Until a few years ago, there was very little research about girls with attention challenges. During the past decade, the National Center for Gender Issues and ADHD (NCGIADD) started researching the similarities and differences in the symptoms of ADHD in girls when compared to boys. Surprisingly, the differences actually outnumber the similarities.
Like boys, girls are easily distracted by others around them. They are also often internally distracted, and may be called “daydreamers”, “spacey” or “scattered.” They show inconsistent alertness and effort, and they easily lose track of time. As a result, they have trouble finishing work, and complete tasks at the last-minute. Adding to this struggle, their room, locker, book-bag are often messy, and they have trouble finding things.
Unlike boys, ADHD girls will often expend extreme effort and mental energy to succeed at academic tasks: as a result, their challenges are identified later in life than boys. Despite (and because of) her unnoticed struggle to do well, a girl with ADD/ADHD may feel she is not effective at anything even though she has lots of talents and abilities. As a result, an ADHD girl may appear unsure, anxious, and “shy” in new situations and around new people, but at home or in familiar surroundings, she may talk non-stop about “everything” and “nothing” at the same time.
Most girls with ADHD are seldom considered “hyperactive.” They are usually considered “well-behaved” but they can be “hypersensitive,” often getting upset more easily, more quickly, and more intensely than others. This emotional reactivity tends to increase in ADHD girls during adolescence. As a result, they are more quickly hurt and their hurt feelings can rapidly escalate into impulsive over reactions that include yelling, screaming, and cursing at the ones who love and care about them the most. Often, after these short-lived outbursts, girls with ADHD are extremely remorseful and saddened by their lack of self-control in the moment.
Unfortunately, many of those who suffer the wrath of this impulsivity become unforgiving of these outbursts due to their misunderstandings of this aspect of ADHD in girls. As a result, private schools may privately ask them to leave and parents may openly hold them responsible for all the ills and dysfunctions of the family. This only serves to snuff out the ADHD girl’s hidden strengths and increase her sadness and worry.
Studies completed by the NCGIADD show that a staggering number of girls and women have been diagnosed with anxiety and mood disorders before their underlying ADHD was finally recognized. Recently, I have seen an unsettling trend in these girls being diagnosed with or being prescribed medications for bipolar disorder even though their emotional reactivity does not even come close to the multi-hours long “rages” seen in teens with this mood disorder.
As they get older, it is very important to monitor their symptoms as girls with ADD/ADHD may take unwarranted risks to try to fit in with their peers. As a result, they are at high risk for teenage pregnancy and substance abuse.
So, how do we save these girls from these multiple risks? It takes a multifaceted. direct, and team approach.
- Seek early identification, diagnosis, and research-based treatment
- Find someone who can provide parent training to help you not only understand your ADHD daughter’s temperament differences, but also teach you how to develop strong problem solving strategies before things get out of hand.
- Provide your daughter early and age-appropriate education about the risks she faces and how to best respond to those risks.
- Seek family counseling focused on effective communication, problem solving, and forgiveness.
- Understand that her emotional reactivity is a part of her ADHD, and recognize when her emotions become more intense: for example, she may be more likely to become emotional when she is stressed, tired, or hungry.
- Understand that the hormonal fluctuations of the menstrual cycle can intensify and complicate her emotional reactions, irritability, and low frustration tolerance.
- Understand that her emotions can tip quickly when environmental stresses suddenly overwhelm the teenage girl’s already distressed system.
- Help her start to recognize and manage the stresses that worsen her reactions.
- Understand that psychotherapy needs to be designed to directly address peer problems, self-esteem issues, and the stresses that increase her emotional vulnerability.
- Understand that she may need both medication to address symptoms of depression and anxiety in addition to ADHD.
- Help her develop time management, planning, prioritizing, and organization skills needed to be successful. Because your teenage daughter is trying to become more independent, someone other than her parents may need to help her acquire these skills: a therapist, coach, or school guidance counselor may be able to help.
- Actively help her recognize her strengths. The more aware she is with her areas of competence the less vulnerable she will be to the frustrations that often accompany ADHD.
- Help her stay involved in structured self-esteem building activities that emphasize her strengths: sports, artistic pursuits, performance arts, part-time work and volunteer work can help her build and maintain self-worth.
- It is especially important for fathers to actively spend positive time with their ADHD pre-teen and teenage daughters so that they are less likely to seek male sexual attention.
- Maintain an open, supportive relationship with her so that she has somewhere to turn for advice if she does become sexually active – either to help her make a wise choice of birth control or to help her make the best decision if she accidentally becomes pregnant.
- Girls (and boys) with ADHD may need more driving practice until their skills become more automatic and they require less concerted effort. It is important to discuss and plan for possible distractions or situations that could lead to impulsive reactions in advance.
- Validate her right to express her opinion, and help her learn to express what she thinks in a constructive, effective manner.
- Help her develop self-advocacy skills for a more independent life beyond high school. Teach her how to assertively and convincingly express her needs to teachers or employers who may not understand the true impact of ADHD.
As a result of their research, Patricia Quinn, M.D. and Kathleen Nadeau, Ph.D. have developed a screening checklist for teenage girls on the website www.ADDvance.com. For more information about girls and women with ADHD, visit the website www.ncgiadd.org and download their article Understanding Girls with ADHD.
If you need additional help and guidance for your daughter, please call us at 817.421.8780: As the parent of a daughter with ADHD, Dr. Davenport truly understands the unique symptoms and needs of girls with attention challenges.
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(c) 2009- 2012, Monte W. Davenport, Ph.D.