Does Shanae Ankney have any idea what ADHD is?

From what we’ve seen on The Bachelor, no! And while it was lovely to see the other contestants and Bachelor Nation at large condemn Shanae’s comments and come out in support of Elizabeth, we’ve noticed that many of those well-intentioned statements showed a lack of understanding as well. 

This isn’t surprising. The way ADHD (Attention-Deficit/Hyperactivity Disorder) is represented in popular culture rarely aligns with the day-to-day reality of living with the disorder. One of our writers, Toby, is intimately familiar with that reality. She was diagnosed just a few years ago.

Women with ADHD often find it hard to talk about their disorder. That’s right: the stigma against ADHD is so strong that people who are defined by their lack of filter, chattiness, and tendency to overshare, don’t share about having ADHD. 

The difficulty of staying quiet is compounded by the fact that women with ADHD are often deeply empathetic (even if they don’t show it in conventional ways). When asked, they say their desire to share their diagnosis comes from the urge to help other women and girls avoid the same struggles they went through. Then, they see women like Shanae on the screen and their decision to shove down that part of them is affirmed. 

But, we need to talk about it. 

ADHD is underdiagnosed in women and girls and that is dangerous.

The bias towards white men in the medical world is real and has serious repercussions. 

Women are fifty percent more likely to be misdiagnosed after a heart attack. When male and female patients expressed the same amount of pain, observers viewed female patients’ pain as less intense and more likely to benefit from psychotherapy versus medication as compared to men’s pain. Historically, medical research has excluded women and pharmaceuticals were tested in male-only studies. Eight out of ten of the drugs removed from the U.S. market between 1997 and 2000 were withdrawn because of side effects that occurred mainly or exclusively in women

So it doesn’t come as a surprise that women are decades behind men in ADHD research and treatment. 

For the longest time, professionals didn’t even think women could get ADHD

“ADHD is a male disorder. Hyperactive boys, deemed disruptive and unmanageable, were the ones referred to clinics. Early studies were based on the behaviors of these white hyperactive boys; these findings helped shape the diagnostic criteria and assessment scales still in use today.”

When Shanae ignorantly mocked Elizabeth’s disability as something that only hyperactive young boys have, it was felt by thousands of women around the country who have had to overcome not just the personal hurdles of having ADHD, but the additional pain of needing to convince people — sometimes their medical professionals — that it was real.

What exactly is ADHD?

ADHD is a neurological disorder.

We’ve seen it referred to as a mental health issue, which is partially right, but it’s complicated because the phrase “mental health” is attached to its own set of stigmas and beliefs. In the simplest terms, people with ADHD struggle with executive function. This means they often have trouble starting or finishing tasks, managing impulses, concentration, distractions, working memory, time blindness, or even emotional regulation.

And, while most people struggle with some of these things some of the time (leading people like Shanae to declare, “everybody has ADHD!”), the difference is that people with ADHD struggle with these things on a daily basis to the point that it interferes with their abilities to function in daily life. 

Girls with ADHD are much less likely to be hyperactive — to the point that some psychologists avoid using the term “Attention-Deficit/Hyperactivity Disorder” to explain the diagnosis. There are three types of ADHD, with most girls falling under the “inattentive” subtype.

ADHD in women is further complicated by gender role expectations,

 “Society’s long list of expectations for women — managing the self, the family, and the home — requires consistent coordination of executive functions.

Women with ADHD are not well-wired for these demands. But in seeking social acceptance, they are often determined to meet them, typically by masking symptoms and problems. Shame and self-blame fuel the dynamic interplay between societal expectations and ADHD’s executive dysfunction. To understand women with ADHD, clinicians cannot underestimate the extent to which women measure their self-worth and self-esteem according to their success in conforming to gender expectations.”

Or, put another way, 

“In an attempt to avoid social sanctions, many girls with ADHD spend excessive amounts of energy trying to hide their problems, which in turn go unrecognized by others.”

Many girls with undiagnosed ADHD excel in school and don’t start visibly struggling until entering an environment like college which requires much more organization and self-direction. 

Where it gets even messier — and more dangerous — is that ADHD is commonly misdiagnosed as anxiety or depression, especially in women.

Nearly one in four women with attention deficit hyperactivity disorder (ADHD) has attempted suicide. 

However, these mental health struggles are often the result of trying to function in a world that is not designed for them and not a symptom of ADHD itself (one theory posits that people with ADHD are wired like hunters in a farmer’s world). 

It doesn’t have to be this way.

How is ADHD Treated?

The disorder is generally treated with medication; however, it’s not a cure-all. People with ADHD don’t get high off of stimulants like Adderall, they just allow them to concentrate on tasks the way a neurotypical person would.

There is also a very unpleasant crash associated with coming off meds at the end of the day, so some people avoid taking them unless they need to in order to do their work.

Because some people do abuse Adderall, the processes to get an ADHD diagnosis, get an Adderall prescription, and then get it renewed every month is tedious. It’s like an obstacle course designed to specifically foil people with ADHD. Lack of access and systemic bias due to race and economic situation make an already impossible process even more difficult. 

Aside from medication, people have found therapy and behavioral coaches to be helpful. There’s also a lot to be said about the benefit of connecting with others in the community. 

There are good things about ADHD.

People with ADHD are often creative, problem solvers, and excel at forging new paths. 

A lot of successful, famous, and super hot women have ADHD (and we’re not just talking about Elizabeth and Toby). 

This website wouldn’t exist without Toby’s constant questioning of the status quo, her insatiable curiosity, and her off-kilter sense of humor. The same is true for a lot of your favorite comedy, music, and art

Many people with ADHD thrive in high-adrenaline situations, like Olympic champions Simone Biles and Michael Phelps.

Entrepreneurs and CEOs like Virgin’s Richard Branson and IKEA founder Ingvar Kamprad attribute their success at least in part to the unconventional thinking associated with their ADHD. (Let’s face it, “we should all assemble our own cardboard furniture” is an extremely ADHD thought.)

In a moment when so many of our institutions are failing us, we need people who will question the way things have always been done and try creative new approaches.

And more people are finding the courage to speak out. Seeing the immediate and vociferous support for Elizabeth and the ADHD community on Twitter speaks to that. 

There has been an incredible increase in awareness in the last several years. So while it might be tempting to question all of the ADHD diagnoses you’ve been hearing about lately as people jumping on the disorder bandwagon, remember that there are decades of women who missed the opportunity to get life-changing support when they were younger. 

xo  Your Nosy Friends, Toby (Hyper-fixation Powered Research Maven) and Jeanie (Proofreader and Keeper of the To-Do List)

PS  If you like our content, you can support our project by buying us a coffee and follow us on Instagram and Twitter (where Toby has shared about ADHD and her diagnosis).

If you have ADHD, or suspect that you might, here are some resources:

Books Recommended to us by The Bachelor/ADHD Community: