How does the clinical picture of ADHD differ in males and females?
Dr Johnson Consultant Psychiatrist in Neurodevelopmental disorders goes through how to recognise the symptoms of attention deficit hyperactivity disorder (ADHD) in girls and women.
Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed behavioural disorders in children and it’s often a lifelong condition. It is known as a Neurodeveoplemtal disorder which means parts of the brain which control emotions, learning, self-control and memory are affected.
The characteristics of ADHD fall under the following domains. Firstly relating to focus and attention difficulties. Then we have impulsive traits and finally hyperactivity symptoms. Some symptoms include:
● having difficulty sitting still
● trouble concentrating or focusing, being distracted
● having difficulty staying organised
● being forgetful
● tasks incompletion
Other examples of neurodevelopmental disorders include Autism, Learning disabilities and conduct disorders. This list is not exhaustive and new changes made to the 5th edition of the DSM include other psychiatric disorders (https://www.psychiatry.org/psychiatrists/practice/dsm).
ADHD and other conditions
Neurodevelopmental disorders frequently coexist. For example, you may have an autism spectrum disorder (ASD) together with intellectual disability. Or you may have (ADHD) and a specific learning disorder.
We have clinical medical research suggesting that ADHD is hereditary. This means if your father or mother has inattentive or hyperactive symptoms, you are more than likely to have ADHD too.
In my clinical practice, I have noticed that ADHD diagnoses among women are on the rise and that more and more women are looking for answers to their difficulties. Most of the new patients who are diagnosed with Adult ADHD are relieved as they can make sense of their difficulties, which nearly always looks different to the typical male ADHD picture. Due to this traditional imagery of ADHD, these women are overlooked and less likely to be referred for mental health services.
What does ADHD in women look like?
It is worth remembering that ADHD is not gender biased. It was not so long ago where we all knew of ADHD in the context of naughty disruptive school boys bouncing off the walls. ADHD symptoms exist in both females and males and in the same proportions. We have a huge gap in the diagnosis profile with males almost three times more likely to be diagnosed with ADHD than females. ADHD really does look different in women.
Therefore it is for this reason, many women grow up feeling misunderstood. Sometimes their difficulties are mistaken for being “hormonal” or “anxious”. At times the ADHD symptoms are attributed to the personality type of being “the chatty ones” and more social.
As with any mental health disorder, symptoms can vary and this can even vary between the genders. Women with ADHD, when reporting childhood experiences, are the ones who “daydream” or doodle on their work. They often report “zoning” in and out, when they should be listening in class.
Research has shown that girls and women are less likely to be diagnosed as parents and teachers are not quite sure what to look out for even if they do notice some difficulties.
Therefore inattentive ADHD is also more common in women than it is in boys and men, who tend to lean towards the hyperactive and impulsive symptoms. As males may display “external” symptoms such as fidgeting and hyperactivity they are more likely than girls to be diagnosed with ADHD.
In school or college women with ADHD are bright and intelligent. This is due to the fact that their symptoms are more subtle. However, they may underperform at critical times such as their exams, due to concentration issues.
Diagnosis later in life
Many women get overlooked until later in life when they begin to struggle to make sense of the difficulties they have been encountering. Often females may get left behind and diagnose later in life because they are able to “cover up” the ADHD symptoms. It’s only later on in life, when responsibilities of family and work build up that it becomes difficult for women to manage ADHD.
“ADHD symptoms in women can often be misunderstood and misdiagnosed by medical professionals, mistaking them for stress, anxiety, or another related condition”
Some common signs of ADHD in Women
Here are some ways that ADHD might show up in your life:
- You struggle to relax and unwind as your mind is on the go
- You are a high achiever but then feel frustrated that you have not met your full potential
- You struggle to move forward with your goals
- Forgotten projects and unpaid bills just keep piling up
- At social gatherings you feel overwhelmed and shy but can end up talking over people as you are nervous
- Your mind drifts during conversations unless you’re the one talking or it’s a topic you find very interesting
- Friendships can be a struggle because social rules seem complicated
- Growing up, you had so much energy and liked to be busy- but later in life you are just exhausted and burning out
- You often overspend to compensate for other problems. For example, you don’t have an outfit to wear for an office party so you buy a new one but don’t really have the money for this.
- Shopping trips and stores overwhelm you, and you find it hard to make decisions about what to buy.
ADHD and Woman power
ADHD as a diagnosis and condition does not need to carry the negative load of chaos and systems failure picture that it might look like. As a woman with ADHD, it is traits such as being enthusiastic, energised and “hyperfocused” where projects and goals can be achieved. The main thing to know it is try to set realistic goals.
ADHD Actions to take
Seek help – ADHD is highly treatable in both women and men of all ages. Our options are medication, behavioral therapy, or indeed a combination of the two which help symptoms very well.
Don’t be discouraged if the first medication or intervention is not an exact fit for you.
Take the time to notice the small progress and improvements in daily life after putting some ADHD friendly strategies in place such as planners and apps.
Try not to see the setbacks as personal failure but setbacks as functions of the condition.
Be optimistic about the condition and treatment – starting treatment in childhood but at any age can have a huge impact on future outcomes and functioning.
Do not get stuck in the negative labelling – visualise success can be encouraged by the progress.
I’m looking at getting my self 41 and daughter 7 tested for adhd we may have other overlapping conditions to. Could you please advise if you have a clinician who has been successful in diagnosing women and girls?
Hi Leanne,
You can view the ‘Our Doctors’ page of our website to choose for yourself. Drs Rawala, Johnson, Rao and Shaha are well versed in ADHD in women but there are many more that are as well.
Bear in mind your daughter would need someone versed in Child Psychiatry (Drs Shaha and Rao for example) and this cannot be covered by Right to Choose.
Thanks,
Joe
I found this all very useful and encouraging.
My entire life I have struggled with hyperfocus/ocd/fixation (this is great if im focused on the “right thing”), i get called “mouth” for talking too much…loud for getting excitable and (unintentionally) talking over people, im aware mid conversation or afterwards iv done this and I get very self conscious of my actions… and repeatedly apologise!! Making me feel more of a dick!! 🙄…i get called “flash” for constantly being unable to sit still. With family and close friends I’m pretty content but out of my comfort zone I’m like speedy gonzalas! Its exhausting!!!
as a child i suffered insomnia, worried about anything and everything and hardly ate. my mother took me back and forth the Dr. Due to concern. She read and researched and believed I had ADHD (this was the 80s/early 90s and every visit she was told “it only affects boys”…now at 40!!! Iv had all the tests and I’m currently awaiting a confirmation of diagnosis…I wonder how much easier my life would have been if only they had listened to my mother
Really starting to think I have ADHD, I’m 26(f) and I keep seeing videos of people explaining their experiences, they send you to Psychiatry U.K. and the list is just spot on.
How do I go to my GP and say I think I have ADHD without them laughing me out the door?
Hi Chelsea- you might try taking an ASRS test- it’s by no means a diagnosis but it might be a decent indicator to have for your GP. https://psychology-tools.com/test/adult-adhd-self-report-scale
I have just come across this page today after looking up adhd regarding my preschooler.
What has been said here is overwhelmingly similar to myself who I, at the moment feel like my life is rushing around me at 100 miles an hour. I was treated with epelim for one year as a child due to hyperactivity and I’ve never understood why my bluntness and emotions aren’t as equipped as anyone else I know however, I’m equally as intelligent.
ADHD, has never crossed my mind until now. It is worth me speaking to my GP about this?
Kind regards.
Hi Janine,
It might be worth taking an ASRS test https://psychology-tools.com/test/adult-adhd-self-report-scale- it’s by no means a diagnosis but it might be a fairly decent indication and you could discuss the results with your GP.
If you want to do a little research off your own back, the ADDitude magazine is a great resource too. https://www.additudemag.com/
Hi, I’m 63 and after a lifetime of being misunderstood, regarded as weird and a whole load of stuff too much to go into now, I am certain I have ADHD. My son has recently been diagnosed and I recognised so many of the indications. I have over the years been treated for depression and anxiety and prescribed pretty much every known antidepressant without success. I am worn out and exhausted and wonder what sort of support is available for older females?
Hi,
You might try an ASRS test if you want to confirm. https://psychology-tools.com/test/adult-adhd-self-report-scale It’s not a diagnosis but it might be an indication as to whether you have ADHD symptoms.
There are support groups and medication would be an option for ADHD, many of our patients are coming to us at an older age and many of them women- you can contact ADDISS http://www.addiss.co.uk/ or speak to your GP to see what support is available for you in your area if you have suspected ADHD.
Kindest Regards,
The P-UK team
Hi I live in England and my GP said that they don’t refer to you – why did she say that?.
Hi Claire,
Unless there is a clinical reason not to or you are under someone else’s care for ADHD then they shouldn’t have. Contact our support team for more information support@psychiatry-uk.com
Kindest Regards,
The P-UK Team
My CPN has just raised the possibility that I may be ADHD. Are bipolar disorder and ADHD coexisting conditions?
I’m not an expert but I’ve read that yes, they can both be present and diagnosable.
I can say yes to all of the examples you give above but the ADHD test I was given came up as high for distraction but low otherwise. They felt that it wasn’t there in my childhood but the test didn’t ask about things like drifting off or doodling or, in fact, any of the things on your list.
I have most if not all of the symptoms and burst out crying from reading this! I’ve always thought there is something wrong with me and misunderstood. I’m 39.
How do I move forward with a diagnosis?
Hi Marie
We are so glad to hear that this post has been helpful. If you decide to go ahead and seek a diagnosis, it might be helpful to visit our ADHD page, where you will find advice on how to seek a referral. You will need to make an appointment with your GP to talk about your condition and discuss any symptoms. It can be a good idea to complete an ASRS form first (Adult ADHD Self-Report Scale) to check whether your symptoms are consistent. This is available to download from the Right to Choose page. There is also a letter template that you can complete and take to your GP.
If your GP feels that an assessment would be appropriate for you, you can ask to be referred to Psychiatry-UK under Right to Choose. Please note that we currently have a waiting list of up to 6 months for an appointment.
Everything was explained very well and clearly. I appreciate it very much.
I’m pretty sure I have ADHD. I also feel there is something, else maybe dyslexia, during an ADHD assessment do the psychiatrists assess anything else like dyslexia or autism?
Hi Kerry – Thank you for getting in touch. Unfortunately, an ADHD assessment that is funded via Right to Choose follows a very strict structure to ensure that all diagnostic criteria are assessed within the time constraints of the appointment. Assessment/treatment for any condition other than ADHD would need to be discussed with your GP/local services separately.
thanku for this article… u explained the symptoms and the condition and the distinction between adhd in women and men very well. thank you for also reminding me that there are strengths with adhd and that it is okay to mess up.
Hi Tanya – Thank you for getting in touch. We are so pleased that you have found this article useful. We are planning to introduce a resources area in the future, where we will work on publishing more information about ADHD in women.