Why ADHD Is Missed/Overlooked In Women

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What is ADHD?

            Attention deficit/hyperactivity disorder is a neurodevelopmental disorder which is characterized by a variety of symptoms such as impulsivity, inattention and forgetfulness etc. It is of three types: inattentive, hyperactive and a combination of both. It is diagnosed in childhood and continues into adulthood. It’s symptoms and complications vary according to age. For instance, in early age, the patient tends to have more benign symptoms comparatively such as inattention (daydreaming) and impulsiveness while in the later age, the complications include depression, anxiety, self mutilative behaviour and suicidal attempts.

Prevalence of ADHD in boys and girls:

            ADHD is a very common disorder whose prevalence differs among communities from 2 to 7 percent with an average being 5 percent. It is thought to be the disorder of boys only and it was understood for a long time that it is very much more common in boys than girls. This was because a lot more boys were diagnosed with ADHD than girls each year with a ratio among boys and girls being 2:1 to 10:1, differing from research to research in different communities.

            However, that’s not completely true because now it is evident from a lot of research and diagnostic tests that girls are as much likely to get ADHD as boys. Girls are even more likely to have serious complications of ADHD such as depression and self mutilating and suicidal behaviour than boys, in later age.

Why is ADHD missed/overlooked in women?

            As is described above, it apparently has been more common among boys than girls. It was definitely a misconception due to which a lot of girls with ADHD remained undiagnosed, developed complications and some of them attempted suicide. Life of such patients is very difficult because they are constantly being called lazy and weird and what’s even is the saddest part, that they cannot explain their situation even knowing that they are special, they are different.

            There are a number of causes to be blamed for missed diagnosis of ADHD in women.

1- Severity of symptoms:

            It is said that “ a baby needs to cry to get fed ”. It means that there should be an obvious presentation of a disease to get attention of the peers and teachers. Boys tend to have more obvious symptoms than girls. The most common type of ADHD in girls is that of inattentiveness. Girls don’t go hopping around like boys. They rather behave like a child who keeps daydreaming in class. While the boys with ADHD tend to be more impulsive and have more obvious symptoms. This is one of the major causes for ADHD in girls to be overlooked.

2- Suppression of symptoms:

            Girls are thought to be more sober and sociable than boys. This is constantly fed to them by our society. They try to suppress their symptoms harder than the boys because of the sense that they would not be acceptable in the community if they showed impulsiveness and interrupted the conversation of others. They channelize the energy of their constantly running mind to be more talkative, but it is pretty common for girls to be over talkative. They also tend to have other ways of calming their mind such as overeating. Later in life, they can develop alcoholism and substance use disorders which initially seem to be helping but does nothing except exacerbating the symptoms. It leads to the development of depression and other behavioural manifestations.

3- Performance pressure:

            Girls take their studies more seriously than boys and they constantly try to have help from teachers and parents. They are higher performing generally than the boys with ADHD and that leads to the overlooked ADHD. I mean a child with good grades at school seems less likely to have ADHD though she has a little bit of odd behaviour which she is already trying to suppress.

These are some of the major reasons for ADHD in girls to be missed and because of these, the girls with ADHD are diagnosed at a later age when they develop overt symptoms. By later age, healthcare professionals mean the age of 40s or 50s. Uphill that age, one can just imagine the difficult life of a woman with ADHD.

Bottom line:

            Girls have equal or more incidence of ADHD. There are multiple reasons for the diagnosis of ADHD to be missed or overlooked in girls. They need to be addressed and if a girl shows inattentiveness or is over talkative or has other behavioural symptoms, she definitely needs a visit to a doctor. Though it is not curable, its symptoms can be controlled and complications can be prevented and the life of a girl with ADHD can be made a little easier.

References:

  1. https://www.bbc.com/future/article/20190530-why-is-adhd-missed-in-girls
  2. https://www.additudemag.com/add-in-women/
  3. https://pubmed.ncbi.nlm.nih.gov/29033005/#:~:text=Attention%2Ddeficit%20hyperactivity%20disorder%20

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