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Book Review: ADHD for Smart Ass Women


(originally written for and posted on NYJB)

Whether you have ADHD or are close to someone who has it, are female or male, young or old, this book will brighten your outlook on it. Rather than focus solely on how to remedy its disadvantages, certified ADHD coach, attorney, and podcast host, Tracy Otsuka—who carries the diagnosis herself—offers an upbeat view of Attention Deficit Hyperactivity Disorder and shows how understanding its brain-based causes and managing them effectively will set and keep you on the road to success.  

Otsuka’s goal is to make this book for women with ADHD “fun and easy so that you feel good reading about it—and keep reading it.” Encouraging curiosity rather than judgment about what she views as this spectrum condition, she advises that those with it find their own unique ways of managing it rather than copying what works for others. She writes from the stance that “ADHD is not a deficit of attention” because those with it may as easily hyperfocus as become distracted, and objects to the term “disorder” because it implies only defectiveness.

The book begins with a rousing foreword by another expert who has ADHD, world-renowned psychiatrist, Dr. Edward M. Hallowell, whose seminal books on ADHD helped demystify the diagnosis. He and another ADHDer, John Ratey, MD, view it as “a term that describes a way of being in the world. It is neither entirely a disorder nor entirely an asset. It is an array of traits specific to a unique kind of mind. It can be an advantage or a curse, depending on how a person manages it.”

Otsuka tells her own story of how she not only realized she had ADHD after her son was diagnosed with it, but recognized the ways it could benefit her and decided to focus on helping other women with this condition live up to their potential as she had learned to do. Through research, case studies, and resource lists, ADHD for Smart Ass Women sends out the consistent message that those with this condition can be successful, happy, and exceed their wildest expectations by rejoicing in and leading with its positive aspects and reigning in its problematic ones.

The book explains the cause of ADHD: a brain deficiency in the production of dopamine, a neurotransmitter that “increases mood, attention, motivation, and memory” and impacts other mind/body functions. It describes ADHD types and symptoms (Hyperactive and Impulsive, Inattentive, and Combined), heritability, lack of correlation with intelligence, ways it can be negatively impacted by trauma, and how it may correlate with other neuro-divergent conditions such as Dyslexia and Autism Spectrum Disorders. Although ADHD is a common developmental condition in children, it is also prevalent in adults and most often diagnosed in men.

However, Otsuka maintains that most adults with ADHD don’t know they have it: “Less than 20 percent of adults with the condition are aware that they have it . . . and girls and women are more likely to go undiagnosed than boys and men.” This discrepancy is due to ADHD manifesting differently in males and females as well as to our (erroneous) popular view that it consists of behaviors such as “fidgeting, misbehaving, or doing poorly in school.” Otsuka explains why women are so often underdiagnosed with ADHD: They are “more vulnerable to hormone-related mood disorders . . . and post-partum depression” and society holds exceedingly narrow, stereotypical expectations of gender characteristics and roles.

She describes ADHD’s “superpowers” as optimism, the ability to tirelessly hyperfocus on subjects of interest, creativity, thinking outside the box, and being driven. This is because ADHD brains are wired for “interest, not information” and those with it tend to zigzag through life rather than take a linear path because their brains “are never at rest.” Using these superpowers to find a purpose in life, for example, Otsuka suggests focusing on activities that involve the overlap of personal values, character strengths, talents, and skills.

Otsuka explains that “As ADHDers, we can be fun, spontaneous, and full of exciting and creative ideas. But we can also be pains in the asses to live or deal with,” facing greater interpersonal problems due to poorer brain-based executive functioning skills than people who are neuro-typical. She explores the role of trauma in connection with ADHD and how together they may correlate with rumination, depression, and anxiety; feelings of overwhelm, overthinking and self doubt; heightened sensitivity to rejection; obsessive-compulsive behaviors; and Oppositional Defiant, Borderline Personality, and Bipolar Disorders.

She spends time explaining the emotional dysregulation that often accompanies ADHD in women, offering solutions for managing it to improve self-esteem and enhance relationships. She tackles how to be a better friend, romantic partner, and parent by exploring how ADHD women can fit in while remaining non-conforming and true to themselves and improve at recognizing and managing social cues with which many have difficulty.

One of her most useful chapters includes strategies and tips for planning and time management which will help even people who do not carry an ADHD diagnosis. Because procrastination is a hallmark of ADHD, she sets out step-by-step ways to get things done by planning, embracing external cues, and using the brain’s craving for dopamine to self-reward for tasks accomplished. She also addresses ways to overcome problems with food, spending, and sleep dysregulation through nutrition, exercise, psychotherapy, ADHD coaching, and practicing healthy habits which will all help build new and healthier neuropathways in the brain.

This book is full of honesty, vulnerability, wisdom, compassion, understanding, guidance, cutting edge knowledge, evidence-based practices, and real-world examples of women with ADHD succeeding, not in spite of having ADHD, but perhaps because of it.

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