Too Few Doctors Screen Women for ADHD — and We Deserve Better
Women with ADHD are often misdiagnosed with depression and anxiety. Until psychiatrists learn to recognize ADD symptoms in girls, we have to take our mental health evaluations into our own hands. At the very least, we deserve a basic screening — and we must begin to demand it.
I have been in and out of psychiatrists’ offices since 2009, when I was diagnosed with prenatal depression during my first pregnancy. It took until 2015, and treatment by the best psychiatrist in the state, before I was tested for attention deficit disorder (ADHD or ADD). My doctor didn’t bring up the subject. However, when we discussed my symptoms, she agreed I should be evaluated.
I had six years of forgotten diaper bags, messy cars, missed appointments, and double-booked play dates; of misremembered names and forgotten faces. Six years. While I was under a doctor’s care.
How About an ADHD Evaluation?
It’s not, of course, that my ADHD had magically developed six years prior. It hadn’t. I’d lived a lifetime of forgetfulness and barely contained chaos. I was screened for depression multiple times, and had multiple diagnoses thrown at me, but no one asked me to fill out a simple, two-page evaluation for ADHD.
Any time I discussed my symptoms with a doctor, they were explained away. If my car was always messy, well, I’d struggled with depression my whole life, hadn’t I? If I had trouble remembering names, I was reminded that untreated childhood depression can cause problems with memory. If my house was a mess and I couldn’t remember appointments, well, depression makes it hard to function.
I followed the typical pattern. Girls with ADHD are three times more likely than boys to be treated for a mood disorder, depression or anxiety, than for ADHD, according to researchers. That’s partially because dealing with ADHD is likely to give us a mood disorder: Our inattentiveness and forgetfulness push us into low-self esteem and feeling inadequate, which leads to anxiety and depression. But when we get on the psychiatrist’s couch, we’re handed our diagnosis and sent on our way, with no discussion of comorbid conditions or what may have caused us to have these feelings in the first place.
Doctors Don’t Understand What ADD Looks Like in Women
Psychiatrists aren’t trained to recognize our ADHD symptoms. They’re familiar with the trope of the hyper little boy and the angry older man. They don’t see the girl in the back of the classroom daydreaming through class, playing with her erasers instead of doing her math problems, not remembering to put her homework in the right place. They don’t see the woman who blurts out unrelated comments during conversations, who spaces out when her friends talk.
Only 4.9 percent of women will be diagnosed with ADHD during their lifetimes, compared to 12.9 percent of men. The fact that so many fewer women get a diagnosis has dire consequences for our mental health. One-third of us with ADHD suffer from anxiety disorders — real ones, not misdiagnoses stemming from psychiatrists determined to stick a label on us. And half of us with anxiety disorders have thought about suicide, a staggering one-sixth of all women with ADHD.
Women Deserve Basic ADHD Screenings
I was lucky. I saw the signs and took my mental health into my own hands. But if the best psychiatrist in South Carolina didn’t recognize my symptoms, after years of treatment, we have a long way to go. Millions of women are left behind, abandoned by their doctors to think that they’re broken and incapable, that they have an irrevocable personality flaw, because they can’t recall dates, remember faces, make friends, keep their cars clean, and put their laundry in piles.
It wouldn’t take much to rectify the situation. Doctors screen women for depression, especially after childbirth, and 10 to 15 percent of us meet the diagnostic criteria. Don’t women deserve the same kind of basic screening when it comes to ADHD? Until that happens, and until psychiatrists learn to ask the right questions about women and ADHD, I fear for our well-being. But most of all, I fear for the little girl in the classroom, daydreaming and catching only every other word the teacher says. She will become one of us, with all of our difficulties, comorbid diagnoses, and frustrations. And no one will have any idea why.