(360) 952-3070 [email protected]
ADHD in Women

ADHD in Women

by | Dec 28, 2022 | ADHD

If you feel like you’re hearing about more and more women being diagnosed with ADHD recently, you’re not wrong! Many women don’t receive a diagnosis until well into their 30s or 40s, while the average age of diagnosis for men is much younger.

ADHD affects men and women equally, but many young girls go undiagnosed for years, only to have their symptoms recognized in later years. Let’s talk through what ADHD is, and why there have been challenges in identifying and diagnosing it properly in women.

First, we’ll look at some of the classic symptoms of ADHD, which are commonly broken up into two main categories: hyperactivity and inattention.

 

Hyperactivity

  • Restlessness
  • Being uncomfortable sitting still
  • Talking excessively or out of turn
  • Interrupting others or having difficulty waiting your turn
  • Fidgeting

 

Inattention

  • Difficulty focusing
  • Trouble staying organized
  • Distractibility
  • Forgetfulness

 

There are three main types of ADHD: primarily inattentive type, primarily hyperactive type, and combined type. What previously used to be known as ADD (Attention Deficit Disorder) now falls under the umbrella of ADHD.

These diagnostic criteria seem pretty straightforward, but for many people, especially people who are assigned female at birth, it’s not so simple.

 

Diagnostic Bias

When ADHD was first being understood, researchers focused heavily on symptoms seen in young boys, there was even a time when it was thought that young girls couldn’t have ADHD!  These young boys showed symptoms like having trouble staying seated, causing major disruptions in class, and having behavioral issues.

To put it frankly, researchers just didn’t see these same concerns in young girls as often, so the diagnostic criteria that resulted didn’t consider how young girls might be struggling. When a young girl started struggling with what we now know to be ADHD, she wouldn’t fit the criteria for ADHD, and then would go undiagnosed and untreated.

 

Masking

Another major reason women are either undiagnosed or diagnosed later in life is because of social conditioning, and a phenomenon known as masking. If you’ve ever felt like you had to put on an act to get through a social situation, you were likely masking.

For many girls and women with ADHD, the strict social rules of how women are “supposed” to act cause them to mask ADHD symptoms that wouldn’t be viewed positively. Masking to get through a short social interaction isn’t necessarily detrimental, but many women with ADHD end up masking all the time, sometimes even so much so that they don’t realize they are doing it until they learn about their symptoms and let themselves drop the masks.

 

So what does ADHD look like in women?

The symptoms of ADHD are essentially the same between men and women, but the way they present can be very different.

Women with ADHD often experience things like:

  • Rejection sensitivity dysphoria (severe emotional pain to perceived rejection or exclusion)
  • Fears of judgment for symptoms of disorganization, forgetfulness
  • Self-esteem issues from perceptions of laziness or trouble with motivation
  • Sensory issues and being easily overstimulated
  • Sleep issues
  • Changes in symptoms and severity of concerns in alignment with menstrual cycles
  • Mental exhaustion from ongoing masking/symptom management
  • Identity issues after struggling to know who they are authentically vs. who they felt they had to be

 

How is ADHD being diagnosed in women?

 ADHD is formally diagnosed in the same way for men and women. A mental health care provider provides an assessment based on historical and current symptoms, but again many of these diagnostic assessments are focused on male-centric symptoms, so it takes a trained provider to notice the ways this might show up in women.

Many women first acknowledge ADHD symptoms after a major life transition. Moving to college, living on their own, and having children can all be common times for this. It’s not that the symptoms weren’t present prior to these life changes, it’s that the person may have lost systems of support that previously helped them cope, or their responsibilities have increased to a level that they can no longer manage with previous coping skills or masking. For some women, it’s not until they notice symptoms in their own children that they reflect on their own childhood/development!

 

If any of this sounds familiar, reach out to one of our ADHD specialists for support!

The Young Adult’s Guide To Navigating Family Boundaries

The Young Adult’s Guide To Navigating Family Boundaries

by | Aug 8, 2022 | Relationships

Healthy boundaries are the building blocks of healthy, successful relationships, but they can be a challenge to navigate, especially as relationship dynamics change and evolve. In many families, children grow up with a clear sense of the family hierarchy and an understanding that the parents set the expectations and family “rules”. It can be a struggle then, when that child grows into an adult, to know how to navigate a new relationship dynamic. Even in loving and healthy families, many young adults struggle with feeling pressure to conform to their family’s expectations from earlier years, but stifling their own needs and wants for the sake of keeping the status quo can quickly lead to resentment and relationship issues. 

 

Let’s explore a few scenarios. You’ll notice in each one of these that the example of a boundary that could be set is more focused on what you will do in response to their choices. We cannot force other people to change their behaviors to be in alignment with our needs, but we can express our needs, and inform them what we will do if those are not respected.  

 

1.  Your family dresses modestly and chooses to not express themselves through clothing, hair, etc.  You have recently found joy expressing yourself in this way, but find yourself dyeing your hair back to your natural color, covering tattoos with makeup, and dressing in clothing that you don’t like when you visit them because they make harsh comments or quietly shake their head when they see you.

The intention: “I tone my self expression down so I don’t make anyone uncomfortable and I don’t draw negative attention to myself. 

What you’re reinforcing: “I can’t be myself with these people, they won’t understand me”

A boundary that might need to be set: “This is how I have chosen to express myself, and as long as my appearance is appropriate for the event and the weather, this is how I will look. 

The outcome of that boundary: Powerful authenticity, showing up as yourself regardless of what others think. 

 

2. Your family is very extroverted and enjoys large gatherings that go late into the evening. You are an introvert and find that after a few hours, you are wanting to leave, but tell yourself you have to stay. 

The intention:  “This is what our family does, I need to stay so I don’t offend anyone”

What you’re reinforcing: “Everyone else’s needs are more important than my own.”

A boundary that might need to be set: “I love you all and have had fun, just letting you know I’ll be heading out at 10”. 

The outcome of that boundary: Signaling that your needs are important and that you do not need to explain yourself. 

 

3.  You are parenting your children in a different way than you were parented. When your child refuses to eat dinner or has a meltdown after a conflict with a cousin, other family members jump in and attempt to discipline them. You are uncomfortable, but don’t want to speak up. 

The intention: “If I jump in, I’ll offend them because they’re disciplining exactly how I was raised. I’ll seem ungrateful or like I think I’m better than them”. 

What you’re reinforcing: “They don’t see me as a capable parent. My child is seeing me not step up even though I”m teaching them something different at home.” 

A boundary that might need to be set: “I am their parent, so any discipline or behavior management is my job, even if it looks different than how you would do it. If you continue to try to discipline him, we will need to head home early. ”

The outcome of that boundary: Confirmation that you get to make the parenting choices with your own children, and your child sees a healthy boundary being modeled. 

 

4.  When you spend time with your extended family, they routinely make rude comments about your weight and eating habits. In the past, if you ask them not to, you’re met with comments like “learn to take a compliment!” or  “we’re just worried about your health”. You eventually fake a smile or laugh and go along with it. 

The intention: “They don’t mean any harm, so I’ll just be quiet when they do it.” 

What you’re reinforcing: “I’m forcing myself to be ok with these comments so I don’t upset anyone else.”

A boundary that might need to be set: “Regardless of your intention, I’m not comfortable with you commenting on my weight or eating habits. If you continue to make those comments, I’ll have to excuse myself from the event”. 

The outcome of that boundary: An act of self-love, creating an environment for yourself that does not include shaming from family members. 

 

 

Boundaries, especially those that are disrupting long-standing patterns, are almost always met with some level of shock or surprise, some level of pushback, as well as some awkwardness. Managing the discomfort that comes with setting the boundary and staying firm in what you need, is usually worth what’s on the other side; authenticity, confidence, peace, and healthier relationships.  So, if no one has offered you this before, here is your official permission to redefine your boundaries, to say no, and to value your own needs and wants. 

 

 

 

 

Contamination Fears In a Contaminated World: What’s Appropriate And What’s Compulsive?

Contamination Fears In a Contaminated World: What’s Appropriate And What’s Compulsive?

by | Aug 1, 2022 | Anxiety, Obsession

Covid, Measles outbreaks, Mokeypox- it can feel overwhelming to manage the constant barrage of new threats. For most people, a significant behavioral change is needed to ensure safety, but for people with OCD or health anxiety, where do you draw the line? What are appropriate safety precautions, and what are compulsive safety-seeking or attempts to manage anxiety? Years ago, it would have been seen as obviously excessive for most people to wear a mask in public spaces, sanitize everything before bringing it into your home, and refuse people in your home, but now that may be exactly what’s needed to remain safe. An added component to this difficulty are the differences in how folks view these threats, complicating factors like having young children or being immunocompromised, and individual tolerance for risk. What might be excessive for one person may be necessary for another.  

 

There is no one right answer to what is an “appropriate” level of safety precaution, again because each person will have a different set of circumstances to consider. The simplest way to explore if your safety precautions are appropriate, or potentially causing you more anxiety/distress, can be boiled down to three questions: 

 

Is this in line with expert recommendations?

The more obvious way to assess your safety precautions is to find experts whose opinions and recommendations you trust. This could be medical doctors, scientists, government agencies, or ideally, a combination of several so you can ensure your information is reliable. For example, both the CDC and the Mayo Clinic advise washing your hands with soap and water for at least 20 seconds or, if that is not available, using hand sanitizer with at least 60% alcohol content. With this in mind, some folks may prefer to go a little beyond these recommendations, but it gives a good barometer for what is considered adequate for safety. 

 

Is this safety precaution causing you harm in an effort to keep you safe? 

This is truly the most important assessment. If washing your hands for 60 seconds feels more comfortable, there’s likely little harm and it could be appropriate to continue. However, if you begin using scalding water, harmful chemicals like bleach, or begin to experience peeling, cracking, or bleeding, it warrants an assessment of whether the safety precaution is appropriate. 

 

Is this causing me to be unable to engage in necessary or preferred activities?

This is a slightly more challenging assessment because nearly everyone has experienced a decrease in their ability to engage in preferred tasks, or are having to engage in them in different ways than we used to. You might have to say no to a large gathering, or only meet with friends outside and masked when you would prefer not to. If you find yourself isolating, or feeling unable to engage in activities even when risk could be mitigated, it might warrant a closer look. Another major component to this question is how much time is being spent on the safety precaution. For example, there’s a major difference between a quick wipe-down on the groceries, and a 5 hour sanitizing deep clean. If you find yourself spending considerable time on safety precautions that you would normally spend on leisure activities, it may be worth exploring. 

 

If you are noticing that your attempts to maintain safety are starting to become detrimental in other ways, please reach out, a trained therapist can help you find a balance between safety and anxiety that opens the door to joy and hope. 

 

For more information, go to https://iocdf.org/expert-opinions/expert-opinion-contamination/ 

 

 

Deep Breathing: Why Do It?

Deep Breathing: Why Do It?

by | Jul 27, 2021 |

If you have ever felt frustrated by being told to just "take a deep breath" when you are feeling angry or anxious, you aren't alone. It's difficult to heed this advice when, in the moment, the mind and body are distracted or dysregulated. The adage of "just breathe"...

7 Skills to Try When You Feel “Overwhelmed”

7 Skills to Try When You Feel “Overwhelmed”

by | Oct 29, 2020 | ,

Have you ever felt completely overcome by an intense emotions? Have feelings at times felt challenging to manage and overcome? The experience of being “overwhelmed” is uncomfortable and impactful in your life at work, home, or school.   Defining "Overwhelm" Emotional...

Burnout Risk: 10 Signs You’re Addicted to Working

Burnout Risk: 10 Signs You’re Addicted to Working

by | Aug 5, 2019 |

We live in a society that worships the overachiever. Burning the candle at both ends and denying yourself pleasure until the work gets done is seen as honorable. And while having a good work ethic is definitely key to living your best life, it is also important to...

5 Ways to Cope with Anxiety as a Parent

5 Ways to Cope with Anxiety as a Parent

by | Jun 2, 2019 | ,

The hard work and unpredictability that makes parenting so rewarding can also cause a great deal of anxiety. Here are some simple ways to bring yourself to a place of calm.   Make a To-Do List Ruminating on worries can cause lots of stress. Clear your mind by...

Things You Might Feel Shame For, That Are Actually Very Common!

Things You Might Feel Shame For, That Are Actually Very Common!

by | Jul 18, 2022 | General, Self Acceptance, Self Worth, Self-Esteem

As therapists, we hear from people in all walks of life. Every client is different and comes to therapy with varied experiences, but one thing remains true; most people hold shame for things they don’t need to. When we feel shame, our brains will often make us think that we’re the only one who could think or feel this way, or that only terrible people would be. Aside from being a horrifically uncomfortable emotion, intense shame is detrimental to our overall mental health, relationships, and long-term self-esteem. 

 

While this is nowhere near a comprehensive list, below is a list of things I often hear in therapy, that are entirely normal. If you’ve ever had these thoughts, you are far from alone!

 

“When ____ died, I felt relieved”

 

What shame tells you this means: I must be a terrible person to feel a positive emotion after a death. Did I wish this upon them? 

 

What it actually means: You’re a human capable of compassion fatigue, empathy for an end to suffering, potential safety benefits to yourself or others, awareness of resource strain, etc. Grief is always complex and there are typically many conflicting emotions that can include relief. 

 

“I lied/cheated/stole in my past”

What shame tells you this means: “I am a liar, cheater, criminal.”

 

What it actually means: Many people hold shame for very minor mistakes or choices from their past. Barring violent or aggressive actions, most of the time there is a reason for these choices, that once understood, lets in compassion instead of shame. 

 

 

“I _____ to cope”

 

What shame thinks this means: I can’t deal with the stress of my life. 

 

What it actually means: Substances, “nervous habits”, and impulse spending are just some of the behaviors people often feel significant shame for engaging in when they are feeling difficult emotions. If your behaviors are causing you harm or aren’t working to reduce your distress as you hoped, all that means is that they aren’t quite the right option for you. There is never shame in trying to feel better, there are only things that serve you and things that don’t. 

 

“I have intrusive thoughts about ________”

 

What shame tells you this means: “My brain is out of control, I’m disgusting/disturbed for thinking that way”

 

What it actually means: You have a normal brain, working exactly how a normal brain should. Intrusive thoughts are so common, that it’s more uncommon to be someone who hasn’t experienced an intrusive thought. To be frank, I’ve never met someone who hasn’t experienced intrusive thoughts, only people who felt strong emotion after them, and people who brushed them off and forgot about them. Having intrusive thoughts (even ones that feel totally out of character!) says nothing about who you are. If these thoughts are causing you intense distress it is certainly worth discussing with a mental health provider, but even then, there is no shame in experiencing them. 

 

 

 

4 ADHD Skills That Actually Work

4 ADHD Skills That Actually Work

by | Jul 9, 2022 | ADHD

If you have ADHD, you know that finding the right set of tools and techniques that work for you can be a process of trial and error. What works for you might be the opposite of helpful for someone else. Below you’ll find a few techniques to try that go beyond the traditional productivity tips.  

 

Body doubling:

Have you ever struggled to complete a task when you’re by yourself, but have no problem doing it once someone else is there? This is known as body doubling; completing a task in the presence of someone else. If you have a task you’ve been dreading, putting off, or half-completing, try video chatting a friend and let them know your task. You can also try body doubling online with other folks looking for the same assistance. Check out https://bodydoubling.com/!

O.H.I.O.

An acronym for “only handle it once”, this is a helpful tool for managing the clutter and organizational challenges that many people with ADHD deal with. Often, when we take something out (for example, a box of cereal), that item gets left on the counter as we move on to the next step of the task (milk, spoon, eat). When keeping O.H.I.O in mind, the idea is that the cereal box is dealt with prior to moving on to the next part of the task so you are only handling (literally and figuratively) it once vs. twice (taking it out, and then later cleaning up from the task). While this does immediately reduce clutter, the more importance aid here is in reducing yoru overall mental load. Completing the task in the moment means it’s one less thing for you to have to remember later on, and keeps your space more functional for other tasks. 

 

Labeling

Another organizational technique is the ever-classic labeling system. This might sound trite, but labeling is another tool to reduce your mental load. Neurotypical brains aren’t typically burdened by remembering which cabinet the strainer goes into, if the tape is put with the gift wrap or the office supplies, and where you put that important reminder card from the doctor. Brains with ADHD tend to forget these things and have to make an in-the-moment decision rather than an automated one. On the back end, that means we spend more time looking for things, sometimes even spending unnecessary money or time replacing things that appear to be lost. Labeling (even things that seem silly or you swear you’ll remember where they go) automates that process, saving you mental energy, time, and even money!

 

Novelty

ADHD brains love novelty, it’s one of the ways we can trigger a dopamine release. While it would be great to be able to lean on this for every task, inevitably we all have repetitive tasks. Introducing novelty is sometimes as simple as a new location (take it outside or go to a new coffee shop you’ve never been to before), listening to new music, making yourself a new drink or snack, or even just changing the lighting or ambience in your home environment. Novelty is an ever-moving target, so these new things will lose their effect at some point, but once you have the framework for what feels novel and interesting to your brain, you’ll know what to switch up to keep it engaging!

 

At Star Meadow Counseling, Alissa Loncar is our resident ADHD specialist.

 

 

 

Counseling: Hope for Those that Are Suffering

Counseling: Hope for Those that Are Suffering

by | Oct 8, 2018 |

Suffering. It’s the reason most people come to counseling. It comes in varying intensity, duration, and complication.   What’s your brand of suffering? Is it… Anxiety that’s no longer manageable? Sadness that’s stuck around too long? Grief that’s shaken you to...