Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that involves a continuing pattern of inattention, hyperactivity, and/or impulsivity. Typically beginning in childhood, these factors commonly interfere with a person’s development and functioning in many areas of their daily life activities. For many years, ADHD was believed to be a condition that primarily affected boys and men. This misconception led to a significant gap in the understanding, diagnosis, and treatment of ADHD in women. The resulting gap has contributed to a wide range of mental health issues, academic difficulties, career underachievement, and an overall decreased quality of life for the many women left undiagnosed.
How Women Suffer in Silence
Boys are roughly 2x more likely to be diagnosed with ADHD than girls. However, ADHD can be expressed differently in girls and often does not emerge until puberty or post-high school or college transition years. What’s more, women with ADHD tend to experience symptoms differently than their male counterparts, a factor that lends to the gross underdiagnosis of the disorder for this gender. Women have been found to experience more internalized symptoms, such as inattentiveness, time management, and keeping track of things, lending to the problem of decreased visibility and recognition of ADHD related issues by educators, professionals, and even family members.
ADHD in girls and women might look like:
- Scribbling or drawing in the middle of a lecture or business meeting.
- Seeming withdrawn or reserved, preferring her own company.
- Not giving close attention to details but still getting things done.
- A very messy bookbag/purse, piles of clutter on her desk, or a messy room/home.
- Screaming on the inside and feeling overwhelmed.
- Staying up later on nights and weekends to get your work done, even if you turn it in when you should (but just a few minutes shy of being late).
There are several societal and gender expectations that contribute to the underdiagnosis problem by teaching women to “mask” or hide their symptoms or to develop strategies quicker than their male peers that allow them to get by and be successful. In some cases, their ADHD is seen as anxiety, depression, or them being “dramatic.” This leaves young girls who wonder why they struggle to focus in class or complete their assignments on time grow up to be frustrated women who find it difficult to organize tasks or complete projects in the home or workplace without feeling like they are falling apart. All the while, they are blaming themselves while trying to answer the question of why they just can’t seem to overcome these challenges. So, they suffer in silence—or they are diagnosed with anxiety/depression or have their experience invalidated by others who dismiss their symptoms as personality traits—rather than recognize a need to rule out ADHD as a primary indicator.
Misdiagnosis/Missed Diagnosis of ADHD in Women
Originally believed to be a childhood disorder, it is now evident that ADHD may extend into adulthood for many diagnosed individuals. As such, it is imperative that we increase awareness of how ADHD might present in girls and women. There are several reasons why the underdiagnosis of ADHD deserves attention.
- It demonstrates the gender bias that exists in ADHD research and treatment, areas that have historically focused on the male presentation and experience of the disorder. As a result, a misunderstanding of how ADHD affects girls and women has persisted and resulted in inadequate care and support for those impacted.
- Many undiagnosed women suffer from secondary mental health issues such as anxiety, depression, and emotional dysregulation. This may be due to their struggle to manage symptoms without knowing the underlying cause or contributor. Thus, undiagnosed women may blame themselves for the challenges they have in their life, a factor which leads to increased stress and diminished self-esteem.
- It is essential that the underdiagnosis of ADHD in women is acknowledged and addressed as a means of empowering them. With the appropriate treatment and support, a confirmed diagnosis of ADHD can lead to drastic improvements in their quality of life, social relationships, academic and career achievements.
Treatment Options for ADHD in Women
Properly addressing the underdiagnosis of ADHD in women requires a multifaceted approach that incorporates psychological evaluation, counseling, and ADHD coaching.
- Psychological Evaluation. This is often a first step toward diagnosis and involves comprehensive assessments that consider the unique ways that ADHD may present in girls and women. A tailored evaluation process aimed at recognizing these symptoms can help with an accurate diagnosis of ADHD and formulating treatment plans and goals. Particularly for women, it is important that evaluations gather a thorough history of home, school, work, and social life along with information about the client’s subjective experience of each life area. It is in this information that we may understand how girls and women meet criteria for ADHD even if they may not outwardly demonstrate them in a stereotypical fashion.
- Counseling. This can play a pivotal role in supporting women who have been newly diagnosed with ADHD. Counseling and psychotherapy provide a safe, nonjudgmental space where women can explore how ADHD has impacted their life, develop healthy coping strategies to address their challenges, and address secondary mental health concerns such as anxiety and depression that might have manifested from having undiagnosed and untreated ADHD. Through counseling, women can gain an improved understanding of ADHD, improve their self-esteem, and learn practical skills to help them navigate challenges they face.
- ADHD Coaching. This is another valuable resource that offers a personalized support approach, which includes more skills-based focus on identifying and implementing strategies to better manage daily life and achieve goals. ADHD coaches work with their clients to develop time management and organizational skills, create structured routines, and implement practical strategies to handle tasks that are often challenging for individuals with ADHD. Coaching uses a strength-based approach to create achievable steps to overcome obstacles, foster independence, and bolster confidence.
Evaluations, Counseling, & Coaching at Magnolia Wellness & Psychology
The underdiagnosis of ADHD in women is a prevalent issue with far reaching implications. At Magnolia Wellness & Psychology, we take a comprehensive approach to helping girls and women understand their ADHD, determine if they meet diagnostic criteria, develop an action plan to address their challenges that also match their life goals, and provide the resources to help them achieve it.
We offer comprehensive ADHD evaluations that are tailored to each person. This not only helps us recognize the nuanced symptoms and characteristics of ADHD that might be present in women, but it also allows us to understand how ADHD might show up differently in their lives. Our highly specialized team also includes licensed professional counselors who work with clients to address the immediate challenges associated with ADHD using counseling and ADHD coaching. Counseling can help explore the mental and emotional impact of a delayed diagnosis and any other concerns while our Coaching package teaches necessary executive functioning skills such as planning, organization, and time management. With an all-inclusive approach like this, we can help the newly diagnosed person achieve their goals for wellness and be more successful in their home, school, work, and/or social lives.
We work to empower women with ADHD to lead fulfilling lives, break the cycle of underachievement, and overcome mental health struggles. If you suspect you might have ADHD, schedule your initial appointment today with Magnolia Wellness & Psychology for an ADHD evaluation, counseling, or coaching. There is no waitlist and evaluation results are available in about 30 days.
*Note: “Girls” and “Women” refers to those Assigned Female at Birth (AFAB).
