ADHD in women

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Attention deficit hyperactivity disorder (ADHD) is diagnosed much more commonly in men then in women and is more likely to go undiagnosed in women. The ratio of men to women with ADHD is about 3:2. This diagnosis gap might stem from stereotypes and the fact that ADHD has traditionally been thought of as a condition that only affects men and boys.

However, it may also be because the symptoms of ADHD in women can differ compared to the symptoms that men typically experience. This can make ADHD difficult to spot and diagnose in girls and women. On the other hand, boys with ADHD are much more likely to have behavioural problems and be disruptive in class. This means that a childhood diagnosis in boys is more likely.

Here, we discuss the differences in ADHD presentations between men and women, the challenges associated with getting an ADHD diagnosis for women, and how you can get support if you need it.

Common types of ADHD in women

ADHD has three different presentations:

• Inattentive
• Hyperactive/impulsive
• A combination of the above

Some people display mainly inattentive symptoms while others display mainly hyperactive symptoms. Some people may display both.

The inattentive type of ADHD is more common in women and girls than men and boys. Because this type of ADHD doesn’t cause noticeable behavioural and hyperactivity issues, it can be overlooked and misdiagnosed well into adulthood.

How does ADHD differ between men and women?

In terms of how men and women experience ADHD symptoms, there are some clear gender differences. These are summarised below:

Why are women often diagnosed later with ADHD?

Because women and girls are more likely to experience the inattentive symptoms of ADHD, which can be more subtle, these can be overlooked and misdiagnosed. This means that they are often diagnosed with the condition much later than men and their ADHD is mismanaged for a long time.

According to Priory’s Dr Paul McLaren: “There are multiple reasons as to why so many girls and young women seem to slip through the net, missing out on an early diagnosis of ADHD. It may be that some girls learn to internalise their feelings and symptoms, meaning that their male classmates are more likely to be referred for further investigation by their teachers and parents. Traditionally, girls have been better at implementing coping strategies to disguise feelings of chaos or impulsivity – a ‘skill’ they carry through with them to later life”.

A lack of understanding of typical symptoms might also have an impact. For example, parents and teachers may only look for hyperactive behaviour when it comes to ADHD. This means it’s more easily spotted in boys and overlooked in girls who are more likely to show different symptoms. Girls’ symptoms may be misdiagnosed as a mental health condition, such as anxiety or depression, and inappropriately managed over a long period of time.

In some cases, women are diagnosed with ADHD after one of their children is diagnosed. A woman might recognise some of her child’s symptoms in herself, and only then request an adult diagnosis.

Furthermore, Priory’s Dr Leon Rozewicz noted that: “There is also growing recognition that menopause – and the associated impact on anxiety levels and cognitive problems – can aggravate existing ADHD symptoms. Women are therefore seeking help in their late 40s and 50s – and this presentation of symptoms, which may have gone unnoticed and untreated since childhood, is becoming increasingly common”.

ADHD symptoms in women

There are a number of symptoms that are associated with the inattentive type of ADHD and are therefore more likely to be experienced by women. Women with ADHD may:

• Have difficulty concentrating
• Struggle to stay organised
• Be forgetful
• Frequently misplace or lose things
• Have problems listening and paying attention to details
• Be easily distracted or ‘zone out’ during conversations
• Be indecisive
• Find it difficult to relax
• Find it difficult to navigate relationships
• Become easily overwhelmed and emotional
• Feel as though their life is out of control or chaotic
• Frequently miss deadlines or be late
• Feel as though they can never meet your full potential
• Appear to be shy or introverted in social gatherings
• Have low self-esteem
• Experience symptoms of mental health conditions such as depression, anxiety or stress
• Feel inadequate

In addition, many women may feel the pressure in modern society to take on the role of ‘caretaker’. This involves looking after children and family, maintaining a happy relationship, running a home and doing well at work. These societal pressures can lead to difficulty when trying to cope with the symptoms of ADHD, especially if you struggle in any of these areas. You may feel as though you need to be organised, confident, punctual and efficient, and can feel inadequate if your ADHD prevents any of this.

It’s also not uncommon for ADHD in women to co-occur alongside a number of other conditions, including:

• Eating disorders
• Alcohol and drug addictions
• Sleep problems
• Depression and other mood disorders – find out more about ADHD and depression
• Anxiety – find out more about ADHD and anxiety
• Obsessive compulsive disorder (OCD)
• Self-harm
• Body dysmorphic disorder (BDD)

It can be useful to familiarise yourself with the symptoms of these mental health concerns so you can spot when you’re struggling. Many women seek mental health treatment for these conditions and end up receiving an ADHD diagnosis and subsequent treatment for ADHD.