Breaking the Stereotype: What ADHD Looks Like in Women

Attention-Deficit Hyperactivity Disorder (ADHD) is defined as a persistent pattern of inattention and/or hyperactivity that impacts daily functioning. ADHD is more commonly diagnosed in boys and men than in girls and women, even though ADHD is just as prevalent in women as it is in men. Additionally, women and men experience the same type, number, and severity of ADHD symptoms. There are multiple factors that contribute to the difference in how often men are diagnosed with ADHD as compared to women.

When most people think of someone with ADHD, they typically imagine a young boy who cannot sit still during class, struggles with organization, and is easily distracted. This is the stereotype that exists for someone with ADHD, even though it does not always look like this. There are three different types of ADHD: predominantly hyperactive/impulsive, predominantly inattentive, and the combined type. Women are more commonly diagnosed with the predominantly inattentive type, which can be harder to spot and which presents differently than the hyperactive/impulsive and combined types.

Inattentive ADHD is characterized by failure to pay close attention to details or making careless mistakes, not following through on instructions and failing to complete tasks, difficulty with organization, getting easily distracted, and forgetfulness. Women and girls with ADHD often learn how to mask these symptoms because they recognize that society expects women to excel in all of these areas. Often when they experience these symptoms, women and girls will hide their struggles and deal with them internally, so it can be difficult for clinicians or teachers to recognize that they may need to be assessed for ADHD. A young girl with inattentive ADHD may struggle to follow directions given by a teacher or have trouble staying organized, but she may keep these issues to herself. The young boy described earlier in this article whose symptoms present externally will be much more easily identified as someone who may need to be assessed for ADHD. Both of these children are struggling in similar ways, but their path to diagnosis and treatment is likely to be different.

Hyperactivity and impulsivity are strong predictors of an ADHD diagnosis, while symptoms of inattentive ADHD can be missed or result in a misdiagnosis. Women with inattentive ADHD can sometimes be diagnosed with a mood disorder or an anxiety disorder instead of receiving an ADHD diagnosis. Research has shown that rating scales and diagnostic criteria for ADHD are skewed towards hyperactive symptoms and this can make it difficult for anyone, male or female, who is presenting with inattentive symptoms to receive the proper diagnosis.

Here are some things for women with inattentive ADHD (or women who feel that they may have inattentive ADHD) to look for in a clinician:

1. Someone who specializes in ADHD and/or specializes in working with women with ADHD.

2. Someone who understands that ADHD in women often presents differently than it does in men.

3. Someone who can provide general psychoeducation about ADHD and who can provide specific information about inattentive ADHD.

4. Someone who will work with you to understand your specific symptoms and will help you to find ways to cope with those symptoms.

Research has shown that misdiagnosis and inadequate treatment for ADHD can result in negative mental and physical health outcomes for women. We also know now that ADHD does not resolve after puberty, and that inattentive symptoms persist longer than hyperactive symptoms and can last a lifetime. Therefore, it is important for women with inattentive ADHD to receive the proper diagnosis, understand that their daily struggles are actually symptoms of ADHD, and find the treatment that is best for them.