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Being a woman with ADHD

Although boys with ADHD outnumber girls with the diagnosis, recent adult studies indicate
that nearly as many women as men have the condition. Girls often have ADHD Inattentive Type
(sometimes referred to as ADD), and as they may not ‘act out’ to the same extent as boys, girls
are therefore less likely to be diagnosed until later.

In our society, women can be expected to ‘have it all’, but this involves a constant juggling act.
You may have to be a mum, a cook, an employee, an employer, a carer, a party planner and a
devoted partner. You may feel you must be the lynchpin of the family taking an overview of the
household organisation; arranging shopping, packed lunches and ironing; supervising homework,
laundry and grandma’s care home, alongside any paid work you do. You may also hold yourself up
to high standards, aiming to be the perfect mother, hostess and homemaker, and may feel guilty
when you cannot maintain this standard.

Remember: gender roles are not set in stone – if your partner is better at organising the kids, let
him. Do whatever works for your family – this is the 21st century!

No-one ever said it had to be perfect; those around you will be happier if you are relaxed and
easy-going even if things aren’t perfect.

Simplify. Simplify. Simplify: food, clothes, activities.

Say no and no again to extra commitments – unless you really want to do them.

Accept or pay for help if you can afford it – child care help, cleaning, ironing.

All you have to be is good enough – not perfect!

Hormones
There are additional issues for women with ADHD because of oestrogen. This hormone has important
interactions with neurotransmitters and with the number and sensitivity of dopamine receptors.
Because of this, at times of low oestrogen levels ADHD symptoms can be much worse. Fluctuating
levels of oestrogen over the monthly cycle can cause disruption, and medication for ADHD can
become less effective in the week or so before a period. Because this is not always considered, and is
difficult to address, many women only have partial improvement in their ADHD symptoms.

At menopause, oestrogen levels drop significantly, bringing a variety of changes for most women,
such as memory problems or mood changes, but these can be much more noticeable in women
with ADHD. Some doctors increase ADHD medication in these circumstances. It may be that
hormone replacement therapy could be helpful to you at this time, but it is important to remember
that some women find that their moods stabilise after menopause, and that with maturity, they
learn to cope better with their ADHD.

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Pregnancy and breastfeeding

Most women will stop their ADHD medication during pregnancy and when breastfeeding. (There
are no studies as yet to indicate the safety of stimulants on the unborn child.) Some women will
find this difficult, although others find that raised oestrogen levels help their concentration and
other symptoms, only to go back to what was normal for them, after the birth. Pregnancy could be
a good time to work on other strategies for ADHD, such as CBT techniques or exercise.

Reading suggestions and references

Matlen, T. (2014) The Queen of Distraction, How Women with ADHD Can Conquer Chaos, Find
Focus and Get More Done. Oakland, CA, New Harbinger Publications.
Quinn, P. O. (2015) ADHD in women. ADHD in Practice 7(3), 44–47.

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ADHD and work

If you have ADHD, you are more likely to have employment problems.

Think about your strengths and weaknesses at work

Your strengths might be that you are:

Lively, Personable, Creative,

energetic friendly imaginative

Good at seeing
the big picture

Your challenges might be:

Poor Poor
Not finishing
organisation attention to
things
detail

Distractibility

You may like to take some time to write these out.

Think about whether your current or desired job is a good fit with these strengths
and weaknesses.

One of the secrets of living well with ADHD is to find your niche. Sitting at a desk for long periods
or a job involving attention to detail is unlikely to suit you. However, this may not be true if you
have a dual diagnosis of ADHD and ASD. A role that is varied, involves some moving around or
requires interacting with other people might work well for you. If there is something that you are
passionate about, your job will remain stimulating, and you may be able to use your ability to
hyper-focus. The autonomy of working for yourself appeals to many ADHD adults, although having
someone else setting deadlines and keeping track of your work is often helpful. You may need
a colleague or partner who is good at following through with the details and task completion.
Examples of good-fit careers might be in sales, teaching, the creative industries, marketing,
catering, and active or manual work.

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Think about the main problems you have encountered at work.

Read up on strategies to address them, such as how to improve your timekeeping or reduce
procrastination. Set yourself goals for improvement, perhaps with the help of your manager or a coach.

Our top tips

• Cultivate allies and find colleagues whose skills complement yours.
• Minimise interruptions and distractions.
• Ask for your assignments to be written down and for clear deadlines.
• Build in your own rewards, and break up the day with variety and movement, even if it’s just
going for a walk at break time.
• Work hard on your organisational strategies.

Should I tell my employer that I have ADHD?

Only you know your manager and the ethos of your workplace well enough to decide how well the
news of your diagnosis will be received. Not everyone understands ADHD. Rather than disclose your
ADHD, you may prefer to present a break-down of what you do best and what you are worst at, and the
circumstances in which you work best (e.g. in a quiet environment, or with clear written instructions).
You could have a positive plan ready to show how you could work together to improve your efficiency. If
you decide to disclose informally, you might provide your boss with information about the condition.

If you do decide to formally inform your employer of your ADHD, there are a number of
advantages. You will then come under the protection of the Disability Discrimination Act, and
your employer (with the exception of the armed services) must make “reasonable adjustments”.
You will also have added protections against dismissal or discrimination. You may like to use the
information leaflet provided to help explain all this to your employer. You will need to provide
documentation about your diagnosis, and most services are happy to provide this, as well as
advice about what accommodations you may need in the workplace.

Once you have a diagnosis you may be entitled to the help of the government’s Access to
Work scheme, details of which may be found on the gov.uk website. This offers grants to pay
for practical support to start or stay in work, or to move into self-employment. They might, for
example, pay for a work computer, computer programmes such as voice recognition systems, or
even a support worker for a few hours of administrative help.

Reading suggestions and references

Fellman, W. (no date) Should You Tell Your Boss about Your ADHD? Available from: www.
additudemag.com/should-you-tell-your-boss-about-your-adhd/. [Accessed 17 April 2017].
Levrini, A. & Prevatt, F. (2012) Succeeding with Adult ADHD. Washington, American Psychological
Association. Chap. 7.

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Advice to employers about Attention Deficit

Hyperactivity Disorder (ADHD)
What is ADHD?
ADHD is a proven neurological condition that a person has from childhood, thought to be
due to genetic causes or other brain changes. People with the condition vary a lot but may
have problems with concentration and organisation, activating themselves and completing
tasks (often referred to as ADD), or may also be talkative, lively or impulsive (ADHD). Many
people assume that adults will have grown out of these problems, but they do persist into
adulthood in the majority of cases.

This is not to say that employees with these conditions are not useful and effective people.
They can be very creative, good at thinking ‘outside the box’, very enthusiastic and energetic.
They can often do particularly well in fast-paced environments as they get on well with high
levels of stimulation, such as sales. They may also be very effective in physical jobs where
there is a lot of movement. In work that interests them, many can ‘hyper-focus’ and work
intensively for longer periods than others might. Investing a bit of time in the person and
making accommodation for their needs can reap benefits to both parties, making the most of
their skills.

Helpful adjustments in the workplace

Since the 2004 revision of the 1995 Disability Discrimination Act, all employers (except the armed
services) must make reasonable adjustments for people with disabilities. The only exception
to this is where the adjustments would involve undue hardship, such as being overly costly,
substantial or disruptive. It is up to the individual employee to let you know what their particular
difficulties are and what accommodations would be helpful to them.

Helpful strategies for the ADHD employee

• Giving a clear structure to the job and helping the person by breaking it down into parts –
having lists or timetables which can be easily seen and referred to which help employees be
clear about what you want them to do.
• Helping them to prioritise and giving short-term tasks with clear deadlines.
• Giving instructions clearly and preferably in writing.
• Being flexible with working times – some people will need to take medication in the morning
and may not be effective until this starts working.

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• Being flexible with breaks. The person may need more frequent, but shorter, breaks,
or need to be able to get up and walk around. If they can do this, they may be
especially effective.
• Having a place to work free of distractions for at least part of the time, to do paperwork or
make important phone calls without being interrupted.
• Giving clear feedback on performance – good and bad. Having a workplace mentor can
be ideal, and if you are unable to provide this yourself, one might be available from the
government’s Access to Work scheme.

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Being a student with ADHD

The years you spend as a student may be some of your
happiest, but also some of your most challenging, especially
when you have ADHD. Concentrating through hour-long
lectures, sitting in the library writing reports, or revising for
exams are unlikely to be tasks you excel at. On top of that,
you have all the responsibilities of looking after your own
food, laundry and accommodation.

What to consider before applying for a course

• How interesting will you find it? If you love it you may be able to harness an ability to
hyper-focus.
• Is it varied, with a practical element? This may work better for you.
• Is assessment based largely on coursework or exams? Which of these suits you better?
• How good is the support available to students with additional needs at the universities you
are considering?
• Might you prefer an apprenticeship or another route into what you want to do?
• Would living at home work better than moving away?

Before starting, get in touch with the support services at your college/university and tell them
about your condition(s). Show them any reports you have giving the diagnosis, and discuss
what assistance you need. You may ask for a mentor, a separate room for exams or extra time
allowance. At some point, too, meet with your personal tutor and explain the issues that you have.

During your course

• You might want to consider medication, even if you don’t normally take it, for the duration of
your course.
• Be prepared to put in longer hours and more effort than other students in order to succeed.
• Don’t compare yourself with others; your learning style is different, and it will just
frustrate you.
• Figure out your strengths and focus on those. Getting the best mark you can at what you are
good at will help balance out the things that are more of a struggle.
• Similarly, take notice of how you learn best, and make use of your best times of day. You may
need frequent breaks, rewards and activity.
• Find yourself a quiet, un-distracting study area, ban social media or internet browsing, or use
them for (time-limited) rewards.

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• Look after yourself by eating and sleeping as well as you can, getting exercise and being
careful around alcohol and drugs.
• Try to get into a good routine with eating and with chores, to leave you free to get on with
more interesting things.
• Take time to relax and enjoy yourself, keep a balance and stay positive.
• Plan ahead: the more organised you are, the easier it becomes. Use whatever tools you need
for this, such as apps or a calendar.
• Break down big tasks into many little tasks and aim to do a task a day at least.
• Use a mentor or coach for support if available, and go to any courses on study skills or time
management that your college may run.
• Don’t skip lectures, sit at the front and keep your attention focused by taking notes. Ask if you
can record the lecture, or request a note taker if you need one. Look over any printed or online
notes the lecturer might make available.
• If an ADHD ‘episode’ has caused significant problems, talk to your tutor, and don’t be afraid to
communicate your difficulties.

Reading suggestion and reference

Levrini, A. & Prevatt, F. (2012) Succeeding with Adult ADHD: Daily Strategies to Help You Achieve
Your Goals and Manage Your Life. Washington, American Psychological Association. Chap. 6.

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Common questions about ADHD medication

1. What do medications do to the brain?
ADHD medications increase the level of either one or two
chemicals that help brain cells communicate with each
other. The two chemicals are Noradrenaline (increased
by methylphenidate, atomoxetine, lisdexamfetamine)
and Dopamine (increased by methylphenidate and
dexamfetamine). The way the drugs achieve this
is different.

2. Can you take medications intermittently?

If so, which ones?
Intermittent use is only practical with the stimulant drugs (methylphenidate and dexamfetamine).
The non-stimulant drug atomoxetine relies on more consistent use. If you stop your ADHD
medication for more than a short period, it is sensible to start again at a low dose and build up
again. You should ask your GP or the ADHD clinic for advice on this.

3. What factors could prevent you from taking

ADHD medication?
Some patients with physical health problems (e.g. heart disease, hyperthyroidism) cannot use
ADHD medications. Street drugs and alcohol use also can prevent treatment from being effective
and can be harmful if taken at the same time as ADHD medications. Some patients are on vital
medicine for other conditions which have to continue, but cannot be combined with ADHD
treatment. A few patients with the most severe forms of mental illness are best advised to avoid
ADHD medication.

4. What difficulties might you have going through

the process of getting medication?
Not all areas have a specialist ADHD service, and it may be hard to find a consultant who will
initiate and supervise prescribing. If you do have such a consultant, some GPs are unwilling or
unable to participate in what is called a ‘shared care agreement,’ for a variety of reasons.

5. How would you choose short-acting versus

slow-release forms of medication?
Short-acting medications give greater flexibility but require multiple doses per day and therefore
require more planning. Long-acting treatments generally require only one dose per day, but this
does not always last long enough.

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6. How long does it take to adjust to medication?

Stimulants work quickly, but the benefits can continue to progress over weeks as patients get
used to being different. Sometimes there may be a backlog of problems (e.g. debt, paperwork,
employment issues) caused by the ADHD, which can take time to be worked through. Atomoxetine
is slower but offers more constant benefit.

7. What differences (positive and negative) may

people notice when they take medication?
Change is tremendously variable. Those patients with the most severe ADHD, and the most
robust evidence for having ADHD, are the group that often sees the greatest change. Those
doing demanding paperwork or needing to organise lots of complex things at once also can
notice a large improvement. For others, this sudden change can feel uncomfortable. Very restless
people, who suddenly find that they are able to sit still, can sometimes find all the spare time
to think troubling. Patients with mild severity, those whose diagnosis is on the borderline of the
threshold for the condition, or those who are not engaged in any challenging activity are likely to
notice less change.

8. What are the most common side effects?

Do these reduce over time?
Most side effects of ADHD medications are mild, although some rare side effects can be very
significant (heart problems, liver damage). The side effects are different for each medication, and
you should have discussed these in detail and had written information from your clinician before
starting any medication.

The most common side effects seen are things like loss of appetite, dry mouth, nausea, vomiting,
abdominal pain, constipation, diarrhoea, weight loss, palpitations, changes in blood pressure,
insomnia, tics, dyspepsia, anxiety, movement disorders, irritability, and sexual dysfunction. The
lists of potential side effects are extensive, as with most medications. Most patients do well on
their first ADHD medication, but some have to try a few to get the balance right.

9. How much do individual experiences

of medication vary?
It is true that individual experiences vary a lot, but we know that ADHD medications are very
effective, more so than many other medications. Some of the variability will be related to other
medical conditions, the level of expectation the patient has and the level of certainty of the
initial diagnosis. You may be told that you are borderline for ADHD, that your ADHD is mostly
gone or that it is not possible to be too certain about your diagnosis (when some information is
unavailable). In such cases, the effects of medication can be more varied.

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10. Do medications stop having an effect

after a long time?
We do often hear that after a few months the medications are not working as well.
Sometimes this requires a slight tweak to the dose. It can also be that the patient has
forgotten how things were without the medication, and a period without the medication (often
called a drug holiday) can help establish if it is still working. Drug holidays should always be
discussed with your GP, ADHD doctor or nurse in advance. To avoid becoming tolerant to them,
it is advisable to keep the number of hours that stimulant medications are working for you to
less than 12 per day.

11. Can you become addicted to ADHD medication?

It is possible, yes. You can become dependent on a wide variety of medications, but not normally
if you take them in the manner advised. With ADHD medications dependency is rare, especially if
taken as prescribed.

12. Are there any problems with coming off tablets?

When medications for ADHD are taken at prescribed doses and by the advised methods, most
patients have little problem coming off them. The main issue would likely be the recurrence of
the symptoms of ADHD (you may even have forgotten what these were like). We always advise
patients to come off their medications slowly, except in the case of patients who have always
taken weekends off stimulant treatment. Some patients can experience withdrawal symptoms,
but this is uncommon with normal usage.

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Useful resources
Books
Barkley, R. (2010) Taking Charge of Adult ADHD. New York, The Guilford Press.
Butler, G. & Hope, T. (1995) Manage Your Mind: The Mental Fitness Guide. Oxford, Oxford
University Press.
Cope, A. & Whittaker, A. (2012) The Art of Being Brilliant. North Makato, NM, Capstone.
Hallowell, E. M. & Ratey, J. J. (1995) Driven to Distraction: Recognizing and Coping with Attention
Deficit Disorder from Childhood through Adulthood. New York, Touchstone.
Kolberg, J. & Nadeau, K. (2002) ADD-Friendly Ways to Organise Your Life. New York, Brunner-
Routledge.
Levrini, A. & Prevatt, F. (2012) Succeeding with Adult ADHD: Daily Strategies to Help You Achieve
Your Goals and Manage Your Life. Washington, DC, American Psychological Association.
Matlen, T. (2014) The Queen of Distraction, How Women with ADHD Can Conquer Chaos, Find
Focus and Get More Done. Oakland, CA, New Harbinger Publications.
McKay, M. & Rogers, P. (2000) The Anger Control Workbook. Oakland, CA, New Harbinger
Publications.
Orlov, M. (2010) The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six
Steps. Florida, Speciality Books.
Orlov, M. & Kohlenberger, N. (2014) The Couples Guide to Thriving with ADHD. Florida,
Speciality Books.
Strong, J. & Flanaga, M. O. (2005) AD/HD for Dummies. Hoboken, NJ, Wiley Publishing.
Young, J. E. (1998) Reinventing Your Life: The Breakthrough Program to End Negative Behaviour
and Feel Great Again. London, Penguin Putnam.

Videos
www.youtube.com – There are lots of short videos on YouTube which are particularly helpful, but
they are not always easy to find. Here are some from ourselves and group members:

• ‘I had a black dog’

• ‘ADD Crusher’ videos
• ‘How to ADHD’ videos
• Holosync Relaxation (www.youtube.com/watch?v=HwgqDEA7zLA)
• Brain Evolution system: just listen while doing nothing for 15 minutes (www.youtube.com/
watch?v=BbLp2G4tgPM)
• Silva Meditation for deep relaxation (www.youtube.com/watch?v=JSGmBGOClQk)

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www.ted.com/talks – This website is brilliant, and here are a few we think are
particularly good:

• Kelly McGonigal (Stress)

• Joshua Foer (Memory)

http://tedxtalks.ted.com – Again, this is a strand of Ted talks, and they are worth a watch!

• Rebecca Hession (Not wrong, just different: ADHD as innovators)

Websites
www.gov.uk/access-to-work. This is the government access-to-work scheme and has lots of
useful information.
www.additudemag.com. ADDitude magazine website for interesting articles.
www.getselfhelp.co.uk/mindfulness. This website provides a lot of self-help information.
www.headspace.com – This website provides short mindfulness tasks. After the 10-day trial,
there is a charge for this service.
www.simpleology.com – A website designed to assist you to prioritise tasks.

Specific articles
(humorous articles about procrastination)

http://waitbutwhy.com/2013/10/why-procrastinators-procrastinate.html
http://waitbutwhy.com/2013/11/how-to-beat-procrastination.html
http://waitbutwhy.com/2015/03/procrastination-matrix.html

Organisations
Living with ADHD – www.livingwithadhd.co.uk
ADD /ADHD Online Information – www.adders.org
ADDISS, The National Attention Deficit Disorder Information and Support Service – www.
addiss.co.uk

Phone apps
Evernote
Outlook web mobile (This app will sync all of your appointments.)
To-do Widget (This will give you regular reminders of your to-do list.)

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Informant (This is a calendar which will also allow a to-do list for each day. If you do not complete
the to-do list, it will automatically transfer for the following day.)
Genius scan (Allows you to take a picture on your phone, and it will convert it into a scanned
document.) This is particularly useful for work and tasks such as expenses, where you may be
required to scan receipts.
Calm App (10 minutes of mindfulness)
Sleep Cycle app (This app records your quality of sleep from your movement, and it also has a
feature that will wake you when you are in your lightest sleep.)

Online support groups

• Psych Central ADHD Support Group
• NeuroTalk’s ADHD Support Group

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