Ep045: Women & ADHD Round Table - Part I - Can Women Be Hyperactive?

David and Isabelle are joined by two fellow therapists who have ADHD, Caily & Sarah. They talk about how they came to feel something was wrong with them, or the system around them, how girls are often socialized to mask impulsiveness or hyperactivity, and how stereotypes around ADHD impact all gender expressions. (Part I of a series)
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After a technical difficulty, David and Isabelle reintroduce Caily and Sarah, two therapists who identify as women who also have ADHD. Caily had shared how when she was little, she wanted to be the teacher’s pet, and remembers a math manipulative (say that five times fast)—these little teddy bear toys, that were colorful—and the moment when a strict teacher said you have to have a calm body, sit still, and not touch the teddy bears until she said so. She was speaking slowly and using the manipulative to do a subtraction problem, and Caily was staring at the teddy bears, and what she wanted to do with play with them, their life stories, and she ended up saying “Caily, write your name on the board” and that meant she had to sit out for recess, and remembers thinking “I’m so bad, I’m so awful” but also “I didn’t mean to, I was focusing so hard on not touching them.” David points out that she got in trouble for playing with a toy as a first grader. Caily names that it was something new and novel, which makes it so much harder not to do—and refers to Sarah, who just talked about how she knew the system was off. Sarah's story was one where she was ditching class, acting out, getting into trouble, and struggling in school. Sarah remembers being in first grade and was sent to the principal’s office after discovering where the ‘leprechaun left candy’ around St. Patrick’s Day—when it wasn’t her turn, but she knew it was dumb to get into trouble for something that she was supposed to find. It wouldn’t occur to Sarah to not touch the teddy bears, she would have immediately touched it, rather than sitting on her hands or resisting the impulse the way David and Isabelle would have wanted to. The set up is wrong: you don’t want 7 year olds to touch teddy bears? Don’t bring them out until they can touch them. She was so impulsive and did things that she wasn’t supposed to do, she broke rules because she thought the rules were dumb. Growing up, the dress code was that all the girls had to wear skirts or dresses, and so she wore pants, and got sent to detention every day for wearing pants. One day the principal even drove her home to change. This was not the 1950’s, this was the 1990’s. Her dad thought it was ridiculous and called WOW, a women’s rights organization—who contacted the school and indeed, the dress code was changed overnight. It was pivotal for Sarah to know she can change the system, and this continues to this day. Her dad was a political activist who encouraged this, but her mom was compliant and trying to fit into her suburban world as a divorced mom. David names that hyperactive (or impulsive type) ADHD, and true hyperactive type is rare, rather than a combination like David or Isabelle. So often people aren’t seen as having ADHD, but rather are seen as obstinate, oppositional, etc. and then there’s an expectancy effect, teachers see you that way and it becomes a self-fulfilling prophecy, and often times you need to start over. In 8th grade, Sarah was labeled as oppositional, no one in her elementary school was talking about ADHD, and in high school, she only saw boys with the diagnosis, and didn’t know that girls could be diagnosed with this. Her paths to high school were catholic all girls’ school, or military school, but her dad encouraged her to write a letter of recommendation for herself to get into a selective enrollment school. The principal had never read something similar and gave her a trial year and gave her an extra class and a chance to prove she can read; previously she had tested at reading at an 8th grade level, after a year of hyper focus proving she could, she was reading at a 13th grade level (college level). No one previously thought she had capacity before, and it made a world of difference. David names it’s a hard thing to recognize how healing or destructive labels can be. So many people with hyperactive ADHD are labeled as bad, or need to be broken in (like a horse? Getting the wild out of the horse?) Punish it enough, be strict enough to not be wild anymore. This is similar to Sarah being pushed to a military option—it takes a special thing to teach a kid to lean into their strengths, and we don’t teach them how to fight. And meanwhile Sarah was taught how to fight, and they were not ready for you. Isabelle resonates with Caily’s compliance growing up, and was scared of getting in trouble, and spaced out and daydreamed a lot, and talked a lot, and would get a lot of feedback about her distracting the other students. Also, this was Catholic school and she had to wear jumpers and skirts and walk through Chicago snowy winters in knee socks, or wearing pants underneath and them taking them off. In 2nd grade, she would be doing SSR (Sustained Silent Reading) and her teacher would take her to the back of the classroom and she would bring her coloring supplies and extra books (lots of Jack London). Isabelle struggles with the idea that the system is messed up, and there’s something in feeling more inattentive part, she would walk around feeling like I missed something. The sensation that getting into trouble was not after standing up for herself, it was more, “I know I’m wrong and I can’t fight back because I didn’t hear what you said the first time.” If she’s driving, and a car beeps anywhere, it’s “that’s my fault.” Isabelle describes how eventually the teachers didn’t know what to do with her and were suggesting she skip a few grades, which her mother advocated against because it would mess her up socially. Isabelle always felt years behind socially, much younger than her peers, even into puberty, still thinking “let’s play with My Little Pony!” When the other girls were getting into makeup and dating. And so she was tracked into a gifted program where the ratio of boys to girls was 3 to 1, and likely 9 out of 10 students were neurodivergent. The girls all turned on each other and were really mean, but there was a new transfer student who Isabelle befriended who had an ADHD diagnosis and was unmedicated during a playdate—and Isabelle loved her. She was energetic and couldn’t stop talking and was so excitable and there was this sense that they could play together all day, but she also sensed that that was not okay, that how the girl was behaving was somehow judged as wrong. And boys were those stereotypically diagnosed as having ADHD, so if a girl had it...that must be really bad?  David talks about social conditioning, and he knows that being a guy, there was a lowered set of expectations for him: of course he couldn’t settle down, pay attention, use too much paste, etc. “boys just being boys.” He got into so much trouble in high school, and no one was surprised, because “you’re a boy.” He got kicked out of high school and went to a specialized high school for kids with learning differences, and about 18 or 19 people—and only 5 women, and they were like classical stereotypes of “bad girls,” getting into trouble with boys, or hating everyone. We are all looking at the same dilemma with very different expertise. David has learned that his perspective of “it’s a mess, no big deal” means a big deal to a women who has been socialized to not make messes. Emotions are validated for women (because we’re “irrational,” heavy on the air quotes), whereas of course guys don’t have feelings, because they’re “idiot robots.” Or they can only show a range of anger or assertiveness. Sarah resonates with this in terms of girls being socialized to be compliant, and to mask their hyperactiveness. And then there’s the stereotype that girls must be inattentive type ADHD and so when that shoe doesn’t fit, what does it mean for a woman who is hyperactive?

DAVID'S DEFINITIONS

Expectancy effect: how was you expect another person to be like affects their behavior; this can also be internal, like how you expect yourself to be affects your behavior

 Subtypes of ADHD (using the metaphor of a car with a gas pedal and brakes, in this case the car is the brain)

 -inattentive type: too much brakes

 -impulsive (or hyperactive) type: too much gas

 -combined type: too much of one or the other depending on the environment someone is in (often having mastery or familiarity in an environment can cue the gas to kick in, versus the brakes).

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Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards

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