Podcast Summary: ADHD In Women & Girls with Dr. Jennifer Garish & Dr. Julia Schechter

Podcast Information:

• Title: Laugh Lines with Kim & Penn Holderness
• Hosts: Kim & Penn Holderness
• Episode: ADHD In Women & Girls with Dr. Jennifer Garish & Dr. Julia Schechter
• Release Date: March 4, 2025

Introduction

In this enlightening episode of Laugh Lines with Kim & Penn Holderness, the hosts delve deep into the complexities of Attention Deficit Hyperactivity Disorder (ADHD) as it uniquely affects women and girls. Joined by esteemed experts Dr. Jennifer Garish and Dr. Julia Schechter from Duke University's Center for Girls and Women with ADHD, the discussion sheds light on the often-overlooked nuances of ADHD in females.

Understanding ADHD in Women & Girls

Dr. Jennifer Garish ([04:19]):
"When you think of ADHD, you generally think of this little rambunctious boy literally running into walls... But we're starting to learn that females can have ADHD, and it might look a little different than the typical male presentation."

Dr. Garish emphasizes that the traditional perception of ADHD is heavily male-centric, leading to the underdiagnosis of ADHD in women and girls. She highlights that ADHD in females often manifests as inattentive symptoms rather than the hyperactive behaviors typically associated with males.

Dr. Julia Schechter ([07:13]):
"A lot more boys and men have been diagnosed than women and girls, but there is some evidence to suggest it might be more even across genders."

Dr. Schechter points out the disparity in diagnosis rates between genders, suggesting that ADHD may be equally prevalent in females but remains underdiagnosed due to differing symptom presentations.

Challenges in Diagnosis

Kim Holderness ([16:26]):
"Women being diagnosed as adults now, because there's more awareness, are going through perimenopause. So is it hard to distinguish what's anxiety, what's ADHD, what's perimenopause?"

The conversation explores the intricate interplay between ADHD, anxiety, and hormonal changes in women, particularly during perimenopause and menopause. This overlap complicates the diagnostic process, making it challenging for both patients and clinicians to identify ADHD accurately.

Dr. Garish ([19:28]):
"Even with all my resources and being embedded here at Duke, it took me two and a half years to find a provider who would listen to me and diagnose me."

Drawing from personal experience, Dr. Garish illustrates the difficulties women face in receiving timely and accurate ADHD diagnoses, even within top-tier medical institutions.

Symptom Presentation in Females

Dr. Schechter ([27:39]):
"Girls and women with ADHD tend to have more inattentive symptoms compared to hyperactive, impulsive symptoms. We're talking about things like being easily distracted, having difficulty sustaining attention, and being disorganized."

The experts discuss how ADHD in females often presents internally, with symptoms such as distractibility and organizational challenges, rather than the external hyperactivity seen in males. This subtlety contributes to the underrecognition of ADHD in women and girls.

Dr. Garish ([30:26]):
"Women tend to be sort of internally hyperactive and externally inattentive. Their brains are racing, but outwardly they might seem calm or just unfocused in non-disruptive ways."

Dr. Garish further explains the "internal hyperactivity" prevalent in females with ADHD, where the constant mental activity isn't always visible, leading to misconceptions about their behavior and capabilities.

Impact of Undiagnosed ADHD

Dr. Schechter ([41:03]):
"Women and girls with ADHD are at higher risk for negative outcomes such as self-harm, suicide attempts, and unintended pregnancies. ADHD impacts every facet of life, from relationships to financial management."

The discussion highlights the severe consequences of undiagnosed or untreated ADHD in females, including heightened risks of mental health issues and impaired life management skills, ultimately contributing to reduced life expectancy.

Dr. Garish ([42:27]):
"Individuals with ADHD are more likely to engage in substance use or smoking, especially if their symptoms are not well managed. There are also connections between ADHD and cardiovascular health."

Dr. Garish underscores the broader health implications associated with unmanaged ADHD, emphasizing the urgent need for comprehensive support systems and effective treatments.

Personal Stories and Advocacy

Dr. Garish ([58:26]):
"First of all, you are not broken. You are perfect just the way you are. You are not alone. Embracing your ADHD means recognizing your strengths and understanding your needs."

Both Dr. Garish and Dr. Schechter share heartfelt personal anecdotes about their journeys with ADHD, advocating for self-acceptance and resilience. Their stories serve as a beacon of hope for listeners grappling with similar challenges.

Kim Holderness ([63:54]):
"Knowing that it took you two and a half years to get diagnosed, don't give up. Start with your primary care physician and go from there."

Kim emphasizes the importance of persistence in seeking diagnosis and support, encouraging listeners to take proactive steps in their mental health journeys.

Strategies for Management and Support

Dr. Schechter ([61:07]):
"If you think you might have ADHD, continue to advocate for yourself and educate yourself. Utilize resources like the Duke Center's website for vetted information and tools to prepare for medical appointments."

The experts offer practical advice for women and girls suspecting they have ADHD, including self-advocacy, education, and leveraging specialized resources to facilitate effective diagnosis and management.

Dr. Garish ([64:01]):
"Don't give up. Start with your primary care physician, go from there, and utilize available tools to organize your thoughts before appointments."

Dr. Garish reiterates the importance of seeking professional help and using structured methods to communicate symptoms and concerns effectively during medical consultations.

Conclusion and Call to Action

The episode concludes with the hosts expressing their deep appreciation for the work done by Dr. Garish and Dr. Schechter. They highlight the critical need for increased awareness, funding, and research to bridge the gaps in understanding and supporting women and girls with ADHD. The hosts advocate for widespread acknowledgment of ADHD's unique manifestations in females and encourage listeners to support initiatives that promote comprehensive education and resources.

Notable Quote:

• Dr. Garish ([42:27]):
  "Not only are women and girls with ADHD experiencing the usual challenges, but there are unique additional burdens that make the difference in mortality not surprising to us at all."

Key Takeaways

• Underdiagnosis in Females: ADHD in women and girls often goes unnoticed due to predominantly male-focused research and differing symptom presentations.

• Symptom Differences: Females typically exhibit more inattentive symptoms, such as distractibility and disorganization, which are less conspicuous than male-associated hyperactivity.

• Consequences of Undiagnosis: Untreated ADHD in females can lead to severe mental and physical health issues, contributing to reduced life expectancy.

• Importance of Advocacy and Education: Self-advocacy, education, and utilizing specialized resources are crucial for women and girls seeking diagnosis and support.

• Need for Research and Support: There's an urgent need for targeted research and comprehensive support systems to address the unique challenges faced by females with ADHD.

Additional Resources

• Duke Center for Girls and Women with ADHD:
  Access extensive resources, educational materials, and support tools at Duke ADHD Center.

• ADHD is Awesome Book:
  For more insights and strategies, consider reading "ADHD Is Awesome: A Guide To (Mostly) Thriving With ADHD" by Kim & Penn Holderness.

This episode serves as a critical conversation starter, urging both the medical community and the public to recognize and address the distinctive ways ADHD impacts women and girls. By fostering understanding and supporting targeted initiatives, society can better support females navigating the complexities of ADHD.