Hyperactive Prescribing? Ctd

A reader writes:

Every time I read an article about over-diagnosis of ADHD, I do a quick scan to see if it mentions girls or women. The Esquire piece mentions the word “girls” exactly twice, but only in the context of little boys, and it has a quote, from a man, about how the “girlification” of the classroom has pathologized boyhood.

I think girls and women, whose symptoms are generally less obvious and less disruptive, are under-diagnosed. I was in gifted-and-talented programs, so no one thought to screen me. I didn’t know until I was 25 that there was actually a reason for my chronic disorganization and not just needing to “try harder.” My sixth grade teacher wrote in my yearbook, “I’ve never met anyone who was so disorganized yet so together.”

Sure, I could go into a three-hour standardized test and score in the 99th percentile. The bigger challenge was not losing my registration forms or photo ID. Once I graduated from college and had full-time jobs, the administrative tasks overwhelmed me to the point that I feared for my employment – until, hallelujah, I was diagnosed and treated for ADHD. On a related subject, I also learned that women are expected to be able to perform administrative tasks even if it’s not their role, while no one expects it to come naturally for men.

Adderall, and much more importantly, the diagnosis of ADHD, changed my life. The excessive focus on the over-diagnosis of ADHD in boys trivializes a problem that can really stunt the life prospects of both girls and adults, and it deepens a harmful stigma that we’ve done nothing to earn.

Indeed, the CDC has found that boys are nearly three times as likely to be diagnosed with ADHD. Psychiatrist David Muzina calls this a classic pattern:

It’s been known for a long, long time that if girls have ADHD they are more likely to have the inattention form, not the hyperactive, aggressive, disruptive form. Perhaps that difference in how ADHD can look is why the diagnosis is missed in girls. They may be quietly suffering and having trouble in school, but they’re not disruptive. They move on into life, where those inattentive symptoms may reveal themselves as academic and social pressures compound. Now it’s becoming more of an issue.

And lastly, we know that women in the United States are increasingly juggling more and more and more. Women still tend to have the majority of the responsibilities at home, particularly when families start up. That elevation of pressure and stress can either produce symptoms like ADHD, or that additional stress can express the underlying ADHD that previously had not been diagnosed.

One female reader’s experience:

I have found ADHD is a misnomer. When I decide to focus, I focus like a laser, be it whatever work I am doing, or subject that intrigues me. But then I cannot focus on much of anything else, just the one thing at hand. For years prior to my diagnosis, my work involved doing a lot of things, all at the same time, with a deadline – media work. I excelled, but burned out more often than my co workers. I was quite good at multitasking, but always felt fractured.