Kelly and Peggy Ramundo said that if you count girls without hyperactivity, the corresponding ratios approach 1:1. Also back in the early nineties, Dr. Daniel Amen, in his video of Windows into the ADD Mind said that “girls are overlooked, and that this huge under-diagnosis would, if corrected, even out the statistics that regularly report so much larger an occurrence in boys.” Another expert in the field, Dr. Larry Silver, author of The Misunderstood Child (1992), wrote at that time that the ratio of girls to boys with AD/HD was probably much closer to equal because girls who are doing poorly in school are more likely to be withdrawn and quiet, thus appearing disinterested or depressed instead of AD/HD.
In the years since Women with Attention Deficit Disorder was originally published, it has become even more commonly accepted to acknowledge that girls and boys are affected equally when counting the inattentive type of AD/HD. Although there is much overlap between boys and girls in terms of the childhood characteristics of inattentive AD/HD, the struggles they face in adulthood, albeit equally challenging, are often very different because of the gender role expectations that women struggle to meet.
Even though I focus in this book on women who have never been hyperactive, much of what I say about them applies to those who are or were hyperactive, as well. Hyperactivity is not the only or critical element of AD/HD. Other executive functioning deficits challenge women who identify with the symptoms of AD/HD.
Why I Chose to Write a Book on Women with AD/HD
1.Women with AD/HD had not been the focus of an entire book before and the topic had not received adequate attention.
2.AD/HD inattentive type (that means without hyperactivity) is the most common form of AD/HD in girls and women.
3.AD/HD inattentive type was and still is the least commonly understood and identified form of AD/HD.
4.Those who have this kind of AD/HD usually remain undiagnosed longer than those with hyperactivity.
5.Those who have remained undiagnosed the longest often have the most serious consequences, especially in the way they internalize their problems, which often results in depression, anxiety, and self-image struggles.
6.Even after diagnosis and medical treatment, women continue to have serious inner barriers to getting the support they need with their real life problems. This is due to the shame they feel about not being able to meet gender role expectations because of their AD/HD challenges.
7.Many women still see their disorganization issues as a character flaw.
8.The partners of women with AD/HD needed a resource where they could get a deeper understanding of what both they and their partner were struggling with.
9.The mental health professional trying to help the women with AD/HD also needs to understand the complex emotional issues involved in order to more effectively guide these women and their partners.
There are many women out there struggling with serious organizational problems who have no idea that something neurobiological like AD/HD could be at the root of their difficulties. A few years ago I read an article about women who formed a self-help group for “disorganized women.” They met in private to protect their anonymity and describe themselves as “self-confessed slobs.” Ever since then, it became very important to me to try to reach these kinds of women, to help them understand that in the absence of any serious mental disorders, there may be another explanation for severe disorganization. Since this book was first published, it has been overwhelmingly received by women all over the world who were previously completely isolated, thinking their problems were the result of personality flaws.
Perspective
This book was written from three perspectives: that of a psychotherapist, that of a woman with AD/HD, and that of someone involved personally and professionally for many years with other adults and professionals in the field of AD/HD. As a psychotherapist, I am specially trained in the impact of life experiences on relationships, interpersonal difficulties, and self-perceptions. This book was originally based on six years of clinical observation and work with AD/HD adults with a focus on the special challenges facing women. Now I have had 10 more years experience, and I feel more strongly than ever that the unique experiences described in this book are shared by countless women who are impacted greatly by the cultural expectations they face and the idealized roles they have internalized. Secondly, as a woman with AD/HD, I observed my own personal process as I began to understand what it meant to live successfully in this culture. Thirdly, the material in this book was drawn from all the talks and meetings I’ve had with women across the country and around the world who have shared their feelings about AD/HD, disorganization, and how it affects their lives. Integrated within all of this are the wonderful writings of many experts, as well as the currently available literature on AD/HD diagnosis and updated treatment options and recommendations. Some of the references first used in this book are out of print or circulation. Many of the quotes still in this edition were from the very beginnings of discussion on this subject; from seminars or tapes no longer able to be referenced. When I am able to I will let the reader know this in the reference section.
The Scope and Focus of this Book
There is great diversity in this thing we call AD/HD, from those who are hyperactive to those who are hypoactive, from obviously impulsive individuals to those who are more shy and withdrawn. There are men with AD/HD, women with AD/HD, those who have been diagnosed since childhood, and those who have just been diagnosed in mid-life. There are those with AD/HD who are well educated, who have work and relationships they enjoy, and those less fortunate, who struggle just to get by. I do not attempt to speak to all the facets or elements of AD/HD, especially the medical and neuropsychological aspects. Although I will touch on the biological issues that impact women, such as PMS, pregnancy and menopause my perspective as a psychotherapist is to trace the emotional journey that women with AD/HD embark on as they try to understand their experience.
There have been many fine books written, virtual textbooks, which address a wide and diverse AD/HD population, their subject matter covering diagnosis, testing, medication, and treatment for both children and adults. These are listed in the resource section at the back of the book.
The Characters in the Book
To illustrate my points, I’ve used material drawn from my clients, as well as interviews with other women with AD/HD. Most of the examples are in the form of composites, which are representative of actual stories that many women with AD/HD have shared with me. Other examples are true stories from specific clients who have given me permission to share their experience with the reader. Of course, I have changed the names and other identifiable information for the purpose of protecting their privacy.
In addition, I’ve created two fictional composite characters named Jodi and Lucy to represent the major struggles reported by women with AD/HD. I use this technique in order to provide certain information in a more narrative and interesting form. I trace them through their formative years to help the reader understand the journey of women with AD/HD on a more personal level.
Overview
Women with Attention Deficit Disorder includes A Pocket Guide to AD/HD, which lays out the basic concepts for those not familiar with AD/HD and serves as an easy reference throughout the book.
PART I, Surviving, starts out with my personal and professional AD/HD story, explaining the beliefs I have come to hold regarding living successfully with AD/HD as a woman. I then trace the development of a little girl in order to examine the effects
