How Undiagnosed ADD/ADHD Puts Girls at Risk
“Girls with ADD/ADHD are in deep trouble in a lot of ways,” says Hinshaw. Over the summer, he and his team analyzed results from 10-year, follow-up interviews of 140 girls who were aged seven to 12 when first surveyed. His data, along with other reports over the last five years, show that girls with ADD/ADHD are at significantly increased risk for problems ranging from low academic achievement to drug and alcohol abuse, and even suicide attempts. Females, in general, suffer greater rates of anxiety and depression than males, and it appears that the rate is even more pronounced when ADD/ADHD is a factor.
A study published last fall in the Archives of General Psychiatry found that girls with ADD/ADHD were at far higher risk than other girls, or than boys with the disorder, for depression and suicide attempts. Another report, published last spring in the American Journal of Psychiatry, revealed that girls with ADD/ADHD were more likely than others to engage in antisocial and addictive behavior, and to suffer from anxiety.
What’s clear from his follow-up, Hinshaw says, is that girls with ADD/ADHD share with boys the strong risks of school failure, rejection by peers, and substance abuse. Unlike boys, they also have a particularly high risk for developing depression, self-injuring behavior, and eating disorders. “In other words, girls with ADD/ADHD appear to show a wider range of difficult outcomes than do boys,” he says.
Hinshaw says girls are harmed by earlier, and more effective, socialization. They are trained from an early age not to make trouble, and to disguise mistakes and miscues. They turn their frustration on themselves, rather than others. When I was a teen, my parents may have worried that I was depressed, but they never suspected that I might have an attention disorder. And so it goes in many families today. Girls with inattentive ADD/ADHD will probably be diagnosed later than boys, and for something entirely different.
Meanwhile, girls with the hyperactive type of ADD/ADHD are stigmatized more than boys with the same diagnosis. Kids on the playground regard impulsivity and distraction as boyish. Boys are more likely to get a pass from other kids and teachers, especially if their symptoms aren’t severe. Girls get ostracized.
For many young women, the anxiety, stress, and low self-esteem that comes with ADD/ADHD feels intolerable by early adulthood. The structure of school is gone, a positive for boys but a loss for girls, who fare better with rules and routines, according to Hinshaw.
When women with ADD/ADHD marry and have kids, many of them hit what psychotherapist and author Sari Solden calls “a terrible wall of shame.” Society expects tremendous feats of memory and organization from moms, from keeping track of critical facts about teachers and pediatricians to organizing meals and multiple schedules. And without treatment, or a “wife” of their own, many women can’t cut it.