A little boy who can’t sit still, constantly interrupts other people, and acts impulsively has long been the image of attention deficit hyperactivity disorder (ADHD), not just for the general population, but even for doctors and researchers. In more recent years, however, we have become more aware of how girls and women experience ADHD, and the diagnosis is very different for them. At Carolina Dunes Behavioral Health in Leland, North Carolina, we treat several mental health disorders that frequently co-occur with ADHD, so we think it is important for our patients and their families to understand what this condition could mean for them.
Types of ADHD
There are three different types of ADHD. The type a person is considered to have is based on which version most of their symptoms most closely resemble.
- Disruptive type: This type often looks like that little boy described above. This type occurs more often in boys than in girls, and sometimes it is outgrown during adolescence or adulthood.
- Inattentive type: This type more frequently impacts women and girls than disruptive types. It is not typically outgrown later in life. The symptoms include forgetfulness, trouble focusing, and organizational problems. Anxiety and depression often result from the patient seeing themselves as less competent, intelligent, or worthy than others
- Combined type: A person with this type has about an equal amount of inattentive and disruptive symptoms.
Delayed Diagnosis in Females
Many women with ADHD do not receive a diagnosis until adulthood. ADHD has a hereditary component, and often, women receive a diagnosis when it is realized that they have a child with ADHD. Otherwise, they may be diagnosed when they struggle to do things that other adults don’t find challenging, such as handling work requirements, managing their busy schedule, and using their time effectively. They may find that their symptoms fluctuate with their menstrual cycle because hormones impact presentation, and this fluctuation could make it harder for them to recognize patterns in their own struggles.
Sometimes, they are not diagnosed at all because they become masters of disguise, masking their symptoms so that no one knows how much harder it is for them to do what others seem to take in stride.
How Presentation Impacts Diagnosis
Doctors and researchers recognizing that differences exist between the genders have not resulted in women and girls receiving timely ADHD diagnoses. This is potentially due to how the symptoms present. A child with disruptive type ADHD is more likely to draw the attention of teachers and parents, who have to do more to keep them safe and prevent them from becoming a distraction to others. Adults are more likely to notice that something is amiss for this child than for the child who daydreams during class, is always losing things, has a messy room, and forgets to do their homework. Often, the child with inattentive type ADHD is told that they need to “try harder”, “buckle down,” and “pay attention” as though their ADHD symptoms are just a choice they are making. No referral is made for diagnosis or treatment, because their condition is perceived as a lack of effort or a personality trait.
ADHD Myths
Despite ADHD being discovered in 1775 and a lot of research happening in the past 250 years, there is still a lot of false information about this condition:
- ADHD isn’t real. 100,000 articles in science journals and references in multiple generations of medical textbooks tell us otherwise.
- ADHD is over diagnosed. The diagnostic criteria for this disorder initially focused on the disruptive type, meaning that about half of the population wasn’t even recognized for a long time, and even now, those with the inattentive type are often missed.
- The meds for ADHD are addictive. When used as prescribed, stimulant medications actually decrease the risk of people with ADHD developing addiction.
- Bad parenting causes ADHD symptoms. While there is a correlation between ADHD and relationship and disciplinary issues, the cause runs in the opposite direction. ADHD causes those issues; they don’t cause ADHD.
- We all have a little ADHD. ADHD causes problems that are severe enough to interfere with a person’s day-to-day life, and it is the result of physical differences in a person’s brain. That means it’s not typical.
At Carolina Dunes Behavioral Health, we treat behavioral health conditions that commonly occur alongside ADHD. While our focus is not directly on ADHD, the tools we provide to our clients, such as coping strategies, structure, medications, and insight into their own behaviors, can also make their ADHD easier to manage.
