Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental condition often associated with hyperactive young boys, is increasingly recognized as a complex issue affecting individuals across the gender spectrum. However, a growing body of research suggests that women with ADHD face unique challenges, including misdiagnosis and delayed diagnosis, due to differing symptom presentation and societal expectations.

Historically, ADHD has been viewed through a male lens, emphasizing hyperactivity and impulsivity. Yet, many women experience predominantly inattentive ADHD, characterized by difficulty focusing, forgetfulness, and disorganization. These symptoms can be easily overlooked or attributed to stress, anxiety, or hormonal fluctuations, leading to missed diagnoses and inadequate treatment.

Societal expectations for women to be organized, efficient, and emotionally regulated further complicate the picture. Many women internalize their struggles, blaming themselves for their perceived shortcomings and masking their symptoms to fit in. This can result in delayed diagnosis and a lack of access to appropriate support.

Although ADHD is more commonly diagnosed in children, new data reveals a significant surge in adult women receiving ADHD diagnoses, with the rate nearly doubling between 2020 and 2022.

“I think a lot of this is attributable to the rise of social media and people talking about it and how women are either under-diagnosed or completely overlooked and missed in their younger years,” neuropsychologist Dr. Sanam Hafeez said to CBS News.

The consequences of this gender gap are far-reaching. Women with undiagnosed or untreated ADHD may face challenges in the workplace, struggling to meet deadlines, maintain focus, and manage complex tasks. This can hinder their career progression and financial security. In personal relationships, their difficulties with organization and communication can strain partnerships and friendships. Moreover, research has linked ADHD in women to a higher risk of self-harm, suicidality, unplanned pregnancies, and intimate partner violence, painting a stark picture of the silent suffering many women endure.

“Chaotic and curious, sometimes we feel like superheroes; other times, super-failures,” wrote Noelle Faulkner for The Guardian in 2020. “It’s not always a lack of interest that makes it hard for us to process information, but our brain’s desire to absorb so much of it. We are jacks of many trades, purveyors of information, collectors of hobbies, beginners of tasks and finishers of few. And we all have similar stories of missed red flags that haunt us.”

Understanding the three types of ADHD

To fully grasp the complexities of ADHD in women, it’s crucial to recognize the three distinct presentations of the condition:

1. Predominantly Inattentive Type: Characterized by difficulty sustaining attention, forgetfulness, disorganization, and distractibility. This is the most common type among women and often goes undiagnosed due to the absence of hyperactive symptoms.
2. Predominantly Hyperactive-Impulsive Type: Characterized by excessive fidgeting, restlessness, impulsivity, and difficulty waiting for their turn. This type is less common in women and often leads to earlier diagnosis due to more noticeable symptoms.
3. Combined Type: Characterized by a combination of inattentive and hyperactive-impulsive symptoms. Women with this type may experience a wider range of challenges but are also more likely to be diagnosed earlier due to the presence of both sets of symptoms.

Recognizing the different types of ADHD is essential for accurate diagnosis and tailored treatment plans. For women, understanding the nuances of predominantly inattentive ADHD can be key to unmasking their hidden struggles and accessing the support they need to thrive.

“When I got diagnosed and started meds, I finally felt like I could do this,” said Melanie Kitto, a bread route distributor to NBC News in 2022. “I believed in myself enough to run my own business.”

Looking ahead

Fortunately, awareness of the ADHD gender gap is increasing. Researchers and clinicians are working to educate the public and healthcare providers about the unique ways ADHD manifests in women. Early diagnosis and appropriate treatment can significantly improve women’s lives, enabling them to manage their symptoms, harness their strengths, and thrive in all areas of life.

As the understanding of ADHD evolves, experts say it is crucial to recognize the diverse experiences of individuals with this condition. By acknowledging the unique challenges faced by women with ADHD and the three distinct types of the condition, the healthcare industry can work towards a more inclusive and equitable approach to diagnosis and treatment, ultimately improving the lives of millions of women and their families.

“I think there’s still a lot of misunderstanding about the disorder, and a lot of misdiagnoses,” said Patricia Quinn, a retired developmental pediatrician formerly associated with Georgetown University Medical Center in Washington, DC, who has published extensively about ADHD in girls and women. Quinn, who herself has been diagnosed with ADHD, says to Knowable Magazine in 2020 that such news “can be a very hopeful diagnosis. These women can be treated, and they can live a very successful life.”