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“ADHD Is Too Often Overlooked in Women. This Needs to Change.” – ADDitude

“Undiagnosed ADHD in women has far-reaching consequences that can impact every area of life. While an early diagnosis is best, a diagnosis at any age can start a woman on a new path that will change her life for the better.”
An ADHD diagnosis, in childhood or beyond, is the first and most crucial step toward effectively managing symptoms. Simply put, a diagnosis can change a life.
But the clarifying experience of an accurate diagnosis doesn’t come easy for many women, whose ADHD is routinely missed or misdiagnosed. In large part, this is because the disorder often presents differently in females and in males — manifestations influenced by biology or by societal standards, among other factors. Current clinical criteria are not set up to account for these differences.
It’s easy to assign the ADHD label if we’re talking about a young boy with a whole lot of energy. In the classroom, he bounces off his seat, interrupts his teacher, and distracts his classmates – the “perfect” ADHD representative. And the DSM-5 would clearly align these signs and symptoms with an ADHD diagnosis for him.
Yet this stereotypical boy does not represent every person with ADHD, or the variety of ways its symptoms present and affect individuals. This archetype is certainly not the way ADHD is often seen in girls.
While the research on girls and women with ADHD is still lacking, we do know that girls are not often hyperactive or impulsive – two of the three symptom categories for ADHD included in the DSM-5. Instead, girls are more likely to exhibit symptoms in the third category: inattention.
[Take This Self-Test: ADHD Symptoms in Women]
We know there’s so much more to ADHD than these broad categories, especially when we’re considering how it presents in girls. Something as simple as picking cuticles can be a subtle sign of ADHD!
Then there’s the little girl who will talk your ear off and somehow always has her head in the clouds, dreaming the day away. And the girl who never seems to pay attention in class, but who always goes above and beyond on every assignment and gets incredible grades.
The signs are also there in the young woman who seems like she had everything figured out — until she reaches college. In over her head, she’s persistently anxious, held back by her fear of failure and scrambling to put all the pieces of her life back together.
These signs of ADHD are often missed in females. At worst, these signs may be misinterpreted as laziness, irresponsibility, rudeness, or another negative quality. Parents, for example, may scold their daughter for forgetting to do homework or having a messy bedroom, viewing both as clear signs of irresponsibility — instead of symptoms of ADHD.
[Self-Test: ADHD Symptoms in Girls]
Many girls who unknowingly struggle with this disorder internalize these misinterpretations. As the criticisms accumulate, their self-esteem plummets. They begin to feel shame and confusion, and they question their ability to handle seemingly simple aspects of life.
Girls and women with ADHD often find it difficult to concentrate in school and in the workplace. While they aren’t disrupting others, their own difficulties with focus can keep them from getting things done. They’ll often struggle silently with these issues, even as they fall behind.
Undiagnosed, some may overcompensate for their difficulties, going above and beyond with lists upon lists, noise-cancelling headphones, and other carefully planned strategies. But it’s not always enough.
ADHD can also make navigating social situations difficult. Individuals may not know why they often lose track of what’s being said or frequently interrupt during conversations, inadvertently annoying and upsetting so many along the way. Then there’s ADHD’s real impact on romantic relationships.
The woman with ADHD wants to be a better friend, sister, daughter, mom, and wife, but she just can’t help how an undiagnosed disorder affects her socially.
Low self-esteem and chronic shame often lead to other mental health issues and disruptions in the lives of undiagnosed women with ADHD. This helps to explain why anxiety, mood disorders, and even self-harming behaviors are so common in this group. By the time a diagnosis is made, the patient has likely had noticeable symptoms of one of these comorbid conditions for years.
Undiagnosed ADHD in women has far-reaching consequences that can impact every area of life. While an early diagnosis is best, a diagnosis at any age can start a woman on a new path, unlocking the tools, supports, and treatments that can help her manage ADHD and change her life for the better.
We need to start recognizing ADHD in women. This is not a male-specific disorder.
Women, take your concerns seriously. Your struggles may be pointing to ADHD, even if the notion seems far-fetched to you. Talk to a professional and get tested — it is so essential.
Clinicians play a role, too. I’ve diagnosed so many women who have been clearly struggling with undiagnosed ADHD for years, but didn’t meet the clinical criteria for the disorder as outlined by the DSM-5. It’s on us, as practitioners, to think outside these incomplete guidelines so that we can help more girls and women get the diagnosis they need.
Let’s push for more research. Let’s push to expand the symptoms of the DSM-5 to better fit females. Let’s push to get girls and women the tools they need to manage ADHD and improve their lives.
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