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 of being undiagnosed at various stages of a girl’s life; this will help the reader understand the challenges and struggles she may face as an adult before diagnosis.
In PART II, Hiding, we go beyond the primary AD/HD symptoms and explore the collision between these symptoms and the cultural expectations placed on women. We will then begin to understand the emotional legacy of “shame” that often results from this life experience. We will also examine the complex and painful “secondary effects” an AD/HD woman may experience such as underachievement, depression, and relationship difficulties.
In PART III, Emerging, I present an overview of diagnosis and treatment issues especially for women. We’ll explore the ease with which women are over-pathologized and misdiagnosed. We will travel the variety of roads one might take on the way to understanding their AD/HD and/or disorganization, and we’ll discuss the tools they will need to start this journey such as moving through the AD/HD grief cycle. I will outline the MESST model of treatment I have devised, an acronym for Medication, Education, Strategies, Support and Therapy. I also include an AD/HD screening tool I designed especially for women.
Finally, PART IV, Embracing, focuses on the essential “three Rs” required for anyone to live successfully with AD/HD, but specifically for a woman. These include the following: restructuring her life, renegotiating her relationships, and redefining her self-image. Doing these things allows a woman at some point to embrace her AD/HD. She crosses a certain line where she is able to become proactive in order to access the help that she needs. This, in turn, leads to a new “cycle of success” in which she can begin to thrive instead of just survive.
AUTHOR’S INTRODUCTION TO REVISED EDITION
“There is no greater agony than bearing an untold story inside of you.”
—Maya Angelou
I recently discovered this quote, and it immediately became one of my favorites. It captures what has been one of the most gratifying experiences for me in the years since I first published this book. When I meet women who have resonated with my book, they proudly show their copy to me—raggedy, well worn, with pages folded over, underlined, highlighted, bulleted, marked with Post-its, multicolored markings, writing in the margins—all to say “This is me. This is my untold story.” They read and reread it,