Sarah, age 33, an editor working for a food magazine in Massachusetts, has difficulty making friends because of her “flighty” and overly emotional behavior. She is disorganized and distracted, and it’s hard to have a conversation with her because she can’t focus on anyone but herself. She is smart and talented, but her work life suffers and she’s been passed up for several promotions because her boss says she’s can’t count on her to follow through on assigned projects.
Carol, age 45, is an accountant working at a large corporation who constantly feels frazzled and pulled in multiple directions. She, too, has had trouble getting promotions, and feels frustrated by her inability to grasp what she needs to do at work to get ahead. Add to that her home life, which is overwhelming: She never seems to be able to finish any of her household tasks, the house is a mess, her husband doesn’t help out much and the kids get on her nerves. In short, she feels like a failure.
Sarah and Carol are adult women with attention deficit hyperactivity disorder (ADHD), an under-recognized and under-treated syndrome that can significantly—and negatively—impact a woman’s life.
Challenging Old Assumptions
Typically, ADHD is thought to be a condition that affects children, and boys more often than girls, at that. But as it turns out, ADHS is neither a “child thing,” nor a “boy thing.” Girls and adult women get ADHD, too, and the numbers seem to be on the rise, reports James Greenblatt, MD, a psychiatrist and pioneer in the field of integrative medicine, and author of the new book Finally Focused: The Breakthrough Natural Treatment Plan for ADHD That Restores Attention, Minimizes Hyperactivity, and Helps Eliminate Drug Side Effects (Harmony Books, 2017; http://www.finallyfocused.com). “Currently, we believe that around 8 million adult women in America suffer from adult ADHD, and only 1 in 5 of them are receiving treatment. Most women with ADHD are undiagnosed and untreated or inappropriately treated. They are suffering in silence, wondering what is wrong with them and why they can’t cope with life,” he says.
Although research is sparse on the topic of ADHD and women, most women have probably had ADHD since childhood, but their symptoms weren’t recognized. “The typical ADHD symptoms are considered to be hyperactive and impulsive behavior and an inability to focus,” says Dr. Greenblatt. “But those symptoms are more commonly seen in boys than girls.” It’s now recognized that there are different subtypes of ADHD, and that girls tend to have more of an “inattentive” set of symptoms—they have trouble paying attention, are forgetful, easily bored, make careless mistakes and have trouble following through. They also daydream a lot and can’t get themselves organized. This more subtle pattern of behaviors is easily overlooked. In addition, girls can become adept at hiding their symptoms, which is why three times as many boys are diagnosed with ADHD as girls.
In adulthood, many women and their doctors may dismiss these same ADHD symptoms as being caused by hormonal fluctuations (PMS, perimenopause, etc.), iron deficiency, stress or other mental disorders, but the diagnosis gap does narrow a bit to about 2 men to every 1 woman receiving an ADHD diagnosis.
“Although the way an individual experiences ADHD may vary over time, and the symptoms may change slightly, ADHD remains essentially the same disorder from childhood to adulthood,” says Dr. Greenblatt. Women with ADHD routinely experience difficulties in their personal and professional lives and aren’t as successful in school as adults without ADHD. They are also more likely to develop mental health disorders: A University of Toronto study published in the medical journal Child: Care, Health and Development in July 2016 found that 36% of women with ADHD have generalized anxiety disorder, 31% have major depression, and 39% have substance abuse problems—much higher rates than seen in women without ADHD. In addition, 46% of women with ADHD in this study said they had considered suicide; it was also found that women with ADHD had more issues with chronic and disabling pain and insomnia, and were more likely to be smokers.
Treatments Can Turn ADHD Around
Medications such as the stimulants Ritalin and Adderall and certain types of antidepressants such as Wellbutrin have been used with great success for many years to treat ADHD in children and adults, and no significant differences have been noted in terms of the effectiveness of these drugs in women versus men, according to Dr. Greenblatt. However, as with all medications, there are some limitations: For one thing, he says, some people can’t tolerate these drugs, either because of negative side effects or life circumstances (such as pregnancy). The drugs also don’t address the emotional difficulties related to ADHD, and they can’t ‘fix’ deeply-rooted psychological issues related to social deficits. A woman with ADHD who has trouble making or keeping friendships, communicating with her peers or monitoring her own behavior may need more than just a prescription.
“In my 30 years of clinical experience, I’ve found the treatment that usually works best for ADHD is integrative treatment,” says Dr. Greenblatt, “which looks for and detects underlying biochemical imbalances that drive the disorder.” Integrative treatment, he adds, addresses those imbalances using natural treatments first and medications only when necessary. “And if medications are used, natural treatments can provide protection or relief from medication side effects,” he adds. Dr. Greenblatt’s success with natural treatments has spurred him to write his book Finally Focused, which details the full range of treatments that can help children and adults with ADHD and how to use them effectively and safely.
One of the best natural treatments for adult ADHD—and often the only treatment that’s needed—are plant extracts called oligomeric proanthocyanidins or OPCs, he says. “Over the decades, I have prescribed OPCs to many adults with ADHD, and I have seen the supplements dramatically normalize brain waves and improve focus.” He adds, “In my experience, the best supplements combine OPCs, such as CurcumaSorb Mind, from Pure Encapsulations, which contains pine bark extract, green tea extract, blueberry extract and grape extract. Or try OPC-3 from Isotonix, which is the supplement I used in some the informal studies on OPCs that I conducted in my office several decades ago.”
Other supplements that can be helpful include magnesium, fish oil (omega-3s) and rhodiolia, he reports, along with lifestyle strategies such as getting appropriate amounts of sleep, exercising regularly, eating a healthy diet and practicing stress-reduction techniques such as meditation and mindfulness. Psychotherapy and other forms of counseling have also been found to help adults with ADHD cope and improve their lives.
“I treat many adults with ADHD, and I let every one of them known that they have a medical disorder—and that seeking and getting treatment for ADHD is the same as seeking and getting treatment for high blood pressure or diabetes. It’s sensible,” Dr. Greenblatt says. And even more sensible may be seeking integrative care for the disorder, taking advantage of the best that both traditional and natural medicine have to offer.