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Attention Magazine Article

Women with ADHD and Friendship
Author(s): Karen Sampson Hoffman
Topic(s): Adults, Behavioral Interventions, Friendships Relationships, Mastering Social Skills, Social Skills, Treatment of ADHD, Women
Summary: For women with executive function challenges, the process of building and maintaining friendships doesn't come easily, but small changes made gradually can have a big impact.
Views:Issue: February 2011

Friendship and Women with ADHD

Imageby Karen Sampson Hoffman, MA

WHAT HAPPENS WHEN A WOMAN NEVER SEEMS TO REMEMBER HER BEST FRIEND'S BIRTHDAY? Or has every intention of baking a casserole to take to a friend who isn’t feeling well and yet forgets? Or frequently runs late to lunch dates or girls’ nights out and her friends are left waiting for her?

The popular culture is filled with references to and images of women’s friendships, giving the expectation that every woman is nurturing, remembers to send that perfect card at just the right time, or is able to spend hours chatting with her best friend on the phone or at the coffee shop. For women affected by ADHD, this portrayal sets up further expectations that the disorder derails in their lives, bringing emotional havoc rather than fulfillment.

Many women affected by ADHD feel the cultural expectation that women have many and deeply personal friendships. They view friendship as something that comes easily to other women, not them, and many internalize a message of somehow not being good enough or capable enough to have friendships. They often feel embarrassed by forgetting to make phone calls or send cards, speaking out of turn, or showing up on time for events. The resulting sense of shame can make them feel immobilized or afraid their friends are angry with them.

“Women with ADHD often underestimate the investment of time and energy necessary to maintain friends,” writes psychologist Ellen Littman in Gender Issues and AD/HD. “Unfortunately, the woman with ADHD may be oblivious to the impact of her inadvertent neglect upon others.”

Deficits in executive functioning, the main challenge of ADHD, can impair a woman’s ability to build and maintain friendships. While in the moment, friendship between women might seem to come easily, it is all those things outside of the moment that impact the quality of those friendships. Friendship includes scheduling, planning ahead, being able to interpret social cues, making transitions between activities, checking in periodically, following conversations in groups, and participating in events where one has little interest. “This maintenance involves many of the executive functions of the brain that can be problematic for women with ADHD,” writes Littman.

“Friendships, connection, and closeness are emotionally important to women,” writes psychotherapist Sari Solden in her book,Women with Attention Deficit Disorder. “[Women with ADHD] want to show what’s in their heart, to give and connect, yet they find it difficult…They begin to question their own character.”

Some women with ADHD will go to the extreme of distancing themselves from close relationships in order to prevent misunderstandings. A woman who has had several failed friendships might decide she’d rather go it solo than risk another one. Another woman might remain in an unhealthy or destructive friendship because she figures it’s better than not having any friends. Neither are truly healthy reactions.

“Women with ADHD want to connect but because of their difficulties with executive functioning, they often develop emotional barriers,” writes Solden. “The key for these women is to take stock of their barriers and make a plan to slowly start getting back on the road to relationships.”

Women can address and overcome some of these challenges through self-coaching and employing calendars and technology. Other challenges can be met by addressing the causes of inattention and distraction and planning for them. Here are some suggestions.

Use your datebook.
Working memory is impaired by ADHD, along with the ability to plan ahead and judge how long a task will take. One of the most frequently offered suggestions is the low-tech, in-your-purse datebook. Writing in your datebook—or on your calendar or day planner—is a good way to remember events and birthdays that need to be marked. But also, it is a good way to do your advanced planning by marking days on which to buy birthday cards and separate dates to mail those cards. Marking days ahead to make “catching up” phones calls also helps. When making those phone calls, keep the datebook handy and immediately write in both the dates for get-togethers and dates that are part of the preplanning for those get-togethers.

“Entering a friend’s name, at regular intervals, in an appointment book, much as one would schedule a haircut, makes it more likely that a woman will make the phone call that she find on Thurday’s ‘to do list’,” writes Ellen Littman.

In addition to the paper datebook, there are electronic options that work just as well (and for some women, even better). Most email systems have calendars that can be updated and will automatically remind you of upcoming dates or events. Smart phones also have calendars and many can be programmed to ring or buzz to remind their owners when to transition between activities and prepare for upcoming events. For more information on using datebooks and day planners, read the National Resource Center on ADHD’s What We Know Sheet (WWK 11), Time Management: Learning to Use a Day Planner.

Use email for quick, friendly notes.
Email offers several benefits in maintaining friendships. It only takes a few minutes to dash off a quick note to a friend. It doesn’t needed be any more than, “Just thinking of you today and hope things are going well.” Email also offers the flexibility to keep in touch at any time of the day, rather than having to remember when is the best time to call. It also offers time to think about what you would like to say to your friend and even write a few practice emails until you’re happy with your message.

Also, you can write in your planner certain times or days to catch-up on your own email from others. Just be sure not to resend Internet memes or form letters on various topics, though it might be tempting. Your friends want to hear from you, but might not be charmed by forwarded emails. Before sending personal emails while you’re at work, however, make sure you are aware of your employer’s Internet policy. If it’s permitted at all, it’s best to send personal emails during lunch or scheduled breaks.

ImageBe realistic about the friendship.
There are people we nod to in the hallways, people we can count as acquaintances, and people who are friends to be counted on. Take some time to think about the people with whom you interact and consider where they are on the friendship scale. An acquaintance is someone you can chat with about the weather and new handbags, while a friend is someone you trust enough to confide in and who confides in you.

Be realistic about what you hope for and expect from your friendships. Not everyone can be a best friend; some friendships may need less maintenance and also less emotional involvement. But having a close friend or a best friend requires that you make the effort to remember birthdays, holidays, and events (write them down in your datebook!). Such a friendship also requires phones calls and getting together to visit. Plan outings based on the things that will help you keep your attention or give you a shared experience, such as going to the movies together. Try to cultivate one or two close friends and take time to see where the friendship goes from there.

Disclose wisely.
While it might be tempting to say, “I do this because I have ADHD,” take some time to consider to whom you disclose and when. An acquaintance doesn’t need to know about your diagnosis. You might say, for example, that you sometimes misjudge time and run late—in other words, describe one of the ways the disorder affects you without disclosing your diagnosis.

Sometimes disclosing can help to mend fences with friends. For example, you can explain to a supportive close friend that you have ADHD and that it affects your memory—that sometimes your lapses of memory can look like momentary thoughtlessness. (And when the disorder does get in the way, be prompt and sincere with an apology.)

But disclosing can also cause difficulties if your friend doesn’t understand ADHD or that the symptoms can sometimes cause social troubles. You might want to discuss whether to disclose with someone you trust (your spouse, partner, or coach) before you tell your friend.

Be open to some coaching.
Coaching can help a woman affected by ADHD to build and maintain friendships. The coach can be a spouse or partner, a relative or close friend, or even a professional who specializes in ADHD challenges. You can learn more about formal and informal coaching from the National Resource Center’s What We Know Sheet (WWK 18),Coaching for Adults with ADHD.

Coaching can provide a chance to role-play new events or practice listening skills with another person. Your coach can help you recognize when your attention is about to wander and help you develop strategies that enable you to bring your attention back to the conversation. Or the coach can help you brainstorm alternative ideas for activities that are more appropriate for you.

Finding someone you are comfortable to have coaching you can be a bit challenging. Talk with family members or friends who already know you struggle with friendships and ask them for their help. Sometimes a good friend who knows you have ADHD can coach you while you are together; she might recognize wandering attention or inadvertent slips and can help you bring your focus back or give you a chance to correct a social gaffe.

Small changes made gradually can make a big impact on maintaining and growing your friendships. “Don’t fool yourself into thinking you will make huge changes quickly,” warns Solden. “Remember, when you are trying to form new patterns of behavior, the slower you go, the longer you will last.”

Good friendships are important to everyone’s health and well-being. In addition to the steps above, you can ask the librarian at your local library to suggest books on building and maintaining friendships. Take it slow, be open to suggestions, and use a datebook or technology to help you with memory and planning. Friendships are built over time and need nurturing, but true friendships are worth the effort.

Additional Reading
 Image Ellen Littman, PhD, “Gender Differences in AD/HD: The Sociocultural Forces,” in Gender Issues and AD/HD: Research, Diagnosis and Treatment, edited by Patricia Quinn, MD, and Kathleen Nadeau, PhD. Advantage Books, 2002.
 Image Kathleen Nadeau, PhD, and Patricia O. Quinn, MD, Understanding Women with AD/HD. Advantage Books, 2002.
 Image Sari Solden, MS, LMFT, Women with Attention Deficit Disorder: Embrace Your Differences and Transform Your Life. Underwood Books, 1995.

Visit the website of CHADD’s National Resource Center on ADHD, to find WWK 11 (time management) and WWK 18 (coaching).



Karen Sampson Hoffman, MA, writes from Hanover, Maryland.
This article originally appeared in the February 2011 issue ofAttention magazine. Copyright © 2011 by Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD). All rights reserved.


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