It wasn’t until attorney Claudia Hinsch had to juggle the activities of three children while up for partner at a prominent Washington, D.C.-area law firm that everything fell apart. “I forgot to bring a kid home, I would lose my keys, and it was really hard for me to focus at work,” she recalls.
Technology not only wasn’t helping; it was making things worse. “The way it had advanced made it really difficult for me. With the constant emails and texts and phone calls, everything was getting so jumbled,” she says. “I spent so much time maintaining my lists and calendar, I was getting nothing done.”
She knew something was going on, and she wondered if it might be Attention Deficit Hyperactivity Disorder, better known as ADHD. Her three kids had been diagnosed with ADHD in grade school. Plus, a younger sister had a learning disability as a child, so Hinsch was no stranger to such difficulties — just surprised to find that she was struggling, too.
After consulting with the psychiatrist who treated her children’s ADHD, she decided to get evaluated. Adults are typically diagnosed through self-reported behaviors, using diagnostic rating scales. Sure enough, she met the criteria, and at age 40, discovered she had ADHD, too.
Since her diagnosis, Hinsch, who’s now a partner at her firm, has developed several strategies for managing her ADHD — including taking Vyvanse, a slow-release ADHD medication. She also exercises — a lot. She says it helps her ADHD: “I do some of my best thinking when I’m out on a run.”
Hinsch is in the minority of women with ADHD. She was diagnosed and has learned how to manage the disorder. Many other women remain undiagnosed and struggle without understanding why, says Ann Arbor psychotherapist Sari Solden, who co-wrote A Radical Guide for Women With ADHD (New Harbinger Publications Inc.) with psychologist Michelle Frank. The book hit bookstores last July.
Meet the Authors
Sari Solden maintains a private practice in Ann Arbor, where she and her associates specialize in psychotherapy and consultant services for women and men with ADHD. Find her at sarisolden.com.
Former Ann Arbor psychologist Michelle Frank lives in Denver, where she works with adolescents and adults with ADHD, and collaborates with Solden on projects that focus on women and ADHD.
“Even though most women work outside the home, they still idealize and internalize gender role expectations,” says Solden, who, in 1995, wrote one of the first books on women and ADHD, Women With Attention Deficit Disorder: Embrace Your Differences and Transform Your Life (Introspect Press). For instance, moms still feel pressure to manage the nuts and bolts of family life, which is daunting to women whose planning and organizing skills are compromised by ADHD.
“It’s like an orchestra, where all the musicians are fine, but the conductor is erratic,” Solden says, citing an analogy used by ADHD expert Dr. Thomas E. Brown. “Your individual talents and abilities could be fine, but your brain has difficulties pulling it all together — prioritizing, synthesizing, getting started, staying with something, regulating your emotions, remembering, categorizing. If you’re in the wrong situation, you will be very overwhelmed.”
Women whose ADHD was missed in childhood often feel shame and embarrassment for their failures — whether it was failure to plan an event, follow through on a project, or manage their emotions. By the time they’re adults, many have built up a reservoir of negative self-talk, wondering why they can’t be like other women, to whom organizing and planning come more easily. They may even end up in therapy, diagnosed with anxiety and depression, when the real cause is undiagnosed ADHD.
Solden has spent more than 20 years trying to get the word out about women and ADHD through her Ann Arbor practice, and through conferences, presentations, and collaborations with other ADHD professionals. Among these pros are Frank and Birmingham psychotherapist Terry Matlen, who was diagnosed with ADHD in her 40s and has consulted with Solden since the mid-’90s.
People from all over the world contact Solden looking for help finding local professionals who specialize in women and ADHD. But they are few and far between. “There are probably five people in the world who specialize clinically in working with women who have ADHD,” Solden says. (Until Frank moved to Denver last March, metro Detroit boasted three of them.) Solden and Frank wrote their book, in part, as a response to that unmet need.
“Even though most women work outside the home, they still idealize and internalize gender role expectations.”
“It’s being used in groups, with therapists, with partners … and in online support groups, book clubs, and even at parties as a way to break that isolation and work through the exercises in the book together,” Solden says.
Solden’s approach to helping women with ADHD focuses less on overcoming it than accepting it. When experts focus on strategies, tips, and tools for the brain, that merely feeds into a woman’s desire to change herself, Solden says. “Rather, a woman who has ADHD can learn to be herself instead of trying to fix herself,” she says. “Instead of saying, ‘Yes, but,’ we help them say, ‘I’m good at this, and I need help with that,’ or, ‘I am competent, and I have difficulty organizing.’ You are all of who you are. But it takes a long time for them to see themselves clearly.”
Attention to the specific needs of women with ADHD has lagged behind other areas of ADHD care, Frank says, in part because the disorder was long underrecognized in girls.
“Most of what we knew about ADHD was through white, hyperactive school-aged boys. Only in the last 20 years have we expanded the dialog to include women,” Frank says. While fidgety behavior in boys — who generally have the hyperactive type of ADHD — is fairly easy to detect, the inattentive type of ADHD more frequently seen in girls is not.
For the girls “who are smarter or have structure growing up, they won’t hit a wall until they to go college, get married, or have children,” Solden says. “At some point, they aren’t able to keep up with the demands of their education or IQ,” or they work hard to stay organized in key areas at the expense of everything else.
That’s just what happened to Hinsch. “Once I was a senior associate and I had kids, there weren’t enough hours in the day to do what I did in law school … because it was too labor-intensive,” she says. “In law school, I wasn’t married, I didn’t have kids, and I worked part-time for a judge. I didn’t do anything else, so I had time to work on outlines and organize everything. When I got to a point in my life when the work was so much, and time and resources were more limited, I really struggled.”
Frank also struggled — but her difficulties started in childhood. “We all thought I was depressed, sensitive, and spacey,” Frank says. “ADHD had been tossed around in my family as something I might have traits of, but my brother had ADHD and he was very hyperactive. Since I wasn’t like him, it was very confusing to everybody, because at the time, we didn’t realize how it presented differently in girls.” Not that girls can’t have hyperactive ADHD — they do — just not as often.
While Frank was always disorganized, she “sort of pulled it together” after unraveling in college a few times. It wasn’t until she pursued a doctorate in psychology at the Chicago School of Professional Psychology that something had to change. “I was having a hard time with self-regulation and doing the work in an organized, timely fashion,” she says.
She finally saw a doctor who diagnosed ADHD. “So I started to do a deeper dive, realizing how it impacted me at home, in my relationships, with my emotions, how I talked, how I connected, how I ate, really seeing the breadth and depth of it.”
Frank, Solden, and psychotherapist Matlen are all advocates of using prescription meds to manage ADHD, as Hinsch does. Research shows they are the most effective treatment, though they should be used in combination with other tools, such as counseling, coaching, or professional organizing services, Matlen says.
“But not all people can take stimulants on an ongoing basis. If they can’t, we now have research that shows exercise is extremely effective in managing ADHD symptoms,” though the benefits don’t last as long — three to four hours as opposed to eight to 10 for a slow-release medication, Matlen says. Though there’s a stigma around medication, “this is how many people with ADHD get through the day.”
Hinsch — who uses meds and exercise, and religiously makes use of a digital calendar, and who has a supportive husband and work colleagues — seems to have escaped the self-defeating behaviors of so many women who aren’t diagnosed until adulthood. Maybe having ADHD children helped her see the disorder as a difference rather than a flaw. “To me, it’s no different than when you need glasses for your eyesight,” she says. “It’s the same thing for your brain. It’s just part of your body, like anything else.”
That’s precisely the outlook Solden and Frank hope they can help other women gain as well.