ADHD is Different for Women

For many years, ADHD was considered something which mainly affected boy, and rarely girls.

This attitude has continued into adulthood where despite the increasing awareness of adult ADHD, it’s only been recently that the unique challenges that women face has begun to be addressed.

For many years, women’s ADHD was felt to be invisible, with little attention being given to the possibility that the disorder presented very differently in females.

However, many women report symptoms which have negatively impacted them for their entire life, without realizing that they are a form of ADHD because they do not always fit the commonly known characteristics such as hyperactivity for example.

Many women also find that elements which are unique to their gender, such as menstruation and menopause also have an impact on their ADHD symptoms.

In addition, many women are responsible for the lion’s share of child caring and housework. Some also hold down jobs outside the home, too. All these aspects add to a complex picture, from which emerges ADHD as a condition which affects women very differently to men.

How are women affected differently?

Many women report difficulties in areas which do not always impact men in the same way.

These issues may include:

•  – Hypersensitivity to noise, touch and smell.
•  – Low feelings of self-worth and hypersensitivity to criticism.

They may also have difficulty remembering names and feel easily overwhelmed; experiencing difficulties starting projects and not finishing them.

A sense of taking on too much and feeling emotionally charged are reported.

Whilst some of these issues may also affect some men, the framework in which women experience them is often different.

This framework can include issues with gender norms and stereotypes, as well as some of the aspects of life that women either uniquely experience, or experience more frequently than most men.

Hormonal Effects

Hormonal issues and the menstrual cycle are one area that women experience ADHD differently.

Whilst many women experience symptoms such as PMS, or difficulty concentrating during their menstrual cycle, these issues may be exacerbated in women with ADHD.

Some women have reported an increase in ADHD symptoms during menopause and peri-menopause. In addition, they can report symptoms such as depression, memory-loss and word-retrieval.

Because there has been little research into how ADHD and menstruation and other hormonal issues interact, much of the evidence is self-reported.

Some women have reported that since entering the menopause their ADHD medication doesn’t seem to be as effective.   In addition, women may find that the experience of PMS around their menstrual cycle negatively impacts ADHD symptoms such as emotional lability and hypersensitivity.

Estrogen levels can also have an influence on symptoms, and many women report that during parts of their menstrual cycle their medication doesn’t appear to work as effectively.

On these days, women may find that they need to make extra accommodations in their life, as they cannot increase their dosage. This might include needing to rest more, lowering stress and not scheduling tasks which are difficult. This impacts both organization and routine, which are powerful coping techniques.

Pregnancy and breastfeeding are also other areas which have not been well-researched, and there is a lack of research into potential effects of ADHD medication on the unborn fetus.

This can lead to some women choosing not to conceive at all, or to stopping their medication during pregnancy, leading to an increase in symptoms.

Pressures of Everyday Life

A further area where women are often affected differently is within their caring and work roles.

Women may feel under extreme pressure when raising children and attempting to organize a household.

Tasks which seem as though they should be easy, such as organizing laundry and household bills, can seem overwhelming.

This can lead to poor self-esteem and feelings of low-worth.

Women often self-report berating themselves, feeling that they ought to be able to do such tasks easily, and feel frustration when they are unable to.

For many women, cultural expectations of being able to easily handle childcare and activities with the children and running a household seem to impact on feelings of inadequacy.

This appears to often be different to the cultural pressures that many men face. Women often reported feeling unable to voice their difficulties, compounding issues of internalizing challenges.

They felt they met a wall of guilt, shame and embarrassment which they found difficult to overcome.

Feelings of Shame or Inadequacy

Shame and fear appear to be a commonly reported feeling among women.

This may well be linked the invisible nature of many women’s ADHD experiences. Women may have spent many years compensating for the challenges they face, assuming that it’s a lack of skill, knowledge or motivation which causes them difficulties.

Or they might assume everyone else feels this way too.

Because girls are so much less likely to be diagnosed than boys, some women often only begin to realize they have ADHD well into their 30’s.

The average age for women to be diagnosed with ADHD if it wasn’t diagnosed in childhood is 36-38 years old.

By this time many women have had families and are responsible for children, as well as holding down jobs.

Some women reported feeling ashamed of being unable to plan what to cook for dinner, pay bills on time, and being able to organize clutter in the house.

These issues and the associated guilt and shame can lead to few women seeking a diagnosis, but even when they do, they may find substantial barriers.

Difficulty in Diagnosis

Women may often struggle to get diagnosed with ADHD, with their symptoms being assumed to relate to other conditions.

Women are far more likely to be diagnosed with depression or anxiety, rather than the possibility of an underlying cause for these symptoms being considered. Because so many women present with the inattentive form of ADHD, their symptoms in childhood have often been overlooked.

This is because, although they had difficulties with areas of executive function such as concentration and paying attention, they were less likely to be overtly disruptive than boys.

In addition, because of differently presenting symptoms, some women are not always likely to fit the standard diagnostic criteria that health professionals use to diagnose ADHD.

For example, they may not show symptoms of impulsiveness or hyperactivity, and yet suffer from immense challenges with concentration and task-management. This can lead to further frustration as women search in vain for the reason behind their lifelong difficulties.

Struggles with Depression, Anxiety and More

Because many younger women have struggled for years with their symptoms, there can often exist a large amount of co-morbid aspects, such as depression and anxiety or self-harm.

Younger women who have been diagnosed with ADHD have been found to be

3-4 times more likely to attempt suicide, and 2-3 times more likely to report trying to harm themselves

than those who did not have a diagnosis of ADHD.

This ties in with the tendency to internalize symptoms. Because people with ADHD often also have issues with impulsiveness, this is a concerning picture when added to the increased risk of suicidal or self-harming behavior.

Difficulty in Coping

Women may also suffer the same stigma and stereotypical assumptions that boys and men face when talking about their ADHD.

However, because of women’s higher tendency to be introverted and internalized, they often feel they cannot discuss their diagnosis.

When added to pressures to be able to organize their home and work life, and fluctuations in hormonal issues which exacerbate symptoms, many women can feel hopeless and unheard.

They may not be believed, because their symptoms do not fit with common assumptions regarding ADHD. In addition, because ADHD is a condition which we know begins in childhood, many women may not seek help because they assume if they were not diagnosed as a child they do not have ADHD.

Even when women do find a correct diagnosis, they often report still feeling low self-worth, guilty and overwhelmed.

Because they have been so used to internalizing their challenges, they may struggle to accept and overcome this internalization even once they have been diagnosed.

Women suffer from ADHD in a multitude of ways.

Some of them may have commonalities with men. However, there are also unique challenges that women face.

These are both biological and cultural, and affect women differently. Many women suffer with ‘invisible’ ADHD, and may not seek help for their condition.

Further research is needed into how ADHD often affects women differently, which can facilitate better access to education and support.