ADHD Survival Guide for Women

If you are living as a neurodivergent woman in a world designed for neurotypical men you have probably already realized that most people aren’t wired the way you are. As a direct consequence you may also receive advice that may be entirely reasonable and relevant for most people but can be absolutely useless and, in some cases, directly harmful to you. Moreover, these well-intentioned but totally misinformed suggestions often exacerbate the frustration and self-loathing that many women with ADHD carry around.

Do you torture yourself with self-doubt and self-criticism wondering what kind of a person you are, failing people around you time after time? Who just don’t show up to a friend’s birthday party because you don’t have any energy that day? And what’s the matter with you who can’t honor a single promise or keep a single secret? Why don’t you exercise regularly, and why  eat so unhealthily when you say that you hate the way your body feels or looks? Why don’t you go to bed and get up on time? Why don’t you quit smoking, and why can’t you drink “moderately” amounts of alcohol like normal people? Do you feel that your emotions are all over the place and out of control and that you get bored when I’m around “normal” people?

You are not alone! We have heard different version of this story from many ADHD women and the people around them.

However, a crucial detail that we often overlook is that the problem, most often, is not lack of insight. In other words, it’s not that you DO NOT know that you should eat healthily, exercise regularly, manage stress appropriately, sleep well, quit smoking, preferably not consume any alcohol, and not let your emotions run wild, causing harm to yourself and others. You probably do the opposite of all this, DESPITE knowing that it creates problems.

Even more challenging, it seems for the 95% neurotypical population to understand that it’s not the facts that’s lacking, but despite having all the facts, change remains elusive. And often, I you get quite meaningless and, frankly, outrageously poor advice.

“Eating until you’re full” is, for example, not a very good idea to suggest to someone who has trouble regulating appetite and reading their body’s cues for hunger and satiety or eats due to emotional storms or restlessness. The link between ADHD, overweight, and eating disorders is indeed very strong.

“Sleep until you feel rested” is not a particularly constructive piece of advice for comforting someone with an innately disrupted chronotropic rhythm or difficulty regulating their energy levels. We know that there is a clear connection between sleep disorders and ADHD and that, due to a different reward system, people with ADHD often experience fatigue or energy depletion that cannot be alleviated by more sleep but instead requires them to activate out of otherwise paralyzing passivity.

“Let your feelings show!” Advice telling someone they must say what they think and feel, and that it’s harmful to suppress emotions, is awful advice for someone with ADHD, since research clearly demonstrate a strong link between difficulties regulating emotions, impulsive behavior, and emotionally driven actions and loneliness, divorces, work life difficulties and exclusion.

“You’ll get used to it! Trying to comfort or normalize someone’s sensory overload, social exhaustion, or perceptual sensitivity with advice like, “everyone gets a bit tired by social gatherings,” is also not particularly insightful. In the worst-case scenario, it can lead to total exhaustion, a sinking self-esteem, social withdrawal, or the development of social phobias.

But perhaps the worst advice to give to someone with ADHD is to “take a drink and relax, you only live once, and you seem so tense.” Because we know without a doubt that individuals with ADHD have a significantly increased risk of developing harmful alcohol and drug use and that we need to take special care when it comes to alcohol and drugs. This does not mean that everyone with ADHD will become substance abusers, but it does means that there is an inborn vulnerability because the same brain systems are involved in both ADHD and addiction disorders. That’s why, people with ADHD should be extra careful not using alcohol, drugs, or any other substances when they are stressed, emotional, tense or challenged in life.

Blog by Lotta Borg Skoglund MD PhD

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