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ADHD: Why girls are often overlooked?

Updated: Dec 1, 2022

By DiverseMinds Research Team

Reading time 10 minutes ⏰


For as long as she can remember, Emily Johnson-Ferguson's spirit has been overactive. She has had an eating disorder since she was a teenager, and it is her way of trying to slow down her brain. Doctors put it down to family problems and stress, but she knew that was not the case.


It was only last year, at the age of 42, that she was diagnosed with ATTENTION deficit hyperactivity disorder (ADHD), finally getting to the root of what had troubled her all her life.


Johnson-Ferguson is not alone. While the stereotype of ADHD is that of a boy jumping up and down in the classroom, that is not the whole story. Girls can have ADHD, too, and many go undiagnosed and untreated, which could change their lives.


Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that comes in three types: attention deficit disorder, hyperactivity/impulse control disorder, and some combination of the two. People with ATTENTION deficits may have poor memories, find it challenging to stay organized, and are easily distracted. People with hyperactivity/impulse control disorder may have trouble staying seated, fidgeting, and interrupting conversations.


Some adults with ADHD rely on multiple cues and calendar reminders to stay organized.


The condition is usually diagnosed in childhood, but most people recover naturally as adults. For those who go undiagnosed in childhood, untreated treatment can cause problems in adulthood.


"When I was in college and able to make my own decisions, I could not concentrate on my studies," says Emily. It did not help that she switched courses. She suffered from anorexia throughout college and self-medicated with alcohol, caffeine and sugary drinks for the next 20 years. This behaviour is common in adults with ATTENTION deficit hyperactivity disorder.

She found life even more challenging after the breakdown of her marriage. She gave up those bad habits and tried to start over, but there was no relief; Instead, the symptoms became more severe. She stayed in bed for days at her lowest point. "I could not concentrate on anything." She said in an interview.


Attention-deficit

There are significant differences in the prevalence of ADHD between boys and girls. In a study of 2,332 twins and siblings, Anne Arnett, a clinical child psychologist at the University of Washington, found that differences in symptom severity could explain the gender difference in diagnosis rates: Boys' symptoms were generally more varied extreme than girls'.


Arnett commented that we are really seeing a neurobiological difference. It is not clear why this is the case, but it could be that girls are genetically better able to protect themselves.


Boys generally have more severe ADHD symptoms and a wider variety of symptoms than girls.


However, it remains unclear how much difference there is.


The ratio of boys and girls with ADHD varied across studies, ranging from 2:1 to 10:1. In terms of real-world diagnoses, boys get diagnosed at a much higher rate than girls, even in the general population who meets the criteria for ADHD. The percentage of boys was also higher than that of girls, but the difference was not as significant.


Florence Mowlem, a consultant at Aquarius Population Health, a healthcare consultancy said that there are more women with ADHD than previously known. Nevertheless, many of them do not seem to be as clinically diagnosed as men.


Research shows that girls with ADHD can only be diagnosed if their symptoms are more severe and evident than boys. In a study of 283 children ages 7 to 12, Molum and colleagues compared boys and girls who met the criteria for an ADHD diagnosis with those who had many symptoms but not enough to diagnose.

Mr. Molum was a Ph.D. student at King's College London. She found that parents' self-assessments tended to downplay hyperactivity and impulsivity in girls and overemphasize them in boys. They also found that girls who met the diagnostic criteria were moodier and had more behavioural problems than other girls. However, boys do not.


In a similar study of 19,804 Swedish twins published last year, Malum and colleagues found that girls were more likely to be diagnosed if they exhibited hyperactivity, impulsivity and behavioural problems, but boys were not. (BBC research)


Girls may also be better at masking their symptoms than boys, similar to how autistic girls disguise them.


Helen Read, a consultant psychologist and lead on ADHD at a large NHS Trust in London, says that Girls are less likely to jump up and down in the classroom or argue and fight with teachers. When a girl does this, she will be criticized by her peers and others, so it's almost impossible for a girl to behave in this way.


Even when girls are hyperactive, they are more likely to be talkative or rebellious, a bit of a wild child. Teachers and parents do not think that these symptoms are caused by ADHD, especially since we assume that girls will be more socially adept than boys.


However, more research is needed before knowing how serious the problem is.


Symptom similarity

If girls are missed because their symptoms are less typical, boys may be too: boys with attention deficit disorder can also go unnoticed.


It is generally accepted that girls are more prone to inattention than boys. However, Elizabeth Owens, associate clinical professor of psychology at the University of California, Berkeley, says that is just anecdotal. She says the best evidence so far suggests that boys and girls have equal rates of inattention.


Elizabeth added thatThese signs of attention-deficit type are actually more common than diagnosed [in both boys and girls], but are often missed or missed because these children are not usually trouble in class.


Owen says that boys and girls with ADHD are more similar than they are different. It highlights that PEOPLE need to take ADHD and girls with it seriously. It has been played down and ignored for a long time.


Girls with ADHD are more likely to suffer from depression later than boys with the disorder.


However, one of the differences is that girls with mixed ADHD -- both ADHD and

HYPERactivity/impulse control disorder -- are at higher risk of self-harming as adults. Girls with ADHD are also more likely to develop anxiety and depression later.


Owen has been conducting a study since the 1990s that followed the lives of 228 girls, 140 of whom had ADHD, for more than 20 years. The average age of the girls in the study was 19 and 25 at the second and third follow-up visits. They found that girls diagnosed with mixed ADHD in childhood had a higher risk of self-harm and suicide.


In theory, identifying and treating ADHD early could help mitigate the risk, but Owen says there is no evidence that it works. ADHD is a chronic disease, it is not a quick fix.


However, TREATMENT for ADHD can make a big difference in a person's daily life.

Soon after Emily Johnson-Ferguson was finally diagnosed, she began taking Lisdexamfetamine. It is a central stimulant used to treat ATTENTION deficit hyperactivity disorder.


She had to work hard to make sure she was as effective as possible, exercising, eating healthy, cutting down on alcohol and cutting out caffeine, but the changes have been worth it. 'The planning I do at work now is too good to be true,' she says in the interview. 'It feels like a different person.'


In addition to taking medication, knowing that a lifetime of problems are not your fault can take much pressure off. Emily Johnson-Ferguson described her life before her diagnosis as "42 years of feeling different from every other person on the planet.


Now, she can take advantage of ADHD -- maintaining an intense focus on short-term projects -- and build a successful career in film marketing while also better understanding her weaknesses.


However, many others are not so lucky. Until we completely abandon the stereotypes of ADHD and understand why girls with the disorder are ignored, too many women will continue to live with the condition for a lifetime, severely affected and unaware that they could have sought help for a new life.

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