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22 December 2023 | Story Michelle Nöthling | Photo Anja Aucamp
Dr Munita Dunn-Coetzee
According to Dr Munita Dunn-Coetzee, it is increasingly recognised that females with ADHD portray a different ‘picture’ in terms of behaviour, symptoms, and comorbidities when compared to males with ADHD.

I’m a failure as an adult. I’m a disappointment as a colleague. I’m a lousy friend. I’m a burden as a wife. I’m a bad mom and I’m constantly scrambling to try and hide it.

This is the secret interior reality of a group of neurodivergent adults who have been long overlooked by scientists and doctors alike. The Lost Generation. It is now recognised that there is an entire generation of women out there who have battled with ADHD (attention-deficit hyperactivity disorder) their entire lives – and don’t know it.

Women and girls living with ADHD

For decades, ADHD has been predominantly associated with hyperactive young boys bouncing off the walls. The reason for this widely-held misconception is due to the fact that studies originally focused on young European American boys – their symptoms becoming the benchmark for all. Women were not even included in ADHD studies until the late 1990s, and the first long-term study on girls was only conducted in 2002. The results? Girls’ ADHD symptoms bear little resemblance to those of boys. Dr Munita Dunn-Coetzee, Director of Student Counselling and Development at the UFS, agrees. “It is increasingly recognised that females with ADHD portray a different ‘picture’ in terms of behaviour, symptoms, and comorbidities when compared to males with ADHD. Females are less likely to be identified and referred for assessment, and their needs are less likely to be met.” Therefore, the majority of girls and women with ADHD remain un- or misdiagnosed.

But what does ADHD in women look like? First, let’s take a step back. There are three types of ADHD: the hyperactive type, the inattentive type, and the combined type – which includes both hyperactivity and inattention. Hyperactivity in females is much more likely to present internally, in the mind, and inattentiveness as daydreaming and disorganisation. This is much more than sitting still in class or having trouble with homework. Faced with behavioural and social pressures to perform, girls often learn to mask and overcompensate for their problems – making diagnosis even more difficult.

Carry the struggle to adulthood

When left untreated, girls with ADHD will most likely carry their struggle into adulthood. ADHD in adult women often results in chronic low self-esteem, self-loathing, feelings of inadequacy, sleeplessness, anxiety, depression, substance abuse, and eating disorders. Women with ADHD also typically present with tremendous time management challenges, chronic overwhelm, and exhaustion – exacerbated by societal pressures. The risk of self-harm and suicide attempts is also startlingly higher compared to their male counterparts.

There is tremendous hope, though. Drs Edward Hallowell and John Ratey – experts in the field who both have ADHD – describe ADHD as an array of traits specific to a unique kind of mind that can become a distinct advantage with appropriate treatment and support. ADHD is not a condemnation of character. Instead, it unveils a kaleidoscope of strengths and a unique constellation of traits deserving of celebration.

News Archive

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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