ADHD – The Gender Difference

Current statistics show that ADHD is more commonly diagnosed in boys than girls, but research on ADHD among adults suggests an almost equal balance between men and women. According to Jane Collingwood at PsychCentral, “about 60 percent of children who experience ADHD in childhood continue to have symptoms as adults. Women are less likely to be diagnosed because the guidelines used in assessment and diagnosis have traditionally focused on males. As with men, undiagnosed and untreated women with ADHD are limited in their potential to do well socially, academically, interpersonally, and in family roles.”

Some women only recognize their ADHD after a child has been diagnosed and the woman begins to see similar behavior in herself. Other women seek treatment because their lives spin out of control, financially, at work, or at home. The lower diagnosis rate among females in childhood may be the due to the fact that  girls with ADHD are more likely than boys to have the inattentive form of ADHD, and less likely to show obvious symptoms. Greater self-referrals among adult women could be the reason for the more balanced gender ratio in adulthood.

According to Mark Griffin at Understood.org, “Boys with ADHD often behave in ways that are tough for teachers to ignore. This helps explain why boys are three times more likely to be diagnosed with ADHD than their female peers and also why boys tend to get diagnosed at younger ages than girls. Girls are diagnosed with ADHD on average five years later than boys—boys at age 7 and girls at age 12. There are also many girls who never get diagnosed. Research indicates as many as 75 percent of girls with attention issues are undiagnosed.”

Further, while a decrease in symptoms at puberty is common for boys, the opposite is true for girls, whose symptoms intensify as estrogen increases in their system, thus complicating the general perception that ADHD is resolved by puberty.

While it is not clear whether biological differences play a role in how ADHD manifests in men and women, one study found that memory problems were likely due to hyperactive symptoms in men and inattentive symptoms in women. This supports the long-held notion that women with ADHD tend to have inattentive symptoms, which may lead to internalizing problems and becoming anxious and depressed. Recent evidence has shown that girls with attention deficit disorder are over five times more likely than boys to be diagnosed with depression and three times more likely to be treated for depression before their ADHD diagnosis.

Another study of adults with ADHD has pointed out that women rate themselves differently: adult women with ADHD reported fewer good personal qualities and more problems than men, despite there being no gender differences in IQ, neuropsychological test scores, or parent or teacher ratings of behavior. A follow-up study indicated that girls with ADHD tend to have a poorer adult psychiatric outcome than boys. It found a higher risk of mood disorder, diagnosis of schizophrenia, and psychiatric admission among women than men. Among a group of untreated people with ADHD, abuse and criminality were found to be more common in men, and mood, eating, and physical symptoms were more common in women.

As researchers discover more about ADHD, we are beginning to see that the disorder presents differently in boys and girls, and later, in adult men and women. Understanding these gender differences could help the medical community make earlier diagnoses of ADHD for girls and perhaps help forestall issues related to untreated ADHD later in life.