Introduction
Studies have shown that males are twice as likely to be diagnosed with ADHD as females. For decades, it was thought that ADHD was more common in males and ADHD was viewed as a predominantly male disorder. We now understand that the lower rate of ADHD diagnosis in females may be because females with ADHD are frequently misdiagnosed or missed.
Why is ADHD Missed or Misdiagnosed in Females?
Inattentive Symptoms
Females are more likely to have the inattentive subtype of ADHD whereas males are more likely to have the hyperactive/impulsive subtype. The inattentive subtype is characterized by a failure to pay attention, difficulty with planning, organization and time management as well as lots of avoidance and procrastination. These inattentive symptoms are easier to miss than the energetic, disruptive behavior which is associated with the hyperactive/impulsive subtype. This is one of the reasons that ADHD is diagnosed less frequently in women and girls.
Co-Occurring Anxiety and Depression
Women with ADHD often struggle with feeling panicked, overwhelmed and exhausted. They frequently feel that their work, home and finances are in chaos and their lives are out of control. This leads to feelings of inadequacy and a deep sense of shame. As a result, women with ADHD suffer from high levels of depression and anxiety. When these women seek treatment, the depression and anxiety are often diagnosed, while the co-occurring ADHD is missed. Furthermore, women’s symptoms are frequently attributed to the hormonal changes of menopause or premenstrual symptoms, rather than ADHD.
Compensation
ADHD often goes unnoticed in females who can compensate through high intelligence, structure and perfectionistic personalities. Girls with ADHD who are highly intelligent and who do well academically are frequently undiagnosed. Others compensate with the help of a highly structured home, school or work environment while some mask their ADHD by developing rigid, perfectionistic personality traits which keep them on track. Although these compensatory strategies can be helpful, they often prevent ADHD from being recognized and treated appropriately.
Conclusion
Women in modern society often feel a tremendous obligation to balance family, work and other responsibilities. For those with undiagnosed ADHD, the burden can feel unbearable, leading to low self-esteem and poor mental health. Women with ADHD tend to experience more inattentive symptoms, which often go unnoticed, or may be attributed to other causes. This results in delayed diagnoses, misdiagnoses and missed diagnoses. If you are a woman struggling with feelings of overwhelm and fatigue, and you suspect that you may have ADHD, do not be afraid to speak up and get the help you deserve.
