When the fidget spinner is a girl
Girls often go unnoticed in school when they have ADHD. They are usually quieter and less noticeable than boys. However, the disorder does not disappear. Many affected individuals are not diagnosed until adulthood or even not at all.
ADHD, the Attention Deficit Hyperactivity Disorder, or AD, the Attention Deficit Disorder, is "a peculiarity of human existence." This is how Astrid Neuy-Lobkowicz describes it. People with AD(H)D are not better or worse than others, just different. Even in women, this neurobiological metabolic disorder is often not recognized, says the psychotherapist for psychosomatics and psychotherapy with a practice in Munich.
The differences begin in childhood. In boys, ADHD is diagnosed four times more frequently than in girls, although the disorder is equally common among the genders, says Neuy-Lobkowicz. She has dedicated her latest book to the phenomenon "Female AD(H)D." Some girls are rather hypoactive, that is, dreamier, shyner, slower, and less noticeable than boys.
Prejudices in Heads
According to Matthias Rudolph, one reason for the different diagnosis rates is also prejudices in the heads of pediatricians and doctors, an examiner bias. "The therapists have the image of a hyperactive boy in their heads," says the psychosomatic medicine and psychotherapy specialist.
Women can also have the impulsive-hyperactive type of disorder. Then they are often "the typical wild child" and are told as children: "You would have been better off as a boy." Or as Neuy-Lobkowicz describes it: They experience "a lot of joy, a lot of sadness, a lot of pain, a lot of excitement. They are simply always a little too intense."
There are not only mixed forms between hyper- and hypoactive, the AD(H)D type can also change. "One can start life as an AD(H)D girl and then develop hyperactive symptoms during puberty," writes Neuy-Lobkowicz in her book. "The same can also be reversed: from the hyperactive type to the inattentive type. We don't know why that is yet."
Girls show socially desirable behavior
Girls with AD(H)D are often victims of bullying, reports Astrid Neuy-Lobkowicz. Girls try to adapt and not stand out. They learn to keep up in school, but have quick feelings of guilt or a bad conscience when they can't. "They try to show contrasting behavior to boys," Neuy-Lobkowicz writes.
If AD(H)D is not recognized, anxiety disorders or depressions often develop, which could easily be prevented in adulthood but then become increasingly noticeable and treated. "Then no one thinks of AD(H)D anymore," says Neuy-Lobkowicz.
In Matthias Rudolph's practice, there were already women who could no longer keep up with the demands of life. They had themselves examined out of fear of dementia because their concentration and memory were severely impaired. Many knew all along that "something was not right with them." "They are often strong women who have managed with 120 to 140 percent effort what others manage with 100 percent," says Rudolph. "Then the forces give out."
## Therapy: Living Better Everyday
A diagnosis of ADHD can be made by specialists in neurology, psychotherapy, psychiatry, psychosomatic medicine, or psychological psychotherapies. This requires proof, using a standard questionnaire, that a disorder existed during childhood and continues into adulthood. School reports or interviews with parents are often used for this purpose.
"It's often difficult to prove for women because they behave so unobtrusively, and there's nothing about it in the reports," explains Astrid Neuy-Lobkowicz. "It depends on the environment in which the children grew up." Some parents closely monitored their children's homework and corrected mistakes, making the disorder less noticeable. "If a doctor suspects AD(H)D but the questionnaire results from childhood are unremarkable, it's worth digging deeper."
If the diagnosis is confirmed, treatment consists of several elements. Medication is an important component. The AD(H)D brain is affected by constant overstimulation, and the neurotransmitters dopamine and noradrenaline are out of balance. Treatment is often supplemented by behavior therapy, which focuses on organizing life better. Other components can be occupational therapy, sports, and self-help groups.
Time-Out Instead of Burnout
Family members can also be a support system. "It's important to engage with AD(H)D," says Astrid Neuy-Lobkowicz. "That is, to understand the condition and not misinterpret the behavior of those affected. They are not inattentive in conversation because they're not interested, but because their thoughts are drifting." Women with AD(H)D are extremely impulsive and always late, not because they don't want to come, but because they have difficulty handling time. "If you don't know that, you're easily offended."
Neuy-Lobkowicz advises against discussing conflicts in relationships but instead taking a break. That is, getting out of the conflict situation and later discussing it calmly. "AD(H)D women are like mimosas with a wooden club," says Neuy-Lobkowicz, who herself has ADHD. When they occasionally "blow up" verbally, they do so to bring order to their world. But only for themselves: "And that's why you need to explain to them that they can cause damage in a relationship."
Communication is also important to Matthias Rudolph. His advice for interaction: Don't hold long monologues, but speak in short, clear sentences. It may be worth summarizing sentences into "have I understood you correctly, that...". Establish feedback rules, Rudolph suggests, and pay attention to a calm environment during important conversations.
In the international psychological community, the misdiagnosis of ADHD in women is a pressing issue. Many affected individuals, particularly those from different cultural backgrounds, may not receive a proper diagnosis due to cultural norms or beliefs about appropriate behavior for women.
Despite the prevalence of ADHD in women, it often goes undiagnosed in many parts of the world. This discrepancy in diagnoses between genders and regions highlights the need for more research and awareness about thegender-specific manifestations of ADHD and its impact on women's mental health.
