From job opportunities to personal income to marital relationships, there's hardly an area in which American women haven't made great strides in recent decades. But when it comes to getting diagnosed with and treated for ADD, women still have a long way to go.
Women are as likely as men to have ADD, and the latest research suggests that ADD causes them even greater emotional turmoil. Yet ADD is still thought of as something that affects only men and boys. Consequently, ADD women are more likely than men to go undiagnosed (or misdiagnosed), and less likely to receive appropriate treatment.
"ADD is still presumed to be a male disorder," says Fred Reimherr, M.D., director of the University of Utah Mood Disorders Clinic and the lead author of a recent study that found that ADD has a disproportionate impact on women. "The women had a much more frequent history of having been diagnosed with other emotionally based psychiatric illnesses, such as depression or anxiety. I think those symptoms are often the things that a physician treating adults focuses on. A woman might come in presenting emotional symptoms, and the ADD that's underneath might be missed."
Girls versus boys
Underdiagnosis of ADD in women has its roots in childhood. Girls with ADD tend to try harder than their male counterparts to compensate for and cover up symptoms. To keep up their grades, girls are often more willing to put in extra hours of studying and to ask their parents for help.
In addition, girls are more likely to be "people pleasers," doing all they can to fit in — even when they know they are "different."
Teachers are often the first to identify children with ADD. Yet because many teachers think of ADD as a male disorder, they tend to be better at suspecting the disorder in boys than in girls. This is true whether girls exhibit the hyperactive (can't sit still), the inattentive (daydreaming in a corner), or the combined version of the disorder.
"Most people have a misperception that ADHD is a disorder of hyperactive elementary school-aged boys," says Patricia Quinn, M.D, a developmental pediatrician in Washington, D.C., and a leading expert in gender aspects of ADD. "When they see behaviors in girls, even disruptive behaviors, the girls still go undiagnosed."
Who should make the diagnosis?
Clinical psychologist Kathleen Nadeau, Ph.D., runs a private clinic in Silver Spring, Maryland, that specializes in the diagnosis and treatment of ADD and learning disorders. She says that she sees many cases in which women come to suspect that they have ADD after struggling for years to balance the responsibilities of a job, a home, and child rearing.
Some women come to suspect what's at the root of their problems after seeing a report of ADD in the media. Other women begin to suspect they have ADD after a child of theirs has been diagnosed with the disorder. CONTINUED ON PAGE TWO