Why ADHD Takes Longer To Diagnose In Women
According to the CDC, Attention Deficit Hyperactivity Disorder, also known as ADHD, is one of the most common disorders diagnosed in children. Although millions are diagnosed, there is a large gender difference within these diagnostics from boys being diagnosed two to three times faster than girls (12.9% of boys compared to 5.6% of girls). This difference is not due to the fact that boys are more susceptible to this disorder, but rather, the symptoms seen in boys are very different in girls.
Research shows that boys actually show externalised symptoms while girls show internalised, which is the main reason that boys are diagnosed more often while girls often get diagnosed at a later age. There are suggested factors that could relate to why boys and girls show symptoms differently such as fluctuating estrogen levels that could impact the intensity of the symptoms, as well as gender-role expectations that go against the ADHD brain like being loud or talkative.
So what are the differences with external or internal symptoms? One of the main differences is that boys can be more physically aggressive while girls are verbally aggressive. Boys can be seen running around, being hyperactive and loud, while girls are more in their head with inattentiveness and low self-esteem. Healthline Parenthood mentions this disparity in their article explaining the different symptoms of ADHD, saying ‘since girls with ADHD often display fewer behavioral problems and less noticeable symptoms, their difficulties are often overlooked.’ Over half of the children who experience ADHD as children continue to show symptoms as adults, allowing women to get a diagnosis as an adult.
However, women with ADHD are often misdiagnosed or left searching for an explanation of their symptoms because of the lack of understanding on the gender differences in this disorder. Research also suggests that women who are left undiagnosed throughout their lives can have a negative impact on their self-esteem and mental health. While men externalise their frustration, women tend to internalise their pain and anger, which causes situations of depression, anxiety and eating disorders. Healthline also mentions that ‘girls with undiagnosed ADHD are more likely to have problems in school, social settings, and personal relationships than other girls.’
What are some symptoms for ADHD in women? Unlike our stereotypical idea of ADHD, such as being disruptive in class, unable to stay still or not paying attention to the teacher, the symptoms in girls can be seen as lazy, spaced-out, or forgetful. The child with ADHD will miss more assignments, which might be mistaken as a learning disability. The child might be withdrawn from others or conversations, have a low self-esteem, have difficulties achieving academically, daydreaming or trouble focusing, appearing to not listen or be attentive, or sometimes more verbally aggressive such as teasing, taunting, or name-calling. A study on adults with ADHD shows how this disorder affects the way that women see themselves. The results showed that women see very few good personal qualities than men, showing ‘adult women’s self-perception is comparatively poorer than that of adult men.’
One of the more common ways that women can be noticed of having ADHD is when they show co-occurring symptoms (comorbid conditions or coexisting conditions), which are symptoms that are present along with ADHD. These can be a number of things shown at a later age such as substance abuse like drugs and alcohol, mood or anxiety disorders like depression, or even an eating disorder.
While there is still work that is needed to help women have access to proper diagnosis for their mental health, we also need to push for overall representation on this disorder because there is little research done for those who are not cis-gendered. There should be more diverse representation in order to help all take care of the mental without feeling like they do not fit the boxes that are only being focused on.
If you are experiencing any of these symptoms and have further questions, definitely seek professional help rather than leaving it unattended. The effects of undiagnosed disorders can cause a serious disruption to your health!