ADHD in Women [2024]: Signs & Symptoms, Causes, and Treatment

Introduction

“Everyone is a little bit of ADHD” has been common for people to hear in casual conversations. Well, yes, while a lot of people may resonate with the symptoms of ADHD- Attention Deficit Hyperactivity Disorder, it is crucial to understand that ADHD is a neurological condition that can significantly impact a person’s life. Symptoms typically include difficulties with attention, hyperactivity, and impulsiveness, which can affect daily functioning and relationships.

Hearing the word “deficit” from ADHD can oftentimes feel scary. Let's be honest, the word “deficit” is not an exciting word. But it is important to remember that the term 'deficit' in ADHD does not define a person's worth or capabilities.

Instead, think of it as a descriptor for certain challenges individuals with ADHD might face in areas such as attention, focus, or impulse control. People with ADHD also possess a range of unique strengths that can contribute positively to various aspects of their lives.

Their creativity often shines through in their ability to think outside the box and excel in artistic endeavours.  While focus can be a challenge, some individuals experience hyperfocus on tasks they find engaging, leading to exceptional productivity. Their high energy levels drive enthusiasm and determination, strengthening both their ability to cope and thrive in challenging circumstances.

Understanding ADHD in women

Neha, a 28-year-old nurse, experiences chronic lateness and forgetfulness. She often misplaces her keys and loses track of time, leading to stress and frustration. Unlike the hyperactive behaviours commonly  seen in boys with ADHD, Emma's symptoms are more internalized. She feels a constant mental restlessness and struggles with low self-esteem because she can't seem to "get it together" despite her best efforts.

This highlights how ADHD affects one’s daily life. It is not just a matter of being distracted or disorganized.It is a persistent pattern that impacts one's ability to manage everyday tasks and responsibilities. Understanding these manifestations can help in recognizing and addressing ADHD in adults, especially in women, who might not fit the stereotypical image of the disorder.

Do Read Is ADHD a Mental Health or Learning Disability?

Can you develop ADHD as an adult woman?

Yes, adults can develop ADHD, including women. ADHD can be present from childhood and continue into adulthood, but sometimes it may not be diagnosed until later in life.

Symptoms like difficulty focusing, impulsivity, and hyperactivity can persist or manifest differently in adults, leading to a diagnosis. So, while it's more commonly associated with childhood, ADHD can indeed develop or be diagnosed in adult women.

ADHD often goes undiagnosed in girls during childhood because their symptoms can be more subtle compared to boys.

For example, girls might not show overt hyperactivity. Instead, they may daydream, appear disorganized, or have trouble focusing on tasks. These behaviours can be mistakenly attributed to other causes like carelessness, leading to a delay in diagnosis.

What percentage of adults have ADHD

Studies suggest that between 2.5 percent and 4.4 percent Americans over the age of 18 are affected by ADHD, with diagnoses of men nearly three times that of women. While there is no precise data on ADHD among Indian adults, the prevalence among school children shows that it is higher in males (66.7%) compared to females (33.3%). 

What does ADHD look like in Men and Women?

ADHD can affect both men and women, but it often presents differently in each. Men are more likely to be diagnosed in childhood, while women are frequently underdiagnosed or misdiagnosed due to subtler symptoms. Despite these differences, ADHD can significantly impact daily life for both genders. Understanding these distinctions is crucial for proper diagnosis and effective management of the condition.

Let us simplify: 

Why ADHD in Women Is Often Misdiagnosed

ADHD in women is often misdiagnosed, leading to many women not receiving the support and treatment they need. This can result in prolonged struggles with attention, organization, and emotional regulation. Let us look at some of the reasons:

• Atypical Symptom Presentation: Women with ADHD frequently exhibit symptoms that differ from the stereotypical hyperactive behaviours seen in boys. Instead of externalizing their symptoms, women may internalize them, manifesting as disorganization, forgetfulness, and emotional dysregulation. These symptoms may get overlooked or attributed to other factors such as stress, or  anxiety.
  
• Societal Expectations: Cultural and societal norms often impose expectations on women to excel in organizational skills, multitasking, and emotional regulation. When women with ADHD struggle to meet these expectations, their difficulties may be dismissed as personal shortcomings rather than symptoms of a neurodevelopmental disorder. 
• Bias: Historically, ADHD research and diagnostic criteria have focused more on male-dominated samples, which may not fully capture the range of symptoms and presentations in women. Healthcare professionals may be less familiar with how ADHD manifests in women, leading to underdiagnosis or delayed diagnosis.
• Coping Mechanisms: Women with ADHD often develop coping strategies to manage their symptoms, such as overcompensating with excessive organization or avoidance behaviours such as such as procrastinating on tasks that seem overwhelming or difficult to start, avoiding social situations or commitments that may cause stress or anxiety, steering clear of activities or environments that are highly stimulating or distracting, putting off responsibilities or delegating them to others to prevent feelings of being overwhelmed. These adaptive strategies may mask the underlying ADHD and make it less apparent during assessments.
• Comorbid Conditions: ADHD frequently coexists with other mental health conditions such as anxiety, depression, or eating disorders in women. Symptoms of these conditions may overshadow or be mistaken for ADHD symptoms.
• Stigma and Awareness: Stigma surrounding mental health conditions and ADHD specifically may deter women from seeking evaluation and treatment. 

How to spot ADHD in Adult Women: Signs and Symptoms of ADHD in Women

In clinical terms, ADHD symptoms include ongoing issues with either inattention or hyperactivity/impulsivity. These symptoms need to be observed in at least two different environments, such as work and school, or work and home. Moreover, these symptoms should significantly impact your daily functioning.

Here are some signs and symptoms commonly associated with ADHD in adult women:

1. Difficulty with Organization: Women with ADHD often struggle with organizing tasks, time management, and keeping track of responsibilities. This can affect work, home life, and relationships.
2. Forgetfulness: They may frequently forget appointments, deadlines, or commitments despite efforts to remember them.
3. Poor Time Management: Difficulty estimating how much time tasks will take, leading to procrastination or rushing to complete tasks at the last minute.
4. Easily Distracted: Women with ADHD may find it hard to stay focused on tasks, particularly those that are mundane or repetitive.
5. Impulsivity: This can manifest as making impulsive decisions, interrupting others in conversation, or having difficulty waiting their turn.
6. Emotional Sensitivity: Many women with ADHD experience intense emotions, mood swings, or anxiety. They may also have low self-esteem or feelings of underachievement.
7. Chronic Stress: Difficulty coping with everyday stressors or feeling overwhelmed by responsibilities.
8. Relationship Challenges: Problems maintaining friendships or romantic relationships due to communication issues, forgetfulness, or difficulty following through on commitments. 

Causes of ADHD in Adult Women 

The causes of ADHD in adult women are not fully understood, but several factors may contribute:

1. Genetics: ADHD tends to run in families, suggesting a genetic component. Women with a family history of ADHD are more likely to develop it themselves.
2. Brain Structure and Function: Differences in brain structure and neurotransmitter levels (like dopamine and norepinephrine) may play a role in ADHD. These differences can affect attention, impulse control, and executive function.
3. Hormonal Factors: Fluctuations in hormones, such as during puberty, pregnancy, or menopause, may influence ADHD symptoms in women. Estrogen and progesterone levels can impact neurotransmitter activity in the brain. We've covered ADHD Brain Fog do read.
4. Environmental Factors: Prenatal exposure to toxins (like alcohol or tobacco), premature birth, or early childhood exposure to lead may increase the risk of developing ADHD.
5. Psychosocial Factors: Stressful life events, trauma, or chronic stress can exacerbate ADHD symptoms in adults.

Why ADHD in Adult Women so complicated and Risky?

Women may face societal expectations to excel in organization and multitasking. For women with ADHD, meeting these expectations can be challenging, but these societal expectations do not define their capabilities.

The struggle for women with ADHD to meet these societal expectations is often internalized. They may feel inadequate or overwhelmed as they try to live up to these standards, which can lead to a cycle of stress and self-doubt. These internal struggles may not be apparent to others, making it difficult for family, friends, and even healthcare professionals to recognize the extent of their challenges.

As women grow older, the demands of adult life can heighten ADHD symptoms. Responsibilities such as managing a household, balancing a career, keeping up at work, or parenting can become overwhelming, making the underlying ADHD more apparent. Stress and increased expectations may highlight difficulties with organization, time management, and attention to detail. Many women report that they seek help when they find themselves unable to cope with these pressures, leading to a late diagnosis of ADHD in adulthood.

How to manage ADHD in adult women: Diagnosis and Treatment

Can Adult Women be diagnosed with ADHD?

Yes, adult women can be diagnosed with ADHD. Symptoms of ADHD often persist from childhood into adulthood but may go undiagnosed until later in life due to differences in how symptoms manifest.

The diagnostic process typically involves a comprehensive assessment by a mental health professional, such as a psychiatrist or psychologist. This includes a review of symptoms and their impact across various settings (e.g., work, home), gathering information from family members or close associates, and ruling out other possible explanations for symptoms.

Treatment Options for Adult ADHD in Women

• Medications:  Stimulant medications (like methylphenidate or amphetamines) or non-stimulant medications (like atomoxetine) can help manage ADHD symptoms by improving focus and impulse control.
• Psychotherapy:  Therapies like Cognitive-behavioral therapy (CBT) and coaching can assist women in developing strategies to manage symptoms, improve organization skills, and address emotional challenges.
• Lifestyle Changes: Establishing regular sleep patterns, engaging in regular exercise, and implementing organizational strategies can significantly improve ADHD symptoms.
• Online Therapy Platforms: Accessible online therapy options provide convenience for receiving psychotherapy and coaching, making treatment more accessible. 

When to Seek Help for ADHD Women  

It's crucial for women experiencing significant impact on daily life due to ADHD symptoms to seek professional help. If symptoms like chronic disorganization, difficulty concentrating, impulsivity, or emotional sensitivity affect work, relationships, or overall well-being, consulting with a mental health professional can provide guidance and support in managing ADHD effectively.

Conclusion

In conclusion, ADHD in adult women is a complex and often misunderstood condition. While symptoms may present differently than in men, they can significantly impact daily life, including work, relationships, and self-esteem. Recognizing and understanding these differences is crucial for proper diagnosis and treatment.

With appropriate support, including medication, therapy, and lifestyle changes, women with ADHD can manage their symptoms effectively and thrive. It’s essential to seek professional help if ADHD symptoms are interfering with daily life, as effective treatments and strategies are available to help navigate the challenges and harness the unique strengths associated with ADHD.

References 

Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders, 27(7), 645-657.

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