When people think about ADHD, they often think of a young boy who is loud and hyper, who misbehaves in the classroom or falls behind on homework, and who can play video games for hours. But this stereotype is not the full picture of ADHD. Young girls are often overlooked because their symptoms tend to present differently, which leads to girls and women being underdiagnosed for ADHD.
If you consider how race and ethnicity intersect with gender, then you find that Asian women and women of color are even more overlooked when it comes to ADHD. This results in Asian women and women of color reckoning with an ADHD diagnosis in adulthood. Honestly, there is not much research on ADHD in Asian women and women of color. Therefore, we wanted to talk about how ADHD is experienced and how you can move forward after an adulthood diagnosis.
What is ADHD?
ADHD stands for Attention-Deficit/Hyperactivity Disorder. It is a chronic condition often diagnosed in childhood, but it can be diagnosed in adults too. It can affect your ability to control your attention and focus, your time management, your organizational skills, your memory, your energy, and your self-esteem.
There are three main presentations of Adult ADHD:
- The inattentive type that involves difficulty with concentration, planning, and organization;
- The hyperactive-impulsive type that involves restlessness, fidgeting, and acting without thinking of consequences; and
- The combined type that has a combination of symptoms.
The stereotype of the boy we described above would most likely fit in the hyperactive presentation of ADHD. On the other hand, many girls fit into the inattentive presentation. This can look like struggling to pay attention, missing details when someone else is talking, or struggling to follow long instructions.
It’s important to note that ‘inattentive’ does not mean that you are unable to pay attention all the time. Inattentive means that your attention span is inconsistent. There are times when you are able to focus intensely for a longer period of time (often called “hyperfocus”), and there are times when your mind wanders unintentionally, or when you think about a million things other than the current topic.
What about ADHD in Asian Women & Women of Color?
Because inattentiveness is more ‘subtle’ and is easier to miss, many girls are not diagnosed until later in life when the difficulties of attention become more prominent, like in college or the workplace. That also means many women have had to find ways to cope or manage their symptoms without support.
It is difficult enough for a young girl to have ADHD without support.
It is often even more difficult for a young Asian girl or a young girl of color. In fact, research shows that Asian, Black, and Hispanic/Latinx children are significantly less likely to receive an ADHD diagnosis and treatment. It is believed that cultural expectations, academic pressures, and familial factors play a role in this underdiagnosis.
For example, young Asian girls are expected to be polite, reserved, and humble. As an Asian daughter, you are expected to behave in all settings and to avoid speaking up or complaining. There are cultural and familial expectations of quiet obedience, and there are stereotypical expectations (like the model minority myth) of academic competence and a strong work ethic. However, these expectations of what a young Asian girl is supposed to act like can actually hide what she might be experiencing.
Here is a personal story from Lisa, a 30-year-old Asian woman who was diagnosed with ADHD later in life:
” I was considered to be the quiet kid in the classroom because I learned that being quiet was being good from my Asian household. In class, I was quiet and looked like I was obediently listening because I was sitting in my chair. However, I was actually not present in my class lectures. I daydreamed about everything else that was not related to my classwork. So my mind was wandering even though it looked like I was listening to my teacher.
More than half of the time, I wasn’t able to tell you what I learned from class that day. Because I was the quiet kid who didn’t disrupt class or misbehave, nobody really noticed I struggled with attention. I got away with academics because my parents put me through one-on-one tutoring, which required me to be accountable for learning the material. “
Young girls like Lisa, who are quiet in class and not outwardly struggling with their schoolwork, are often missed for an ADHD diagnosis. The focus on academic performance from many Asian families adds another layer of complication. Many Asian families in the U.S. are first or second-generation immigrants, and they often have the mindset of ‘academic success will lead to economic success later in life.’ This often results in significant pressure on their children to succeed in school, but while high expectations can be motivating, they can also lead to shame or embarrassment if the child struggles academically.
Learning disabilities and attention disorders, like ADHD, are not well known in many Asian communities
Parents often think their child is being lazy, not trying hard enough, or is not naturally smart. Parents may also blame themselves for not disciplining their children well enough. In order to ensure their child succeeds, without ‘losing face’ for having a child fail their classes, they will push academics even harder and seek private tutoring or other resources.
Thus, putting together a young girl who is seemingly attentive in class and a family who tries to push her towards success without seeking help from the school, and you get a story very similar to Lisa’s – an Asian woman whose ADHD symptoms have been hidden until later in life.
The impact of Adult ADHD being overlooked for Asian women and women of color
Lisa’s story is a common one for many Asian women and women of color, and it is often a story filled with anxiety, self-consciousness, and exhaustion. These women were expected to present as successful, and they found they had to rely on themselves and their limited resources to succeed. They found themselves struggling to start schoolwork or housework and ended up staying up to study or going on day-long cleaning sprees. But to the outside observer, these behaviors can look like independence or responsibility. They also found themselves feeling intense anxiety because of academic pressure, only to have their feelings invalidated or ignored because they seemed to follow class lectures or get decent grades.
Pressure to Perform as an Asian American Adult with ADHD
Many of these women end up blaming themselves for not being able to keep up with their peers. Or, they end up feeling constant stress and frustration because they are trying to meet the external pressures to succeed, but their brains just don’t do what they want them to do. They might even internalize the ideas that they are ‘stupid’ or ‘lazy’ because they were never given the support to be otherwise. Then, when they are later diagnosed as an adult, they may feel regretful that they were never able to access help earlier.
Here is another personal story from Alice, a 25-year-old Asian woman on college struggles and invalidation:
” I never thought I could have ADHD. Honestly, I just thought I was a procrastinator. I did well from elementary school through high school because I always got away with doing homework last minute. My parents thought I was just studying hard, and when they saw I had good grades, they never thought more of it. But this last-minute strategy didn’t work as well when I got to college.
I struggled to pay attention in my lectures, even ones where the topic was interesting, and found myself fidgeting with a rubik’s cube or reading books on my phone. Then, I would spend the entire night before a paper was due frantically working on it and blaming myself for being lazy and not starting earlier. I asked some friends if I might have ADHD, but they saw me with good grades and productive all-nighters, and suggested strategies for procrastination and time management.”
Many young Asian women find themselves seeking treatment for anxiety or depression because of undiagnosed or misdiagnosed ADHD. The stress of the external pressure from their families to succeed and the pain of their inner critic telling them they are not ‘good enough’ can lead to worry about their school/work performance, low self-esteem, low motivation, and self-consciousness about seeking help.
What can we do about Adult ADHD in Asian women and women of color?
We believe that earlier identification of ADHD in young girls of color means access to support and resources earlier in their lives. By asking these girls more questions about their experiences in school and being nonjudgmental about their answers, their struggles with attention and learning can be identified more quickly.
Adult ADHD Therapy and Coaching at YCC
For example, if you find yourself struggling with starting tasks, your ADHD coach can help you break that task into smaller steps, make a plan for how you’ll achieve each step, set reminders for when to start each step, put together ‘rewards’ for accomplishing each step, and be your accountability partner.
*names changed to protect the identities of the people interviewed*
Written by: Angela Nguyen, MSW
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Other Services at Yellow Chair Collective
The skilled therapists at our Los Angeles-based counseling center are ready to meet you. Not only do we specialize in Adult ADHD therapy, but we also provide expert EMDR for trauma therapy and PTSD treatment. If you are looking to improve your romantic relationship, we offer couples therapy. Likewise, if you are working on yourself, we offer individual therapy, burnout treatment and work stress management, and HSP treatment and therapy for empaths. We also have experience working with teens as well as mothers for postpartum therapy. Please reach out to us at Yellow Chair Collective for any questions you may have about our in-person or online therapy services.
Additional Reading about Adult ADHD Affecting Asian Women and Women of Color
Stories about Adult ADHD