The “devastating” findings of a decades-long ADHD study | Hyperfocus - YouTube

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70,098 views Dec 5, 2024 MissUnderstood: The ADHD in Women Channel

A recent episode of the Hyperfocus podcast featured a crucial discussion with Dr. Stephen Hinshaw, a leading voice in understanding ADHD in women and girls, largely due to his work on The Berkeley Girls with ADHD Longitudinal Study (BGALs). This decades-long research followed 140 girls with ADHD and a control group into adulthood, yielding significant insights that have shaped our current understanding of the condition in females.

Why Study Girls with ADHD?

Back in the 1990s, ADHD was predominantly seen as a "boys' disorder," leaving girls largely out of the conversation. Dr. Hinshaw recognized the clinical reality that girls do develop ADHD and continue to experience it as women. The BGALs study was a landmark effort to address this gap in understanding.

"Devastating" Findings: Internalizing Symptoms and Combined-Type ADHD

While girls with ADHD share many features with boys, the study revealed a particular likelihood for them to develop severe internalizing symptoms such as depression and anxiety over time. Shockingly, the data showed elevated rates of attempted suicide and non-suicidal self-injury (NSSI) in this population.

Furthermore, the study highlighted the significance of ADHD subtypes. Girls with the combined type of ADHD (characterized by hyperactivity/impulsivity and inattention) experienced the highest rate of negative outcomes. By their late teens, these girls were over two and a half times more likely to have self-harmed or attempted suicide.

Dr. Hinshaw explained that girls with predominantly inattentive ADHD might suffer silently, their struggles often overlooked until later in life. However, the combination of inattention and impulsivity in the combined type appears to create a "double whammy," leading to significant challenges with peers, academic expectations, and self-esteem.

The Impact on Self-Esteem and the "Triple Bind"

Growing up, girls with undiagnosed ADHD often face a "toxic combination" of feeling like they're not meeting expectations, leading to self-blame. It becomes difficult to distinguish between underlying ADHD and subsequent depression and anxiety. For too long, clinicians often attributed these struggles in girls solely to their gender.

Dr. Hinshaw's 2009 book, "The Triple Bind," explores the immense pressures teenage girls face – being nurturers, being highly competitive academically and athletically, and doing it all while appearing effortlessly attractive. ADHD magnifies these pressures, contributing to a plummeting of self-esteem during puberty and aligning with societal trends of increased suicide rates and mental health challenges in girls.

ADHD as a Feminist Issue

The underdiagnosis and lack of recognition of ADHD in women and girls compound the already unrealistic standards they face, making it a feminist issue. Underrecognized ADHD symptoms can lead to misunderstandings, perceived lack of empathy, and a constant struggle to meet societal expectations of "perfection."

ADHD as a "Trend": Navigating Recognition and Misinformation

The recent surge in ADHD diagnoses among women, partly fueled by the pandemic and social media, has a positive side – increased awareness and support. However, it also presents risks, such as less scrupulous online screeners leading to potential self-misdiagnosis and access to medication without proper evaluation.

Moving Forward: Addressing Stigma

Dr. Hinshaw stresses that despite progress, stigma surrounding ADHD persists, particularly for women. This can hinder them from seeking and receiving necessary help and support. Addressing this requires:

  • Knowledge and Contact: Educating people about ADHD and fostering connections with individuals who have it to break down misconceptions.
  • Enforcement of Anti-Discrimination Laws: Utilizing the Americans with Disabilities Act to protect individuals with mental and neurodevelopmental conditions in public and the workplace, while acknowledging the fear of being "outed."
  • Broader Societal Shifts: Changes in media representation, policy enforcement regarding mental health parity, and challenging stigmatizing language.

For many women, receiving an ADHD diagnosis brings immense relief, providing a name for their lifelong struggles and a path toward understanding, growth, and effective coping strategies. While not a "cure," appropriate treatment involving medication, behavioral therapies, and organizational strategies can significantly improve outcomes.

This important conversation was featured on the Hyperfocus podcast, created by Rae Jacobson and Cody Nelson, with video production by Calvin K, music by Blue Dot Sessions, mixing by Justin Dri, supervised by Ash Beer, production direction by Brianna Barry, and editorial direction by Neil Drumming.

Hyperfocus is brought to you by understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. To support their vital work, you can donate at understood.org. For more episodes and transcripts, visit the Hyperfocus podcast page at understood.org.