Attention Deficit Often Overlooked in Females

Natali Tremblay's image of attention deficit disorder was a rambunctious little boy jumping on tables. 

The 35-year-old insurance saleswoman knew she was a little eccentric. But she always kept two feet on the ground. 

It took Tremblay a   year to accept a    psychologist's diagnosis that her  mood swings, her  occasional depression, her mental exhaustion, her inability to complete a task - even when she could start 1,000 - were symptoms of an attention deficit. 

``I thought I had Alzheimer's,'' said Tremblay, who lives in southeast Connecticut. ``I'd walk into a room and didn't know why I was there. I'd forget appointments. I'd forget to call people back.'' 

For years, she said, she flitted from job to job, always moving on because she got bored or was unable - or as she saw it, unwilling - to conform to a company's routine. 

When she focused on a task, she tended to obsess, becoming so deeply engrossed that she might forget to eat or show up at an important meeting. Other times she was so distracted by background conversation or music that she could not concentrate on her work. 

``It's like driving in a snowstorm and not having your wipers working,'' Tremblay said, describing her racing thoughts. 

Ronald Weinstein, who worked with Tremblay, said her symptoms are classic. Weinstein, director of the A.D.D.  & Family Support Centre said many of the women he works with have sought help for depression or anxiety but found little relief. 

``What ADD is is the inability to wait. It's neurobiological,'' Weinstein said. ``If you can't wait, you can't learn from your mistakes.'' 

Like most women diagnosed with attention deficit disorder as adults, the signposts were there through Tremblay's childhood, if only somebody had stopped to read them. But the symptoms in girls can be subtle and easy to misinterpret. As a result, many girls grow into adulthood with never a mention of ADD. 

Although statistics indicate that more boys than girls suffer from attention deficit disorder, experts believe the distribution would be more equal if girls' symptoms were better recognized. 

The girl with an attention deficit may be quiet, gazing at her teacher with what looks like attention, when her thoughts are off in daydreams. She may be a tomboy, or a chatterbox. She may worry about assignments and try hard to do her work. But disorganization overwhelms her, often masking her intelligence. 

To help Tremblay, Weinstein met with her mother, spoke with her close friends and looked at her report cards from school in her native Canada. 

He patched together a portrait of a quiet girl who struggled in school, faltered in her career and drove her roommate crazy when she stopped to iron a blouse in the middle of an exercise workout they were doing in her basement. 

Because attention deficits tend to be inherited, Weinstein was not surprised when he also found signs of ADD in Tremblay's mother, Louise. 

While some women with ADD are written off as ditzy, others such as Tremblay's mother are viewed as supermoms - high achievers who seem to have their lives in perfect order. It is the stress of keeping order that can drive a person with ADD to the breaking point, Weinstein said. 

``I struggled for years, and nobody wanted to know the energy it took to get dinner on the table for five people at 6 o'clock,'' said Louise Tremblay, who raised three children outside Montreal. She said she would run around the house starting task after task, but finishing few. 

``Everybody can be inattentive, hyperactive or impulsive at times,'' Weinstein said. ``When it's the rule, and it's been this way their whole lives, then it may be ADD.'' 

Although he doesn't prescribe, Weinstein recommends stimulant medications such as Adderall, which seem to help people with ADD focus and concentrate. He then helps them learn and acquire the tools they need to structure their thoughts and activities. 

Tremblay takes a stimulant called Adderall and now uses a daily planner and multicolored Post-it notes to remind her of tasks that must be completed and appointments that must be kept. She also has hired a coach, a sort of personal trainer for the mind, to help her meet her goals. She says organizing her life continues to be exhausting, but it is no longer impossible. 

``When I was in my 20s, [I thought] `Who cares about stability?''' said Tremblay, explaining why she only recently felt compelled to confront her disorganization. ``I decided it was time to accomplish things. I accept that I just have to get the tools; I don't have the tools to do it myself.''  ©1999