Summer 2023 Issue of ADDitude Magazine

A Dad’s Role in Modeling Social Skills

Carly Broadway — Wed, 10 May 2023 09:15:02 +0000

I cringed when I heard my nine-year-old son saying to a group of his peers at wrestling practice, “Excuse me. Excuse me.” The boys look perplexed. Why would a kid their age say “excuse me” to them? This was certainly not something I taught him; rather, he learned this in his social skills group at school.

When I realized my son needed help cultivating and sustaining friendships, I looked for a social skills program but found nothing specifically for boys with ADHD. There were plenty of these groups in our area, but most featured well-meaning female clinicians or guidance counselors teaching formal etiquette and scripted communication that did not resemble the way boys talk to each other. “How are you doing today?” “What are your hobbies?” When boys speak in that way, as my son had done at wrestling practice, it comes across as inauthentic. I know this because I was a boy, and I’ve worked with hundreds throughout my career as a school social worker, therapist, and camp director who runs programs for boys with ADHD.

When kids with ADHD struggle socially, their inability to read social cues isn’t the problem. Instead, they more likely have lagging and inconsistent use of social executive function (SEF) skills, which we use to understand others’ thoughts and feelings. These SEF skills help us know how we’re coming across to others, how to read a room (or situational awareness), how to initiate and end conversations, and how to use humor appropriately.

Building Boys’ Social Savvy

When fathers call me about their son’s social difficulties, they tend to talk much more than mothers do, perhaps because this is the first time they’re speaking to another man about this challenge. During these conversations, I find that most parents don’t see the connection between ADHD and lagging social skills. (In fact, I’ve heard a lot lately about kids who were misdiagnosed with autism because of their difficulty with SEF.) I explain the important role that male role models play in helping boys improve SEF skills; and the differentiated and valuable perspective they bring to their sons because they understand how boys’ friendships evolve and how boys communicate when adults aren’t around.

I want each father to understand that his son’s emotional awkwardness, and difficulty understanding how he’s coming across to others, is neither a choice nor apathy. These are skills he is still developing, and he is most likely several years behind his peers’ emotional maturity because ADHD is an executive function developmental delay.

[Download: Solving Behavior Problems Rooted in Executive Function Deficits]

When boys with ADHD struggle socially, their fathers often resort to lecturing, telling their sons what they’re doing wrong. In turn, their sons typically become argumentative or defensive because they truly don’t understand how they’re coming across to their peers. The defensiveness is often a result of their shame, knowing that they have a harder time connecting with their peers but not knowing why.

Tips for Dads

Here are a few tactics for dads, and other male role models, to help boys improve socially:

Cite successes. ADHD brains live in the present. Kids do not think about how to cultivate and sustain friendships when they’re not around their peers. Point out situations when your child showed another boy that he wanted to be friends and kept that friendship going.

Describe healthy friendships. Say what it means to be a good friend as well as when to end friendships that have become hurtful. Many of the boys I’ve worked with were quick to latch on to other boys who showed interest in them. I’ve seen boys cling to friendships when they’re not being treated well out of desperation for friends, or for inclusion in a peer group. In my school-year programs and in summer camp, I share stories about when I was growing up to give the boys examples of good friends I’ve had, and times I’ve had to cut off a friendship.

[Read: Help Your Child Forge Lasting Friendships]

Raise awareness of patterns. Teach boys to understand how they come across to others. In Socially Smarter, my parent training program to build SEF, I depict a sequence of events: your child’s words, another person’s response to those words, and your child’s thoughts and feelings about their peer’s response. Parents can discuss why the interaction worked, or didn’t work, and how future communications can be improved.

Teach tolerance. Being part of a peer group means being flexible. If your child is invited to go bowling, he should go, even if he doesn’t like bowling. He was invited because someone wants to spend time with him. If he says “no” whenever he doesn’t like the activity, he may stop getting invited to outings because the other kids might assume he’s not interested in spending time with them.

Give praise. Kids can’t learn what they should be doing if we don’t praise them for what they’re doing well. That’s why it’s important to offer recognition of and praise for behaviors we do want, such as thinking about others, being flexible, and putting effort into social relationships.

The ADHD executive function liabilities are not gender-specific. Girls with ADHD struggle too. But I don’t teach girls because I did not have the experience of growing up female.

Just as girls need friendships with girls, boys need friendships with boys. They do not need social skills groups or role playing; research shows that clinic-based social skills groups offer no benefit to kids with ADHD. Boys need male role models to help them understand social communication and how friendships evolve between males.

Social Skills & ADHD: Next Steps

Download: Questions to Get Your Child Talking
Watch: The Social Lives of Boys with ADHD
Read: What Parents Misunderstand About Executive Function
Read: 10 Hard (But Essential) Truths for Dads of Boys with ADHD

Ryan Wexelblatt, LCSW, is a licensed clinical social worker, former school social worker, and father to a son with ADHD. He creates content at the ADHD Dude YouTube channel. Learn more at www.adhddude.com.

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Solve My Problem: I Can’t Make Myself Exercise!

Nicole Kear — Tue, 09 May 2023 09:14:43 +0000

ADHD brains benefit from exercise — but they also struggle with follow-through and lack of motivation. Which is why, for most of us, having the best intentions to exercise doesn’t always translate into actually breaking a sweat.

We asked ADDitude’s innovative readers what tricks they have up their sleeve to avoid the powerful pull of the couch and embrace exercise. Here’s what they said:

“I purchased a treadmill and put it in front of the TV. If I want to watch TV, I have to walk on the treadmill for at least 15 minutes.”

“I signed up for a workout class with a friend.”

“Finding someone local to go on a walk with can be a game changer, especially if you explain that you need support getting out of the house). Having the other person to help me “task initiate” is brilliant.”

[Read:Take It Outside! How to Treat ADHD with Exercise]

“When I put a load of laundry in, I do a yoga or walking video until the washing machine buzzer goes off. I get in exercise and feel productive.”

“I just got a VR (virtual reality) headset and am super into one of the fitness games in it. I don’t even realize I’m working out.”

“I tricked myself into liking the gym by getting a “black card” which gets me access to a hydro massage chair! I work out, I get a massage.”

“My creative solution: accountability and competition. I don’t want to exercise, but I do want to keep my promise to play tennis with my friend (and I also want to destroy him).”

[Watch: “How to Leverage Sports Psychology to Benefit ADHD Brains”]

“Committing to just the warm-up portion of a video exercise helps. I usually feel like doing the rest once I’ve warmed up.”

“I have finally, after years of wanting to, got into doing yoga regularly —every single weekday morning. I’ve identified the barriers, and tried to address them. Number one is: I have to work out straight away, as if I do anything else, my meds kick in and I’ll get focused on it too much.”

“Sign up for an intramural sports team. That way, you have people counting on you to show up to practice and for games.”

Workout Motivation with ADHD: Next Steps

Read: 6 ADD-Friendly Tips for Starting and Maintaining an Exercise Program
Download: Free Guide to Health & Fitness — Lifestyle Changes for Adults with ADHD
Read: Exercise and the ADHD Brain -— The Neuroscience of Movement

How Parental Alienation Harms ADHD Families

Melanie Wachsman — Mon, 08 May 2023 09:01:30 +0000

When Nadine Vogel* got divorced, she rented a four-bedroom house so each of her children, ages 14, 16, and 18, could have their own room when they came to visit as her custody agreement dictated — one night a week and on alternating weekends. Except her children rarely came. And when they did, they were often angry and suspicious, repeating their father’s accusations about Vogel. That she was crazy. That her efforts to seek treatment for their ADHD — all three kids had been diagnosed with the condition — proved she over-medicated them. That she was trying to cut off the kids from their dad. That she was not to be trusted.

“In his senior year, my son started drinking, doing drugs, and not going to school,” says Vogel, who lives near Washington, D.C. “They didn’t let him graduate. My kids were all suffering.”

What Is Parental Alienation?

What Vogel and her kids experienced is called parental alienation, a form of emotional abuse so profound its effects on children can last a lifetime. Parental alienation happens when a child aligns with one parent and rejects the other, without justification, due to manipulation by the favored parent. This typically occurs during high-conflict divorces. Methods of manipulation include badmouthing the targeted parent, limiting contact, and interfering with communication.

”We Don’t Talk About It”

A study, published recently in The Children and Youth Services Review found that more than 3.8 million children were affected by parental alienation.¹ These numbers, as devastating as they are, may not reflect the full scope of the problem because “it’s shameful and heartbreaking, so we don’t talk about it,” says Danielle Silverman,* a New York City mother who has been alienated from her three kids, ages 22, 23, and 28, for several years. “It reflects on you, even if you know you did nothing to deserve it.”

Amy J.L. Baker, Ph.D., co-author of Surviving Parental Alienation: A Journey of Hope and Healing (#CommissionsEarned), emphasizes that catching alienating behaviors early, when it’s easier to treat children effectively, is critical. “A mildly alienated child comes back after spending time with the other parent; they may be a little suspicious, cold, wary, but that distrust only lasts an hour. It might take a full week for a moderately alienated child to warm up. Severely alienated children are shut down the whole time they’re with the targeted parent — or they don’t come [to see them] at all,” she says.

[Click to Download: 13-Step Guide to Raising a Child with ADHD]

It’s important to note that, to establish whether a child is being alienated, experts must determine that the targeted parent has not committed abuse or neglect, as the other parent may have alleged.

“Your Dad’s in a Cult”

Crystal Shivers was five when her mother told her that her father was in a cult that killed people. She said it wasn’t safe for Crystal to talk to him or any of his family. This story wasn’t true. “I remember being so sad,” says Shivers, who reunited with her father as an adult. “I missed out on relationships with my cousins, aunts, uncles, extended family, grandparents. It was a huge and heavy burden to carry.”

Joshua Coleman, Ph.D., author of The Rules of Estrangement: Why Adult Children Cut Ties and How to Heal the Conflict (#CommissionsEarned), and senior fellow with the Council on Contemporary Families, says children in alienation situations often suffer from depression and anxiety and have difficulty trusting themselves and others. They also suffer from guilt, low self-esteem, impulse control, and academic challenges. The emotional abuse is usually invisible to teachers, social workers, and even family court judges involved in custody hearings, according to a report by the National Center for State Courts.²

“Your child is out to sea. They’re being pushed underwater,” Coleman says. “You have to be the lighthouse on the shore that’s always on.”

[Self-Test: Does My Child Have Generalized Anxiety Disorder?]

Parental Alienation: Warning Signs

Examples of parental alienation behaviors include:

telling a child that their targeted parent does not love them
saying, or implying, that the targeted parent is dangerous
asking a child to spy on the targeted parent or keep secrets from them
withholding medical, academic, and other important information about the child from the targeted parent

When You’re the Target of Parental Alienation

Look at your own behavior: Is there anything you can change about how you’re relating to the co-parent to avoid triggering them?
Don’t argue with your child about the lies being leveled against you. Do everything you can to make your time together pleasant.
Document every instance of alienating behavior in the event you need to hire a family lawyer, preferably one knowledgeable about parental alienation.
Learn about coping strategies from organizations such as the Parental Alienation Study Group and the National Coalition Against Parental Alienation.

Parental Alienation: Next Steps

Read: When Parents Disagree About ADHD Medications
Q&A: “How Do I Manage Inconsistent Routines and Discipline in a Shared Custody Situation?”
Free Download: Take Charge of Your Child’s Medication

*Vogel and Silverman asked that their names be changed.

Nicole Kear is Consumer Health Editor at ADDitude.

Sources

¹Harman, J. J., Leder-Elder, S., & Biringen, Z. (2019). Prevalence of Adults who are the Targets of Parental Alienating Behaviors and Their Impact: Results from Three National Polls. Child & Youth Services Review. 106, 1-13. https://doi.org/10.1016/j.childyouth.2019.104471

² Lewis, Ken. (2020) Parental Alienation Can Be Emotional Child Abuse. NCSC Trends in State Courts https:www.ncsc.org/__data/assets/pdf_file/0014/42152/parental_alienation_Lewis.pdf

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication

The Dope on Dopamine Fasting: Expert Answers to Your Digital Detox Questions

Carole Fleck — Fri, 05 May 2023 09:51:28 +0000

What Is Dopamine Fasting?

“Dopamine fasting” is a buzzy term for the practice of temporarily abstaining from stimulation — via smartphones, social media, video games, and other platforms that deliver reliable dopamine hits — to feel more pleasure later. Here, psychologist Wes Crenshaw, Ph.D., weighs in on the Silicon Valley and TikTok trend that is gaining momentum, particularly among people in their 20s who have ADHD.

Q: People say they go on a dopamine fast or digital detox to “reset their dopamine levels” so that they will feel heightened pleasure when they return to their screens and other forms of stimulation. Does this work?

Our minds are so habituated to a heightened level of engagement from near-constant phone or computer interaction that taking a pause seems wise. But when it comes to video games, TikTok, and other high-dopamine-hit engagements, doing a “fast” isn’t the way to go because you’re not really changing anything about your brain. It’s better to moderate your device usage to have an effect that’s less negative than stopping cold.

[Read: “My Phone Was My Drug”]

Q: Can a digital detox help your brain overcome addictions to compulsive behaviors like checking social media and high levels of stimulus delivered via texts and alerts?

The idea of using abstinence to address addiction is not supported by research. And it’s not a practical solution for behaviors integral to functioning in the modern world, such as using social media and texting. These tools, when used in moderation, are a regular part of modern life. But when these devices draw you away from more necessary activities, or impair your ability to do daily tasks, they become destructive.

I have college-age clients who put their phones in timed lock boxes for, say, three hours during their study time. Once the box is locked, there’s no opening it without a sledgehammer. This technique is referred to as “precommitment,” and in my experience, it is much more effective than other phone apps.

Q: Can individuals exert control over their dopamine levels or is sensitivity to stimulation just baked into your DNA?

[Read: “I Need a Digital Detox. How Do I Break a Social-Media Habit?”]

The timed lock box is a good example of exerting control, except you’re not really controlling your dopamine; you’re moderating your behavior. That’s about the best anyone can do. Another kind of moderation is setting an alarm to signal when it’s time to exit a game or social media, or shutting down the Internet at 10pm to avoid interrupting sleep with multiple dopamine hits.

Q: Are there risks associated with dopamine fasting? Should people be trying it?

I think the risk is that you constantly feel uncomfortable. Unfortunately, feeling uncomfortable is exactly what a lot of people are trying to escape with so-called addictions. They want things that are easy, fun, and stimulating to their brains instead of the tedium of getting business done.

Dopamine Fasting and ADHD: Next Steps

Read: Wasting Time on Social Media? 6 Ways to Stop ADHD Brains from Doom Scrolling
Read: Hooked on Social Media? How to Break the Habit
Read: My ADD Sabotages My Social Skills Online

Carole Fleck is Editor-in-Chief of ADDitude.

“I Feel Judged and Attacked:” A Teen’s Eye View of RSD

Nicole Kear — Thu, 04 May 2023 09:17:40 +0000

Q: “When friends or classmates at school say that one of my favorite books or movies is bad, I feel very hurt. It doesn’t feel like they just disagree. It feels like a personal attack. When I mentioned at lunch that I liked the Jack Reacher book series, Brendan said, “Ew, that’s a bad book. Why are you reading that?” I got very upset because it felt like he was saying I had bad taste, that I was strange and weird for reading that book. I said softly that I liked it and changed the subject. When someone says something that hurts me, I feel like I’ve messed up somehow.

If someone doesn’t value spending time with me as much as I value spending time with them, I feel rejected. Last month, I said to one of my closest friends that I would like to hang out with him more like we used to. He said that he was cool with the way things are. This hurts a lot. What can I do to make this less painful?”

When teens with ADHD struggle with rejection sensitive dysphoria, it affects their relationships — and their self-esteem. Often, they don’t know how to cope with their intense emotions and, feeling overwhelmed, they may lash out at friends and/or family members.

[Read: Why ADD Makes You Feel. So. Much.]

One of my teen clients told me: “When I come home from school, sometimes I just can’t hold it all together. I yell at my mom and then I feel bad afterward, but I know that I can’t get kicked out of my family.” Other kids will withdraw quietly into their rooms and swallow their pain. As parents, there’s a fine line between supporting your adolescent in managing their big feelings and intervening to diminish their distress.

While some ADHD non-stimulant medications or antidepressants, such as SSRIs, can reduce sensitivity and overwhelm, the following behavioral tools can be very effective to quiet the inner critic, shift perspectives, and develop self-confidence.

How to Deal With Rejection: Help For ADHD Teens

1. Identify limiting core beliefs.

Remind them of situations that contradict those beliefs. Help them to recall times when they felt uncomfortable and did something anyway.

[Self-Test: Could You Have Rejection Sensitive Dysphoria?]

2. Challenge negative self-talk.

Name and reinforce their strengths. Pay attention to what is going well. Give examples of their successes.

3. Help quiet their inner critic.

Help them combat the negative messages they tell themselves by prompting them to create positive self-talk phrases. Practice these so they will be familiar and handy when they are needed most.

How to Deal With Rejection: Next Steps

Read: How Does RSD Really, Actually Feel?
Free Download: Understanding Rejection Sensitive Dysphoria
Read: How ADHD Amplifies Emotions
Learn: 3 Defining Features of ADHD That Everyone Overlooks

Sharon Saline, Psy.D., a licensed clinical psychologist, is an expert in how ADHD, learning disabilities, and mental health issues affect children, teens, and families. She is the author of What Your ADHD Child Wishes You Knew.

ADHD and the Midlife Crisis Crisis

Anni Layne Rodgers — Wed, 03 May 2023 13:18:59 +0000

The film industry has dedicated a whole genre to it. From Lost in Translation and Sideways to American Beauty and Thelma and Louise, it has captivated our cultural psyche since Dudley Moore chased Bo Derek to a remote beach in Mexico. I’m talking, of course, about the midlife crisis — that emotional and psychological inflection point encountered between ages 40 and 60, when the undeniable truth of our mortality smacks headlong into our unrealized dreams and ambitions.

The concept of the midlife crisis began a century ago with Sigmund Freud and Carl Jung, who argued that greater self-awareness and self-actualization in midlife leads to a fear of impending death. Critics challenge whether mortality-related anxiety is actually to blame for the drastic life changes so commonly associated with midlife crisis: divorce, job loss, and convertible acquisition.

Research suggests that 10% to 20% of adults will experience a midlife crisis.¹ Among adults with ADHD, that number is considerably higher: 59% of men aged 40 and older, and 51% of women aged 40 and older said they have experienced a “period of emotional turmoil in middle age frequently characterized by a strong desire for change,” according to a recent ADDitude survey of 1,829 adults with ADHD.

The 690 women and 228 men who responded in the affirmative shared stories of career upheaval, infidelity, divorce, money problems, substance abuse, and burnout. For some, the change was more like a “midlife catharsis” that was long overdue; for others, it was traumatic.

“I divorced my narcissistic ex, started graduate school to become an educator, met the best man I’ve ever known, fell in love (for real this time), and earned two black belts during about an 18-month span of time,” wrote one 49-year-old mother in Washington.

[Take This Self-Test: Do I Have ADHD?]

“I didn’t feel I was able to function in the world,” wrote a 49-year-old male who rated his ADHD symptoms as “life-altering” in his 40s. “I left a seven-year relationship with my partner and stepdaughter, quit my job with no other job to go to, and went to live at a Buddhist monastery.”

These may seem like extreme examples, but the root causes of these crises — namely, ADHD traits like impulsivity, emotional dysregulation, and restlessness — form a ribbon snaking through many of the ADDitude survey respondents’ answers. Indeed, 81% of men and 71% of women who said they have experienced a midlife crisis attributed it to ADHD symptoms and attributes.

“I believe my midlife crisis was a perfect storm of life-stage dissatisfaction, perimenopause, a poor relationship, and the upsurge of previously well-masked ADHD symptoms due to stress, hormonal deficiency, and increased emotional dysregulation (oh, and lockdown!),” wrote a 53-year-old mother who quit her job and divorced her husband of 28 years. “I experienced a peak in my impulsivity, libido, mood changes, and interests in new and varied topics, which I pursued in ways that my husband saw as distractions from the marriage. I needed new stimulation and to get out of old situations that were no longer serving me.”

Here are more stories of ADHD’s impact at midlife, from ADDitude readers reflecting on their experiences:

Impulsivity

“I made a lot of impulsive decisions that weren’t thought through,” wrote a 43-year-old man in the UK. “I cheated on my long-term partner, split up with her, had multiple short-term relationships, sold my house, and invested all my money into a new business without adequate planning that ultimately wasn’t successful and got into a lot of financial debt.”

[Take This Self-Test: ADHD Symptoms in Women]

Emotional Dysregulation and RSD

“I had been driving in the rain my whole life,” wrote a 51-year-old Minnesotan who divorced her emotionally abusive husband. “When midlife hit, I was suddenly navigating rush hour with tornado warnings, hail, and zero visibility. I could no longer manage… To say that my ADHD symptoms of RSD, depression, anxiety, working memory, and overwhelm affected me is an understatement.”

Restlessness and Boredom

“I had created a comfortable life for myself by achieving all of my major goals, but then became extremely restless, feeling like the rest of my life would just be spent maintaining my current success,” wrote a 43-year-old male with ADHD who quit his job, ended a long-term relationship, moved, and “essentially started over.” “There wasn’t enough to look forward to, not enough variety or excitement to be had. The novelty of my previous successes had long worn off.”

Anxiety

“Lately, I want to quit my current job of 27 years, move out of my home of 22 years to another state, and make other life changes like opening my own business,” wrote one 53-year-old woman in Illinois. “I feel this is a result of many things, but namely my ADHD disorganization and emotional dysregulation have heightened my anxiety to a whole new level.”

Risk-Taking

“I quit my job, abandoned a lot of responsibilities, and neglected friendships,” wrote one 44-year-old mother in Pennsylvania. “Eventually, I got sober in AA and realized during that first year of sobriety that I have had ADHD since childhood.”

Overwhelm

“Life feels like it doesn’t work,” wrote a 51-year-old mother in Vancouver, Canada. “How I organize my time, my life, everything is impacted by ADHD. Challenges with self-care and health issues brought on by decades of untreated ADHD make it exceptionally hard to get into a routine that works and is consistent. Life feels harder than ever with perimenopause, teens with ADHD, and my own mother with failing health and untreated worsening ADHD.”

Bravery

“It wasn’t a crisis so much as I reached my limit,” said a 57-year-old woman who escaped an abusive marriage, moved, found new work, filed for bankruptcy, and continues to fight. “I sought counseling and learned that I wasn’t a terrible person; I was in an abusive marriage with a covert passive-aggressive narcissist. I stopped second-guessing myself, feeling shame and self-blame, and not trusting what I saw or valuing how I felt.”

Tenacity

“I’m not sure ‘crisis’ is the right word here,” wrote one 56-year-old Californian who divorced her husband. “I believe it took me until I was 29 to gain the confidence in myself to make the change. And it made my life so much bigger. I would call it midlife bravery. I was never in crisis.”

Regret and Shame

“I had massive burnout due to not being diagnosed earlier and thinking I was a useless waste of space, even though I was taking care of my chronically ill wife and two kids and holding down a full-time job,” said a 44-year-old man with combined-type ADHD in the UK. “I could never relax or rest because, as soon as I stopped, I just wanted to get high or drink as it felt like the only way to calm my mind. I became a shell of my former self.”

Midlife Crisis: Next Steps

Read: ADHD Symptoms in Men Manifest Differently
Download: Free Guide to Hormones and ADHD in Women
Read: Realistic Solutions for Managing Life, Time, & Emotions with Adult ADHD
Watch: “ADHD in Women – How to Unlock Your Potential After a Midlife Diagnosis”

Source

¹Lachman, Margie E. (2003). Development in Midlife. Annual Review of Psychology. Vol. 55:305-331. https://doi.org/10.1146/annurev.psych.55.090902.141521

Hormonal Changes & ADHD: A Lifelong Tug-of-War

Anni Layne Rodgers — Mon, 01 May 2023 09:42:43 +0000

May 1, 2023

Hormonal fluctuations worsen symptoms of attention deficit hyperactivity disorder (ADHD) for men and women alike, and the severity grows more pronounced with age, according to a recent ADDitude survey of 1,829 adults with ADHD. Across genders, ADDitude readers almost equally cited progressively more debilitating challenges during the marked hormonal shifts of puberty, pregnancy, postpartum (the time after childbirth), perimenopause, menopause, and andropause (often called male menopause).

These findings suggest that the traditional view of ADHD — as a childhood disorder that resolves after puberty — was entirely backward.

In reality, both women and men with ADHD report the greatest symptom severity from ages 50 to 59 — during menopause and andropause, respectively. On a scale of 1 (minor impact) to 5 (life-altering), ADHD symptoms from age 50 to 59 earned a 4.24 rating from women and a 4.14 rating from men. In contrast, symptoms during childhood earned ratings of 2.79 and 2.9, respectively. Fading memories, late diagnoses, and recency, or availability bias, may factor into these ratings, but the stories shared by ADDitude readers support the idea that ADHD grows more pronounced — not less — with age.

“The reason so many women are not diagnosed until menopause and beyond is because estrogen falls, leaving our brains when we need it more than ever,” wrote one Californian diagnosed with ADHD at age 62. “Estrogen and dopamine go hand in hand — or, rather, synapse to receptor! Whatever dopamine you have in the center of your brain needs estrogen to get it moving to the frontal lobe, where executive function takes place. It’s a travesty that menopausal women are typically left to feel like we have finally lost our minds.”

Another interesting survey finding that contrasts with traditional thinking: The rate of inattentive-type ADHD was nearly identical across genders, impacting 36.6% of women and 37.9% of men.

[Get This Free Download: Hormones & ADHD in Women]

Both genders share more in common than we might have imagined, however distinct and important differences do exist. For one, women with ADHD are far more likely to experience debilitating comorbidities. According to the ADDitude survey:

Anxiety affected 77.6% of women surveyed (with an average age of 46.4) and 68.9% of men surveyed (with an average age of 47).
Depression impacted 67.9% of women and 61.3% of men.
Migraines were cited by 25.8% of women and 13.4% of men.
Eating disorders affected 16.5% of women and 7.9 percent of men.

Other important gender differences influenced by hormonal spikes and dips were revealed in the ADDitude survey.

Hormonal Changes: ADHD in Puberty

Men said their ADHD showed up in puberty, when testosterone production increases nearly 30-fold¹, by way of the following:

Academic performance issues: 61%
Anger or hostile behavior: 49%
Risk-taking behavior 42%

[Read: Boys 2 Men — When ADHD and Puberty Collide]

For women with ADHD, adolescence was marked by the following:

Feelings of sadness or depression: 70%
Rejection sensitive dysphoria: 63%
Greater worry or anxiety: 58%

A staggering two-thirds of women surveyed said they have experienced premenstrual syndrome (PMS) and/or premenstrual dysphoria disorder (PMDD) — well over the prevalence of PMS and PMDD in the general population.² Survey takers said they experiences the following PMS and PMDD symptoms:

Irritability: 80%
Mood swings: 79%
Cramps or discomfort 79%
Tension/anxiety: 68%
Lack of focus/concentration: 66%

“For me, PMDD meant suicidal ideation, increased meltdowns and shutdowns, a decrease in emotional regulation, extreme sensitivity to rejection, and intrusive thoughts,” said a 39-year-old woman diagnosed with ADHD, anxiety, and autism.

Women also were more likely to report social anxiety, self-harm, and eating disorders in adolescence. “I didn’t show any signs of ADHD or major depressive disorder until I started menstruating. Then all hell broke loose,” said a 41-year-female diagnosed just two years ago.

Men were more likely to report illegal drug use, hypersexuality, and anger-management problems in adolescence than were women. Testosterone levels typically reach their peak around age 20, when challenges shift to procrastination, emotional dysregulation, and relationship problems, according to the ADDitude survey.

“I have always had procrastination and time-management issues, but porn and masturbation became my dopamine release in adolescence, and after the pleasure, it became exhausting,” wrote one 31-year-old male with combined-type ADHD. “It’s been almost 20 years, but my porn addiction hasn’t gone despite trying in multiple ways.”

Hormonal Changes: ADHD in Pregnancy

During pregnancy, a woman will produce more estrogen and progesterone than she will throughout the rest of her life. For 20% of women surveyed, heightened hormones during pregnancy brought greater focus, drive, organization, and sleep.

“My sleep problems completely resolved in pregnancy (I was able to fall asleep easily at a ‘normal’ time and wake up when needed in the morning),” said one 34-year-old woman in the UK. “I was able to focus and felt the most productive I’ve ever felt in my life.”

But 44% of women said they noticed no difference in ADHD symptoms during pregnancy, perhaps because spiking hormone levels were offset by discontinued stimulant medication use (98% of women said they stopped treatment in pregnancy). Another 36% of ADDitude readers said their ADHD symptoms worsened in pregnancy with exhaustion, poor memory, emotional dysregulation, and sensitivity topping the list.

[Free ADDitude Webinar: ADHD, Pregnancy, and Motherhood]

Hormonal Changes: Postpartum and ADHD

Estrogen and progesterone fall off a cliff following childbirth, contributing to postpartum depression in roughly 15% of women.³ Among our survey takers, the rate of self-reported postpartum depression skyrockets to 61%. ADDitude readers reported that symptoms of postpartum depression lasted roughly one year, and included the following:

Crying spells: 76%
Feelings of worthlessness, shame, guilt, or inadequacy: 72%
Mood swings: 66%
Irritability: 62%
Lack of concentration: 58%
Sleep problems: 57%

“It still makes me sad, nearly 20 years later,” said one 49-year-old woman with inattentive ADHD who suffered postpartum depression. “I didn’t want to hold my child and actively sought to hand him off to others in the early weeks. I felt strongly that I wanted a redo, that this wasn’t what I had expected…. I still feel robbed of that miraculous time, but my son and I are closer now than ever — he’s awesome and gives great hugs. Maybe that makes up for it a little.”

Almost half of ADDitude survey respondents said they were not offered any treatment for their postpartum depression, while 41% were prescribed antidepressants and 20% received therapy. “I thought I was a bad mom for feeling how I did, so I masked my issues,” said one 50-year-old mother with ADHD in Colorado.

“The nurses I spoke to did not recognize my postpartum depression and told me it was probably a normal hormonal drop, but things never improved,” said a 36-year-old mother in Pennsylvania.

Hormonal Changes: ADHD in Menopause and Andropause

In 2022, ADDitude fielded a survey of nearly 4,000 women regarding ADHD symptoms in menopause, when production of both estrogen and progesterone drop. It found, among other things, that 70% of women said ADHD had a “life-altering” impact in their 40s and 50s — a finding echoed in the latest ADDitude survey, which found that half of women called ADHD “extremely severe” in menopause.

The most debilitating symptoms during menopause, they said, were the following:

Procrastination and time management: 79%
Working memory problems: 74%
Feelings of overwhelm: 72%
Greater disorganization: 70%

“Menopause coincided with my ADHD diagnosis, starting medication for ADHD, 1-on-1 and group therapy, and I have better coping strategies now than I have ever had,” said a 55-year-old woman diagnosed with ADHD four years ago. “The sadness is still there, for what I have lost and my struggles, but I feel I have developed wisdom, self-acceptance, and awareness.”

In men, testosterone levels gradually drop with age, triggering andropause in their 40s and 50s. Nearly three-quarters of ADDitude survey respondents aged 40 and older said they have experienced andropause, which heightened these symptoms:

Procrastination and time management: 79%
Feelings of sadness and/or depression: 70%
Work performance issues: 68%
Working memory problems: 67%

For many, it was difficult to assign blame to dwindling testosterone, or one of many other life factors during this life stage — namely, divorce, the death of parents, the loss of a job, other health problems, or decades of low self-esteem and a feeling of failure.

“My anger at the world increased and I always felt unsettled,” said one 61-year-old man about how andropause impacted his mental health. “I experienced drug use and fear of sexual failure. I was either bored of things or obsessing on things, feeling frustrated, and intensely trying to please people.”

“In my 40s and 50s, I started to feel an accumulation of self-doubt as I questioned why I was not successful and why I was so self-isolating. I was just not feeling good about myself,” said a 58-year-old male who noticed signs of stress, anxiety, and physical deterioration that led him to seek a diagnosis late in life. “This carried a heavy burden of not feeling pride or confidence in myself, of not liking who I had become, and of never being able to let go of my failures to move on.”

Hormonal Changes and ADHD: Next Steps

Free Download: Menopause & ADHD — Treatments & Interventions
Read: Perimenopause Problems — How Changing Hormones Exacerbate ADHD Symptoms
Read: Inside the Aging ADHD Brain
Resource Hub: The Ages & Stages of ADHD

Anni Layne Rodgers is general manager at ADDitude.

Sources

¹ Nottelmann, E. D., Susman, E. J., Inoff-Germain, G., Cutler, G. B., Jr, Loriaux, D. L., & Chrousos, G. P. (1987). Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels. The journal of pediatrics, 110(3), 473–480. https://doi.org/10.1016/s0022-3476(87)80521-8

² Clark, K., Fowler Braga, S., Dalton, E. (2021). PMS and pmdd: Overview and current treatment approaches. US Pharm, 46(9), 21-25. Retrieved from https://www.uspharmacist.com/article/pms-and-pmdd-overview-and-current-treatment-approaches

³[1] Bauman, B. L., Ko, J. Y., Cox, S., D’Angelo Mph, D. V., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020). Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression – United States, 2018. MMWR. Morbidity and mortality weekly report, 69(19), 575–581. https://doi.org/10.15585/mmwr.mm6919a2

Treating for Two: ADHD Meds in Pregnancy

Nicole Kear — Fri, 28 Apr 2023 09:07:31 +0000

ADHD symptoms can impair work and home life so severely that women are increasingly electing to continue taking their medications during pregnancy. In perinatal psychiatry, clinicians meet with women and their families as they plan for pregnancy and review the risks associated with continuing and discontinuing their ADHD treatment throughout pregnancy.

Stimulants During Pregnancy: Insights from Research

Many of the largest studies on the reproductive safety of stimulant medications are reassuring, finding no increased risks for adverse outcomes like congenital malformations, perinatal death, and obstetric complications. More recent studies have suggested a potential association between the use of methylphenidate and cardiac malformations, particularly ventral septal defects (a hole in the heart). Though the risks are low, and confounding variables exist, the patient and her obstetrician could consider doing a fetal echocardiogram, a procedure that provides additional data on the baby’s heart development, if she chooses to continue her methylphenidate throughout pregnancy.Other women decide to stop using stimulant medications during pregnancy due to a lack of data about long-term neurodevelopmental outcomes for children. These women would do well to consider nonpharmacologic treatment for ADHD, including cognitive behavioral therapy, a reduced workload, stress-mitigating strategies, and coaching and support groups.

[Download: Navigating Natural ADHD Treatment Options]

A small study showed that women who discontinued stimulant treatment during pregnancy, but who didn’t stop taking their antidepressant medication, experienced a clinically significant increase in depression. They also were more likely to experience conflict within their family, rate parenting as more difficult, and report feeling more isolated.

Conversely, many perinatal women (the time before and after the birth of a child) have reported significant benefits from taking their ADHD stimulant medication, including feeling more “together,” centered, and generally competent. This, in turn, can have a positive impact on functioning and parenting. One change in ADHD treatment can potentially lead to psychiatric symptoms, which doctors seek to avoid during the transition to motherhood.

ADHD Treatment Considerations

The new demands of caring for their babies during a time of changing hormone levels, infant feedings, and sleep disruption are exceedingly difficult for some women. Being an effective mother requires the ability to get and stay focused, modulate attention, control impulsivity, and utilize executive function skills. Women with ADHD struggle in these domains, yet this population and the course of their condition during pregnancy and the postpartum period have received little attention and systematic study.[Read: Women, Hormones, and ADHD]

Women of reproductive age with ADHD would benefit from working with a psychiatrist and/or medical team to understand the impact of hormones on ADHD throughout the lifespan, and the interplay with medication. For example, stimulants may be less effective during the second half of the menstrual cycle, and hormone replacement therapy can improve ADHD symptoms in postmenopausal women.

Working with an integrated, informed, and supportive health care team can lead to better outcomes for women.

ADHD Treatment in Pregnancy: Next Steps

Read: Motherhood with ADHD
Download: Free Guide to Hormones & ADHD in Women
Download: Free Parenting Guide for Moms & Dads with ADHD
Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, and Treated Inadequately

Allison S. Baker, M.D., is a child and perinatal psychiatrist at Massachusetts General Hospital.

Help! My ADHD Spouse Finds Relationship Drama Stimulating

Melanie Wachsman — Thu, 27 Apr 2023 09:34:03 +0000

Relationship Problem: Couple Fighting

Q: “My spouse and I fight a lot. He provokes conflict, whether he’s aware of it or not. It’s like he needs the stimulation of an adrenaline rush. How can I break this pattern?”

Here are some approaches you might take based on the underlying motivation for his conflict-seeking behavior.

He finds conflict stimulating. If the fights are purely about stimulation, then your approach should be two-fold. First, don’t engage by being sucked into an argument. Practice emotional stability work such as meditation, journaling, exercise, mindfulness, or anything that enables you to stay calm in the moment. Respond to him by saying, “I can see that you’re upset.” You might want to tell him in advance that you don’t wish to join in these conflicts but would be happy to address any relationship problems you have when he is calm.

[Free Resource: Emotional Regulation & Anger Management Scripts]

Second, it would serve him well to replace the conflict with another form of stimulation, such as exercise, or taking up a new sport or hobby. Of course, he would need to first agree that the conflict between you is not desirable. The less you feed the conflict stimulation, the more likely he is to go in a better direction.

He is stressed out. Stress and ADHD are a combustible pair, and many people lash out when under pressure. In this case, stay clear if the stress cannot be avoided (for example, he’s late for a plane and very agitated) or seek ways to reduce household stress, if there isn’t a specific trigger.

You’ve become the “enemy” in your relationship. Your partner might be picking fights with you because a storyline has developed in his head that you are doing things to him that he doesn’t like. Common examples: You’re too controlling, or your behavior triggers feelings of shame. He generally feels unloved and even disliked, so he lashes out in anger. If this is the situation, you need professional couples counseling.

— Melissa Orlov is a marriage consultant who specializes in helping ADHD-affected couples balance their relationships.

Relationship Problem: Toxic Love

Q: “We’re worried about our young adult daughter’s relationship. Her boyfriend seems manipulative and controlling. She has ADHD and hasn’t had a lot of romantic experiences. What should we do?”

Since your daughter is an adult, the best (and only) thing you can do is express your concerns and offer your support. Pushing or encouraging her to leave her partner may strengthen their bond, and he may use this to further alienate your daughter from friends and family.

[Free Resource: Manage ADHD’s Impact on Your Relationship]

If or when your daughter does leave the toxic relationship, offer support without judgment. Refrain from criticizing her former partner. Remember that a person in an abusive relationship will return three times, on average, before they leave for good. Be prepared for the possibility that she’ll return to the relationship and decide in advance how you will respond if she does.

— Stephanie Sarkis, Ph.D., is a clinical specialist in child and adolescent counseling.

Relationship Problems with ADHD: Next Steps

Learn: How to Respond to Gaslighting — in Your Relationship and in Yourself
Free Download: Get A Grip On Tough Emotions
Watch: “Gaslighting, Love Bombing & Beyond – How to Recognize (and End) Toxic Relationships with ADHD”
Read: How to Fix a Relationship: 9 Solutions from ADHD Couples

“Stop Trying to Fix Everything!” Scripts for Reflective Listening

Carly Broadway — Wed, 26 Apr 2023 15:46:56 +0000

Q: My teen has ADHD, and sometimes, she can be very sensitive. When she confides in me, I don’t always know when I should give her advice and when to stay quiet and just listen. How can I tell which response is best?

When your teen opens up, try to determine whether she just wants a safe space to vent or she is uncertain and seeking guidance. Knowing is half the battle. A teenager’s primary job is to move away from their parents little by little to eventually become fully independent. Teens are a lot like toddlers—venturing farther from you to test their independence, but still requiring support as they face a host of dangers they don’t understand. Your role is to encourage safe exploration and stand by.

You can do this by listening reflectively and asking thoughtful questions. Your best strategies will be to reflect on what you’re hearing, to be honest about your own uncertainty, and to ask what she needs. If she does want guidance, be sure to keep your advice simple, brief, and nonjudgmental.

[Download: Free Parenting Guide for ADHD Caregivers]

You might say something along these lines:

“It sounds like this situation with Suzie is really frustrating. I have some thoughts about how you might handle it, but I’m not sure that’s what you want right now.”
“Seems like you’re facing a tough choice. What would be the positives if you made choice A? What about B? Are there any negatives to either choice?”
“Gosh, that is a dilemma. How would you feel if you didn’t (do the thing, say the thing)?”
“I see how much thought you’re giving to this, and I get how challenging this must be. What does your gut say?”

Walking alongside her as she thinks about and solves her own problems is far more powerful, and supportive of a growth mindset, than is solving the problems for her. But don’t be surprised if she resists answering your questions. If her response is a sigh and an eyeroll, show your reflective listening with responses like, “I get it. Wow, that’s hard.”

Remember to acknowledge her thoughtfulness, as praise is scarce for many teens who have ADHD. You might say, “Thanks for including me as you think this through. I’m really impressed by how you’re handling it.” For a teen who struggles (and let’s face it: what teen doesn’t?), knowing you’re her ally, confidante, and biggest cheerleader can be the best scaffold in the world.

Parenting Teens with ADHD: Next Steps

Download: Questions to Get Your Child Talking
Read: “When Fixing His Problems Didn’t Fix Anything, I Finally Learned to Listen.”
Read: Don’t Freak Out! And 13 More Rules for Navigating Teen Behavior Challenges

Merriam Sarcia Saunders, LMFT, is a licensed psychotherapist working with parents who have children with ADHD. She is the author of five books on ADHD and the creator of the on-demand course, How to Parent ADHD: 5 Steps to the Relationship You Want with Your ADHD Child.

I Fired My Therapist. It Was an AI Chatbot.

Nathaly Pesantez — Tue, 25 Apr 2023 09:46:23 +0000

My therapy sessions typically begin with a big smile. “Hi, Eliza!” Stephanie says. “It’s so good to see you!” She usually mentions something fun and asks, “So how’d [that thing I was excited about] go?” Maybe it’s a secret therapist trick, but even via a telehealth portal, her care feels genuine — her smile reaches her eyes; she nods along.

I have another therapist whom I see on my phone, too. But unlike Stephanie, this therapist starts a session by asking if I would like to “get help with a problem,” “work on my goal” (which has been decided for me), or “track and journal.” Also unlike Stephanie, this therapist is available 24/7 — but doesn’t remember my big parties, my book launches, my successes, or my failures.

This therapist is named Woebot, and it’s a therapeutic chatbot powered by artificial intelligence (AI).

A free app available for both Apple and Android devices, Woebot serves “tens of thousands” of users daily, said its founder and president, psychologist Allison Darcy, in The New York Times in 2021. Based on principles of cognitive behavioral therapy (CBT) and “natural language processing,” Woebot engages users in text-based conversations, and is designed to help people cope with stress, anxiety, and depression in a growing field of mental health tools.

Woebot tells me during our chats that it can also help with my anger, procrastination, and guilt — common issues for people living with attention deficit hyperactivity disorder (ADHD). It sounds useful: America is plagued by a therapist shortage and long wait times for care. The high cost of therapy can also be a barrier. If you can’t find a therapist and you need one fast, a free chatbot built on sound CBT-based science sounds tempting.

My advice: Resist.

[Read: The Top 6 Mental Health Apps, According to ADDitude Readers]

WoeBot Woes

Woebot assumes neurotypicality. It expects that all brains can be retrained to cope with negative emotions using the same therapeutic model. But ADHD brains process information and emotions differently.

For example, Woebot doesn’t understand that people with ADHD have big, all-consuming emotions. When I told it I was mad, Woebot told me to “imagine my emotions had a voice.” Wait, what? I was in total rage mode when it asked me to write down three of my angry thoughts. So I did, albeit poorly. It then asked me to identify my “cognitive distortions” — i.e., thought patterns that aren’t based on facts.

But when I’m mad, I am too flooded with hot emotion to stop and look for cognitive distortions. Something is wrong; I need to calm down, but the opposite is now happening.

Woebot also claimed it could help with procrastination. But it offered such a complicated mathematical equation about the merits of doing something now or later that I couldn’t (and still can’t) understand. Maybe it could assist in a pinch — if I remembered it existed. But Woebot did not intervene when I began tumbling through TikTok rather than washing dishes.

[Read: The Emotional Resilience Playbook for People with Big Emotions]

Woebot was no match for my negative self-talk, either. When I told it I felt sad because I don’t have any friends — social issues are a common problem in women with ADHD — it launched an ineffective CBT round-and-round that had me fill in blanks and flag “unhelpful” thoughts. Eventually, I avoided my negative thoughts by watching TV instead. (Avoidance is not an acceptable tactic for coping with negative thoughts, of which I had several regarding Woebot.)

We Need More Than AI Chatbot Therapy

At least Woebot comes with safeguards: Certain words trigger suggestions for immediate clinical intervention. During one conversation, Woebot told me, “I can’t comment on the content of your thoughts, just the process. If you’re looking for guidance around content, this might best be done with a human.” I still don’t know what triggered that response, so how would someone in serious trouble understand it, and how could it help those people using Woebot in place of that therapist with availability in October?

No matter how poor my efforts or how ineffective our sessions, Woebot always told me that making an effort was the important part. Unfortunately, mental illness doesn’t get bonus points for effort. We need effective help to improve our lives. And that means a human therapist, not a bot.

AI Chatbot Therapy and ADHD: Next Steps

Find: Psychologists and Therapists Who Understand ADHD
Free Download: Emotional Regulation & Anger Management Scripts
Read: “How Therapy Helped Me”
Read: How Cognitive Restructuring Reframes Failure and Erases ADHD Self-Doubt

Heart Health and ADHD: On Cardiovascular Risks and Treatments

Nicole Kear — Mon, 24 Apr 2023 09:41:38 +0000

As if having an ADHD nervous system were not hard enough, research now shows that having the disorder nearly doubles the risk of heart disease, regardless of a person’s age, gender, or ADHD medication use.

In a study of 5 million adolescents and adults from Sweden, researchers found that having any mental health condition increased the risk for all cardiovascular conditions — and that risk more than doubled for those with ADHD and one or more co-existing conditions. Surprisingly, the greatest risk was in young adults and not in the elderly. While the cause is not yet known (a genetic predisposition is likely), we can now see that the risk is broad and substantial.

How Comorbidities Complicate Heart Health

The incidence of heart disease was 1.8 times higher among people with ADHD than it was in the general population, with cardiac arrest and strokes posing the greatest risk. If a person has ADHD and a co-existing mental health condition, the risk of heart disease more than doubles. For those with substance use disorder, the risk increases 2.53-fold; eating disorder increases the risk 2.75-fold; conduct disorder boosts it 2.79-fold.

The study also confirmed previous findings that men faced higher risk than did women throughout the lifespan.

[Read: ADHD Medication Not Associated with Cardiovascular Risk at Any Age]

Many people want to ignore or deny the seriousness, and even the existence, of ADHD to justify not treating their own and/or their child’s ADHD. The Swedish study should raise awareness and a sense of urgency about the necessity of making good lifestyle choices, such as quitting smoking and substance use, eating healthy, and exercising, all of which have been shown to protect against many illnesses.

Treating ADHD Decreases Your Risk

It is important to emphasize that medication treatment of ADHD and other mental health conditions effectively decreased the risk of heart disease in many cases. The research also emphasized that ADHD and other mental health conditions, such as depression and anxiety, should be aggressively treated with medication to protect against the well-known risks posed by the conditions.

6 Ways to Improve Your Heart Health

Mitigate the risk for heart disease by doing the following:

Establish ongoing care with a clinician who can guide you toward a more balanced lifestyle.
Get a baseline cardiac workup, especially if you’re a young male adult.
Ask relatives about heart disease in the family. Most of the risk of heart disease is genetic. This can help you to assess your individual risk.
Exercise regularly.
If necessary, lose weight on a healthy, balanced diet.
Use a pill box to assist you in taking all of your medications consistently.

[Read: The Dopamine Deficiency That’s Sabotaging Your Diet]

This new information confirms much of what we already know: People with ADHD and other mental health conditions can lead healthy and fulfilling lives when they protect their health and wellbeing.

Heart Health and ADHD: Next Steps

Read: Exercise and the ADHD Brain – the Neuroscience of Movement
Download: The ADHD Healthy Habits Handbook
Read: The Best Nutrition & Diet Apps for ADHD Brains
Download: Free Guide to Healthy Lifestyle Changes for Adults with ADHD

William W. Dodson, M.D., LF-APA, is a board-certified adult psychiatrist and one of the first practitioners to specialize in treating adults with ADHD.

ADHD Symptoms in Men Manifest Differently

Melanie Wachsman — Fri, 21 Apr 2023 09:57:43 +0000

As a 62-year-old man with ADHD, I can get emotional quickly and often about relatively insignificant things. I can be immature and irresponsible. For years, I have felt embarrassment and shame about the lack of progress in my career. I also have learned that these characteristics, among others, are more pronounced in many men with ADHD than they are in their female and neurotypical counterparts.

Much has been written, deservedly, about the unique challenges facing women with ADHD. But, arguably, not as much has been written about how men experience ADHD differently. Sure, most of us know that hyperactive boys are more likely to be diagnosed than are inattentive girls. However, the people in our lives really need to understand the differences men with ADHD experience.

Here are examples of how I think ADHD manifests differently in the sexes.

Common ADHD Symptoms in Men

Delayed emotional development. Research has shown that males mature more slowly than do females, and this seems especially true for men with ADHD.

Being quick to anger. While girls tend to internalize emotions, boys are more likely to externalize theirs. It stands to reason, then, that boys with ADHD have higher rates of oppositional defiant disorder (being argumentative, uncooperative, and sometimes hostile). In adulthood, men with ADHD are more prone to emotional outbursts fueled by anger at real or perceived slights.

Resistance to pursuing a diagnosis. In my many years of ADHD coaching, I’ve encountered countless women who struggle with their husband’s or young adult son’s resistance to seek or accept an ADHD diagnosis because they fear the “stigma” of the disorder, and, in their male minds, it’s admitting to “weakness.” Unsurprisingly, most of my female social media followers are the ones who most actively pursue understanding ADHD on behalf of their husbands, their kids, and themselves.

[Take This Test: Could You Have Adult ADHD?]

Lackluster career advancement. This issue for men arises, in part, from the social construct that still expects men to be the head of the household, the main breadwinner. When a man with ADHD is unable to perform optimally in or successfully retain his job (as was the case for me for many years), the shame and guilt can be devastating.

Think about how often new social interactions begin with, “So, what do you do for a living?” In other words, what is your value? And when you’re not proud of what you do, or how well you’re doing it, you feel shame and embarrassment.

How Men Can Manage ADHD Symptoms

Men with ADHD need a safe place to share their struggles, like a support group with people who share similar challenges. Feeling heard, and learning new ideas for how to cope, can be very comforting.

Mindfulness training and exercise can help with mood stabilization and rein in emotions. I also recommend working with your partner, and perhaps a therapist, on communication strategies to control outbursts before they happen.

[Take the ADHD in Men Survey]

I’ve found that understanding common ADHD symptoms in men and working on managing them has helped me become more effective in my life as an adult with ADHD.

ADHD Symptoms in Men: Next Steps

Read: Men with ADHD Are Asking, “Why Am I So Angry?”
Blog: “I’m a Better Father, Now a Better Person”
Download: Emotional Regulation & Anger Management Scripts

Alan P. Brown is an ADHD coach and host of CrusherTV. His free eBook, 5 Things You’re Doing Every Day That Make Your ADHD Worse, is available at www.ADDCrusher.com.

Q: “Should My Child Skip ADHD Medication on Weekends?”

Nathaly Pesantez — Wed, 12 Apr 2023 09:58:14 +0000

Q: “What do doctors think of ADHD medication vacations? What happens if we don’t give our child medication on the weekends? Can we stop medication during holidays, school closures, and any other time our child isn’t in school?”

ADHD medication vacations are the biggest no-no that I can think of. I say that as a clinician with decades of experience treating children with attention deficit hyperactivity disorder (ADHD).

Often, parents are driven to give their child breaks from medication because of appetite reduction, sleep difficulties, and other side effects associated with taking stimulants. But medication vacations, even just on weekends, only increases the likelihood that side effects will occur.

[Read: ADHD Medication Vacation Pros and Cons]

Here’s why: The body and brain need to gradually adjust to the side effects of ADHD medication, if there are any. That can only happen if medication levels are constant. Side effects like appetite reduction and sleep difficulties tend to dissipate after a few steady weeks on medication. Children will begin to sleep better, and their appetite often improves to what it was before taking medication.

I can’t emphasize enough that this process takes time. If a child stops taking medication every weekend, then it is as if that child is newly starting on ADHD medication every Monday morning. The brain does not have a chance to adjust to medication treatment — an effect that is even greater with longer medication vacations. As a result, children experience fewer side effects if they take medication seven days a week, 365 days a year.

Medication adherence is a problem among teens, who commonly think they only need medication for school-related matters. But ADHD, as we know from research, affects practically all domains of life, from social relationships to driving. Consider the teen who wants to drive to meet their friends over the weekend. If they’re unmedicated, their risk for getting into an accident is two to six times greater than if they were on medication.

The bottom line: Think twice and talk to your physician before you stop your child’s treatment plan, even for a short break.

How to Treat ADHD in Children: Next Questions

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “ADHD Medication Options and Benefits for Children” [Video Replay & Podcast #438] with Walt Karniski, M.D., which was broadcast on January 19, 2023. Dr. Karniski is the author of ADHD Medication: Does It Work and Is It Safe?

10 Awesome Audiobooks for Teens Who Think Differently

Nicole Kear — Mon, 03 Apr 2023 09:26:48 +0000

Best Audiobooks for Young Adult Readers

Books don’t typically compete with the fast pace, easy excitement, and instant gratification of TikTok, Snapchat, and YouTube — especially for ADHD brains that crave stimulation. Many teens who struggle with print, whether because of dyslexia or another learning difference, would rather scrub the bathroom than crack open a work of literature. That’s where audiobooks fit in.

Far from the dry “books on tape” of yesteryear, new audiobooks come to life with high production values, celebrity narrators, and often a multi-person cast of voice talent. Readers have noticed the improvement, and they are riding the audio wave in record numbers: the most recent report from the Audio Publishers Association shows that sales have increased by double digits each year for 10 straight years. Among the most popular genres are fantasy, science fiction, and mystery — all hugely popular with a teen audience. What’s more, audiobooks can bolster reading skills, according to recent research, including a study published in Journal of Neuroscience, which found that the brain responded the same way to content, whether read or heard. Long story short: audiobooks are worth a look — or, rather, a listen.

So, we’ve compiled a list of 10 terrific audiobooks that will rivet young adult readers. Spanning fantasy, historical fiction, dystopian lit, love stories, and murder mysteries, every book on our list features voice actors who powerfully conjure the story, drawing in even the most resistant teen.