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Women and ADHD: Under-recognized and Under-treated

10/01/2013 12:04 EDT | Updated 01/23/2014 06:58 EST

On the go and gabby is one way Zoe Kessler describes herself. Another is that the 54 year-old has spent her first 47 years suffering from the effects of attention deficit hyperactivity disorder, or ADHD. Until seven years ago, she was one of an estimated four million adult women in North America who have ADHD -- many of them, like her, totally unaware of it.

ADHD is a condition widely recognized in kids -- in boys, in particular. But research now indicates that ADHD can remain until adulthood. And while the ratio of childhood ADHD is two boys to every girl, adult ADHD affects women and men equally. Adult ADHD, especially adult ADHD in women, is an under-reported and under-treated condition.

And Kessler is not alone: Celebs who've talked openly about their ADHD include Dancing With The Stars dancer Karina Smirnoff, heiress/socialite Paris Hilton, and Trudie Styler, the eco-activist and film producer who is married to Sting. "We are lagging behind in our knowledge of women with ADHD," says Kessler.

She told me that when she was born, ADHD was a diagnosis mostly given to out-of-control boys. "I was seen as a tomboy and my mom thought I was willfully badly behaved," she told me. "I literally could not sit still." Over the years she tried everything from organic foods to therapy in an attempt to control her racing body and mind. But it wasn't until she was 47 -- tired of seeing how her then-so-far unproductive writing career threatened her financial stability -- that she sought help and found a doctor who finally diagnosed her condition.

Kessler, whose popular blog ADHD from A to Zoe is on www.psychcentral.com, wrote about living fearlessly with her condition in a new book entitled ADHD: According to Zoe. In her view, ADHD is not so much about not having enough attention but rather "not having the ability to keep our attention on the things we need to. With women the hyper part often comes out as needing to talk all the time," she told me, adding that she paced while we were on the phone. "If I can get my thoughts pared down to six or seven, that's a tranquil space for me."

Dr. Tim Bilkey, a psychiatrist and international ADHD expert, told me that the majority of females do not have the hyperactivity component, but they do have the other factors of being impulsive and easily distracted: In fact, many women have a diagnosis of ADD, ADHD without the hyperactivity. "Women with adult ADHD are usually procrastinators, they lose track of time," he told me. "Some have wandering minds. They are daydreamers so they miss out in school and sometimes in the workplace. Others try to pay attention but outside distractions like loud sounds make it difficult for them to get a task done."

ADHD is not just a little kids' syndrome, says Dr. Bilkey, creator of the book Fast Minds and DVD Her Fast Mind. "Adults who have it have to juggle all the balls themselves and they are drawn into multiple domains, are often underachievers. 60 per cent of people feel that ADHD has held them back in their careers." One survey on ADHD in the workplace concluded it amounted to 22 days of lost job performance per year. "These are often adults who get passed over for promotion."

Zoe Kessler says that advances in the diagnosis and treatment of ADHD means that nobody has to let their lives be run by their condition. "Everything flows from the right diagnosis," says Dr. Bilkey, who recommends that anyone who suspects they have ADHD to start with an online screening tool like the one found at www.coulditbeadhd.ca. An actual diagnosis should then be confirmed with a doctor; Health Canada has five medications approved for the treatment of adult ADHD. All work on raising the brain's dopamine levels, he says. "That sharpens the attention network so people can pay attention more." One more thing: ADHD is "as heritable as height," he says. "More genetic than asthma or breast cancer. The apple drops right out of the tree."

Medication helped Kessler: "When it was prescribed, I didn't give it a second thought. At age 47 if you can't focus for a few hours at a time you are pretty desperate." Coping with her condition has been a challenge, for sure, but she has rebuilt her self-esteem and learned to accept herself. And there's a plus side to having ADHD, she says: "I think of it as the fountain of youth. You talk faster and you walk with a bounce in your step. If only I could bottle it!"