ADHD Diagnosis and Treatment – A Systemic Bias
There is a bias in the diagnosis of ADHD that shows up in the statistics about the condition. According to the National Institute of Mental Health, males are almost three times more likely to be diagnosed with ADHD than females. And during their lifetimes, 13 percent of men will be diagnosed with ADHD while just 4.2 percent of women will be diagnosed.
Why such a large discrepancy? At least part of the answer to that question includes:
- Lack of understanding of the differences in how ADHD symptoms present between males and females and the timing of when they first appear. For example, ADHD in girls usually shows up later than for boys and is the inattentive type versus the hyperactive type of presentation.
- A bias toward the male presentation in diagnostic tools – e.g., on hyperactivity. This relates to the historical origins of the diagnostic tools when less was known about the condition.
- Clinical focus on the comorbidities of ADHD rather than the condition itself in women. Often, with girls and women, clinicians diagnose and treat only the anxiety and depression that often occur with ADHD rather than the underlying condition itself.
- Complicating factor of short and long term estrogen cycles that can mask underlying ADHD.
In addition to the day-to-day problems of executive function impairment – attention, prioritization, organization – untreated ADHD can have severe long term consequences for women. For instance, girls and women with ADHD are much more likely to:
- Engage in self-harm and suicidal ideation
- Struggle academically and experience work-related problems
- Face problems establishing and maintaining relationships
- Have unplanned pregnancies
- Suffer more violence from intimate partners
All of these can have a devastating impact on self-esteem.
How ADHD Symptoms Typically Show Up in Women
Some signs of potential ADHD in women may include:
- Feeling overwhelmed in crowded or busy environments
- Struggling to stay organized and on top of routine things
- Experiencing large swings in energy and activity levels
- Difficulty coping in social situations and missing routine social cues
- Regularly experiencing feelings of low self-esteem
- Unable to manage clutter and organize your household
- Difficulty with routine money management
There are numerous self-assessments you can take if you believe you might have ADHD. Following that, you should schedule a visit with a clinical professional trained in diagnosing adult ADHD. If you are diagnosed, your treatment regime may involve medication, therapy and / or coaching.
Removing the Bias
Ultimately, as more women seek treatment and diagnosis for ADHD, researchers need to conduct more studies that look at gender differences in the condition, create more targeted diagnostic criteria, and develop forms of treatments that better serve females. This of course needs to be communicated to the clinical professionals who make the diagnoses and deliver the treatments.