The emotional and social fallout of ADHD can be very serious. Girls with ADHD sometimes struggle to make and keep friends. Many also experience low self-esteem, depression or anxiety. They also have higher rates of self-harm, substance abuse, and suicide attempts than other girls.
Helping kids with ADHD is a big job. Both sexes benefit from medication, organizational assistance and accommodations. But girls with ADHD—like me—face a different set of challenges than boys, and when it comes to helping, parents need an approach that addresses these differences head-on.
Make the invisible visible
In girls, ADHD is often referred to as a “hidden disorder,” and with good reason. Most girls with ADHD have the inattentive type, which means that they have problems focusing but are not hyperactive and impulsive. But even those who are hyperactive and impulsive present with less obvious symptoms than boys, so it often goes unnoticed or unacknowledged. Instead of a diagnosis, girls with ADHD often get criticism from parents, teachers, and peers, and the fallout takes a serious toll on self-esteem.
“Pardoxically,” says Stephen Hinshaw, PhD, who chairs the psychology department at UC Berkeley, “Stigma is stronger against subtle disorders than obvious ones: ‘You’re bright. You should have it together! What’s wrong with you?’ The very subtlety and inconstancy of the symptoms fuels stigma—it doesn’t reduce it.”
Educating yourself about ADHD can help build understanding around a frustrating, complex disorder. It will also give you the arsenal you’ll need to become a strong advocate for your daughter.
“I didn’t understand it for a long time,” he told me. “It was invisible. We’d never heard of girls having ADHD. It seemed like you should be doing fine but were screwing up, and I didn’t know what it was about. That made it very hard to get on your side.”
Reach out to other parents
“The not-ADHD parent is going ‘I don’t get it!’ ” she says. “When parents have to keep repeating the same things—’You’re not getting up on time.’ ‘Put your shoes away.’—it adds up and makes it hard to see past the behavior to the causes behind it.”
Dr. Nadeau suggests that parents with ADHD daughters spend time talking with and listening to other parents whose children have ADHD. Hearing the similarities and sharing struggles and strategies helps non-ADHD parents understand the disorder better. “It really helps to have people who can relate,” she says.
Help with friends
Girls with ADHD sometimes struggle to make and maintain friendships, and the relentless complexities of the girl social world are overwhelming. Patricia Quinn, MD, co-founder and director of the National Center for Girls and Women with ADHD, recommends helping girls with ADHD find social outlets that make them feel comfortable and play to their strengths. “If your daughter is socially awkward, find environments that are socially accepting—places that are more supervised and focused on kindness and treating people well and self-acceptance,” she explains.
Encourage your daughter to get involved with afterschool activities—clubs that focus on her interests or group activities that allow for individual space, like art classes or book groups—to help her learn to feel safe, comfortable and confident in a social setting. Likewise, if your daughter is impulsive or hyper, social situations where she can release some energy, like theater or sports, can make things go more smoothly.
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And because boys are more likely to be diagnosed, even though lots of girls have ADHD, it’s easy for girls to sometimes feel alienated. Help your daughter normalize and legitimize her experiences by connecting her with other girls her age who have ADHD. Check out books about girls with ADHD and try reading and talking about them together. It also might help to find an older girl with ADHD to mentor your daughter, through school or a program like Eye to Eye. Meeting other ladies with ADHD, especially those who are open about their disorder, can make girls feel less alone and more hopeful.
Engineer her environment
When you have a clear understanding of what your daughter needs, you and she can work together to create situations that bolster her abilities and offer support in the areas where she feels less competent. Dr. Nadeau calls this “environmental engineering.”
For example, says Dr. Nadeau, “Extroverted, hyper-talkative girls might benefit from forming a study group. If studying alone is a nightmare but socializing is easy, find a way to make it constructive.”
Similarly, girls who are more introverted or struggle to stay focused might do well in a quiet, calm setting, with minimal distractions. As I write this, I’m facing a white wall (visual stimuli are really distracting for me) and using a white noise app on my phone—which is set to ignore all calls until I’m done working—to block out distracting sounds.
Build self-esteem
Research shows that girls with ADHD, especially those who’ve gone undiagnosed, suffer from low self-esteem. I was no exception.
Failure, I’d think morosely, shaking my head for the umpteenth time when the teacher asked if I had my homework. I’m a stupid, useless failure.
The emotional fallout of ADHD can be as or more severe than any academic difficulties. We know now that girls with ADHD have higher rates of self-harm, substance abuse, and suicide attempts. Encourage your daughter to talk about how she’s feeling and seek further help if necessary.
Highlighting her strengths is one way to build back lost self-esteem and help your daughter see herself in a more positive light. “Look for islands of success,” says Dr. Nadeau. “Look for what she’s good at and really likes to do and arrange her world so that it’s a major focus in her life.”
Help her come out of hiding
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Having ADHD can be frustrating and humiliating. Girls with ADHD often hide, minimize or compensate for their difficulties, too embarrassed to ask for help (even when we really need it). A 16-year-old I know explained how painful it was trying to cover up her struggles. “I wanted so badly to be like everyone else,” she said. “I didn’t want to ask for help because I didn’t want to be the weird girl who couldn’t get it done, but—of course—I did need help so then, after all that, I’d fail anyway. It was terrible.”
Work with your daughter to help her get comfortable with asking for help. It can be very hard for girls with ADHD to acknowledge their needs, and it may take time and practice for her to find her voice.
It may sound simple, but for me, learning to say, “Please repeat that. I have trouble remembering things if I don’t write them down,” instead of ducking my head and quietly panicking, has been life-changing.
In the meantime, you can model how it’s done by being her advocate. Standing up for your daughter will not only help her get the services and accommodations she needs but also send the message to her that ADHD is nothing to be ashamed of. This will help empower her to become her own advocate as she grows up. The more she is able to figure out what works for her, and ask for the help that will enable her to succeed, the more she will thrive.
The best advice
“Dan,” she said, with no hesitation.
“Rae thinks a little differently than the other kids,” he told my parents. “It’s not a bad thing, but it might make some things more difficult for her as she grows up.”
My parents were confused and worried. “What should we do?” they asked. “How can we help?”
Dan thought for a moment.
“Keep her ego intact.” He said. “Make sure she knows you think she’s smart and you love her no matter what.”
“That,” my mother told me, nearly 20 years later, “was very good advice.”
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Photo: SHARMAINE MONTICALBO
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