--------------------
Finally getting attention
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After years of frustration, some women are learning their difficulties are
due to ADHD

By Kimberlee Roth
Special to the Tribune

July 21, 2004

This story contains corrected material, published July 22, 2004.

Tolonda Henderson's accomplishments--graduating Phi Beta Kappa from college,
working toward a second master's degree, a job as a library assistant that
she loves--all belie a daily struggle.

Last year, the 26-year-old Hyde Park resident was diagnosed with attention
deficit hyperactivity disorder, or ADHD. The suggestion first came from a
professor during a conversation about Henderson's master's thesis and oral
defense, "the most miserable experience I've ever had," Henderson said.

The conversation about Henderson's difficulty pulling her extensive--too
extensive--research together reminded Henderson of another paper ... and
another ... During the wending conversation, her professor asked whether
anyone ever thought she might have ADHD.

ADHD is a neurobiological disorder that affects "executive functions," which
include planning, organizing, setting priorities and considering
consequences. Symptoms start in childhood but they're often missed in girls
because there tends not to be as much hyperactivity displayed as there is in
boys. Left unaddressed, challenges persist in adulthood, resulting in lost
opportunities, social troubles and emotional distress.

ADHD afflicts 6 to 8 percent of children and about 2 percent of adults,
according to Mark Stein, director of the ADHD Clinical Research Program at
the University of Chicago. It affects boys at a rate of 3 to every 1 girl,
but in many clinics ratios range from 9- or 10-1 to 4-1.

Why the disproportion?

"Girls [with ADHD] are less troubling to other people," says Kathleen
Nadeau, co-founder of the National Center for Gender Issues and ADHD in
Washington, D.C. "Not less troubled, but less bothersome. As a general rule,
girls with ADHD aren't going to misbehave, talk back to the teacher, throw
footballs across the room or knock their desk over."

Research on the disorder in girls is indeed scant. In 2002, Stephen Hinshaw,
chair of the psychology department at the University of California,
Berkeley, published two studies on the subject. In Hinshaw's studies, girls
with ADHD did make friends, but they had fewer and a harder time keeping the
ones they made. They were hard for others to get along with, being intrusive
and unable to read social cues clearly. Study subjects also showed
impairments in executive-processing functions, which "aren't [related to]
your intelligence or what you learned in school, but your ability to plan,
to say, `Wait a minute, this is not going well; I need to change my
strategy,'" Hinshaw said.

Girls, or boys for that matter, don't necessarily outgrow ADHD when puberty
arrives as was once believed of boys.

"We're really just sitting on the tip of the iceberg--there's a bigger
problem of ADHD in women than if you just look at what's going on in
childhood," Hinshaw said.

Park Ridge psychologist Alan Graham said, "a lot of the women I see were
initially diagnosed with depression and anxiety. They were [thought of as]
the `ditzy girls.'"

Struggles continue, if not grow, with adult responsibilities at home and
work. "What typically happens is they get down on themselves and get
depressed," Graham said.

At the time of Henderson's conversation with her professor, she was being
treated for depression and anxiety by a psychiatrist who subsequently
diagnosed ADHD. She read up on it and the "a-ha moments" began.

Once she was diagnosed, she understood why she never felt she connected with
others, why she has always gone "in fits and starts," enthusiastically
taking up new hobbies but soon losing interest and, perhaps most important,
why she wasn't living up to her own expectations. Although she got excellent
grades, she was frustrated because she knew she could do better.

"I knew I had the candlepower, but it's like someone stuck it under a
bushel," Henderson said.

Jennifer Garrison, 32, who conducts computer training for a university, also
was being treated for depression. One day, her therapist mentioned ADHD,
based on observations of Garrison's behavior over time: changing the
subject, difficulty focusing, fidgeting, starting and not completing tasks.
The therapist suggested Garrison read "Driven to Distraction: Recognizing
Attention Deficit Disorder from Childhood Through Adulthood" (Touchstone
Books) by Edward Hallowell and John Ratey.

"I cried the entire time," said Garrison, a Near West suburban resident. "I
could've written it myself ... I went and got tested and, sure enough."

Evaluation for adult ADHD entails a thorough evaluation, including
discussion of current symptoms and how they affect daily living as well as
childhood symptoms that may not have been noticed by parents or teachers.
It's important to rule out "mimics," said the U. of C.'s Stein, including
thyroid problems, seizures, sleep deprivation, medication side effects, too
much caffeine, and certain psychiatric disorders.

Garrison's diagnosis, made three years ago, explained frustrating habits
like being late no matter how much she hurried, and constantly forgetting
and losing things.

Treatment for adult ADHD involves helping sufferers identify their strengths
and weaknesses, and redefining their sense of self, Graham said. Behavioral
therapy also is used to target specific areas, such as scheduling.
Medication--namely stimulants such as Ritalin, Concerta, Dexedrine and
Adderall, and a relatively new non-stimulant medication, Strattera--may be
prescribed as well.

Henderson has chosen to remain on the medication she was taking for her
depression and anxiety, Effexor. She also has learned to be "much kinder" to
herself. She worries less and is more selective about what she gets involved
in.

Garrison takes Adderall and she has developed her own organizational
strategies, such as using different colored pens to write notes and organize
her work files.

She has mixed feelings about her diagnosis.

"I think especially as a woman, you just push yourself so hard and develop
ways to cope," she said. "Luckily, I think a lot of people with ADHD are
extremely intelligent and creative, so I always managed to pull myself
through. ... Even though most days I'm frustrated, it also gives me some of
the great characteristics I have."

- - -

Resource list

Here's more information on ADHD:

- Children and Adults with Attention Deficit Hyperactivity Disorder, at
www.chadd.org

- National Resource Center of ADHD (a CHADD program), at www.help4adhd.org,
or call 800-233-4050

- CHADD of Chicago, at chaddofchicago.tripod.com/

- National Center for Gender Issues and ADHD, at www.ncgiadd.org.


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