Why Women Are Underdiagnosed With ADHD
Some research would have us believe that ADHD is more common in men than in women. But in reality, millions of women live with ADHD, but might not even realize it. The truth is that these numbers are skewed — ADHD is certainly more often diagnosed in men than in women, but many experts now say that may be because women with ADHD are often mis- or underdiagnosed.
Many women don’t get correctly diagnosed with ADHD until they’re in their 30s. Often, they seek a diagnosis and treatment after their children are diagnosed with ADHD and they recognize some of the symptoms in themselves.
There are several complex reasons behind why women are underdiagnosed with ADHD; here are some of the most important ones.
Related: How ADHD Is Different in Women
Table of contents
Misunderstanding of ADHD
Although advocates and researchers are trying to change things, ADHD is still very misunderstood. Many people and even professionals, whether they’re teachers or mental health providers, still think of ADHD as a “hyperactive boys’ disorder.”
This is one reason why women often go undiagnosed in childhood: Adults aren’t taught to recognize all the signs and symptoms of ADHD, especially the way it presents in girls. The symptoms used to diagnose ADHD are also largely built on research with males, meaning many key presentations may be getting missed.
Inattentive vs. hyperactive ADHD
Women are more likely to present with the inattentive subtype of ADHD. People with this type of ADHD are more likely to be distractible than hyperactive.
When teachers and other adults are primarily looking at hyperactivity and restlessness as the only sign of ADHD, then it’s understandable that girls with inattentive ADHD often get missed. Think about it: Are you more likely to notice a child who’s constantly running around and having outbursts of energy, or the child quietly daydreaming at the back of the room?
Signs of inattentive ADHD often get missed both in girls and boys. The problem is that girls may not present with any hyperactivity at all (or try harder to hide their hyperactivity), which leaves them mostly unnoticed.
Girls “act in,” and boys “act out”
Unlike boys, girls often internalize their ADHD symptoms.
When boys with ADHD are faced with challenges, they may act out. For example, they might refuse to do the work, or become defiant against teachers and parents. In other words, they are more likely to express their frustration outwards. Although this may get them into “trouble” at school or at home, it also gets them needed attention.
Girls, on the other hand, are more likely to internalize their feelings. They may blame themselves for the difficulties they face in completing tasks that their classmates seem to do with ease. They may label themselves as “stupid” or “ditzy.” This doesn’t get attention, and it also causes girls with ADHD more emotional distress.
Girls and women with ADHD have been found to have a higher rate of co-occurring mental health disorders like depression and anxiety. They’re also more likely than men to suffer from low self-esteem.
Gender Norms and ADHD
There’s no doubt that gender norms, and the way women are expected to perform in society, also contributes to the gender gap in ADHD diagnosis.
Girls and women may “mask” symptoms
Whether it’s direct or subtle, girls and women are usually expected to have it all together. At both work and home, women are expected to keep things neat and tidy, and know where every item belongs. They’re expected to be well-behaved, and certainly to avoid having angry or hyperactive outbursts.
So, girls and women with ADHD learn how to “mask” their symptoms.
“Masking” is the term used to describe the way some people learn to use coping skills to hide their ADHD symptoms and fit in. For example, they may force themselves to stop speaking their mind in order to avoid talking “too much.” They may start arriving at events extremely early to avoid being late. Masking can be very exhausting and even stressful when used regularly.
But, as they say, the squeaky wheel gets the grease. When girls and women hide their ADHD symptoms, they’re less likely to get the help and attention they need.
ADHD or “Chatty Cathy”? Girls with ADHD and labels
Other times, even if they aren’t masked, ADHD symptoms in girls may be labeled as just part of being a girl. For example, boys who talk “too much” may get noticed, but girls who talk the same amount may be labeled as “Chatty Cathys.”
Teachers may notice boys who seem to daze off as a possible ADHD student, but girls who daze off may be labeled as “daydreamers.”
This goes back to the way ADHD, in general, is misunderstood. Teachers, parents, and other adults aren’t looking for ADHD in girls, so the signs of ADHD that are there tend to get explained away or missed entirely.
Getting Help for ADHD as a Woman
If you are a woman with ADHD, chances are you went through a difficult childhood trying to cope with your symptoms on your own. But it doesn’t need to be this way; with the right diagnosis, you can get access to effective treatment that can make your life a lot easier.
Why ADHD treatment is important for women
Women with ADHD are more likely to have other emotional and mental health problems like depression, anxiety, and low self-image. This may be because women don’t typically get diagnosed until adulthood. This means that women often spend their entire lives blaming themselves for what they see as “shortcomings,” but which are actually just symptoms of ADHD.
Getting a diagnosis and treatment for ADHD can equip you with tools to live well with this disorder. On top of that, it can help explain why certain tasks seem to be more difficult than it is for others — and reassure you that you’re not spacey, slow, or ditzy. You just have ADHD, and it’s not your fault.
I think I may have ADHD
If you think you might have ADHD, take our free assessment questionnaire to find out if you are eligible for a diagnosis. If you do have ADHD, then you can get started with treatment, like medication, online tools like Frida, or behavioral therapy. All of these treatments have been found to effectively help women with ADHD better manage their symptoms.
You can live a successful and fulfilling life with ADHD, and you don’t have to do it alone.