ADHD/ADD in Girls

[Anonymous]

I've read that ADHD/ADD can present differently in girls and the more I read, the more I'm curious about my DD. With the following symptoms, what would you think?

- Very emotional
- Perfectionist
- Low self esteem
- Struggles with multi step directions (she forgets parts of it along the way)
- Needs constant reminders to do daily tasks (brush her teeth)
- Zones out (overall, she's pretty focused at school and activities, but she does have a tendency to just zone out and not pay attention)
- Anxiety (fairly severe at times)
- She has told me she can't shut her brain off
- Has some OCD tendencies (will do something over and over till it's perfect)
- Easily frustrated by minor things

She's not disruptive in class or at activities. She does well in school. She's your quintessential "good kid".

Thoughts?

[Anonymous]

I have some form of adhd that went undiagnosed as a child, because I was like your daughter. It was more of an inattentive adhd and not a hyperactive one.

My son is much more afflicted than I was as a child and has required interventions since a young age. But I was never disruptive behaviorally, did well enough at school (but not my full potential due to difficulty focusing), and had friends so I was never diagnosed until I was an adult and things came to a head as a parent managing a career, family, house and a child with raging adhd.

I also had ocd and anxious tendencies. I don’t think that’s part of adhd necessarily but is comorbid and I can hyperfixate on things, which I see in my son.

It’s good you recognize things in your daughter. I would start with a good psychologist or neuropsych. Her symptoms may be okay with interventions other than medication.

[Anonymous]

Anonymous wrote:I have some form of adhd that went undiagnosed as a child, because I was like your daughter. It was more of an inattentive adhd and not a hyperactive one.

My son is much more afflicted than I was as a child and has required interventions since a young age. But I was never disruptive behaviorally, did well enough at school (but not my full potential due to difficulty focusing), and had friends so I was never diagnosed until I was an adult and things came to a head as a parent managing a career, family, house and a child with raging adhd.

I also had ocd and anxious tendencies. I don’t think that’s part of adhd necessarily but is comorbid and I can hyperfixate on things, which I see in my son.

It’s good you recognize things in your daughter. I would start with a good psychologist or neuropsych. Her symptoms may be okay with interventions other than medication.

The bolded is where I would go with it I think. As PP mentioned I'm not sure all the symptoms you describe are directly related to ADHD/ADD and it's possible there's a different root cause.

I am pretty sure my oldest developed ADHD around age 10 (onset is often later in girls). The key issue I see with her is a ping ponging between five different tasks at once and an inability to focus on any one. So she'll be doing her homework, but suddenly stop to clean her room, but suddenly stop to go do a different class's homework, and on and on. It's exhausting to parent, especially because I am the same way. However it has never risen to the level where we need interventions.

[Anonymous]

This sounds just like my 11 year-old daughter. She was diagnosed with ADHD and GAD with panic attacks this year. She's unmedicated. She's been in therapy for a while (even before the dx), and her anxiety is better. Overall, she is doing great, but we're thinking puberty is going to hit her like a freight train.

[Anonymous]

She sounds very much like my kid, now 14, who was diagnosed first with ADHD (more the distracted than the hyperactive kind) and later with low level autism. My daughter's emotions manifested not externally through hitting or acting out in anger as a boy's might have, but more internally via blaming herself and crying when a task would become too stressful. Diagnosis, some medications, and an IEP really helped a lot.

[Anonymous]

Sounds similar to my very high achieving DD. I didn’t know that ADHD could look that way and it didn’t click for me until she was in college that something was not right. She had severe ADHD and dyslexia! Straight A, all the activities, bookworm. She took medication for about a year and now uses it occasionally, and she received accommodations that were very helpful. She remained a high achiever, but she was much happier and much less stressed.

No one ever caught it- no teacher, doctor, or therapist. She was so “good.” I’m glad people are becoming more aware of how ADHD wears many hats. I wish my DD hadn’t gone through K-12 as she did. Have an evaluation- there’s nothing to lose.

[Anonymous]

This sounds a lot like my 7 yr old. We have not gotten a neuropsych at this point primarily because her behavior at school has been fine and I am not sure putting a label on what is going on with her is useful at this point (I'm not opposed to diagnosis generally just taking a bit of a wait and see approach now because it's manageable so far). I also don't want to medicate at this stage and don't want pressure to do so.

One thing I did do that was useful was take a parenting class geared toward parents of kids with ADHD and similar issues. This helped us implement some rules and systems at home that have really helped with the inattentiveness as well as her perfectionism. One thing that really resonated with me is the idea that kids like this tend to have more issues at home than at school because school is pretty regimented and expectations are very clear. Creating clearer expectations at home (like REALLY clear -- we wound up putting up laminated photos of the steps for brushing teeth and washing her face and we rearranged her room to create a kind of assembly line type morning routine so that key steps aren't missed) have helped a lot with minimizing distraction and reducing the conflicts that come up over this stuff. Having a more rigid schedule at home has also actually created more time for her to play because on the advice of the parenting coach we scheduled in two big chunks of playtime daily and so she gets solo play in her room in the morning before school and playground time every night after dinner and this combo has been great for her and for us -- she is less day-dreamy or resistant when she needs to focus becuase she's getting more time to indulge those needs on a daily basis.

[Anonymous]

It could be ADHD. It could be ASD. It could be both. Get a neuropsych. https://stixrud.com/

[Anonymous]

This is me as a kid and DD now.

[Anonymous]

Anonymous wrote:She sounds very much like my kid, now 14, who was diagnosed first with ADHD (more the distracted than the hyperactive kind) and later with low level autism. My daughter's emotions manifested not externally through hitting or acting out in anger as a boy's might have, but more internally via blaming herself and crying when a task would become too stressful. Diagnosis, some medications, and an IEP really helped a lot.

OP here. This is totally her. Her self doubt is high and she has horribly negative self talk too. Breaks down when tasks are too hard. It was harder to see when she was younger, because you could just write it off as a "tantrum". But now, I can see it's not that. She even said to me that she hates when she gets worked up over simple things because it's embarrassing and she worries people think she's a brat, but I can tell now that it's totally out of her control.

[Anonymous]

Anonymous wrote:Sounds similar to my very high achieving DD. I didn’t know that ADHD could look that way and it didn’t click for me until she was in college that something was not right. She had severe ADHD and dyslexia! Straight A, all the activities, bookworm. She took medication for about a year and now uses it occasionally, and she received accommodations that were very helpful. She remained a high achiever, but she was much happier and much less stressed.

No one ever caught it- no teacher, doctor, or therapist. She was so “good.” I’m glad people are becoming more aware of how ADHD wears many hats. I wish my DD hadn’t gone through K-12 as she did. Have an evaluation- there’s nothing to lose.

OP here. Who did the evaluation? I'm not 100% sure where to go from here. I just know something is not right.

What medication did she end up on out of curiosity?

[Anonymous]

Anonymous wrote:

Anonymous wrote:She sounds very much like my kid, now 14, who was diagnosed first with ADHD (more the distracted than the hyperactive kind) and later with low level autism. My daughter's emotions manifested not externally through hitting or acting out in anger as a boy's might have, but more internally via blaming herself and crying when a task would become too stressful. Diagnosis, some medications, and an IEP really helped a lot.

OP here. This is totally her. Her self doubt is high and she has horribly negative self talk too. Breaks down when tasks are too hard. It was harder to see when she was younger, because you could just write it off as a "tantrum". But now, I can see it's not that. She even said to me that she hates when she gets worked up over simple things because it's embarrassing and she worries people think she's a brat, but I can tell now that it's totally out of her control.

I'm PP you responded to above and just want to tell you that while we as parents were concerned about how DD's autism diagnosis would affect her, she experienced it as such an absolute RELIEF to know that the problem's she was experiencing were basically not her fault, or something she needed to blame herself for, which was really affecting her self-worth. This was true even while her ADD/ADHD diagnosis had come about 2 years earlier - the ADD medication basically was helping somewhat but was not solving ALL the problems, so she was still experiencing severe anxiety at school and at home with homework.

My daughter really struggled with perfectionism all through grade school and she still deals with it, but I also think the anti-anxiety medication she is on helps. She went through a very difficult period toward the end of grade school/early middle school, but the ASD diagnosis has helped so so much and she currently seems to be thriving in high school - has supports at school, good friends, good grades, and positive feelings about herself which is the most important thing. I think the diagnosis helped her see herself as a person heroically persevering in the face of a setback rather than as someone who had all the advantages but was just constantly screwing up because they weren't ... I don't know, trying hard enough? Although anyone could have seen how hard she was constantly trying.

My heart goes out to you -- good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sounds similar to my very high achieving DD. I didn’t know that ADHD could look that way and it didn’t click for me until she was in college that something was not right. She had severe ADHD and dyslexia! Straight A, all the activities, bookworm. She took medication for about a year and now uses it occasionally, and she received accommodations that were very helpful. She remained a high achiever, but she was much happier and much less stressed.

No one ever caught it- no teacher, doctor, or therapist. She was so “good.” I’m glad people are becoming more aware of how ADHD wears many hats. I wish my DD hadn’t gone through K-12 as she did. Have an evaluation- there’s nothing to lose.

OP here. Who did the evaluation? I'm not 100% sure where to go from here. I just know something is not right.

What medication did she end up on out of curiosity?

We went to a licensed clinical psychologist and board certified neuropsychologis (PhD, ABB-CN) at a neuropsych practice. If your daughter is younger you should look at the similar credential for Pediatric Clinical Neuropsychiatry. DD used Adderall and then Elvanse for a few months, it’s the European name for Vyanse.

She has learned that when she has a lot of control over her schedule she doesn’t need the medication, but when she has limited control she does. So in terms where she did independent research she was ok without, but terms with a heavy class load and intense schedule, she needed the medication. She had a host of accommodations that made life better. Also did some CBT because years of telling herself she was a worthless, faking, failure were sort of engraved. Medication, therapy, and accommodations were life changing. But also knowing that her brain worked differently than others was such a relief and allowed her to start unwinding the self-hatred.

[Anonymous]

This sounds like ASD and anxiety to me. In any event you need a neuropsych.

[Anonymous]

It may be a combination of ADD and something else. A lot of your description of your DD would describe me as a kid.

I was diagnosed ADD as an adult a couple years ago, between older and younger DS both being diagnosed ADHD. While we didn't understand how it presented in girls, particularly in the early 80s when I was growing up, my life would have been so much easier if I'd been diagnosed and started medication then.

I've been on medication since I was diagnosed and it's been life-changing for me. I'm a better parent, work is easier, etc.

Please get a full assessment and see what is going on and then get your child the tools she needs to be successful and happy.

We tried not doing medication for my guys but it was very much necessary for them.