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Stress, Friendship and Women with
AD/HD
By Kathleen G. Nadeau, Ph.D.
It’s been my observation over many years working as a clinician,
that women with ADHD, have a strong urge to connect with other women
as they try to understand and learn to cope with this challenging
condition. A landmark study at UCLA suggests important reasons why
connections with other females should be one of the cornerstones
of a successful treatment program for females.
It’s no secret that AD/HD challenges create high levels
of daily stress. What has been secret until recently, however, is
that women have both a different physiological reaction to stress
and a different behavioral reaction to stress and that these differences
may hold the key to women’s greater longevity.
Laura Cousin Klein, Ph.D. (now at Penn State University), one
of the UCLA researchers, explains that women respond to stress with
a flow of brain chemicals that lead them to initiate and maintain
friendships with other females and that this friendship pattern
may help women feel calmer and live longer. Klein, Taylor and colleagues
have challenged long-standing beliefs about human stress reactions
– which were based almost entirely on studies of males. The
classic “fight or flight” reaction to stressful situations
that has become a catch phrase in our high stress culture is a pattern,
Klein believes, that only applies to males – a survival mechanism
developed during the early stages of human evolution, to escape
threats such as the attack of wild animals.
Klein and Taylor believe that women developed a larger behavioral
repertoire in response to stress compared to men. In females, when
the hormone oxytocin is released during periods of stress, it buffers
the fight or flight reaction and encourages her to engage in behavior
that has been dubbed the “tend and befriend” reaction.
Women under stress react by tending to their children and gathering
with other females. This tending and befriending behavior tends
to cause the release of more oxytocin, which produces a further
calming effect.
In men, this calming response doesn’t occur because testosterone
– produced in high levels when men are under stress –
counteracts the effects of oxytocin, while estrogen, in women, enhances
oxytocin’s effects.
Klein and Taylor’s research was initiated by a casual observation
between them – that when they were feeling stressed they tended
to come into the lab, have a cup of coffee together, and clean and
straighten the laboratory while talking. They jokingly commented
to one another that this was a very different reaction to stress
than what they observed in their male colleagues, who tended to
hole up in their offices, withdrawing from interaction during periods
of high stress. Klein and Taylor realized they might be on to something
worth looking into on a biochemical level. In nearly five decades
of research on stress reactions, over ninety percent of research
had been conducted on males. They set out to study stress reactions
in females, publishing their landmark study in 2000. (See reference
at the end of this article.)
It is only speculative at present, but this “tend and befriend”
pattern triggered by oxytocin in women’s brains may help explain
why women live longer than men. Recent studies have shown that friendships
are such an important factor in health maintenance, especially in
old age, that having no close friends is as detrimental to health
as smoking or being overweight. Furthermore, studies show clearly
that the women who fare best following the death of a spouse are
those with close friends and confidantes.
Ruthellen Josselson, Ph.D., a researcher and co-author of Best
Friends: The Pleasures and Perils of Girls’ and Women’s
Friendships, has written about the critical importance of friendship
for female well-being – and the destructive pattern of giving
up time with friends when women’s lives are chronically overcommitted.
“We push them (friendships) right to the back burner,”
she explains. “That's really a mistake; women are such a source
of strength to each other. We nurture one another. And we need to
have un-pressured space in which we can do the special kind of talk
that women do when they're with other women. It's a very healing
experience.”
What does the “tend and befriend” female stress reaction
mean for women with AD/HD? It means, for one thing, that the mentoring
program established by NCGI is right on target - helping women with
AD/HD support one another in learning how to manage their AD/HD.
(Readers can find out how to participate in the NCGI mentoring program
by going to our website, www.ncgiadd.org/mentor).
It means that one of the most critical issues to address in treating
girls and women with AD/HD may be social skills training. By improving
social skills, girls and women with AD/HD can become better equipped
to find and maintain the friendships and support networks so essential
for reducing stress, feeling calmer, finding support, and better
managing their high stress lives.
T.E. Apter & R. Josselson (1998) Best Friends: The Pleasures
and Perils of Girls' and Women's Friendships, Three Rivers Press.
Taylor, S. E.; Klein, L.C.; Lewis, B. P.; Gruenewald, T. L.; Gurung,
R. A. R.; & Updegraff, J. A. (2000). Female Responses to Stress:
Tend and Befriend, Not Fight or Flight", Psychological Review
107(3), 41-429.
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