ADHD in women is probably one of the most misunderstood aspects of ADHD overall, even today. Once we clarify the uniqueness of ADHD symptoms seen in women, and understand how a diagnosis can be made, women ADHDers can embrace their uniqueness and find self-compassion to start navigating their diagnosis.
December 2022, Agave Health Team
For decades, ADHD was seen as a condition of mischievous boys. Only recently, it became common knowledge that kids and adults across the entire gender spectrum can experience symptoms of ADHD. Despite facing similar challenges to boys and men, girls and women with ADHD are especially susceptible to being either undiagnosed or misdiagnosed. Early signs often go unnoticed by teachers and doctors, all because of a subtler clinical picture.
Is it necessary to distinguish between men and women with ADHD at all?
ADHD is a condition that affects specific brain pathways that all people share. It is these brain differences that produce the core symptoms of ADHD, symptoms that have been medically recognized since 1902. However, it was nearly a century later - in 1994 - that a formal conference in the United States first brought up gender differences in ADHD.
Since then, experiments have been published, and books have been written, but the 92-year-long knowledge gap is felt to this day. For one, males are still more likely to receive an ADHD diagnosis than females. According to the Centers for Disease Control and Prevention (CDC), 12.9% of boys are diagnosed with ADHD as opposed to 5.6% of girls, despite emerging research suggesting the prevalence should be comparable.
Widespread confusion around the presentation of ADHD in women persists. Women struggle with the same difficulties as men with ADHD - but often in silence.
The challenge of diagnosing ADHD in women
Teachers and medical professionals may confuse ADHD symptoms with other mental conditions. Women with ADHD exhibit a consistent pattern of internalizing symptoms compared to their male counterparts. So, instead of impulsive behavior or acting out, women and girls with ADHD are more likely to have racing thoughts and anxiety.
Women are more likely to be diagnosed later in life - often in their 30s or 40s when their kids receive an ADHD diagnosis. By this time, ADHD might have already affected their personal life and triggered secondary mental challenges, such as anxiety or depression. These mental struggles can overshadow signs of ADHD and delay a diagnosis by years or decades.
The symptoms of ADHD in women
The clinical presentation of ADHD varies across genders. For one, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) and other credible sources suggest that women are more likely to present with the inattentive than the hyperactive type of ADHD. They are the girls who doodle in class, the women who daydream during boring work meetings, or the mothers who are late to pick up kids from school.
Such early signs of ADHD are usually perceived as character flaws, and women grow up with intense feelings of guilt, shame, and learned helplessness. "A woman with ADHD is less likely to make efforts to finish challenging tasks due to her belief that she has no power to change the negative outcome. By giving up, she further reinforces the belief that she is unable to accomplish things in life," Julia J. Rucklidge, Ph.D., an assistant psychology professor at the University of Canterbury in Christchurch, New Zealand, is quoted as saying in the Monitor on Psychology.
Many women also describe signs of impulsivity and hyperactivity. However, these symptoms are either misattributed as “overly social” behavior or internalized.
Overall, ADHD manifests in various aspects of a woman’s life; here are a few concrete examples:
Day-to-day Life
Doesn’t finish projects and forgets to pay bills.
A messy house, car, or workspace.
Struggles with money management and impulsive spending habits.
Indecisive - e.g., feels overwhelmed when picking foods on a menu.
She cannot relax at the end of the day.
Work and Education
She makes careless mistakes.
Struggles with organization and instructions.
Misses deadlines.
She feels she does not realize her potential, despite working twice as hard as others.
Social Life
Overwhelmed or shy in social situations.
Distracted during a conversation.
Struggles to sustain friendships.
Is described as overly chatty.
Relationships
Called selfish because she forgets important dates.
Clings to unhealthy relationships for fear of rejection.
Becomes sexually active at a younger age.
Are there any similarities to symptoms of ADHD in men? Oh yes, most symptoms from this list are applicable to ADHDers across the gender spectrum.
The stats and data may seem rather bleak, but there is a silver lining. More than ever before, the world is aware of ADHD in women, and health professionals are ever expanding the diagnostic tools and treatments to include ALL individuals with ADHD. Remember, no matter your age and gender, ADHD can be managed.
One last message to those who relate to the experiences and symptoms outlined in this article: resist being stuck in the negative loop and seek help if you wish.