When It's Not Just Anxiety or Depression: The Surprising Prevalence of ADHD in Moms
Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, but boys are more than twice as likely to be diagnosed than girls. And that's not because boys are more susceptible. Instead, their symptoms tend to be hyperactive-impulsive, making them more noticeable. On the other hand, girls may present with inattentiveness and cause no notable disturbances in their surroundings, leaving their condition overlooked.
Here's the problem: these girls often go into adulthood untreated. By that time, their ability to cope becomes harder, their ADHD symptoms are far greater, and the condition affects various aspects of their lives. And the issues only escalate when these women decide to become parents. But diagnosing and treating the condition, which affects more than 4 percent of U.S. adults, can be lifesaving.
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How Untreated ADHD Affects Adulthood
Marilou Jimenez, M.D., the chair of the Addiction and Mental Health Center at MedStar Montgomery Medical Center in Olney, Maryland, says majority of women do not outgrow the ADHD symptoms they had as girls. As adults, they may suffer from poor self-image, have a hard time with social obligations and relationships (studies show people with ADHD have twice the divorce rate compared to the general population), and an inability to organize and complete tasks in a timely manner. They are also at risk for underachieving and being less successful than their peers.
"Sometimes they are scattered with things in life," says Baltimore-based licensed clinical professional counselor Hope Gilchrist, who has patients with ADHD. "Some may have had multiple jobs or career changes due to boredom or due to too many moving parts in the job."
Many of those affected also have at least one comorbid condition, such as depression, anxiety, bipolar disorder, conduct disorder, tics, learning disorders, and substance abuse, according to David W. Goodman, M.D., an assistant professor in psychiatry and behavioral sciences at the Johns Hopkins School of Medicine. A study of adult ADHD in the United States found a significantly higher proportion of females than males with ADHD receive treatment for mental or substance abuse problems. But only about 12 percent of adult women with ADHD actually get treatment for the condition.
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How Untreated ADHD Affects Parenting
Women with untreated ADHD can find themselves struggling with parenting. "Some moms may be a little more stressed when trying to deal with the structure that may come along with mothering, depending on the age of the kids. Some who have a better handle on it may keep notes, put reminders in calendars, but at times still find it overwhelming to try to keep things managed," says Gilchrist. "They may also struggle with feeling like they are all over the place, and then are down on themselves for maybe not feeling adequate as a mom."
These women also tend to have reactive or short-fused emotions. In turn, their frustration tolerance is lower, leading to impatience and outbursts with their children. "Women may have to function in the workplace and at home with kids. These responsibilities require different skill sets along with frustration tolerance to stay on task without outbursts or abandoning the task," says Dr. Goodman.
Added stressors can also make things worse. Stay-at-home orders during the coronavirus pandemic, for example, challenge the ADHD-riddled working mom, especially as they're expected to homeschool children. According to Dr. Goodman, disorganization diminishes their ability to help with schoolwork or even teach their child organization skills. Also, distractibility leads to poor task completion and unreliability; poor time management leads to chronic tardiness and can provoke anxiety in the child.
COVID-19 is also not helping the comorbid relationship between ADHD and alcohol and substance abuse, adds Dr. Goodman. "The current isolation has exhausted ADHD women, some of whom may drink more to get through the day," says Dr. Goodman. "Ultimately, these drugs only worsen the woman's daily functioning leading to a downward spiral."
Gilchrist has also seen women using wine or alcohol to cope with the scattering they feel or the amount of work it takes to stay focused and get tasks completed.
Cannabis is also used as a coping tool, typically to relax and destress. On Instagram alone, a quick search led to nearly 20,000 posts associated with a #420mom hashtag or variation thereof. Dr. Jimenez believes the use of cannabis to cope is a sensitive and personal issue for which women should seek direct consultation, but advises against using it to manage depression, anxiety, or other behavioral challenges. "Women with ADHD," she says, "can further the vicious cycle as co-morbid conditions cause their attention dysregulation to worsen."
How to Seek Treatment for Adult ADHD
It's not uncommon for mothers to learn they've been living with ADHD after their child begins to have concentration issues and are then diagnosed with the condition by a professional. "Once the parent addresses the diagnosis with their child, the mother often then realizes that they have been living with the same symptoms their whole lives, too," says Dr. Jimenez, whose research also found ADHD runs in families.
But it's important to get treatment as early as possible. Dr. Goodman encourages women—especially mothers—to educate themselves about ADHD. "If a woman is struggling with focusing, restlessness, disorganization, or other similar issues, they should consult a professional to seek a diagnosis and discuss care options. Treating the root issue is critical," says Dr. Jimenez.
Other symptoms to look out for include deflated self-esteem and mood difficulties, drug and/or alcohol abuse because of poor impulse control and/or in their search for social acceptance, and excessive anxiety from growing responsibilities as they pursue higher education, marriage, motherhood, or career. There are resources available to learn more about ADHD, such as the Children and Adults with ADHD Association.
Treatment usually consists of medication with or without stimulants in an effort to reduce distractibility, strengthen the working memory, and enhance organizational ability, among other things. Dr. Jimenez adds if the woman is still in school, obtaining academic accommodation is beneficial. If they have the mood and anxiety sequelae, individual therapy and/or psychotropic medications is encouraged.
But bottom line: treatment can be life-altering. "[Patients] speak of regret for not seeking help sooner, at times blaming their parents for not getting them help earlier in life," says Dr. Jimenez. "They feel they are in control of their lives for the first time."