Though ADHD has often been painted as “just a boy thing,” experts say unique symptoms in women and girls may be behind decades of missed diagnoses.
Attention deficit hyperactivity disorder (ADHD) is a relatively common neurodevelopmental disorder. ADHD can make daily functioning seriously challenging, including:
- focusing on a single task or conversation
- sitting still
- staying organized
Millions of children worldwide are diagnosed with ADHD, but this condition doesn’t only affect kids. According to the National Institute of Mental Health (NIMH),
However, there is a striking difference in rates of ADHD between males and females, according to the
Researchers and experts are investigating this gender-based difference in ADHD diagnoses. Their discoveries challenge longstanding beliefs about this condition in women and girls.
ADHD is generally split into three different subtypes:
- hyperactive-impulsive ADHD
- inattentive ADHD
- combined ADHD
Symptoms of the hyperactive-impulsive type are typically what people picture when they think of ADHD, such as:
- high energy
- fidgeting
- restlessness
- impulsivity
With inattentive ADHD, adults exhibit five or more — and children six or more — of nine classic symptoms, including:
- lack of attention to detail or frequent careless mistakes
- trouble sustaining attention
- drifting thoughts and difficulty listening
- failure to follow instructions
- trouble organizing tasks and physical belongings
- avoidance of activities that require sustained focus
- losing items
- distracted easily
- forgetfulness in daily activities
To outsiders, a girl or woman with ADHD might seem “spaced out,” or like she’s off in her own world.
Women and girls may be more likely to have inattentive ADHD, according to a
- focusing on tasks
- managing time
- generally keeping track of things
Some ADHD symptoms are more disruptive, like difficulty concentrating and keeping thoughts and belongings organized. These symptoms can cause daily challenges that may lead to other issues, such as:
- feeling out of control or overwhelmed
- depression
- low self-esteem
- feeling shame or embarrassment
Some
Even though there is overlap in ADHD symptoms between girls and boys, there are also some significant differences in how the condition presents.
A 2014 review suggests that women may be better than men at developing coping strategies to manage their symptoms. But that doesn’t mean symptoms have no impact on women’s daily life and mental health.
Studies from
And while boys with hyperactive-impulsive ADHD may be fidgety or in some cases physically aggressive, girls with ADHD are typically less likely to act out in a violent or physical manner.
ADHD symptoms that make it difficult to listen or complete tasks can lead to underachievement in school or work, though this isn’t always the case. To compensate for ADHD symptoms, girls may spend long hours on work or obsess over small tasks.
Because symptoms can significantly affect everyday life, ADHD can be an underlying cause of other mental health disorders.
Conditions that are more often related to ADHD in girls and women include:
Girls and women with ADHD have been overlooked by doctors and therapists for decades for a number of reasons.
But ADHD diagnoses in females seem to be rising steadily in recent years. This may indicate that ADHD occurs more equally across genders than experts previously believed.
Differing symptoms
Girls and women can often exhibit symptoms that look different from those of boys and men with the same condition.
The symptoms of hyperactive-impulsive ADHD tend to be more disruptive and obvious, while the symptoms of inattentive ADHD tend to be more discreet. Inattentive ADHD symptoms are often hard to detect, even for experienced doctors. Observers are typically more likely to refer kids with classic ADHD traits for intervention and evaluation.
More overt behaviors that are common in boys with ADHD don’t tend to show up in girls, such as:
- talkativeness
- aggression
- being physically overactive
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Gender biases
Many people — including teachers and medical professionals — think of ADHD as a “boy thing.” To them, ADHD is mainly found in hyper little boys who have trouble sitting still.
But the reality is that many girls and women have ADHD, too.
Common gender biases in mental health care might be the reason many girls with ADHD go undiagnosed or are misdiagnosed with a different condition.
The diagnostic criteria for ADHD were recently changed to include more inattentive symptoms, but the skewed and incomplete public perception of ADHD remains. And because ADHD research has historically focused on boys and men, more is known about how the condition affects them.
Societal expectations
When girls exhibit behaviors consistent with ADHD, they’re often deemed negative personality traits and not symptoms of a mental health condition. These behaviors can include:
- disorganization
- being “hyper” or energetic
- messiness
However, when observed in boys, these same characteristics are often viewed as signs of a condition, not personality flaws.
Girls are also more likely to compensate for ADHD symptoms due to societal pressures.
In family settings, there are often societal pressures for women to be caretakers and organizers. When feelings of chaos and confusion make daily tasks challenging, women with ADHD might experience low self-worth or inadequacy.
Hormones
Estrogen and other hormones may play an important role in ADHD, which could help explain why girls often don’t show symptoms until puberty or later.
Hormones may also influence ADHD symptoms.
It’s easy to feel frustrated or overwhelmed by ADHD sometimes.
There is no “cure” for ADHD, but it’s possible to manage symptoms. Many effective treatment options exist that can help improve the quality of life for people with this condition.
Correct diagnosis is often the best first step toward finding the right treatment for girls and women.
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- organizational skills
- establishing routines
- stress management
Other common treatments for ADHD include:
- Medication. This could include stimulants like amphetamines or nonstimulants like atomoxetine (Strattera). A
2020 review found that girls who have been diagnosed with ADHD may even be significantly less likely to be prescribed medication as treatment. - Therapy. Cognitive behavioral therapy can help girls and women learn coping strategies to manage symptoms and identify patterns of negative behaviors.
- Family or group therapy. Being in a therapy setting with family members or other girls with ADHD can help clarify how ADHD affects relationships and lessen feelings of shame and loneliness.
If you think you or your child may have ADHD, you’re not alone.
Since many popular beliefs about ADHD don’t accurately reflect how girls and women experience this condition, learning about it can be an empowering place to start.
Visiting your doctor or pediatrician for a screening is the first step to seeking treatment for ADHD. If you feel like your doctor or therapist isn’t listening or is dismissing your symptoms and concerns, finding a professional who’s a better fit might be worthwhile.
If you’re ready to get help but don’t know where to start, Psych Central’s guide can help you find mental health support.
ADHD is a manageable condition with a variety of treatment options for girls and women, including:
- medication
- therapy
- learning coping skills
Despite the biases around ADHD symptoms in women, your experience of this condition is valid. Like many girls and women with ADHD, you can live well with this condition.