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It is quite common for women to come for an ADHD assessment, and wonder why for a long time they have been suffering from symptoms of anxiety or depression. In some situations, they may have accessed different support, experiencing limited success. Because the symptoms of hyperactivity and impulsiveness are less likely in women, they may be more difficult to be diagnosed with Adult ADHD. Women are more likely to silently suffer from inattentive symptoms, which are more difficult to diagnose, causing anxiety, or feelings of not being good enough.
The previous ratios in diagnosing ADHD in children were 5 boys to 1 girl. This can be one of the reasons why a woman suffering from ADHD is more likely to be diagnosed later in life. We need to be mindful that for many years it was thought this condition affects only men and naughty, hyperactive young boys. With time and new research available, it will be interesting how the ratios will look in the future.
Why ADHD symptoms in women can present different?
The ADHD symptoms are more subtle compared with men; they are more likely to internalise the symptoms due to fear of feeling inadequate. Due to certain expectations in the society, women may be better at masking their inattentive symptoms. And as a coping mechanism, strive to perform better, spending more time which eventually may lead to burnout or depression. One of the release pressure mechanisms are through emotional dysregulation, which some describe it to be more common in women undiagnosed. However, depending on the support available these can become misinterpreted by more severe conditions, such as personality disorders. According to NICE guidelines, women may be more likely to receive an incorrect diagnosis.
Women with ADHD present with inattentive symptoms
It is estimated that from all types of ADHD, approximately 1 in 3 cases are due to inattentive type. In our practice, we are seeing more this type in particular in women with or without an associated condition. Very often anxiety, can manifest itself as a form of headaches or migraines, secondary due to undiagnosed ADHD. Hormonal changes and oestrogen are gathering more attention towards understanding the inattentive symptoms. Having a holistic approach in understanding the link between ADHD and physical health is essential.
Symptoms of ADHD in women may be viewed as anxiety, depression, or personality traits
In some situations, the secondary effects of persistent inattentive symptoms, are more likely to be diagnosed as depression, anxiety or personality disorder. Although, ADHD can co-exist with these conditions it is very important to seek support from a healthcare professional trained in diagnosing and treatment of most mental health conditions.
Women suffering from ADHD tend to space out and daydream due to inattentive symptoms
This population group is often overlooked, since women tend to internalise the symptoms by spacing out or daydreaming. Therefore, in the school years they may retreat in their own world, underperforming, but at the same time not disturbing others. The ADHD symptoms can go under the radar for many years, and people around may see this as normal since the patterns occurred for a long time. Only when a close friend may get diagnosed and improve their quality of life, may consider looking further into this path.
ADHD in women and comorbid conditions
When symptoms of ADHD in women are well managed, the symptoms of other mental health conditions, can improve or achieve remission. However, it is also common for women diagnosed with ADHD to continue to suffer from co-morbid conditions. Some of the more common associated conditions in women suffering from ADHD:
Sleep problems: Circadian rhythm disorder, Narcolepsy, and other sleep disorders
Sleep conditions are generally common in people suffering from ADHD. Due to high pressure and expectations to perform in school, women suffering from ADHD may stay late at night to compensate. Therefore, the night transforms in the day, and in a safe sanctuary of peace where there are less distractions around. This comes at a cost of waking up later in the day, not making in time at school or at work, and eventually getting in trouble. With years of repeatead patterns this may also lead to burnout.
Anxiety and mood disorders
Anxiety disorder is some of the most common mental health conditions. The episodes may be triggered from hyperstimulation, crowds, lost sense of direction, or fear of not performing good enough. When the feelings of innnadequacy persist, combined with unpleasant life events it may be only a step when these progress into depression. From here the path may be into trying different treatment options as the route cause may not be addressed.
Binge eating disorders
The adult deficit hyperactivity disorder it is associated with a degree of impulsivity, in particular in women. Therefore, food can become a reward system of calming down, leading to seeking comfort through food . From this stage, developing an eating disorder can only be the next step, and the feelings of inadequacy further reinforce. Some research suggests an overlap of up to 30% of people suffering from ADHD may have symptoms of binge eating.
Personality disorders
The impulsivity associated with hyperactive and inattentive symptoms can mimic certain personality disorders. However, at the same time both conditions can co-exist. In some cases, the ADHD symptoms may be overlooked for years due to the stigma associated with personality disorders. Beginning your journey with a healthcare professional trained to manage both conditions may be a good starting point.
Autistic spectrum disorders (ASD)
To the untrained eye, women with ASD often display less social and communication difficulties compared to their male counterparts. They may be better to camouflage the symptoms, adapting their demeanour to the societal norms and expectations. This can involve learned behaviours of mimicking or copying others which long-term may itself lead to exhaustion and burnout. Therefore, it is highly important for the clinician performing the ADHD assessment to be well knowledgeable in identifying autistic symptoms in women.
Alcohol and drug addictions
Due to the unique set of challenges women suffering from this condition may self-medicate using alcohol and drugs as a coping mechanism. Whilst in other situations the path of trying something new, is fuelled by curiosity and chase of another dopamine hit. Combined with the society pressure, these options may be the last resort for the suffering person looking to numb their feelings. It is important that not all women suffering from ADHD will develop addictions, however it is important understanding the link.
Types of ADHD in women
Inattentive ADHD is more common in women, and the least frequent type is the hyperactive presentation. For more information about different types of ADHD, you can visit our ADHD assessment page.
Conclusion
ADHD in women is an interesting topic, and although the condition was not well recognised in the past, we are seeing more women seeking help. We need to understand that women suffering from ADHD can be equally if not more affected by this condition. However, the symptoms can have a different presentation. Some may find it useful using technology-based apps in enhancing their daily productivity, such as an ADHD planner app. However, some may find having a technology free approach more productive. When dealing with symptoms of ADHD and any other mental health condition, it is good to remember that everyone is different.
With the more recent awareness of ADHD in women, the future diagnosis rate may be very likely to change. More research is necessary in understanding how the condition may be differently diagnosed and managed in women suffering from ADHD. If you identify experiencing symptoms of ADHD, talk to your mental health professional or healthcare provider. Having the appropriate support can significantly improve your quality of life and well-being.
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References
Prevalence of hormone-related mood disorder symptoms in women with ADHD - PubMed (nih.gov)
Are Eating Disorders Related to Attention Deficit/Hyperactivity Disorder? - PMC (nih.gov)
Data and Statistics About ADHD | CDC
Disclaimer: The information is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, and information, contained in this article is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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