CW: Discussions of ADHD diagnosis
In October, I was diagnosed with ADHD. This news was a big relief as so many things I have struggled with suddenly made sense. However, it is also frustrating that it took until I am 20 and in the final year of my degree to realise that many of my difficulties are not felt the same by everyone, and to start getting proper support.
Many people with ADHD do not fit the typical assumptions of ADHD; young boys being unable to sit still or concentrate on one thing. While this is a fairly accurate presentation of ADHD in some people, it is just a small part of what ADHD involves, and is not representative of how many people experience and display symptoms. This causes people of all genders to receive late diagnoses, but affects women at far greater rates than men. ADHD is all too often still considered a ‘male condition’, and it is common for women with ADHD to go undiagnosed until even their 30s or 40s.
As children, boys are five times more likely to be diagnosed than girls, despite there being roughly the same number of adult women and men with an ADHD diagnosis.
There are many reasons for ADHD to be so underdiagnosed in women.
Women are less likely to display external hyperactive traits, often due to gender expectations of women being more ‘well-behaved’ and sensible from a young age, causing increased masking of symptoms. Therefore, the main symptoms commonly displayed in women are less obvious than those seen in men, typically including things such as difficulty with organisation, changing and starting tasks, time keeping, memory (especially short-term and working memory), and feelings of being overwhelmed, as well as struggling with attention regulation and emotional regulation.
These are often either masked and overlooked, or brushed off as personality traits of being ‘scatty’. Some of the more subtle and unknown signs of ADHD can also include talking a lot and quickly, as well as interrupting others, which can be similarly brushed off as being ‘chatty’, rather than a sign of hyperactivity.
However, even when women and men display the same symptoms, men are more likely than women to be referred for an ADHD assessment, a trend shown similarly in statistics for diagnosis of autism and other forms of neurodiversity, often because of gender bias. However, if the symptoms I have described, or you have heard about elsewhere, sound familiar, you can still self-refer to PsychUK even if your GP does not choose to refer you.
There is also a huge discrepancy in research done on ADHD in women in comparison to men, so there is still a lot about women’s experiences of ADHD which is overlooked even with a diagnosis. Symptoms worsen at certain points in the hormonal fluctuations experienced by women throughout our menstrual cycle, as well as at different points in life, especially puberty and menopause. However, there is no treatment currently available which specifically takes these shifts into account, and no ADHD medication has yet been produced which is proven to be safe for pregnant women.
Of course, my personal experience with ADHD has been from a woman’s perspective, but there are also similar issues of late (or no) diagnosis for people who are not white, and for nonbinary and transgender people, as well as a lack of research.
Late diagnosis for people of any gender often leads to an increase in the comorbidities which are already common for people with ADHD, including anxiety and depression. It is, therefore, vital that more be done to improve diagnosis rates, and that diagnosis and treatment plans are adjusted to work more effectively for everyone. This would also be made easier by increased awareness and education for everyone of the realities of neurodiversity beyond just the stereotypes.
---- Sophie Jackson, Guest Blogger
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