Last week, a CDC report revealed that between 2003 and 2015, prescriptions for drugs to treat ADHD among American women aged 30 to 34 increased 560 percent. For women aged 25 to 29, they increased a whopping 700 percent. The most common prescriptions, according to the report, were Adderall, Vyvanse, and Ritalin, and prescription rates in Southern and Western states rose most dramatically.
As diagnoses of ADHD have risen among children, experts are divided on whether medical professionals are doling out the label (and subsequent stimulant prescriptions) too leniently. With the CDC’s report, this controversy is now shining its light on adult women.
For years, the stereotypical ADHD patient has been a white boy with hyperactivity — and the research reflects that bias. As of 2016, just one percent of ADHD research focused exclusively on girls. That research shows that ADHD presents itself much differently in girls than in boys, that symptoms can worsen for girls when they go through puberty (rather than lessen as they can in boys), and that girls often work harder to hide and manage their condition than boys do. For these and other reasons, ADHD often goes overlooked until adulthood. A Quartz report even called these women “a lost generation.”
And some women develop ADHD as adults without ever experiencing symptoms as children, in what’s known as “late-onset ADHD.” The research is extremely limited so far, but studies have shown that those with late-onset ADHD are mostly women. It’s still not clear whether late-onset ADHD is an entirely separate disorder than childhood ADHD, or if it’s the same disorder that was overlooked in childhood.
What is clear is that ADHD is a complex diagnosis, made even more complicated when the patient is a woman. We talked to ten of those women — some diagnosed in childhood and some in adulthood —about their symptoms, medication, coping mechanisms, and more.
“There’s this carnival ride called the Mind Scrambler that spins the seats past each other, gradually gaining speed while slinging you out to one corner and then another, over and over again. ADHD kind of feels like that — not in the fun way, but in the way that all you can really do is hold on and hope that it slows down. I think most people have days where they feel disorganized or have trouble prioritizing or focusing, but it’s pretty exhausting to feel this way every day.
I’ve had this diagnosis for a couple of years now and I still get hung up on the ‘disorder’ bit — how can I have a learning disorder if I love learning so much, and don’t I have enough to contend with already? But having ADHD doesn’t mean you’re not smart or thoughtful or capable; it isn’t a matter of being broken or having something wrong with you. It’s just another way of being.”
“I think people perceive us as selfish or narcissistic. We really just feel inspired by a lot. I’m aware of so much that seems interesting and it’s really hard to cut anything off. I sincerely want to do 100 things at the same time, feel devastated when I can’t, but try anyhow. Everything seems so interesting and important.
When I was younger, [my ADHD] was written off as behavioral problems. I grew up in the ’80s in the South. I couldn’t sit in my seat, always interrupted teachers, and was constantly bored. It was a relief, honestly, to have a prescription that would help me do basic functions and focus so I wouldn’t get kicked out of school. I still take Adderall for deadlines and high-priority projects involving many people, but not daily.”
“The biggest challenge for me is coping with the everyday challenges of being an adult. I have bills that I forget to pay. I have forgotten to go to work as my schedule changes a lot. I constantly forget plans I make with friends. I forget to put things in my calendar. I lose my keys. I lost my passport. I lost my bag with my wallet and driver’s license. I constantly lose track of time. I forget to take showers. Often I’ll walk out of coffee shops without my bag. I will walk to the subway and then have to walk back home because I forgot my wallet. I have to triple-check constantly that I have all my things. I’m very behind on important paperwork and feel deeply overwhelmed by the practical aspects of life.
On the flip side, I’m a painter. I have magnetic focus on my art and I can work all day and night. I daydream, a lot. I feel like this aspect of ADHD has given me such a deep, dreamy world inside [my brain] and a rich imagination.”
“You have to use coping mechanisms in addition to medication, otherwise you’re playing yourself. One of the craziest things I learned about myself through my ADHD test results was that I have incredible difficulty with prioritization — I never even thought that was a symptom. Sometimes, even when I’m on Adderall, I have to literally talk to myself and say, ‘Is this the most important thing I should be doing right now?’ If it isn’t, I tell myself that I have to stop and go do that other, more important thing.
I would describe it as your brain having a secret life. It’s off doing its own thing but is still very much in your body, so you’re dragged around with it while it binge-watches The Office again instead of studying for that big test you have tomorrow. It all seems very innocuous until you’re failing classes and stumbling at work and you’re like, ‘How did this even happen?’”
“I don’t take medication anymore and I manage my symptoms with caffeine instead. I rely on Google Calendar notifications and Google Assistant reminders to manage day-to-day tasks. I’ve been relying on digital reminders in one form or another since I got my first Palm Pilot in college. Over the years, I’ve learned that I work best late at night, so instead of fighting that, I’ve figured out ways to work my schedule around it.
ADHD doesn’t necessarily mean bouncing off the walls. I never was particularly hyper as a kid, which is why it wasn’t diagnosed until after college. It can also manifest as the quiet kid whose head is in the clouds and who can read for hours, completely oblivious to everything going on around them. My mom would ask me to do chores while I was reading. I’d respond and say I would, and several hours later it still wouldn’t be done. I wouldn’t even be aware that I had been asked to do something (and had responded).”
“I can’t explain how emotional the diagnosis was. I went through my entire life, not graduating college when I was supposed to, not understanding why I was interested in certain subjects or events, while at the same time, not being able to finish them in the correct timing. I had zero intuition that [ADHD] was my issue, and my psychiatrist completely blew my mind when she diagnosed me after testing. I went through high school and college being extremely behind even when I was trying my hardest.
It’s extremely frustrating to know that I went through life with this disorder when I could have possibly succeeded instead of failing. Now I’m on medication and understand my setback, and I’m thriving at my job. I’ve gotten multiple promotions and I’m living out my real potential.”
“Initially, I was very secretive about my diagnosis. I had mixed feelings about it (which continue), but back then I saw it as a personal failing, and I was concerned about the stigma. I knew that ADHD wasn’t in my control and wasn’t my fault, but I felt like it was a personal failure. I had always compensated in school and professionally, and I was doing okay, but it wasn’t enough. I wasn’t what I could be — and that had always been the case for me.
My teachers in elementary school always told my parents that I was so bright, but I wasn’t reaching my potential. I was in gifted classes, but couldn’t manage turning in work on time or locating work that I had done and misplaced. My brother, who is three years younger than I am, was diagnosed early in elementary school, but no one suggested it to me until my late 20s. My brother was very active and failing in school; I was quiet and making decent grades even though I wasn’t working to my potential.”
“I was pretty resistant to trying medication because addiction runs in my family. I didn’t like how the first two medications I tried made me feel. The third medication I tried was Adderall and I was afraid of it; I only took a quarter of the prescribed dose and then put the bottle aside. When my nurse-practitioner friend visited and I updated her she said, gently but firmly, “Why not try the medication, as prescribed, for at least two weeks?”
The first time I took the prescribed dose, a skylight opened in my brain and a filing system began to establish itself. Every single thing got better and better. For years at the same dose, it made every facet of my life more manageable. And when I took breaks from the drug, I noticed I was able to focus on work for many more hours than ever previously. I felt like I was able to build new focus habits in a way I hadn’t been able to before.”
“My energy is the best and worst thing in the world. I’m a medium-sized hurricane, and that can be amazing when that power is directed in a positive way. If I can get myself going I’m pretty unstoppable. I have a dear friend who once told me I’m the most ‘unfuckwithable woman’ she’d ever met. But in relationships, all that energy and boredom and lashing out when I’m not engaged is a pretty tragic flaw. I do poorly in relationships — I get bored or I want to hold on too tight. A boyfriend once broke up with me using the analogy, ‘Plants die when they get too much water, just as quickly as when they don’t get enough.’ I just don’t know how to balance.
I interrupt people a lot. I always have. I hate it about myself, but I can’t not spit out my thoughts. I don’t mean to be bossy or pushy or any of those words we use to describe powerful women. I think hyperactive women are seen as needing attention, and people say nasty things about women who need attention. But I don’t need attention — I just can’t pay attention!”
“As a child I was a ‘nerd,’ but I always had to study a lot harder than my peers. Throughout school, I had reading comprehension problems as well. Others can read a page in a textbook or a chapter in a book and immediately answer questions; not me — I might have to read it three or four times, being mindful that I’m not drifting off because then I’ll have to go back and start over. When I studied, I would have to read a chapter, read it again to highlight the important points, then read the highlighted portions so I could take notes on them, then highlight my notes, then read the highlighted sections from my notes. Towards the end of middle school and throughout high school, I had to lock myself in the bathroom so that I could have complete quiet and no distractions. I would spend hours reading and studying in there.
As a mental-health professional today, I recognize that because I was smart and got excellent grades, ADHD wasn’t ever considered. I don’t think anyone even thought there was a problem, and I just assumed this is how things were for me. I made it through graduate school using the same techniques I did all my life. But receiving this diagnosis was a game changer.”
Interviews have been edited for clarity and length.