When most people hear the word Ritalin, they think of little boys: waist-high hellions throwing spitballs and punches, requiring pills to control themselves. Almost nobody thinks of the boys' mothers. But these days, millions of grownups are getting treated for attention-deficit/hyperactivity disorder too. And 50% to 60% of them are women, according to recent studies. Since boys outnumber girls roughly seven to one among kids on medication for ADHD, that leaves researchers and physicians wondering where all these women have come from.
The leading theory is that the women now seeking treatment in unprecedented numbers have actually had ADHD since childhood--they just went unnoticed. Now that those girls are women with jobs, children and dinner to worry about, they tell doctors they're overwhelmed. They can't finish what they start. They're incapable of organizing their daily lives. Those are classic ADHD symptoms. They're also the prototypical laments of the modern-day working mother, which sometimes makes it hard for doctors to distinguish the dysfunction from the lifestyle.
"Girls have really been underdiagnosed for years," says Timothy Wilens, a veteran ADHD researcher at Harvard Medical School. That's because girls are less apt to be disruptive--and thus less likely to get sent to a psychiatrist by adults. "If you have a boy with a big mouth, teachers walk in and nail him," says Wilens.
As grownups, however, females are generally more likely than men to accept mental-health treatment. Julie Bloch learned she had ADHD the same way many other women do: she took her young son for treatment, and the psychiatrist suggested she consider a twofer. "I had never thought about it before," says Bloch, 47, a sales executive in the San Francisco area. "I was always different. I didn't have a lot of focus. But I didn't really think adults could have ADHD."
Bloch and her son started Ritalin on the same day. They both reported benefits. She felt newly focused on her job, and he pulled his grades way up. But as the working mother of two, she still has a frantic life: "Somebody else's needs always come first." Says Sari Solden, author of Women with Attention Deficit Disorder: "Men are encouraged to focus narrowly on their area of interest and are much more likely to have secretaries or wives who do things for them. Women have much more diffuse roles to fill."
That's why Lawrence Diller, author of Running on Ritalin, says it's tricky to know if his women patients really need drugs--or just simpler lives: "The biggest problem with the women is that they set the bar too high. Nobody could realistically accomplish all these things without taking a performance enhancer."
As word about adults with ADHD continues to spread, some researchers fear that doctors may overdiagnose women with ADHD just as they have allegedly done with boys. And that could delegitimize what is, for many, a serious impairment. In college, Peggy Clover couldn't even finish Cliffs Notes. At age 49, she went on medication for ADHD. In the five years since, she has read more books than she had ever done before. Eventually, Clover told her friends about her disorder. She had kept it a secret, she says, afraid it sounded absurd: a grown woman with an attention-deficit problem. Imagine that.
--By Amanda Ripley