How To Diagnose Adhd In Women
This article was co-authored by Padam Bhatia, MD. Dr. Padam Bhatia is a board certified Psychiatrist who runs Elevate Psychiatry, based in Miami, Florida. He specializes in treating patients with a combination of traditional medicine and evidence-based holistic therapies. He also specializes in electroconvulsive therapy , Transcranial Magnetic Stimulation , compassionate use, and complementary and alternative medicine . Dr. Bhatia is a diplomat of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association . He received an MD from Sidney Kimmel Medical College and has served as the chief resident in adult psychiatry at Zucker Hillside Hospital in New York.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 9,896 times.
While a diagnosis of ADHD does not differ based on gender, sometimes symptoms of ADHD may be expressed differently in men and women. Women generally do not get a diagnosis of ADHD until adulthood, often shortly after one of their children receives a diagnosis. Even though much of the understanding about ADHD is on school-age boys, more information is becoming available about adults with ADHD and women with ADHD. If you think you may have symptoms of ADHD, make an appointment with a mental health provider to discuss a diagnosis and ways to move forward in treatment.
What Is Attention Deficit Hyperactivity Disorder Inattentive Type In Adults
Attention deficit hyperactivity disorder is a neuropsychiatric disorder that makes it difficult to pay attention, control impulsivity or manage excitable behavior . The disorder interferes with the quality of life by intruding on day-to-day functioning.
Three different types of ADHD have been identified based on criteria from the American Psychiatric Association. These are:
- Predominantly inattentive presentation.
- Predominantly hyperactive-impulsive presentation.
- Combined presentation .
Adults who have significant problems with inattention, but exhibit few or no symptoms of hyperactivity, are said to have the predominantly inattentive presentation of ADHD. People with this type of ADHD have trouble paying attention to details, are easily distracted, often have trouble organizing or finishing tasks and often forget routine chores .
For Decades Now Adhd Has Been Almost Exclusively Understood As Hyperactive Behavior In Young Boys But That’s Finally Changing Heres What You Should Know
For decades now, has been almost exclusively a boys clubunderstood mostly as hyperactive behavior in young boys. An outdated trope resulting from factors like stereotypes, lack of ADHD symptom knowledge, and adult women being excluded from important ADHD research, discussion, and .
Even one of the most useful metaphors about ADHD was likely thought up to describe ADHD brains in boys: ‘ is like having a Ferrari brain with bicycle brakes.
Its a good one, but its a guys one.
Many women we asked said theyor their daughterswere described as flaky or spacey and diagnosed as depressed, anxious, or even bipolarbut not ADHD. The impact of limited diagnoses, difficult to manage symptoms, and a shortage of experts who specialize in the treatment of females of any age, cannot be underestimated, no matter how small the numbers appear.
Estimates vary but new research found that adult ADHD prevalence is 6.76%.¹ Experts also believe between 20% to 25% of ADHD adults are diagnosed in adulthood. Of that 5%, women typically arent diagnosed until their 30s and are far less likely than men to get professional help.²
What’s with the late diagnosis? Ironically, many mothersin search of help for their undiagnosed childrenrecognize their symptoms when reading about childhood developmental disorders and think, I am not a rowdy boy who has trouble sitting still, but that really does sound like me!
Fortunately, things are finally starting to change.
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Why Are We Focusing This Site On Women
50-75% of women with ADHD go undiagnosed
Women and girls are less likely to be diagnosed because ADHD presents itself differently physiologically and socially. Young girls may exhibit hyperactivity differently than boys, and girls are also more likely than boys to suffer from inattentive ADHD. The symptoms of the inattentive subtype tend to be less disruptive and obvious than those of hyperactive ADHD. A hyperactive boy who repeatedly bangs on his desk will be noticed before the inattentive girl who daydreams while staring out the window.
Delay in diagnosis is life damaging
Undiagnosed ADHD can cause life damaging consequences. Delay or lack of appropriate diagnosis and treatment can result other conditions such as depression, anxiety, bipolar, learning disabilities, OCD, PTSD, drug and alcohol addiction and eating disorders.
The female experience is invisible
ADHD is commonly associated with children and men yet 4% or 6 million adult women live with ADHD. Women face unique challenges due to lack of scientific knowledge, resources, or public understanding. Stigma leads many women with ADHD to stay silent about their experiences feeling alone, confused and misunderstood.
Theres a rapidly growing need
Ordering A Physical Exam
You might need a medical exam to rule out any underlying medical reasons for your symptoms. Conditions like thyroid disorders and seizure disorders can sometimes cause symptoms very similar to ADHD.
If its been more than 1 year since your last medical exam, your evaluator might need you to take one before they can accurately diagnose ADHD.
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Strategies For Accurate Diagnosis Of Adhd In Women And Girls
Increased awareness among health care professionals that ADHD is an important medical issue in women and girls is critical for ensuring proper diagnosis and treatment. It has been suggested that women often seek help for their symptoms on their own,21 but they may not be aware that ADHD is responsible for the problems they are experiencing. Although female patients have been less likely to receive ADHD medications in the past, a review published by Cornforth and colleagues66 suggested that the efficacy and tolerability of ADHD medications is similar in male and female patients, and a review of outcomes from the Multimodal Treatment Study of Children With ADHD found that girls were more likely than boys to have favorable long-term outcomes with ADHD medication.67 Growth rates in medication use suggest that the treatment of adult ADHD in women is increasing,6 possibly because of increased awareness of the presentation of ADHD symptoms in women and a subsequent diagnosis of ADHD.
How Do Gender Norms And Stereotypes Play A Role
In media, portrayals of male characters with ADHD-associated traits are frequently viewed positively . Negative traits of ADHD, such as disorganization, tend to be looked on more judgmentally in women and more easily “forgiven” in men.
Many girls and women with ADHD try hard to suppress behaviors that may be counter to the norms of feminine behavior, such as hyperactivity, impulsiveness, disruptive behavior, and disorganization, for fear of judgment.
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When Problems Arise In The Classroom
To address the problem of girls with ADHD not being referred for treatment by teachers and to prevent girls with ADHD from being overlooked in the classroom, it is important to screen girls who are not doing well or require extra help to succeed. In a retrospective analysis of young women diagnosed with ADHD as children, ADHD was recognized as contributing to impaired academic progress by the parent but not by the individual with ADHD.45 Lack of academic progress also resulted in an increased use of tutoring services, repeating of grades, and placement in special education classes for girls with ADHD compared with controls.8,15 Educational impairments were also reflected in lower rates of graduation from high school in girls with ADHD compared with non-ADHD controls.16
More Research Is Necessary
As more and more adult women seek treatment and diagnosis for ADHD, scientists say they need more studies that look at gender differences in the condition.
For example, some experts believe female hormones play a role in the ADHD symptoms of young girls and women. Females may need other forms of treatment than what boys or men need. Many girls also are raised to behave differently from boys. This could make them express their ADHD symptoms in other ways.
Ultimately, experts say more research can help them identify, diagnose, and treat ADHD symptoms early in young girls and women. That early intervention is key to better management of the condition in the long run.
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Common Adhd Diagnosis Mistakes And Challenges
Depression, anxiety, or other psychiatric conditions may be mistaken for ADHD, Solanto says. So may some learning disabilities, as well as medical issues including thyroid problems, seizure disorders, and sleep disorders.And children, teens, and adults with ADHD may be able to work around the challenges of the condition and perform at a high level in school or work, essentially hiding or not really recognizing that theyre dealing with the condition until they meet a major challengesuch as moving from elementary to middle school, from high school to college, or into the working world.
Some people can compensate, she notes. Thats why its important to have a thorough, good evaluation.
ADHD may also be overlooked in girls and women because the condition is more likely to have symptoms related to inattentiveness rather than hyperactivity and impulsivity. Research indicates that females with ADHD that begins in childhood are less likely to be recognized and diagnosed than males, she says. Theyre not disruptive in the classroom. Theyre quiet. Theyre encountering insults to their self-esteem, so they may start thinking of themselves as incompetent or unintelligent. And theyre more likely to be socially ignored by their peers.
Stigma Of Adhd: People Think Its A Fake Disease
Public disbelief as a cause of additional problems, and self-doubt
I think that people think ADHD is sort of a made up excuse for being unfocused and undisciplined, that it just takes self-control or something. I dont think that people think ADHD is as real as anxiety and depression. I think that ADHD is often still seen as a kids disease, and I think that theres this perception of adults having ADHD as being immature and choosing not to act like an adult.
Its a disability that cant be seen, its not as if your leg doesnt work or something. It cant be seen, and therefore you get no sympathy from people.
So even today I dont accept it a 100%, because of the way its diagnosed its not like its a brain scan or something, or a DNA test, so since its qualitative I wonder if its really legitimately ADHD that I have.
To tell or not to tell: Selective disclosure
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Adhd Is Different For Women
The standard conception of the disorder is based on studies of hyperactive young white boys. For females, it comes on later, and has different symptoms.
This article is from the archive of our partner .
When you live in total squalorcookies in your pants drawer, pants in your cookies drawer, and nickels, dresses, old New Yorkers, and apple seeds in your bedits hard to know where to look when you lose your keys. The other day, after two weeks of fruitless searching, I found my keys in the refrigerator on top of the roasted-garlic hummus. I cant say I was surprised. I was surprised when my psychiatrist diagnosed me with ADHD two years ago, when I was a junior at Yale.
In editorials and in waiting rooms, concerns of too-liberal diagnoses and over-medication dominate our discussions of attention deficit hyperactivity disorder, or ADHD. The New York Timesrecently reported, with great alarm, the findings of a new Centers for Disease Control and Prevention study: 11 percent of school-age children have received an ADHD diagnosis, a 16 percent increase since 2007. And rising diagnoses mean rising treatmentsdrugs like Adderall and Ritalin are more accessible than ever, whether prescribed by a physician or purchased in a library. The consequences of misuse and abuse of these drugs are dangeroussometimes fatal.
The drawer thing, though, is a work in progress. The next time I misplace my keys, the fridge will be the first place I look.
Adhd In Women: Inattentive Symptom Presentation
- A subtle symptom presentation with a greater likelihood of inattentiveness marks the ADHD experience for many women and girls, who are not outwardly disruptive to others. Many clinicians, however, are most familiar with the hyperactive, disruptive presentations of ADHD that are more common in men and boys. Studies indicate that hyperactivity and impulsivity, along with other externalizing symptoms are strong predictors of diagnosis compared to other ADHD presentations.3
- Camouflaging symptoms: Research shows that women are highly motivated to hide their ADHD symptoms and compensate for them. The symptoms that are observable are often anxiety or mood-related, which can lead to misdiagnosis.
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Adult Symptoms Of Adhd
Recognizing ADHD in adults is more challenging than in children due to how this disorder presents at different ages. For example, children are more likely to exhibit outward signs such as an inability to sit still, interrupting conversations, difficulty focusing on tasks, and excessive movements when not appropriate. In contrast, adults have more subtle manifestations of this diagnosis due to both a greater understanding of cultural norms and general maturity. Adult symptoms* include:
- Difficulty organizing tasks at home or work
- Frequent changes of interest in hobbies
- Being easily distracted by noises/other stimuli
- Excessive talking, talking over others
- General forgetfulness
*This is not a replacement for medical advice. Any concerns about behavior should be discussed with a medical or mental health professional.
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Types Of Adhd And Symptoms In Women
The CDC estimates 8 million adults display the symptoms of attention deficit hyperactivity disorder , which includes a complex grouping of symptoms that impact women and men differently.
Kathleen Nadeau, PhD, director at Chesapeake Psychological Services of Maryland in Silver Spring specializes in treating women and girls. Nadeau says the single most common word women use to describe their symptoms when they see her is a pervasive sense of overwhelmone that evades all kinds of remedies and persists for months or years.
The latest diagnostic manuals include : inattentive hyperactive/ impulsive, or a third combined group. ADHD is far from a monolith. It is a complex neurological condition, says Dr. Hallowell, co-author of ADHD 2.0, a book written for both clinicians and people with ADHD to better understand the most recent brain science and how it can positively and negatively affect peoples lives.
ADHD is divided into three types with the following diagnostic criteria:
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Trainwreck: The Impact Of Undiagnosed Adhd
There are serious physical and mental health outcomes for women with undiagnosed ADHD. Undiagnosed women tend to earn less than their peers and are less likely to have stable employment. In addition, there is a higher chance for them to become alcoholics, have unplanned pregnancies or even land in jail. In a study, an astounding 23.5% of women with ADHD even reported that they had attempted suicide before, as opposed to 3.3% of women without ADHD.
Adhd Symptoms In Girls And Women
We now better understand how ADHD tends to show up in girls, but some still go undiagnosed for years. “We know girls are much less likely to receive a diagnosis of ADHD than boys because boys tend to be more hyperactive and disruptive. Girls tend to be inattentive, which can go unnoticed by parents and teachers,” says Nebraska Medicine psychiatrist Sharon Hammer, MD, who specializes in women’s mental health. An increasing number of adult women seek help, many of whom ultimately look back and recognize a pattern of symptoms since childhood. “ADHD is the most genetic and inheritable illness of all psychiatric illnesses,” says Dr. Hammer. “The most at-risk people are those with a family history of ADHD. We see a lot of women come in for help when they have a child of their own get diagnosed and realize they have many of the same symptoms.”
As opposed to boys, girls with ADHD tend to internalize their struggles and blame themselves without garnering the attention of the adults in their lives. They may manifest anxiety or depression, which is secondary to inattention. “About 50% of adult women with ADHD have a comorbid condition. Many times we end up seeing a person due to anxiety or depression, and through that, we end up discovering the ADHD,” says Dr. Hammer. “In my practice, it seems rare to have a woman come in and say ‘I think I may have ADHD.’ They come in and talk about how anxious, frustrated or irritable they are.”
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Adhd In Women: Signs And Symptoms
ADHD in women primarily means a greater likelihood for the following:
- inattentive symptom presentation, including, per the DSM-5
- failing to give close attention to details or making careless mistakes in activities
- trouble holding attention on tasks
- not following through on instructions and failing to finish duties
- trouble organizing tasks and activities
- getting easily distracted
What Kind Of Doctors Diagnose Adhd
A licensed mental health professional or physiciansuch as a clinical psychologist, psychiatrist, neurologist, family doctor, or clinical social worker with training and experience working with children, teens, or adults with ADHDcan perform an ADHD evaluation.¹² Pediatricians often diagnosis ADHD in children, according to the American Academy of Pediatrics.²¹ In fact, a 2015 report from the CDCs National Center for Health Statistics found that half of all children with an ADHD diagnosis had been evaluated by their family doctor.²²
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