The ADHD Homestead

Create the life you want with the mind you have.

Tag: mental health care

Falling through the cracks: one ADHD girl’s story

About the author:

CarolynCarolyn is a single mother of two and a Registered Nurse working in General and Cardiovascular Surgery. She also has a background in Behavioral Health. She’s just started a new blog at www.thedistractedmom.com, where she writes about parenting with ADHD while raising ADHD children.

Follow Carolyn on Twitter at @NurseMallon.

Thank you, Carolyn, for sharing your story!

Missing the warning signs

Do you know what it feels like to be a girl with ADHD?

I do, as do nearly 6% of all girls. But many of us struggle for years before we figure out why things seem so much harder for us.

We expect boys to be boisterous and loud. Even without a diagnosis of ADHD, it surprises no one when a boy acts like a clown, and they give him a pass when he talks back (after all, he’s got to grow up to be confident, right?).

We expect something else from girls.

We want them to follow directions and be tidy, and to be mindful of the feelings of others. There isn’t as much leeway for being messy and haphazard.

As an ADHD girl, you’re forever falling short of everyone’s expectations, never living up to your “potential.” You try to stay organized, but the lists and notebooks just get lost. You forget plans and goof on names. You struggle to fit in with the other girls, and you feel like everyone else has a cheat sheet of social rules.

As an undiagnosed ADHD girl, my childhood and teen years were awful.

I was depressed and crippled by anxiety attacks and a school phobia. At one point I had an ulcer made worse from the meds I was taking for my ‘emotional problems!’

I was only 12 years old. I just wanted to know what was wrong with me!

My older brother had ADHD, but he had the obvious kind — and he was a boy. He was hyperactive and oppositional. He engaged in risk-taking behavior that was hard not to notice. I worked very hard to behave and do well in school, even when it was obvious to me I wasn’t keeping up.

The tragedy was that in working so hard to hide my impairments, I only succeeded in postponing proper treatment.

I was intelligent enough to leave an impression on my teachers. In fact, I was in the gifted program, but I lacked the organizational skills to meet their academic expectations.

If I found a subject interesting, I could do well easily, but if a subject didn’t grab me, I could stare at a homework assignment for hours and still not make progress. I would try to follow the class lecture, but if I lost track of what they were discussing, I might as well have wandered alone in the woods. I just couldn’t catch up.

After a while, I started skipping classes to avoid the shame and embarrassment of having no assignment to turn in or knowing I was going to flunk a test. This contributed to my poor self-image: I felt like a loser and a delinquent.

By 11th grade, I wasn’t in honors classes at all anymore. I was failing remedial math and getting suspended for truancy. I was drinking, experimenting with drugs, and feeling more miserable than I’d been in my life.

This is often the lot of the undiagnosed ADHD girl.

ADHD’s far-reaching effects on women & girls

ADHD is the most common childhood psychiatric disorder, marked by impulsivity, hyperactivity, and inattention. While girls often present with those symptoms, they more commonly have difficulties sustaining attention, initiating and maintaining effort, and organizing information. Many struggle with learning impairments.

Left undiagnosed, girls tend to under-perform academically. Each year that goes by becomes a longer history of failure, social problems, and feelings of under-achievement.

More so than with ADHD boys, these impairments often lead to peer rejection. Relationships among girls are sophisticated and require more maintenance. Boys tend to be more forgiving of forgetfulness, hyperactivity, and inappropriate outbursts. Social awkwardness it not as easily forgiven among teen girls. There’s a perception that girls should know what to say and when; how to keep a secret; how to keep their lives in order and make it look effortless.

If they can’t do this, they feel like something is wrong with them.

What Happens When You Can’t Keep Up?

Depression and anxiety are common with ADHD, but even higher in girls, who tend to internalize problems. Whereas boys engage in oppositional behavior, girls more commonly internalize anger and engage in self-injury. Half of ADHD girls report self-harming behavior (Child Mind, 2012).

Perhaps not surprisingly, girls are also particularly prone to substance abuse disorders, possibly related to later diagnosis and high levels of stress as they try to self-medicate.

45% of women diagnosed with ADHD also meet criteria for another disorder.

But it’s not the end of the world, right?

Well, it can be the end for some. 18% of teen girls with ADHD report suicidal ideation (Rucklidge, J.J. 2008), and the incidence of successful suicide is five times higher in those with ADHD (Medscape, 2013).

There are other risks associated with “slipping through the cracks” and not being diagnosed. Left untreated, ADHD increases the risk for driving-related accidents, particularly for teen girls. Adolescent girls with ADHD also have a higher risk for teen pregnancy (30-40%) and a fourfold increased risk for STDs (Rucklidge, J.J. 2008).

As any grown-up girl can tell you, low self-esteem and poor impulse control do not add up to the best decision-making.

I had all the symptoms — how was it missed?

The therapists and doctors saw my anxiety and depression, my sense of never being focused or present, my inner feelings of restlessness, anger, and self-loathing. I also engaged in self-harm, but my impulsive behaviors looked like psychiatric symptoms, and didn’t point to ADHD. They threw around words like “dysthymia,” “generalized anxiety,” and “borderline.”

What they missed was ADHD combined-type — and just enough shame about my impairments that I managed to distract from the issue entirely. Rather than let anyone know how disorganized and forgetful I really was, and because I interpreted that as a personal failing, I focused instead on how miserable I felt. Understandably, they focused on that, too.

In doing so, we all failed to address the symptoms that were contributing to my unhappiness and poor self-image in the first place.

You couldn’t pay me a million dollars to relive my teenage years.

It’s not too late

Dropping out wasn’t the end of my story. I did get my life back on track eventually. But first I had to address the self-image issues holding me back and the ADHD symptoms keeping my life in disarray.

If you know a girl struggling with attention or anxiety issues, whether she’s been diagnosed or not, let her know she doesn’t need to struggle like that. And she’s not alone.

There’s no one-size-fits-all solution, but one intervention that does fit every situation is support. Not lectures, not tough love, not “ignore it; she’s just doing it for attention,” not hollow reassurances. Just support. Let her know that you notice her, and you want to help, and you’re there for her. Then ask how you can help.

References

ADHD Persists in Adulthood, Ups Mental Illness, Suicide Risk. Medscape Medical News, Psychiatry. Wed. 10 April 2015.

Cumyn, L., PhD., French, L., PhD., & Hechtman, Lily,M.D., F.R.C.P. (2009). Comorbidity in adults with attention-deficit hyperactivity disorder. Canadian Journal of Psychiatry, 54(10), 673-83. Retrieved from http://ezproxy.snhu.edu/login?url=http://search.proquest.com/docview/222845215?accountid=3783

Mikami, A. Y., Ransone, M. L., & Calhoun, C. D. (2011, 12). Influence of Anxiety on the Social Functioning of Children With and Without ADHD. Journal of Attention Disorders, 15(6), 473-484. doi: 10.1177/1087054710369066

Ramsay, J. R. (2005, 12). Girl, Repeatedly Interrupted: The Case of a Young Adult Woman With ADHD.Clinical Case Studies, 4(4), 329-346. doi: 10.1177/1534650103259741

Rucklidge, J. J. (2008, 12). Gender differences in ADHD: Implications for psychosocial treatments. Expert Review of Neurotherapeutics, 8(4), 643-655. doi: 10.1586/14737175.8.4.643

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Employee Assistance Programs: an ADHD adult’s lifeline

Happy Monday, everyone! Today I’m going tell you how I fast-tracked my own ADHD diagnosis and treatment — and how you can, too. If you’re struggling, you don’t need to navigate the mental health care maze alone. There’s a free, simple program out there to help, and it may be just a phone call away.

overwhelmed photo

Photo by geralt on Flickr

Does your company have an Employee Assistance Program (EAP)? Maybe you’ve seen a poster behind the coffee maker or gotten a cheesy-looking brochure with your new hire materials. Employers offer EAPs to help workers sort through all kinds of personal issues: everything from career planning to marital struggles to smoking cessation to serious mental illness.

The process is simple: call the 800 number, talk to someone, and schedule an appointment to visit their office if you need to. Most EAPs are contracted out to a third party, not managed directly by your employer, and maintain strict confidentiality about who uses the service.

As a former human resources professional, I know it’s easy write off a service like this. Even I believed it was something for other people — until my ADHD became too much to bear. Then I picked up the phone.

If you’re struggling right now and you have access to an EAP, call them. You owe it to yourself.

5 reasons to call your EAP

  1. You might have an EAP even if you’re unemployed.
    Really and truly. EAPs generally cover everyone in the employee’s household. That means even if your employment situation doesn’t afford you an EAP, you may still have access through your spouse, roommate, etc.
  2. It cuts out the extra steps.
    Forget the red tape, multiple calls and appointments, and HMO referrals. Forget combing through a list of therapists and trying to pick one. Your EAP is a one-stop shop for every problem in the book. While they’ll have to refer you back to an independent specialist eventually, you get several sit-down visits with a professional before that happens.
  3. You get professional help without spending a penny.
    Specialist copays are no joke. If yours are on the high side, don’t let money get in the way of the support you need. EAP visits are free, and they can accomplish a lot. After I met with an EAP counselor, they referred me back to my primary care doctor for a more consultation and a prescription for stimulant medication (the EAP can’t prescribe — just give advice). I may not have invested thousands (or even hundreds) of dollars in therapy, but I still changed the course of my life.
  4. You won’t have to wait.
    Have you ever called a doctor’s office in a panic and found out you can’t get an appointment for weeks? If you’ve gotten a recommendation for the best ADHD coach in town, don’t consign yourself to suffering every day until your first meeting. The EAP can provide stop-gap support the very next day.
  5. Did I mention the bill is already paid?
    If your employer offers an EAP, they’re already paying a monthly fee for every employee. You’re not putting anyone out or costing anyone money, and no one at your office is even going to know you called — not even your HR person.

What are you waiting for?

When I finally sought help for my ADHD, I was at an all-time low. Getting that help felt like a task execution challenge I couldn’t face. If you’re struggling just to get within sight of the starting line, EAPs are a lifesaver.

Of course, you’ll want to prepare as much as possible before meeting with any mental health professional, even one at your EAP. Take a few minutes to gather your thoughts before your appointment. Write down a few notes. Make an inventory of the ways you feel your ADHD affects your quality of life right now, personally and professionally, and think about struggles you’ve had in the past. Be prepared to talk honestly and openly about what your life is like and how you’re feeling.

Most of all, give yourself a little praise. You’re taking advantage of a program that’s there to help you thrive and succeed.

Do you have experience with an Employee Assistance Program? Please share your thoughts and advice in the comments so others can benefit!

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