Why ADHD in Women is So Commonly Misdiagnosed & Dismissed

Why ADHD in Women is So Commonly Misdiagnosed & Dismissed

"About 60 percent of women have ADHD that continues into adulthood, compared with around 30 percent of men."

The ADHD diagnosis rate among American men is nearly 69 percent higher than it is among American women.1 Some women do not even receive a diagnosis until they are in their late 30s or early 40s when one of their children has been diagnosed.2 This gap between genders reveals an ongoing misperception about ADHD that requires a correction. Girls and women aren’t immune to ADHD; their symptoms just tend to present differently.  

Gender Bias in ADHD Diagnosis: Exploring the Disparities in Women

Most ADHD diagnoses occur in childhood, but girls are often missed because their symptoms are less pronounced than boys. Where ADHD in boys commonly shows up as hyperactivity (impulsive behavior, constant movement, fidgeting), ADHD in girls tends to show up as inattention (daydreaming, lack of focus, forgetfulness). Since most of the research on ADHD has focused on male subjects, there has been a huge blind spot when it comes to what characterizes ADHD. And this can be especially harmful for girls. Untreated ADHD puts them at risk for chronic low self-esteem, underachievement, anxiety, depression, teen pregnancy, and early smoking during middle school and high school.3

Understanding the Unique Presentation of ADHD in Women

There are three main types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive, and combined inattentive and hyperactive. It’s possible for a woman to have hyperactivity, just like it’s possible for a man to have inattention, and it’s also possible for presentations and symptom severity to change over time. However, research shows girls and women most often appear to have the inattentive presentation. And, according to the Cleveland Clinic, women are less likely to outgrow their ADHD. About 60 percent of women have ADHD that continues into adulthood, compared with around 30 percent of men.4

Uncovering the Hidden Signs & Symptoms 

From overspending to always playing catch up at work, ADHD in women isn’t always easy to spot. The following symptoms are some of the most common issues for women with ADHD:

  • Careless mistakes at work
  • Forgetfulness
  • Difficulty following instructions
  • Constantly feeling overwhelmed and working overtime to catch up
  • Feeling the need to “go the extra mile” to appear competent to others
  • Social anxiety
  • Wandering mind during conversation
  • Confusion over social rules and cues 
  • Trouble navigating friendships
  • Feeling disorganized with money and bills and often overspending
  • Having a disorganized home (and/or anxiety about your disorganized home)
  • Difficulty relaxing
  • Frequently referred to as a daydreamer 
  • Rejection sensitivity
  • Sleep difficulties
  • Prone to sensory overload

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What are Some Contributing Factors to Misdiagnosis? 

In addition to being underdiagnosed, women with ADHD are often misdiagnosed with other conditions. Studies show women with inattentive type ADHD are often misdiagnosed with depression, while even women who have hyperactive-impulsive type are misdiagnosed with bipolar disorder.5 While it’s true that ADHD has many comorbid conditions, ranging from substance use disorder (the most common) to mood disorders and anxiety, treating (or incorrectly treating) only these conditions while ignoring ADHD can leave many women struggling.6  

Even more, boys don't just display different ADHD symptoms, they also experience them earlier than girls.7 While boys' ADHD symptoms often settle during puberty, women tend to experience heightened symptoms during their teenage and early adult years due to increased estrogen production.

Societal Expectations & Stereotypes

Complicating matters even more are societal expectations and gender stereotypes. Women are typically expected to manage the home, the family, and somehow take care of themselves at the same time, but these things require a great deal of organization and coordination. Women with ADHD often struggle more to meet these demands but feel they must hide their struggles to achieve social acceptance. This only further hurts a woman’s self-esteem and self-worth.

Overlapping Conditions & Masked Symptoms in Women 

By adulthood, many women with ADHD have at least one comorbid disorder. This can make it even more difficult to diagnose their ADHD, especially if women have grown accustomed to masking their symptoms to appear “normal” to others. These conditions include anxiety, depression, substance abuse, eating disorders, and more.8

Research also shows there appears to be an age-related increase in the prevalence of comorbid anxiety. In one study of adults whose ADHD started in childhood and continued into adulthood, researchers discovered more than 40 percent of men and more than 50 percent of women with ADHD had multiple anxiety disorders.9

Complex Comorbidities: How to Distinguish ADHD from Other Conditions

If you think you have ADHD, it’s important you get the help you need. It’s equally important you seek support if you have another condition that may only look like ADHD. Here are some of the following conditions that can produce ADHD-like symptoms:10

  • Anxiety: May manifest as restlessness, lack of focus, impulsive reactions, and constant fidgeting
  • Depression: Can produce lack of focus, forgetfulness, low motivation, indecision, trouble completing tasks, fatigue, disorganization, and sleep problems
  • Bipolar disorder: May look like hyperactive behavior, such as excessive talking, racing thoughts that make it difficult to concentrate, impulsiveness, and risky behavior
  • OCD: May produce inattention and lack of concentration due to over focusing and obsessive thinking
  • Substance abuse: Can cause difficulty concentrating, memory loss, restlessness, irritability, excessive talking, sleep problems, moodiness, and work difficulties
  • Autism: People with autism may become overexcited, hyperactive, and impulsive in stimulating environments, have trouble shifting focus, and struggle to understand social cues 

While many people experience the hallmark symptoms of ADHD like inattention and hyperactivity occasionally, for people with ADHD these symptoms occur more frequently and with greater intensity, often interfering with one’s work, academics, and relationships. 

Raising Awareness to Improve Diagnosis & Support for Women with ADHD

There are many reasons why an ADHD diagnosis can go missed or misdiagnosed in women. As ongoing research emerges and we stop portraying ADHD as a condition that only affects little boys, it’s more likely for women to access the support they need.

Talking to a therapist, joining a support group, and even making healthy lifestyle tweaks like getting better sleep and practicing mindfulness techniques can all be a tremendous help. Brillia’s Five Pillars offers a blueprint for reducing ADHD symptoms through healthy lifestyle changes, which include: proper nutrition, adequate sleep, controlled screen time, and mindfulness

If you need more support, consider taking Brillia, a non-prescription medication that targets symptoms of inattention, anxiety, restlessness, and irritability with clinically-proven antibody ingredients. Free from harsh, synthetic chemicals and harmful side effects, Brillia targets the brain-specific S100 protein (S100B), a crucial regulator of various different intracellular and extracellular brain processes. This regulating effect promotes a balanced mood and improves focus without affecting any other systems in the body or masking the personality.

Brillia is part of a holistic approach that views whole-body health as the best defense for ADHD symptoms. Unlike prescription ADHD medications, you will not build up a tolerance to Brillia, so you will not have to increase your dosage over time. Brillia can also be used in conjunction with your current medication instead of increasing your dosage or to address other secondary symptoms caused by your current medication.

Learn more about how Brillia works and find more resources on ADHD support at the Brillia(nce) Resource Center

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References: 1https://www.additudemag.com/adhd-in-women-misunderstood-symptoms-treatment/, 2https://www.apa.org/monitor/feb03/adhd, 3https://www.apa.org/monitor/feb03/adhd, 4https://my.clevelandclinic.org/health/diseases/24741-adhd-in-women, 5https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195638/, 6https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0277175, 7https://archive.attn.com/stories/5413/adhd-diagnoses-in-women-vs-men, 8https://www.additudemag.com/adhd-women-comorbid-conditions/, 9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1896299/, 10https://www.verywellmind.com/adhd-like-symptoms-but-not-adhd-20583
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