I would add to this that for individuals who are unable to mask, and who's struggle to mask is so to speak, "visible" to others, while they are still subjected to all of the ableiem that comes with being neurodivergent, it's almost like their inability to mask becomes a punchline for neurotypicals. I think some NTs use the joke as a way of trying to relieve the pressure to mask thinking they're being accommodating, while still addressing the disabled elephant in the room. The end result is that the person's lack of masking capacity is mistakenly correlated to their entire set of abilities - people assume they're incapable of everything. It's pretty dehumanising and infantalizing, and puts so many limitations on the opportunities available for folk who can't mask.
And on the other side of that coin, people who have the ability to mask really well are expected to do it flawlessly 24/7, and failing to do so isn't a sign that having ADHD can be disabling, no, for people who can mask, not masking 24/7 is apparently a moral failing. Which is not the kind of social expectation you want on someone who's condition predisposes them to anxiety inducing perfectionism, and leads to this expectation also being internalised.
Which occurs for both types of people - internalising the expectations. if society treats you as useless, you start to feel useless, until you fall into a pit. if society expects you to always be performing at 110%, you begin to feel like a failure if you output anything less than 109% until you burn out and fall in the same pit.
(because I don't think neurotypical people realise that masking is operating at >100%, it's an additional request on our mind and body, it's an additional labour, it's not sustainable long term. There really is the misconception that we can choose to turn it on and off at no personal cost to us.)
Same with autism. Learned when my son was diagnosed.
Same here my son got diagnosed with adhd and all the symptoms matched me too… hmm… weird huh.
Lol same. Son got diagnosed with ADHD so I go "I swear a lot of this he gets from me".
"But it's becoming more common!"
No it's not. It's being diagnosed better and earlier.
The great news is that after being diagnosed I was able to go on Focalin, then Vyvanse and it’s really helping.
I'm glad you found what works for you!
No