women with ADHD
women with ADHD

Why ADHD Is Often Underdiagnosed In Women

Posted on September 7, 2023 by Henry Ford Health Staff

When you think of someone most likely to have attention-deficit/hyperactivity disorder (ADHD), you may picture a rambunctious boy who can’t sit still in school. And that makes sense when you consider the numbers. Millions of children in the U.S. have ADHD. But according to the Centers for Disease Control and Prevention (CDC), boys are three times more likely to receive a diagnosis of ADHD than girls.

“That doesn’t necessarily mean that fewer girls have ADHD,” says Lisa MacLean, M.D., a psychiatrist at Henry Ford Health. “But symptoms of ADHD in girls and women can be more subtle and harder to recognize. That can delay diagnosis.”

What Does ADHD Look Like In Girls?

There are two types of ADHD—attention deficit (or inattentiveness) or hyperactivity/impulsivity. In order to receive a diagnosis of ADHD, a person can have one or both of those symptoms.

“Girls (and women) are more likely to have inattentive behaviors,” says Dr. MacLean. “But that doesn’t mean that’s their only symptom.” The hyperactivity side of ADHD is often also present in girls—it may just look different.

“Unlike the stereotypical presentation of a boy who’s jumping up and down and getting in classmates’ faces, girls with ADHD may just seem energetic, talkative and social,” says Dr. MacLean. “Since girls often display fewer behavioral problems and less noticeable symptoms, their difficulties are often overlooked.” As a result, they aren’t evaluated and treated for ADHD as often as boys.

Girls with ADHD often experience symptoms including:

  • Being easily distracted or forgetful
  • Difficulty following instructions
  • Fidgeting
  • Inattention to detail leading to careless mistakes
  • Racing thoughts that make it hard to keep their mind on one topic
  • Speaking without thinking
  • Trouble staying organized and on task

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Signs Of ADHD In Women

Because fewer girls receive an ADHD diagnosis and treatment, many enter adulthood still coping with symptoms. “You don’t just develop ADHD as an adult,” says Dr. MacLean. “But many women are realizing and recognizing it later in life.”

The signs of ADHD in adult women are similar to those in younger girls. But years of living with untreated ADHD often leads to new symptoms and challenges. “Undiagnosed ADHD can have a negative impact on self-esteem and mental health,” says Dr. MacLean. “That puts girls and women at higher risk for depression, anxiety and eating disorders.”

Women who’ve been living with undiagnosed ADHD typically develop coping mechanisms over the years that can further mask symptoms. “Women are good at hiding their struggle,” says Dr. MacLean. “And they use strategies—like working late into the night to keep up—to compensate.” But the struggle still takes a toll on their self-esteem and their success in various aspects of life.

“Women with untreated ADHD can have difficulty maintaining friendships and romantic relationships, trouble finding a career path and succeeding at work and typically blame themselves for these perceived ‘failures,’” says Dr. MacLean. “Getting a diagnosis can help give them back some self-esteem.”

When To Seek Help For ADHD

If you’ve made it to adulthood without being diagnosed with ADHD, it may not even cross your mind that you could have the condition. “It often happens that when a woman has a child who’s getting diagnosed, a lightbulb goes off for the parent and they realize they’ve been suffering with it,” says Dr. MacLean.

Women who feel that at least some parts of their lives are out of control may benefit from evaluation and—if appropriate—treatment. “Women with untreated ADHD often describe themselves as feeling exhausted and overwhelmed by the demands of life,” says Dr. MacLean. Their finances may be in disarray, with bills unpaid and poor record-keeping. At home, at least one space in the house is disorganized and messy.

Behavioral and lifestyle management are possible treatment options. Things like career coaching and working with a professional organizer can help women with ADHD feel more in control and better organized. Prescription stimulant medications are the gold standard of ADHD treatment. “About 80% to 90% of people respond very well to medication therapy,” says Dr. MacLean.

Reviewed by Dr. Lisa MacLean, a psychiatrist specializing in adult ADHD treatment at Henry Ford Behavioral Services in Detroit. She is the director of physician wellness for Henry Ford Health, using her expertise to help doctors optimize wellness and find balance by teaching them healthy coping strategies so they can better serve their patients.

Categories : FeelWell

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