A Hidden Disorder: ADHD as a Woman
f you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.
Attention deficit hyperactivity disorder, or ADHD, is an incredibly misunderstood neurodevelopmental disorder. Living with the condition is frustrating, but women and girls with ADHD deal with an additional dimension of difficulty and stigma attached to the disorder.
When people think of ADHD, they tend to envision children who are uncontrollably hyper and constantly causing obvious disruptions. However, when it comes to childhood ADHD — young boys are 3 times more likely to be diagnosed than girls. This is because the generally accepted criteria for diagnosing ADHD is built around how the disorder presents in boys.
In reality, ADHD is not so simple. There are three subtypes for the disorder: hyperactive, inattentive, and combined. Women and girls who have ADHD tend to have the inattentive subtype, which was previously referred to by medical professionals as just attention deficit disorder (ADD). ADHD is also not strictly a childhood disorder -- for many people, ADHD symptoms continue into adulthood. In fact, a staggering amount of women with ADHD are not diagnosed until they are adults: the average age of diagnosis for women who did not have their ADHD diagnosed in childhood is around 36 to 38 years old. In fact, just doing a quick google search of “ADHD in girls” or “women with ADHD” will generate a wealth of stories from women who weren’t diagnosed until their teenage or adult years.
A fact that cannot be ignored is how the socialization of girls and boys around rigid gender expectations impacts the way ADHD is perceived between them. It is undeniable that gender plays a large role in overall ADHD diagnosis and treatment. For girls and women who have ADHD, our symptoms are much more subtle and they do not match the more obvious behaviors that the disorder is often associated with. Women are more prone to internalize their struggles. This is largely because girls live with the societal obligation to accommodate the needs of others’ before their own.
Consequently, girls and women with ADHD live with the symptoms of the disorder for years without the appropriate support or treatment. What results is often a feeling that you’re never enough and that no matter what you do, you will always fall short of being a normal, functioning human being. Many young women with ADHD, myself included, struggle with imposter syndrome while in social and professional spaces. For girls with ADHD, since our symptoms don’t cause trouble or inconvenience to others, they will often go unnoticed until our mental health is dangerously close to falling off.
That’s exactly what happened to me when I was 14, the age at which I was first diagnosed. I had just started high school. Teenage years are a transitional stage in development as that is when we become more self aware and start to form our identities. It was this key point when all the confusion and shame caused by my undiagnosed condition finally imploded, starting a chain of events that landed me in therapy and then in front of a psychiatrist for the first time in my life.
My first year of high school was defined by low self-esteem, depression, self-harm, as well as feelings of loneliness and failure. Unfortunately, studies have shown that girls with ADHD are more prone to suicidal thoughts and self harm during adolescence than those who do not have the disorder. The consequences of ADHD going undiagnosed in girls are dangerous.
Instead of sending off alarm bells to teachers and parents the symptoms of ADHD in girls are often presented as flaws in their character contributing to our confusion and shame, only further keeping our disorder in the dark. Women and girls who have ADHD are “overlooked and misunderstood,” even within the fields of psychology and psychiatry. ADHD in girls is often called a “hidden disorder” and girls with the disorder tend to be more impulsive, scatterbrained, and closed-off all while being too embarrassed or nervous to ask for help. As a result, girls with undiagnosed ADHD grow into women who become more prone to developing depression, anxiety, and eating disorders.
However, sometimes being just diagnosed isn’t enough. Even though I was diagnosed at 14, my diagnosis was shrouded in skepticism by my family. This is the case for many young women who are diagnosed with ADHD — their family and peers express disbelief about their diagnosis and don’t take it seriously.
It was because of this skepticism and disbelief that I wasn’t able to access medication to treat my ADHD until I was an adult — almost 21 years old — meaning that I could control my own medical decisions. As a result, I lived without the proper support for years. Behaviors that were out of my control such as my tendency to forget important details, my inability to concentrate, and my struggles with time management made it next to impossible to complete routine, everyday tasks that were second-nature to everyone else. I could barely keep up with class readings, my emails constantly piled up and texts remained unanswered for weeks. Despite this being a consequence of an untreated disorder out of my control, I felt like they were all personal failings and like no matter what I did, I was just not good enough as my peers.
ADHD medication has been life changing for me. For the first time ever, I feel like I have some control over my life. Despite this, the damage to my self-esteem and self-worth from living with undiagnosed or untreated ADHD continues to linger. That will take much more time and effort to fix. So many women have had to fight for their access to ADHD medication, myself included. For years, I told myself I just had to work harder, but that didn’t solve anything. All it did was make things worse, creating an even more intense spiral of anxiety and depression. I spent years feeling like I was at the mercy of my ADHD, and that no matter how hard I fought, I would never get control over my own brain. I felt like it was all my own fault and that I was hopeless.
I’m not the only woman who has lived like this — barely keeping her head above water, beating herself up because it shouldn’t be this hard, all while suffering in silence and blaming it all on herself. Not only is living with ADHD difficult enough, being a woman adds another layer to the experience because too many of us with this condition are denied the quality of life we deserve because of how ADHD is perceived when it comes to our gender.
An overwhelming majority of the scientific research concerning ADHD focuses on male subjects and this has dangerous repercussions. It is critical that this changes so that caregivers are easily able to spot the girls and women who need extra support and ensure that they are taken care of accordingly. In terms of ADHD and mental health, women and girls deserve better. Instead of forcing girls to conform and thus condemning them to suffer alone, we owe it to them to challenge the gendered discrepancies in how mental illness is recognized and treated.
About the Author
Fidan Baycora (she/her) is a senior studying international affairs and history at the George Washington University. Although born and raised in Nashville, Tennessee, she was born to immigrant parents, growing up between countries and cultures. This background has always defined her throughout her life, from her chosen path of study to her writing. Fidan enjoys traveling, photography, journaling, memes, and shamelessly binge listening to true crime podcasts.
