‘We Have Failed the Girls’ – ITAKOM Meets Lotta Borg Skoglund

Lotta Borg Skoglund is an associate professor in psychiatry at the Department of Medical Sciences at Uppsala University, and affiliated researcher at the Department of Clinical Neuroscience at Karolinska Institutet. Her scientific work research targets the intersection of ADHD and comorbidity conditions (substance use disorders, personality disorders and mood disorders) as well as gender discrepancies and hormonal factors associated with ADHD.

We met with Lotta recently to catch up about her work and the upcoming Edinburgh lecture at ITAKOM next year.

ITAKOM: Lotta, when did you first become interested in the brain, and how did you end up where you are? Does it run in the family?

Lotta: “Well, my dad is actually a psychiatrist who specialises in addiction, but when I was younger I thought I wouldn’t go down that same route. I tried economics but ended up failing terribly at that. I then reluctantly went to medical school. I was so confused about what I wanted to do back then. I thought ‘I don’t like stitching people up but I do love talking to them’; I loved communicating with patients, helping them find the best way to move forward. So eventually, I ended up in psychiatry even though I really didn’t plan on that…

I ended up in research but wasn’t happy with where we were at, and where the knowledge was at, on specific questions (and for specific groups). It was always the groups we tend to marginalise in healthcare, so I started with substance abuse disorders, people suffering with addiction. They are really second and third care patients in the healthcare system, so then I got interested in ADHD as there is a huge overlap between them. I then began research into ADHD and I looked at what we know. I realised we only know about it from the research of boys and men, less so women. So that’s how I ended up where I am now – working with females.”

ITAKOM: “What does a typical day look like for you?”

Lotta: “There is no typical day for me. Today, I am going to Norway to lecture; then I will do some research for a couple of hours, then I will see some of my patients, so that’s absolutely essential for me to keep up the energy and do different things. The ultimate combination of a great working week is when I can meet with my patients, lecture a lot and do a lot of research. There are a lot of women coming here discussing hormones and ADHD medication. I predominantly work for Smart psychiatry which I founded with my colleague Martin Hammarström in 2018.”

ITAKOM: “Are you excited about coming to Edinburgh for the ITAKOM Conference?”

Lotta: “I am so excited to visit the conference I have heard so much about and also since I have never visited Scotland before. I am planning on staying for a while. I usually travel so much and very quickly. But now, I want to take the time to really experience the land and the culture. I am also doing another lecture for a health care giver while I’m there, the day after the conference.”

ITAKOM: “What can we expect from your ITAKOM Big Talk?”

Lotta: “My lecture will be focused on introducing, perhaps, a slightly new way of looking at ADHD. I would like to introduce a way of viewing the difficulties and the struggles that may be specifically significant for girls and young women. Viewing it from the lens of, what are the underlying mechanisms, instead of looking at ADHD and ADD as different fixed subtypes. We know women are typically diagnosed with ADD, but we really need to dive into how this is displayed in everyday life of girls and women. And to factor in the hormones that not only fluctuate across the female lifetime but also differs hugely with every menstrual cycle. This will influence how the brain process information and may be very different when you have ADHD and when you don’t. I want to make it clear to everyone listening that what we need right now is more research. The earlier you get your diagnosis, the earlier you get the correct explanatory model, the better you will do in life. Hopefully viewing ADHD through this lens will prompt diagnosis and appropriate support earlier.”

ITAKOM: “Because, females present differently with an ADHD diagnosis, as opposed to males, correct?”

Lotta: “Men and women have the same diagnosis, and the same assessment procedures are used. But females may have different symptom displays and their hyperactivity, impulsivity may be displayed as inner restlessness or verbal impulsivity. Also, their inattention will, on a group level, show in a different way. They tend to not disturb others with their problems and that’s often why it doesn’t get recognised and referred to treatment. There are gender differences on a group level, what I am trying to tell people is that men and women are two different subspecies of the same species. We haven’t factored this in that at all when we look at mental health and ADHD symptoms. Hormones have a huge impact on how we feel and function in everyday life. Just think that there is 50% of the population going through huge hormonal fluctuations every month during their life. Therefore, we can’t use the male norm here! We know from science and theoretical models how vulnerable females are during periods of low estrogen, for example. We have low oestrogen across periods of our menstrual cycles and during/after menopause. Due to this, we go through periods in our life when we are more vulnerable to mental health issues.”

Lotta Borg Skoglund will deliver her ITAKOM Big Talk: ‘We Have Failed the Girls’ at ITAKOM Day One, 14;30.

For more information on Lotta, visit www.smartpsykiatri.se or connect with her on Facebook, LinkedIn, and Instagram.

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