The frequency of ADHD in girls is probably on a par with that of boys but presents differently so is often missed. Emotional dysregulation is a core feature of ADHD in girls resulting in a diagnosis of a mood disorder like anxiety or depression rather than ADHD. The following article outlines the different presentation of ADHD in girls and what influences it.
Girls with ADHD say they feel different, that something is just slightly off but not enough for others to see and validate. Friends or parents try to normalize it by saying “ everyone feels like this, everyone thinks this is difficult or struggles with this sometimes.”
They often feel like their brain fails them and when they need to concentrate their thoughts just slip away or stop and when they should relax, their mind starts working like crazy like what they did wrong or what their friends might have meant. They often feel hopeless as they can’t control their emotions or energy levels and that if they are going to pass or manage their lives, they will have to be so disciplined and so controlled. Controlling what they eat, when they exercise, study and how they are with their friends. By 19 there is not much spontaneity left in their lives. Their perfectionist tendencies are turning into a prison for them.
They experience social and academic challenges yet keep it together outside the home, as unlike boys they care what’s expected of them in a social setting. This drains them of energy and often results in melt downs and tantrums when they arrive back to a safe environment like home.
Hormonal influences are paramount in girls with ADHD. Oestrogen and Progesterone pass through the blood brain barrier and access the brain. There are hormonal receptors in the regions involved in emotional regulation effecting how girls feel and function and these are thus affected by their cyclical variation. Often in the first half of their cycle where oestrogen is climbing they can be more hyperactive and impulsive whereas during the latter half where Progesterone dominates they can have low energy levels, sleep, cognitive and memory problems as well as suffer more from rejection dysphoria. These changes depend on their ADHD profile. Oestrogen and Dopamine may also potentiate each other thus influencing the effect medication has over a particular period of their menstrual cycle.
The 24/7 model helps explain ADHD to girls as it breaks down the relevant difficulties of the condition in a way they can understand. 24/7 signifies that ADHD effects your child every waking moment of her life. There are 2 basic human needs for mental health, 4 Aspects Of The Brain that are different in ADHD and 7 Lifestyle Factors that influence it.
The 2 basic human needs for mental health are to belong to a social community where you can safely communicate what you think, feel and what you need without being judged as well as to have a calling or purpose in life while feeling competent to handle the challenges that you face.
Girls with ADHD often don’t feel safe in environments outside their home and often feel disconnected so battle to see life’s purpose while often feeling justifiably incompetent in the way they manage their lives. Without real purpose many girls battle to motivate themselves to get involved and participate in anything outside their comfort zone.
The 4 Aspects Of The Brain that are different in girls with ADHD are: Overview, Regulating, Filtering and Shifting
Overview :This is the brain’s control tower and is the ability to overview what you need to plan, prioritise, organise and execute in everyday life . They don’t have someone in the control tower so have to manage everything manually and just an ordinary day at school will require an enormous amount of energy.
Regulating: This is the brain’s volume button. It’s either at zero or full. When at zero it’s impossible to do anything. They can’t exercise, study, go out or see friends and then for no reason it shoots up to 100 and it’s impossible to stop talking, eating, shopping, not be the centre of the party, wind down or go to sleep.
Filtering: It is impossible to filter out irrelevant information from the outside world and from their own body. How their clothes feel, sounds and smells from outside all compete for their attention. This constant bombardment of stimuli causes girls with ADHD to get extremely tired in social situations. Not because they don’t appreciate them, they just cannot handle the influx of competing stimuli and will often say their social battery is flat.
Shifting: This is the brain’s gear box. It is the inability to shift out of negative ruminating thoughts or try something new when the things you do don’t work anymore. They get stuck in loops of negative toxic thoughts of self-doubt, not doing things good enough, letting themselves and others down or being a failure or feeling like an imposter. Even although they know that it would be really good to try to view things in a lighter perspective, these thoughts cloud their mind and poison their relationships and self-esteem.
The 7 Lifestyle Factors : These include Sleep, Diet, Exercise, Structure Stress, Addiction and Emotions. The ADHD brain finds it so much harder to set up and keep to healthy routines for diet, exercise, sleep and workload in school. They lack the ability to plan and thus structure their lives often working until they drop. They get stressed out as feel easily overwhelmed. It’s more difficult for them to regulate their emotions so can lash out at friends and family. They all too often become addicted to social media.
So how can you help your daughter with ADHD. Be careful of well-intended advice like “If you feel angry, stand up for yourself and say that… “ This is really bad advice when so much of the emotional lives of girls revolve around social struggles and rejection sensitivity. So rather listen to what your daughter is trying to tell you. To be heard and listened to is empowering and builds emotional strength more than advice.
Rejection Sensitivity Dysphoria is characterised by an extremely painful emotional response to real or imagined criticism or rejection from others and can become a self-fulfilling prophecy. It prevents them from saying no, often to their own detriment as well as resulting in them feeling offended too easily.
To keep themselves socially accepted these girls with emotional dysregulation must learn to give themselves time to not react on instinct but to reappraise what they are seeing or what they are experiencing and then respond when they feel more emotionally anchored.
Knowledge that emotions are made from perceptions and previous experience is key here and knowing that as long as they don’t act on their emotions, they can’t hurt them.
In conclusion ADHD in girls is more emotional than behavioural, as seen in boys. They have social issues which are exacerbated by their overpowering sensitivity for rejection and will often cover up the struggles they are experiencing as they fear judgement almost more than they fear failure.
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