Why ADHD in Women Goes Unseen: Signs You Might Be Missing

As a therapist, I often encounter clients who have struggled for years without understanding the root cause of their symptoms. If you’ve ever felt overwhelmed by disorganization, forgetfulness, or a pervasive sense of being out of sync with the world, it might not just be stress or the challenges of daily life. For many women, these experiences point to Attention-Deficit/ Hyperactivity Disorder (ADHD)—a condition historically underdiagnosed in females, causing many to suffer in silence.

Why ADHD Goes Unnoticed in Women:

Subtle Symptoms

Unlike the conspicuous hyperactive symptoms often seen in boys, ADHD in women often manifests as primarily inattentive. This can include being easily distracted, forgetful, and generally disorganized. These symptoms might not disrupt a classroom or irritate parents, but they can significantly disrupt your inner world and personal growth.

Societal Expectations

Society often expects women to be empathetic, organized, and composed. When symptoms of ADHD like impulsivity or disorganization appear, they clash with the typical narrative for "feminine" behavior, prompting many women to mask their struggles. You might find yourself working twice as hard to manage perceptions, feeling the need to hide your difficulties to align with societal expectations.

Diagnostic Biases

The criteria and processes used to diagnose ADHD have historically been developed with male behavioral patterns in mind. This gender bias means that more internalized symptoms—such as feeling restless rather than being overtly restless—might be overlooked by educators and healthcare providers.

Overlapping Conditions

Many women with ADHD also experience conditions like depression or anxiety, which can mask ADHD symptoms. It's not uncommon for these co-occurring issues to overshadow the underlying ADHD in treatment plans. Many women describe their path to diagnosis as a long journey filled with confusion and misdirection. However, finally receiving a diagnosis can be profoundly validating, helping them to understand that they are not alone in their experiences.

Benefits of Diagnosis

Receiving a diagnosis can be transformative. As one woman explained, "It finally made sense why things were so hard for me." A diagnosis often leads to increased self-compassion, improved self-esteem, and a newfound ability to advocate for oneself. It also provides an opportunity to connect with others who share similar struggles, creating a community of support and understanding.

Symptoms of ADHD

Women and girls can exhibit any form of ADHD presentation, and the intensity and nature of symptoms can fluctuate throughout their lives. Research and personal stories suggest that the inattentive form of ADHD is most common among females, characterized by:

• Poor attention to detail or frequent careless errors

• Difficulty maintaining focus and seeming not to listen

• Challenges in following instructions and organizing tasks

• Reluctance to engage in tasks that require ongoing mental effort and a tendency to lose items

• Being easily distracted and often forgetful in daily routines

It would be misleading to claim that all women and girls only show signs of the inattentive type of ADHD. Many also experience internal sensations of hyperactivity and other less recognized symptoms, often misinterpreted culturally as typical of very "social" girls:

• Excessive talking

• Fidgeting and a frequent need to move around

• Impulsive actions or speaking without thinking

• Seeming to daydream, yet experiencing rapid and uncontrollable thoughts

• Forming friendships easily but struggling to maintain them

• Engaging in self-harm or extreme, unhealthy levels of self-discipline

• Utilizing compensatory techniques, resulting in working two to three times harder than peers to achieve the same success

• Fear of rejection leading to overly clingy behavior or staying in detrimental relationships

These descriptions provide a more nuanced understanding of how ADHD can manifest and affect the lives of women and girls differently.

Treatment for ADHD in Women

Effective treatment for ADHD in women often involves a combination of approaches. Recommended treatments depend on various factors, including the nature, severity, and impact of ADHD symptoms. Remember, recognizing the signs of ADHD and seeking help can be the first step toward a more fulfilling life.

Treatments may include medication, therapy, lifestyle changes, and accommodations in school, work, and home settings. It is crucial to start by getting an accurate diagnosis to find the appropriate treatment. Since ADHD is often overlooked well into adulthood, getting a diagnosis is an essential step toward understanding aspects of yourself that you might have previously attributed to other causes. Once diagnosed, you can feel more empowered to seek help and make changes in your life that will help you better manage the symptoms of the condition. It can also help you appreciate some of your strengths, such as high energy levels and creativity, which can be leveraged when coping with the challenges you face.

Reference:

Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: a systematic review of ADHD in adult women. Journal of attention disorders, 27(7), 645-657. ISO 690