ADHD – a woman’s problem.

‘We were in the same class from the age of four to sixteen.

Guess who was diagnosed at eight

And who was diagnosed at nearly thirty?

You’re right, the latter was me – the she.’

(‘She’s bright but she talks too much.’ – Natalie Jayne Clark)

During childhood, Attention Deficit and Hyperactivity Disorder (ADHD), is more frequently diagnosed in boys than girls. This is thought to be because boys are likely to ‘act out’ in school, and their problems cause more disruption in the classroom. On the other hand, girls are believed to internalise their attentional difficulties, drift away and daydream without causing too much of a problem to anyone else.

Research suggests that between 50 – 70% of adult females with ADHD remain undiagnosed. 

Symptoms of ADHD in women: –

• Over reacting emotionally, with an aversion to being teased or criticised, in addition to a reputation for being moody. 
• Constantly making careless mistakes, for example, collecting parking fines and tickets for the same offences. 
• Losing, forgetting or misplacing possessions, regardless of the item’s importance: glasses, car keys, house keys and bank cards.
• Impatience with any sort of delay, for example, when queuing or having to listen to, what the woman considers to be, unnecessary or irrelevant information.
• Engagement with tasks is variable. The woman will hyper-focus if an activity interests her, but procrastinate over anything she perceives to be boring. 
• The woman will have a constant sense of her underperformance, wishing she could do the things that others do so easily: enjoy a steady personal relationship, maintain a rewarding career rather than job hop, be socially adept, multi-task, concentrate and be well organised. 

Common misdiagnoses for women with ADHD include: mood disorder, anxiety, low self-esteem, sleep issues, bipolar disorder, stress, obsessive-compulsive traits or depression. These misdiagnoses may result in the woman being given inappropriate medication or treatment. 

Particular problems of diagnosing ADHD in women include: –

1. Diagnostic criteria for ADHD describe symptoms observed in childhood and adolescence. Very few women will receive a diagnosis in childhood and will not match the diagnostic criteria as an adult.
2. Women may try to compensate for their ADHD symptoms through overwork, often to the detriment of their physical and mental health. They will be in danger of becoming people pleasers, work alcoholics or perfectionists. 
3. The constant mental activity that is a common symptom of ADHD, could be interpreted as mental restlessness and diagnosed as anxiety.
4. The problems with relaxation and sleep associated with ADHD, may be diagnosed as stress or depression. 
5. The individual can appear unmotivated and tired, but then be easily lifted by something they find interesting. Irritable when bored and over excited when engaged, this behaviour could lead to a diagnosis of bi-polar disorder.
6. Little is known about the emotional implications for women of experiencing ADHD, but these will include irritability, mood instability and problems with emotional regulation. These emotional symptoms are different and separate to the hormonal changes that are linked with women’s menstrual cycle. 

While a holistic approach, (diet, exercise, yoga, mindfulness, etc), should always be the first treatment suggested for women experiencing ADHD, it is estimated that 75% of adults will get positive results from medication. 

However, as many women report changes in their ADHD symptoms at different times in their menstrual cycle, in addition to during the perimenopausal, menopausal and post-menopausal period of their lives, increased research is needed into the reaction of different individuals to ADHD medication, in order for women to receive the support they so desperately need.

‘Society’s perceptions and expectations of our genders are vastly, vastly different.

Not to mention the gender data gap. The lack of knowledge about the condition affects everybody.’

(‘She’s bright but she talks too much.’ Natalie Jayne Clark)