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EPSTEIN QUARTERLY
Updated October, 2003
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INTRODUCTION
The numerous problems which face women with ADD have received increasing attention in
recent years. While ADD symptoms are the same in men as women, the effect of these
symptoms can be quite different - not only for the woman, but also for her family. To help
clarify the condition and its impact, this edition of the Epstein Quarterly will focus on
ADD in women.
THE SYMPTOMS
Beth is a 45 year old woman with two children. Her history indicates that she had been
called a dreamer, an underachiever, or just plain lazy since the second grade. Her family
was intact but not particularly understanding, and childhood was not happy for Beth, who
was never diagnosed with ADD. She considered herself to be stupid. High School was filled
with disorganization, procrastination and a very mediocre academic performance. She used
marijuana or alcohol to self-medicate when she felt depressed. She went to college for two
years, but it was a struggle and she left. She married at age 24, but the marriage has
always been stressful. She could never keep the house organized, had major problems with
routine activities such as bill paying, and often did not seem to be listening when her
husband spoke with her. Problems increased when her child was diagnosed with ADD plus some
oppositional behavior.
However, the diagnosis of her child became a turning point in Beth's life. As she
learned about her child's ADD she realized that she too had the condition, and sought
help.
The symptoms of ADD in adults include distractibility, a short attention span,
difficulty with organizational skills, procrastination, restlessness and impulsivity. The
symptoms in women are not different, but the impact is often distinctive. (For a
discussion of ADD in Adults please consult my web sight or previous Newsletter, Vol. 11,
#1, March 1998).
IMPACT
Following are a number of key spots in the life of the ADD woman. Though no different
from most daily challenges non-ADD women confront, the ADD escalates even the smallest
challenge into a potential problem area. I recognize that each will vary from woman to
woman depending on specific circumstances such as the age of the woman, the severity of
the ADD, the attitudes of family members, etc. Nevertheless, these are good starting
places as you begin to evaluate the impact of the ADD.
THE ADD WOMAN AS MOTHER, HOMEMAKER, AND WIFE
The Home
Let's focus on the routine tasks. Generally children have to be gotten up, dressed and
out. Then beds have to be made, laundry started, the dishwasher emptied, shopping done -
and soon the kids will be home. But before that, phone calls have to be made, and maybe
Mom needs a little while for her own activities or interests.
But ADD interferes. Distractibility combined with organizational limitations plays
havoc, and it may take the whole day to do a half day’s worth of chores. In a
disorganized home there can be piles everywhere, with important papers being hard to find.
This is not to say that things don't get done, but they take much longer than they should
and limit time for other activities.
This in turn can lead to tension with spouse or children because projects are not
getting done, and since they don't understand ADD, the family can be very critical of Mom.
The Children
It is no secret that child rearing is difficult, and often much of that task falls to
the mother. Basic ADD problems interfere, as she may not listen, may forget to buy the
necessary notebook, etc. Also, because most ADD has a genetic basis, there is a
probability that one of the children will also have the condition.
Problems change with the age and number of children, but rarely do things get easier.
Instead, they get more complex. For example, homework becomes increasingly important, and
with an ADD child it can be a daily struggle.
Since most children need guidance and help to organize such things as their time, their
book bag, or even their room, the weakest link in the ADD Mom's ability is always being
tested.
Husbands
"Without my husband's warm support and help, I don't know what I'd do."
"My husband likes everything to be highly organized and doesn't understand why I
don't cooperate."
"My husband finally learned that I need help to do things like paying bills, and
since then our marriage has been much better."
A married woman with ADD can do much better with support from her spouse. At times this
support exists without comment, but that is not always so. Mary's husband Don works in New
York and earns enough to support his family. He does not expect his wife to work, but he
is very demanding when it comes to her carrying out his chores. These include picking up
his shirts, going to the post office, etc. Her disorganization makes her unable to do
everything on her list when expected, and he often becomes quite angry. His attitude makes
her low self-esteem worse, and puts a great strain on the marriage.
While some husbands are unwilling to change their attitude and expectations, others are
willing to accept the fact that their wife has a problem which needs time, attention and
understanding. When a husband is willing to come in to learn about ADD, how it effects his
wife and, therefore how it Affects him and his family, great progress can be made.
The understanding of ADD and its impact often takes time, but it is certainly a good
investment in the present and future.
ADD WOMEN AT WORK
The working ADD woman brings all of ADD's attentional problems with her when she goes
to work. The distractibility interferes with staying focused on the task, leading to less
effective work or very lengthy hours to get the job done.
Several ADD teachers come to mind to illustrate this example. They all have energy,
enthusiasm and creativity. They also have a tendency toward disorganization and
distractibility. They compensate while at work, but many hours go into preparation because
of the need to come to class being highly organized and because staying focused while
preparing is not easy.
I also work with several women who own their own business. Being self-employed is
positive in that you can work out a system that works for you and avoid criticism or
review by others. At the same time all the systems, the structure of the workplace and the
activity itself depend on a person with ADD.
Here's an example of the difference between working for someone or having your own
business. Take the highly artistic person who designs and makes jewelry with beads. She
uses glass beads, pottery beads, old and new crystal and all kinds of little pieces to
enrich the beads. For several years she worked part-time, asked the store owner to order
the supplies she needed, and created pieces that were in great demand. Having developed a
following, she decided to have her own business, and to run it out of her home.
Suddenly, the problems with distractibility, disorganization and procrastination became
major. If you don't remember to order, you can't make the jewelry; if you don't pay the
bills on time, the suppliers cut you off; and if you don't keep good records, tax time
becomes a nightmare. Clearly, ADD requires the entrepreneur to do additional planning to
ensure successful results.
How can this be accomplished? Some have the help of an administrative assistant to deal
with the details of the operation. Many use medication in varying ways to make them able
to function more effectively. It is not easy, but the outcome can certainly be successful.
It is very important for the ADD woman at work to evaluate her job situation. Some jobs
are good, but others are just not right. Recently diagnosed women may find that they have
been struggling at work for years because the job was not a successful fit for someone
with ADD. Therefore, if you have a job or are considering returning to work, be sure you
understand the impact of your ADD on the job requirements.
EMOTIONAL COSTS
The adult woman with ADD was probably diagnosed after the age of 25, and perhaps as
late as 50. This means that it is quiet likely that she carries a good deal of
"emotional baggage" because of early negative experiences. If you think of Beth,
whom I mentioned earlier, you can easily see how damaging undiagnosed ADD can be. The
negative remarks begin in grade school. Academic performance never correlates with
intelligence or ability. Over a period of years a feeling of failure grows. Many women do
not finish college, and consider this a failure, a badge of shame. This leads to poor
self-esteem, with feelings of inadequacy. With these feelings it is hard to feel
optimistic about themselves or their world. From this depression can follow, either mild
or more severe.
I don't mean to suggest that ADD always has negative emotional consequences. However,
when thinking through the effects of ADD, the emotional impact, past and present, must be
included.
COURSES OF ACTION
If you think you might have ADD, I suggest you read "Driven to Distraction"
by Hallowell and Ratey to become more informed about Attention Deficit Disorder. Of
course, many ADD adults do not read because of distractibility, so this is not a starting
point for everyone. For them I would suggest reading some shorter descriptions.
Next, it is important to schedule an evaluation to properly diagnose the condition. It
is important to have this done by someone experienced in the diagnosis and treatment of
ADD. It is not enough to go and get medication from a physician who can write a
prescription, but who does not have experience with ADD in adults. This is because there
are many aspects to the problem that need to be understood that go beyond the medication.
Beyond the physician, there are people who can help teach organizational methods, as
well as coaches who meet regularly to evaluate and help handle the ADD. There are
published day planners and organizers to learn how to use, including new and possibly
valuable electronic ones.
Guidance, education and medication, offer the best approach to developing methods to
make life reasonably normal and very successful.
CONCLUSION
At work or at home, each situation faced daily by the ADD woman will vary depending on
her specific circumstances such as age, marital status and whether there are children,
perhaps some of whom have ADD as well. A working ADD woman has additional stresses. But in
my experience, I've found most ADD women to be creative, energetic and motivated, and they
do very well with appropriate guidance and treatment.
READING LIST:
Women With Attention Deficit Disorder by Sari Solden, MS
Out of the Fog - Treatment Options and Coping Strategies by Kevin Murphy, Ph.D.
ADD on the Job by Lynn Weiss, Ph.D.
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