ADHD: the White Boy Bias
One of the best moments of my life was when, while sitting in my psychiatrist’s office after having filled out a series of questionnaires, she looked up at me and said, “Well, you have ADHD.”
I was 26. I had graduated from college with honors, was working a full-time job, and led an outwardly stable life. At the same time, I was experiencing debilitating anxiety and depression and struggling to cope. I saw myself as lazy, incompetent, and immature—I had incredibly poor self-discipline, was always forgetting things, and constantly ping-ponged between excitedly volunteering for roles and feeling completely overwhelmed. It seemed like I had to work twice as hard for twice as long to keep up with my peers.
For me, diagnosis meant I wasn’t intrinsically broken. I suddenly had a rationale for why I did the things I did, and I had become one of millions of people with the same disorder who experience similar symptoms. Where I had spent years feeling trapped by, and constantly at odds with, my own brain, I now had access to research on the ways my mind worked and tools to help me function better in a neurotypical world.
While I was relieved to finally have an explanation, I was also angry that no one had noticed my symptoms sooner. It turns out, my story is not unique. One study found that elementary school teachers are more likely to give referrals for potential ADHD diagnoses to boys than they are to girls who have the same symptoms, while another showed that therapists are twice as likely to diagnose boys with ADHD than they are girls who, again, have the exact same symptoms.
Why the discrepancy? Historically, ADHD research has focused on clinically-referred white males, and an analysis of 70 ADHD studies published between the mid-80s and mid-90s found showed that 81 percent of research participants were boys. As a result, teachers and medical professionals tend to have a really clear idea of what ADHD looks like in white boys, and pretty murky understanding of how it presents in everyone else.
When it comes to ADHD symptoms, research shows that girls with ADHD are more likely to be inattentive and have additional disorders that are focused inwardly, like anxiety and depression, whereas boys with ADHD tend to be more hyperactive and compulsive and have comorbid disorders that impact others, such as oppositional defiant disorder and conduct disorder. When girls with ADHD do have hyperactive symptoms, they are often things like emotional reactivity or hyper-talkativeness—characteristics that are more likely to be written off as girls being girls—rather than physical movement.
If you, like me, weren’t diagnosed as a child, but are wondering if ADHD might be a fit for some of the stuff your brain does—or if you have or know a child who hasn’t received a teacher referral but seems like they may fit the ADHD criteria—figuring out what to do next can be daunting. So here are some suggestions based on things that worked for me. Your mileage may vary, but it’s always nice to have somewhere to start.
First, know what you’re looking for. Jessica McCabe’s “How to ADHD” website and YouTube channel are full of great facts on what ADHD is, ways to know if you might have it, and tips for living with it. Most of her information is in video format, which my ADHD brain is not great at absorbing, but the internet also has a wide selection of articles on ADHD in women, to give you a better idea of how it presents.
Second, find someone who knows what they’re looking for. Psychology Today lets you search for psychiatrists in your area who take your insurance and specialize in ADHD. The site gives you the option to email providers, so you can ask specifically how much experience they have diagnosing ADHD in people your age/gender/race/etc.
Once you receive a diagnosis, the next step is to decide whether you want to go the medication route or the therapy route, or do both. Like with everything in life, what works for one person won’t necessarily work for another, and it usually takes some trial and error to find the best fit for you. In the meantime, though, I recommend trying to find an ADHD community, even if it’s just you and one or two other people with ADHD. Being able to talk about your symptoms and compare coping strategies helps make the ADHD experience less isolating and easier to navigate.