Does ADHD Look Different in Female Born Individuals?

WHAT IS ADHD AND WHY SHOULD I CARE?

ADHD (Attention-Deficit/Hyperactivity Disorder) can look very different in women and girls compared to men and boys, and these differences are often overlooked or misinterpreted. It  is important to note that ADHD is a neurodevelopmental disorder that can affect individuals of any sex. More often than not, individuals who do not struggle with ADHD, or families who do not have family members with this diagnosis, assume ADHD only presents as hyperactivity and impulsivity.  While both sexes can exhibit these symptoms, men and boys more often present with these visible symptoms. Having a better understanding of the symptoms that each sex may present with may help these individuals seek out treatment sooner and learn effective strategies to be more successful in their lives.

HOW DO MOST BOYS AND MEN PRESENT WITH ADHD?

As mentioned, ADHD is traditionally associated with hyperactivity and impulsive behavior in men and boys. They may be more prone to behaviors that are more visible to others, such as physical restlessness, impulsivity, and overt hyperactivity.  Hyperactivity and impulsive behavior in boys and men may lead to more overt social challenges as well, such as difficulty maintaining friendships. They may struggle with following rules, taking turns, or engaging in activities quietly. Finally, academic challenges in boys with ADHD might be more apparent due to disruptive behaviors in the classroom that teachers and other staff must address to bring order and organization to the environment that all students need.

HOW DO MOST GIRLS AND WOMEN PRESENT WITH ADHD?

Conversely, girls and women with ADHD often display fewer externalizing behaviors. Instead, they may exhibit internal symptoms, such as daydreaming, forgetfulness, and disorganization. This can make it less noticeable or get misinterpreted as something else.  Girls might internalize their difficulties, leading to social withdrawal, anxiety, and low self-esteem. They may develop coping mechanisms (healthy and/or unhealthy ones) to mask their symptoms, making it harder to identify ADHD.  Girls may struggle academically as well, but their symptoms may be less disruptive, leading to less immediate attention or intervention. Again, they might internalize their struggles and face difficulties in staying organized and completing tasks.

HOW DO I USE THIS INFORMATION TO HELP MYSELF OR MY CHILD GET THE RIGHT TREATMENT?

When it comes to obtaining a formal diagnosis, traditional ADHD diagnostic criteria were often based on male symptom presentation, which may have led to underdiagnosis in girls and women.  Due to the nature of how ADHD presents in men and boys, these individuals may also struggle with conduct or oppositional defiant disorders.  ADHD in females is sometimes underdiagnosed or misdiagnosed as other mental health conditions (e.g., anxiety or depression) because the symptoms may be less overt and more internalized.  Something to also be aware of is that girls and women with ADHD may also struggle with comorbid diagnoses of depression, anxiety and/or eating disorders.  Starting a conversation with the professionals around you (whether it be your doctor or the school) may feel big but reaching out for help can only improve outcomes (social and professional functioning) for your future or the future of your child.

FINAL THOUGHTS

Due to how differently each person (sex aside) presents with symptoms, it is highly recommended that family members or the adult with ADHD symptoms seek out professional assistance through the school district or with a mental health professional who specializes in ADHD.  As a final thought- girls and women with ADHD might not fit these stereotypes, and there is a growing awareness in the medical community about the need for gender-sensitive approaches to ADHD diagnosis and treatment.  The hope is that with updated approaches individuals with ADHD can thrive as their counterparts do.