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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects individuals across various age groups and genders.
However, the impact of ADHD on girls and women often remains underestimated and overlooked.
In a society that traditionally associates ADHD with hyperactive boys, females with this condition frequentlygo undiagnosedor misdiagnosed, leading to significant challenges and consequences.
ADHD can have a profound impact on most aspects of girls and women’s lives, influencing their academic performance, career prospects, relationships, and overall well-being.
Consequently, girls and women with undiagnosed and unmanaged ADHD face unique hardships, struggling silently and grappling with daily tasks that others may find effortless.
Impact of ADHD
By understanding the complexities ofADHD in femalesand advocating for improved recognition and tailored interventions, we can work towards empowering these individuals to navigate their lives with greater success, fulfillment, and self-acceptance.
Academic/occupational
‘I think ADHD for me… really starts to show when adult life takes a hold when you’re going into further qualifications or perhaps you’re going into the working world where you do have to meet certain deadlines, you do have to structure your life… you’re waking up on time, and you’re holding down the other parts of your life.’
Girls and women may have to put in extra work to overcome barriers such as procrastination and attentional difficulties. They may also struggle to manage their time on work tasks:
‘I definitely feel that when my days are busier, I use my time more efficiently, but if there’s more open ended time with just one large task, it can be harder for me to use that time well.’
While academic and occupational success is indeed possible, girls and women with ADHD may have a feeling ofimposter syndrome, feeling as if they do not deserve their success due to how challenging it was to get there, compared to others, who may seem to be succeeding effortlessly.
Home life
Women with ADHD may struggle with maintaining an organized home life. Their finances may be chaotic, paperwork and record-keeping are often poorly managed, and they may feel less able to keep up with the daily tasks of meal planning, cleaning, and other aspects of life management.
‘We’ve (women) been raised to take on a lot of responsibilities and make sure that things are okay . . . and I think that it can be extra challenging for women with ADHD, since women almost are expected to have an inborn ability to organize and maintain things in order.’
Some women may manage to hide their struggles and may work on tasks late into the night to get things done.
Relationships
Women and girls with ADHD are more likely to have a high turnover of friendships and experience social isolation, peer rejection, and more bullying than those without ADHD.
A study found thatgirls with childhood ADHD that persisted into adulthood demonstrated social problems.
They may also find it difficult to navigate romantic relationships with others, especially if ADHD is undiagnosed and their partner cannot offer understanding.
Even made aware, research suggests that husbands of women with ADHD are less tolerant of their spouse’s ADHD patterns than wives of men with ADHD.
As a result, women with ADHD may be more likely to experience breakups or divorce as a consequence of their ADHD.
Mental and physical health
Whether a woman’s life is in chaos or they can hide their struggles, they often describe themselves as feeling overwhelmed andburnt out.
Compared to women without ADHD, women with ADHD are more likely to suffer depressive symptoms, are more stressed andanxious, and havelower self-esteemand feelings of shame.
Many clinicians are finding significant concerns and other co-existing conditions in women with ADHD, such as compulsive overeating, alcohol abuse, and chronic sleep deprivation.
There is also an alarming link between ADHD and non-suicidal self-injury (NSSI) and suicidal behavior.
For NSSI, it is thought that adolescent externalizing behaviors, poor executive function, and peer victimizationare mechanisms for this.
For suicidal behavior, early internalizing problems and peer rejectionare documented mediators.
Chronic stresscan also take its toll on women with ADHD, affecting them physically and psychologically. Chronic stress associated with ADHD puts someone at risk for stress-related diseases such as fibromyalgia.
Therefore, it is becoming clear that the lack of appropriate identification and treatment of ADHD in women is a significant public health concern.
‘there are physical and psychological impacts… particularly for women with ADHD… we see higher rates of self-harm, suicidal intent. We see higher rates of physical challenges like chronic fatigue syndrome, chronic pain, migraines, putting on weight. Some people have learned to use alcohol and cannabis to help calm them to help them with a busy brain.’
Social judgment
Women and girls are often encouraged to exhibit traditional ‘feminine’ qualities such as beingempathetic, good with relationships, and nice, as well as traditional ‘masculine’ qualities such as being assertive, academically driven, and career-focused.
So, when they display impulsive, disorganized, or disruptive behaviors, they risk harsh social judgment since these traits violate the norms forstereotypicalfemale behavior.
Parenting
In a lot of families, the primary parent is the mother. The mothers are usually expected to be the household and family manager, roles that require focus, organization, and planning, as well as the ability to juggle multiple responsibilities.
ADHD typically interferes with these abilities making the job of a mother with ADHD very difficult.
‘When I drop my daughter off at the day care, I’m always late, and I can see what the teachers are thinking. People think you’re a bad mother, right.’
Women with ADHD are also more likely to have a child with ADHD, which further increases parenting challenges.
Frequently, a woman comes to recognize their own ADHD after one of their children has received a diagnosis. When learning about the child’s diagnosis, the mother may begin to see similar patterns in their own behavior.
Coping with ADHD
The following strategies can be incorporated into life without the guidance of a therapist toreduce the impact of ADHD.
Professional Support
It is worth noting that not every person with ADHD needs additional treatment or support and can manage their lives independently. Each person with ADHD is different and so it is down to the individual if they believe they may need extra support from professionals.
Consequently, most clinicians use standard psychotherapeutic methods. Although these can help provide insight into emotional and interpersonal issues, they may not help a woman with ADHD learn to manage her ADHD daily better or learn strategies to lead a productive and enjoyable life.
Effective treatment for women may involve a multimodal approach that includes medication,psychotherapy, stress management, and group therapy.
Medications
Medications may only be prescribed if a diagnosis of ADHD is obtained.
Common stimulant medications include Ritalin, Adderall, and Vyvanse. However, these medications can have side effects like addiction, sleep problems, or heart problems.
Non-stimulant medications are not as commonly prescribed as stimulant medications and are more often used for those withsevere anxiety.
All aspects of a woman’s life need to be considered when prescribing medicative treatment, including the treatment of any coexisting conditions.
Behavior therapy
For some,behavior therapycan help people with ADHD learn the skills required to manage their symptoms and help them complete tasks. Behavior therapy aims to adjust unhelpful behaviors with more helpful ones.
People with ADHD can learn strategies to improve in areas they struggle with, such as organization, focus, and impulse control, among others. Many find that behavior therapy can help them effectively manage their ADHD symptoms without using medications.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) involves working with a therapist to identify patterns of behavior andunhelpful thought patternsthat can make ADHD symptoms worse.
Once identified, these thoughts and behaviors can be challenged and adjusted to more realistic thinking. New behaviors can be learned tomanage stress, obligations, coping, and many aspects of everyday life.
As well as helping with ADHD symptoms, CBT can be helpful for women with ADHD to manage other conditions which can coexist alongside their ADHD, such as depression and anxiety.
Group therapy
As many women with ADHD may feel shame and rejection due to their symptoms, psychotherapy in a group setting designed for women with ADHD may provide a beneficial experience.
Parent management programs
Evidence-based parent management programs are found to be effective in children with ADHD and are also recommended for parents with ADHD.
However, these approaches have shown that parent training may be less effective if the mother has ADHD signs that are particularly debilitating.
Therefore, it may be useful to incorporate adult ADHD life management strategies into parent training programs for mothers with ADHD.
Frequently Asked Questions
Can early intervention and diagnosis improve outcomes for girls and women with ADHD?Yes, early intervention and diagnosis can significantly improve outcomes for girls and women with ADHD.By identifying and addressingADHD symptomsearly on, appropriate support and interventions can be implemented to enhance academic performance, social functioning, and overall quality of life.Early intervention allows for the development of coping strategies, improved self-awareness, and access to specialized resources.It also helps prevent potential negative consequences associated with untreated ADHD, such as low self-esteem, academic difficulties, and mental health challenges, leading to better long-term outcomes and a higher likelihood of successfully managing ADHD symptoms.
Can early intervention and diagnosis improve outcomes for girls and women with ADHD?
Yes, early intervention and diagnosis can significantly improve outcomes for girls and women with ADHD.By identifying and addressingADHD symptomsearly on, appropriate support and interventions can be implemented to enhance academic performance, social functioning, and overall quality of life.Early intervention allows for the development of coping strategies, improved self-awareness, and access to specialized resources.It also helps prevent potential negative consequences associated with untreated ADHD, such as low self-esteem, academic difficulties, and mental health challenges, leading to better long-term outcomes and a higher likelihood of successfully managing ADHD symptoms.
Yes, early intervention and diagnosis can significantly improve outcomes for girls and women with ADHD.
By identifying and addressingADHD symptomsearly on, appropriate support and interventions can be implemented to enhance academic performance, social functioning, and overall quality of life.
Early intervention allows for the development of coping strategies, improved self-awareness, and access to specialized resources.
It also helps prevent potential negative consequences associated with untreated ADHD, such as low self-esteem, academic difficulties, and mental health challenges, leading to better long-term outcomes and a higher likelihood of successfully managing ADHD symptoms.
What steps can individuals take to advocate for greater awareness and understanding of ADHD in girls and women?
To advocate for greater awareness and understanding of ADHD in girls and women, individuals can take several steps.
Supporting and promoting ADHD organizations, participating in ADHD-related events, and sharing informative resources on social media platforms can also contribute to increased awareness.
How can educators and healthcare professionals better support girls and women with ADHD in various settings?
Providing clear communication, offering individualized learning strategies, fostering a supportive and inclusive environment, and collaborating with parents, caregivers, and mental health professionals are crucial.
Regular monitoring of progress, providing feedback, and offering targeted support services can further enhance the educational experience and overall well-being of girls and women with ADHD.
References
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Chronis‐Tuscano, A. (2022). ADHD in girls and women: a call to action–reflections on Hinshaw et al.(2021).Journal of Child Psychology and Psychiatry.
Finlay, M. (2022, May 12). Why aren’t women getting diagnosed with ADHD? [Audio podcast episode]. InScience Weekly.
Gershon, J., & Gershon, J. (2002). A meta-analytic review of gender differences in ADHD.Journal of attention disorders,5(3), 143-154.
Gurian, A. (2014). Girls with ADHD: overlooked, underdiagnosed, and underserved.NYU Child Study Center About Our Kids.
Hinshaw, S. P. (2002). Preadolescent girls with attention-deficit/hyperactivity disorder: I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices.Journal of consulting and clinical psychology, 70(5), 1086.
Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2021). Annual Research Review: Attention‐deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions.Journal of Child Psychology and Psychiatry.
Hinshaw, S. P., Owens, E. B., Zalecki, C., Huggins, S. P., Montenegro-Nevado, A. J., Schrodek, E., & Swanson, E. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury.Journal of consulting and clinical psychology, 80(6), 1041.
Holthe, M. E. G., & Langvik, E. (2017). The strives, struggles, and successes of women diagnosed with ADHD as adults.Sage Open,7(1), 2158244017701799.
Meza, J. I., Owens, E. B., & Hinshaw, S. P. (2021). Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder.Development and psychopathology, 33(4), 1351-1367.
Öster, C., Ramklint, M., Meyer, J., & Isaksson, J. (2020). How do adolescents with ADHD perceive and experience stress? An interview study.Nordic Journal of Psychiatry,74(2), 123-130.
Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis.The primary care companion for CNS disorders, 16(3).
Steer, J. (Host). (2022, December 21). ADHD in women, Prof Lucy Easthope, Debbie [Audio podcast episode]. InWomen’s Hour.
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
