Girls with ADHD are called many things before they ever receive an accurate diagnosis. Here is everything you need to know about ADHD in girls and women, so you – or your daughter – don’t slip through the cracks.
Girls and boys currently are diagnosed with attention deficit disorder (ADHD or ADD) at a ratio of about 1 to 3. This doesn't mean that fewer girls and women have ADHD; it means more ADHD in girls and women is going undiagnosed. When left undiagnosed, ADHD can take a toll on a female’s emotional health and general well-being, leaving them with low self-confidence and psychological damage.
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Differences in ADHD Symptoms
Doctors and teachers often overlook ADHD in girls because they exhibit hyperactivity differently. For example, in a classroom setting, a boy might blurt out answers or repeatedly tap his foot and get out of his seat, whereas a girl might demonstrate hyperactivity by talking incessantly. A girl who talks all the time is often viewed by the teacher as chatty, not hyper or problematic — and thus is less likely to be recommended for an ADHD evaluation, 50 percent less likely.
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Another reason why ADHD girls fly under the radar is that they’re more likely than boys to suffer from inattentive ADHD. The symptoms of this sub-type (which include poor attention to detail, limited attention span, forgetfulness, and distractibility) tend to be less disruptive and obvious than those of hyperactive ADHD. Put simply, a (hyperactive) boy who repeatedly bangs on his desk gets noticed, and helped, before the (inattentive) girl who twirls her hair while staring out the window.
Some girls compensate for their ADHD by developing strategies that mask the symptoms. To ensure she gets a good grade, a girl may become a perfectionist and spend hours taking meticulous notes on every chapter she’s being tested on, or become obsessive-compulsive, and check and recheck her backpack to make sure she has everything.
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ADHD gender differences can also affect a girl’s social life. Research shows that girls with ADHD may be rejected more often by their peers than boys. Compared to boys, girls’ friendships require greater sophistication and more maintenance. For example, two boys can meet on the playground and start digging a hole with their shovels, and they’re instant friends. Friendship among girls requires picking up on social cues and bonding, something girls with ADHD may have trouble with.
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The Price of ADHD in Girls
The self-esteem of girls with ADHD also appears to be more impaired than that of boys with ADHD. It’s not surprising, then, that the condition can take a toll on a female’s emotional health and general well-being. Girls with ADHD tend to have more mood disorders, anxiety, and self-esteem problems than women and girls without the disorder. Girls with ADHD are at a significantly increased risk for problems ranging from low academic achievement to drug and alcohol abuse.
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Public Perceptions of Girls
Girls with the hyperactive type of ADHD may be diagnosed earlier, but are often 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. Hyperactive boys are just “being boys,” while hyperactive girls get ostracized.
Women are taught to be "pleasers," and often put unrealistic demands on themselves as they try to balance family and a career. When women with ADHD marry and have kids, many feel shame. Society expects tremendous feats of memory and organization from moms, from keeping track of critical facts about teachers to organizing meals and schedules. Without treatment or help, many women feel inept.
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If you believe that your daughter may have ADHD, do not to wait for the teacher to express concern before seeking a doctor’s evaluation. Teachers usually look for hyperactivity, disorganization, or forgetfulness as the signs of ADHD before recommending an evaluation, but the way ADHD often expresses itself in girls — excessive talking, poor self-esteem, worrying, perfectionism, risk-taking, and nosiness — is seldom read as such.
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Adult Diagnosis: Relief
Any woman who suspects she has ADHD should educate herself about the condition — and consult a mental-health professional who specializes in adult ADHD. ADHD is strongly hereditary, and many women seek help as adults because a light bulb goes off when they have a child who is diagnosed with ADHD. For most women diagnosed later in life, it is a relief to finally have an explanation for why they are the way they are.
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ADHD not only presents different symptoms in girls and boys, but it often requires a different treatment strategy. Both genders benefit from stimulant medications, but girls may also need treatment for anxiety. Some girls cannot tolerate stimulants without extra pharmaceutical support.