Why is ADHD Underdiagnosed in Girls?

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Attention deficit hyperactivity disorder (ADHD) is commonly thought to affect more boys than girls. However, this is a myth – ADHD is underdiagnosed in girls and young women. Statistics show that boys are more likely to be diagnosed rather than girls – 12.9% compared to 5.6% – a statistic that exemplifies how often ADHD is dismissed in girls.[1]

Symptoms of ADHD in Young Women

There are three different ways that ADHD can present:

  • Inattentive ADHD
  • Hyperactive/impulsive ADHD
  • A combination of inattentive and impulsive ADHD

The symptoms of ADHD in women often present very differently than those in men. Many women and girls with ADHD exhibit signs of inattentive ADHD, whereas men and boys often have hyperactive/impulsive ADHD.[2] Symptoms of inattentive ADHD include:

  • Trouble paying attention to tasks or school
  • Difficulty learning new information
  • Appearing not to listen in lessons or when being spoken to
  • Processing information slowly and with more mistakes
  • Daydreaming frequently
  • Becoming bored easily

Another symptom of ADHD in women can include overspending, as organisation can be such a challenge that it can appear easier to buy new things rather than search for them or clean them. This disorganisation can spill over into school and work, with young women and girls unable to keep track of deadlines, homework, and important dates.

It is also not uncommon for girls and young women to exhibit hyperactive/impulsive ADHD, with symptoms including being fidgety, disruptive, and impulsive. In this case, girls may be more likely to receive a diagnosis, as it reflects the type of ADHD that boys experience.

These symptoms can often be dismissed as character traits in young women, and if they reach out for help, they may be misdiagnosed with depression or anxiety. Girls with this type of ADHD can be seen as lazy or like they don’t care when this is far from the truth.

Furthermore, girls commonly work harder to mask their symptoms and make up for their bad grades or disorganisation. This can make ADHD much more challenging to spot, and researchers have concluded that practitioners need a deeper understanding of the gender-specific presentation.[3]

ADHD and Co-occurring Conditions

Women and girls with ADHD can sometimes struggle with co-occurring conditions, also called comorbid conditions. These conditions can stem from their ADHD being consistently misdiagnosed, or can be underlying conditions that can make their ADHD worse:

  • Substance use disorders – some women or girls may use substances such as drugs or alcohol to manage or numb their symptoms. However, there is a myth that the medication often used to treat ADHD can contribute to a substance use disorder in the future, although this has been proven to be untrue.
  • Anxiety disorders – ADHD can increase the risk of anxiety in young adults, as they can spend a lot of time worrying about tasks they have to complete or things they may have missed.
  • Mood disorders – many people with ADHD also struggle with mood disorders simultaneously. Disorders they may suffer from include bipolar disorder and depression.
  • Eating disorders – young women and girls with ADHD are at a higher risk of developing eating disorders than those who do not have ADHD. Research has found that they are especially at risk of developing bulimia nervosa, which follows a binge and purge cycle. Other girls develop anorexia nervosa, severely restricting their food intake as a form of control in their chaotic life.

These co-occurring conditions can make living with ADHD even harder for girls struggling with this condition. If ADHD continues to go undiagnosed, girls can feel like something is broken or wrong with them. However, this is not the case – help is out there.

Treatment for ADHD

The most common medication for ADHD is stimulants. These stimulants include Ritalin or Concerta and have long-acting effects that help those with ADHD focus for longer. Medication does not work for everyone with ADHD and may be adjusted or changed to get the best results.

Behavioural therapy, including cognitive-behavioural therapy (CBT), can also help with symptoms of ADHD. Therapy can teach children and teenagers new skills to help them pay better attention in class and complete their chores.

It is essential to remember that neither of these treatments is a cure for ADHD. However, a combination of therapy and medication can help young adults manage their symptoms and learn skills they will keep for a lifetime.

Conclusion

Medical professionals have historically overlooked girls and young women with ADHD, with their symptoms often being mistaken for the wrong conditions. However, as more research is done into how different genders exhibit ADHD, more girls will receive the treatment they need.

It is also important to remember that girls with ADHD can suffer from many co-occurring conditions that worsen their symptoms. Depression, anxiety, eating disorders and bipolar disorder can be common amongst those with ADHD and substance use disorders. Therefore, it can be challenging to treat the various conditions, and residential treatment is highly beneficial.

This is where The Wave comes in. We offer specialist treatment for mental health conditions, substance use disorders, and eating disorders and pride ourselves on our compassionate, comprehensive services. Get in touch today to discuss how we can help you.

Sources:

[1] Centers for Disease Control and Prevention. Attention-deficit/hyperactivity disorder (ADHD). Reviewed November 16, 2020.

[2] Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01596

[3] Quinn, Patricia O, and Manisha Madhoo. “A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis.” The primary care companion for CNS disorders vol. 16,3 (2014): PCC.13r01596. doi:10.4088/PCC.13r01596

 


 

Fiona Yassin is the International Clinical Director of The Wave Clinic. Fiona is a UK Registered Adolescent and Family Psychotherapist and Clinical Supervisor (Licence number #361609 NCP/ICP), further trained in the specialty of Eating Disorders and Borderline Personality Disorder Treatment. Fiona is trained in FBT (Family Based Therapy), CBTE for eating disorders, FREED (King’s College, London), EMDR for eating disorders (EMDRIA) and has a Post-Graduate Diploma in Neuroscience and Trauma from the University of Tennessee, Knoxville.

Fiona works with international families and family offices from the UK, Dubai, Kuwait, Singapore and Malaysia. Fiona can be contacted by email on [email protected].

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