Mental Health, Coronavirus, Adhd, Covid-19 (Coronavirus), Web

Mental Health, Coronavirus

The Pandemic Surprise Many Women Did Not Expect? An ADHD Diagnosis.

It's been a tipping point for some with the condition.

4/7/2021 9:49:00 PM

It's been a tipping point for some with the condition.

It's been a tipping point for some with the condition.

According to the latest edition of theDiagnostic and Statistical Manual of Mental Disorders (DSM-V),which is how health care providers formally diagnose ADHD, you can have one of three types: hyperactive/impulsive, inattentive, or combined. Although the criteria have been updated over the years, ADHD experts agree that the evaluation still skews toward typical male symptoms because for decades the research focused on boys. This can make it harder to diagnose the condition in girls and women, which is complicated even further by the fact that ADHD often occurs alongside other mental and behavioral disorders. The issue of underdiagnosis becomes even more complex when factoring in race; Black girls and women are often

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underdiagnosed and undertreatedwhen it comes to ADHD. The potential reasons why are multifaceted, including barriers to health care access and assumptions that Black children with ADHD are simply “defiant,” not potentially in need of help.With researchers just beginning to understand how gender relates to ADHD, there is less data on prevalence among trans and gender-nonconforming people, but

early studiessuggest the rate could be even higher in this group.Many of the women who miss early treatment have experienced years of self-loathing, internalizing the shame of being perceived as spaced-out, lazy, and not living up to their potential. Ellen Littman, Ph.D., a clinical psychologist, researcher, and co-author of

Understanding Girls With ADHD, has studied adults and teens with the disorder for more than 30 years. She says women with undiagnosed ADHD may experience anxiety and depression at a higher rate because of the constant overcompensating they’re doing to keep up with gender norms.

The pressure on women to juggle all the things seamlessly—family, work, social life—can cause a tremendous amount of stress for anyone, but particularly those who struggle on a day-to-day basis with things like attention, memory, decision-making, organization, and emotion regulation. So it’s no wonder that adults with

ADHDare also more likely to experience anxiety, depression, and substance-use disorders, among other related problems.“Anxious about being judged an impostor, they are consumed with shame,” says Dr. Littman. “They’re demoralized by their inability to conform, they compare themselves harshly to their peers, and they often isolate themselves.”

Factor in the worstmost of us have experienced in our lifetimes and that anxiety can be unbearable. Dr. Littman says that since the pandemic began, she’s been “absolutely inundated” with people wanting to be evaluated, which psychologists can now do via telehealth.

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“The pandemic has amplified all ADHD challenges tounprecedented levels,” says Dr. Littman. “When women are robbed of routines that provide a structure for them, which is really essential to their functioning, they're reporting much more anxiety, depression, and self-doubt.”

Everyone benefits from the predictability and organization that structure provides, but when you have ADHD and struggle with self-regulation and controlling impulsivity,those external structuresare even more critical, explains Dr. Littman. Routines typically help people with ADHD to be consistent and remind them of expectations and consequences.

So now, Dr. Littman says, her patients report being more overwhelmed and frantic than ever. Their family members, who are suddenly around all the time, are newly privy to the problems most of these women are trying to hide, which is how their brains work differently. One way of looking at how the ADHD brain functions is an “interest-based nervous system,” which often makes it extremely difficult for people with ADHD to do things that don’t interest them. “Women have told me that their [male] partners have shamed them by asking, ‘What do you do all day?’ and wonder why they can’t find the time to prepare dinner,” says Dr. Littman.

Meetings are another problem, which Zoom isn’t helping. When people with neurotypical brains are understimulated, they can often still motivate themselves to power through their meetings and remain engaged, says Dr. Littman. But this typically isn’t the case for people with ADHD, who, according to Dr. Littman, “will disengage and start scanning the environment for a higher-stimulation distraction.”

For some, the pandemic may serve as a tipping point that makes ADHD symptoms no longer avoidable or manageable without help. Sari Solden, L.M.F.T., psychotherapist and co-author of, explains that suddenly jugglingeverythingat home can cause an overload of executive functioning difficulties—particularly when it comes to things like compartmentalizing and prioritizing, some of the main challenges for people with ADHD.

Solden describes the role of executive function as similar to an orchestra conductor’s. “Executive functioning is orchestrating and coordinating and making decisions seamlessly,” she says.Krista Broda, a 35-year-old mom of two young boys in the Canadian city of Regina, says she realized she had ADHD in March 2020, shortly after her province went into lockdown. Being stuck at home in those early weeks amplified some of things Broda already struggled with: disorganization, irritability, and an inability to sit still. “The traits I consider to be my biggest flaws were spiraling to a point that I felt they were no longer manageable,” she

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wrote in an essayfor the Canadian Broadcasting Corporation.Without the routine of her job as an educational assistant in a primary school and managing the busy social lives of an 8- and 5-year-old, Broda tells SELF, “I was completely lost. I had three or four commitments in March, drive-by birthday parties, and I missed all of them.” Then, a friend who had been recently diagnosed posted an article about adult ADHD on Facebook. “I read it and every word popped out at me, and I thought maybe this was something I should look into.”

When Broda saw a psychologist for a diagnosis, the first question he asked her was how many speeding tickets she gets, which was regularly. “He said that’s a big indication of inattentiveness. You know the cameras are there. You know they're going to be taking pictures, but you just blow right past them.”

If you suspect you have ADHD, a first step that could be helpful is seeing your family doctor, who may be able to recommend treatment right away. But they can also refer you to a psychologist or psychiatrist for a diagnosis. Treatment for adults with ADHD, similar to with children, may include medication, either with stimulants such as Adderall and Concerta, or non-stimulant options.

Read more: SELF »

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