ADHD in Women: The Impact of Misdiagnoses or No Diagnoses at All

ADHD letters spelled out on diceAccording to a 2015 study in the Journal of Clinical Psychiatry, between 2003 and 2011, diagnoses of girls with ADHD increased by 55% as compared to 40% for boys. Why was there such a stark increase in the diagnosis of females with ADHD? Quartz reported that despite the growing awareness of ADHD diagnoses in females, there are still women who go undiagnosed.

Dr. Ellen Littman, clinical psychologist and co-author of Understanding Girls with AD/HD, says this is because of the way the diagnosis guidelines were written. ADHD was first diagnosed in young, white males with hyperactivity as a key indicator. Therefore, the guidelines were based on how it manifests in boys, and thus, research is almost exclusively focused on males. Littman says that only 1% of ADHD research is specific to females. Additionally, the American Psychiatric Association’s diagnostic criteria required that symptoms be visible by 7 years-old in order to confirm a diagnosis, but females do not traditionally exhibit symptoms until they are older. To compensate for this, the American Psychiatric Association recently adjusted the age to 12 years old.

Also, females exhibit different symptoms. Unlike the hyperactivity males with ADHD exhibit, female symptoms tend to be daydreaming, trouble following instructions and making careless mistakes on homework and tests. However, the pressure to perform academically can lead females to see this disorder and its symptoms as personality defects, which often makes them more likely to experience major depression, anxiety, and eating disorders than females without ADHD. To make matters worse, these symptoms of ADHD in females are sometimes misdiagnosed and patients are prescribed anti-anxiety and depression medication, which can actually make the symptoms of ADHD worse. Also, research conducted in 2012 suggests the risk for self-harm and suicide attempts in females with ADHD are 4-5 times higher than females without ADHD.

According to Michelle Frank, a clinical psychologist and ADHD expert, this perfect storm has created “a lost generation of women who are diagnosed with ADHD later in life and who have had to manage the condition on their own and deal with it on their own for the majority of their lives.”

To learn more about the identifying factors of ADHD in females and how a misdiagnosis or no diagnosis at all can affect females, you can read the entire Quartz article here.