Joanne Steer - Understanding ADHD in Girls and Women

Understanding
ADHD in Girls
and Women

Edited by JOANNE STEER

Foreword by Andrea Bilbow OBE

ANDREA BILBOW OBE

I have been waiting for this book for a very, very long time; and yes, its personal. It is a book which tells the story of my life and of the lives of so many brilliant and talented women. And it is a book like no other in its ability to take you, the reader, on a journey of discovery. The pages not only reveal individual experiences but, taken as a whole, weave together a rich and colourful tapestry of knowledge illustrating what it is, as a woman, young lady or girl, to live with ADHD.

It has long been accepted that the prevalence rate in boys and girls is in a ratio of 4:1 But we now know this is not the case. The diagnostic tools for assessment in children have a very strong male bias. Experience tells us that many more women are being diagnosed mainly through self-awareness and self-referral. So many teenage girls have been suffering in silence as their ADHD goes unrecognized, often misdiagnosed as conduct disorder, hormonal changes, mood disorders or depression. These late and incomplete diagnoses lead to missed opportunities for education and employment, broken relationships and unwanted teen pregnancies. It is just so unfair. There is so much hidden, untapped talent amongst these women who consider themselves to be a failure, a failure as a wife and mother or simply just as a woman.

Because this is my story too. My ADHD has been a loyal friend and mortal enemy, and I am both humbled and honoured to have been invited to write this foreword. As someone who has travelled the same path, I relate so well to the many women and girls who are still struggling. I have stumbled often and been knocked back by the same challenges faced by other women speaking here. The feelings of inadequacy, of worthlessness, of having aspirations and dreams that could not be realized. Like so many others after me, I saw only through the diagnosis of my children that this is what had been at the root of all my childhood problems. I grew up in a warm and loving, secure family but felt different and apart from my peers. Receiving my diagnosis in my early 30s, I can honestly say it has been so empowering. When you know what is wrong, you know how to fix it. When you know your limitations, you know where to stop or redirect yourself. I had to put aside the education I craved, but that strong feeling of injustice and passion to impart knowledge that so many of us have took over. I found my mission. It was intense. And I too have finally become fearless and confident in my dedication to fighting for others.

This is an urgent book about learning and understanding, a book covering new ground, shedding a bright light on a condition which has been misunderstood in women for far too long. It offers a factual look at the route to assessment and diagnosis as well as offering a treasure trove of tips and ideas for anyone working with ADHD. It is original in its view of ADHD and women from several different perspectives. The chapters stand alone and offer a chance to dip in and take away a particular piece of knowledge. What does it mean to have ADHD in school? How do I get an assessment? Why do I struggle with friends? When read together, the chapters present a journey from experience and assessment through to diagnosis and treatment.

The reality of living with ADHD presents mighty organisational challenges and distractions, and this is voiced beautifully by the girls and women themselves throughout the book. Rather like living life on a board of Snakes and Ladders, daily life with ADHD can be an emotionally challenging matter. Severe premenstrual tension can lead to actions in the short term which can destroy relationships long term. Feelings of failure run deep. These voices are important, they are urgent. What they have to say really matters.

The chapters ahead offer readers, for the first time in the UK, a comprehensive map of the people, places and experiences girls and women will encounter on their own journey to diagnosis. There is no one size fits all presentation of being a girl with ADHD; described as the condition where the only consistency is inconsistency, it makes accurate assessments critical.

Many will discover this only in their teens, and some, like myself, when they are women. The joy of this book is that it will speak to many other women who have always wondered if, perhaps, they too might have the condition and perhaps feel more reassured to seek a diagnosis. It provides you with the right information about where to go and what you can expect.

Written by professionals who have worked with girls, teens and women with ADHD over many years, the book offers the reader a sympathetic, honest and clear insight into what it really means to have ADHD.

Think on this shy little girl, who climbed under the table with embarrassment as her friends sang happy birthday to her, who hid behind her mothers skirts when meeting new people. A girl who struggled every day at school and underperformed despite her obvious intelligence. A teenager with awkward friendships and low self-esteem, how did she end up running a national charity for 25 years, sit at the head of a European ADHD organisation as President for six years and lecture internationally to large audiences without so much as a single butterfly in the stomach?

Getting my diagnosis changed everything and the key is education. The education I lost is not the education that would have allowed me to be the person I am today. I went on a different path. When I work with parents and adults with ADHD, I make it very clear: you are the one who will make the difference in your life and your childs life. Become the expert in ADHD. Take ownership of it. Read everything you can. Go to conferences, join support groups. Educate yourself. You can never know enough. After 25 years of learning I know there is still more to learn. This knowledge will be your superpower. It will give you confidence and it will give you courage to be the person you are meant to be.

This book is essential, it may save lives, and it is long overdue.

Andrea Bilbow OBE is the founder and Chief Executive of the National Attention Deficit Disorder Information and Support Service ADDISS, the national ADHD patient advocacy group in the UK, and is Vice President of the Board of ADHD Europe.

DR JOANNE STEER

My best friend at school was the first person to suggest that I might have ADHD. I had not heard of this condition before, but after she explained what it was, it greatly resonated with me. My diagnosis was confirmed shortly after my 15th birthday and medication was commenced immediately. The effects were astounding. I was able to engage properly with lessons for the first time in my life and was surprised by how interesting I found them. My relationships with my teachers (as well as my parents) flourished as I discovered I was able to make them proud as well as making them laugh.

With medication and support, I managed to gain almost all A* and A grades in my GCSEs and A levels, and am now just over halfway through medical school, contrary to many of my teachers expectations. I have conducted a research project related to ADHD, for which I earned a Bachelor of Medical Science (BMedSci) degree, and am considering specialising as a psychiatrist in the future. I would not be who I am without ADHD, but I would not be where I am without adequate diagnosis and treatment.