ADHD: How does it affect women differently?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by a range of behavioural symptoms that manifest in various ways. Although commonly associated with boys and men, recent research has shed light on how ADHD uniquely impacts girls and women, leading to an increased awareness of the disorder's signs, diagnosis, and treatment. Dr Nagaraj Konappa, renowned consultant general and forensic psychiatrist, provides an expert insight.

What is ADHD?

ADHD is a complex neurodevelopmental disorder that affects behaviour. While the exact cause of ADHD isn’t fully understood, it’s believed to arise from a combination of genetic, environmental, and neurological factors.

The symptoms of ADHD are often categorised into two main types:

• Inattentive symptoms: difficulties in sustaining attention, following through on tasks, organising activities, and being easily distracted.
• Hyperactive-impulsive symptoms: fidgeting, difficulty remaining seated, excessive talking, or interrupting others.

ADHD typically presents in childhood, but many people may not receive a diagnosis until later in life.

How does ADHD manifest in women?

ADHD presents differently in women compared to men, with symptoms often being more subtle or internalised.

For example, women with ADHD may experience difficulties with inattention and disorganisation, making it hard to focus on tasks, stay organised, or manage details without becoming overwhelmed. This can lead to frequent misplacement of items, trouble with planning, and challenges in completing activities.

Social interactions can also pose challenges, as women with ADHD may interrupt others, miss social cues, or have difficulty maintaining the flow of conversation, making it harder to sustain friendships and social relationships. Additionally, women with ADHD tend to have heightened emotional sensitivity, including increased sensitivity to criticism and mood swings, which can make managing emotions in stressful situations difficult.

Furthermore, perfectionism is a frequent issue, with many women with ADHD striving for success in their personal or professional lives but often feeling unsatisfied with their accomplishments, which can lead to increased anxiety and stress. These struggles, combined with societal expectations, can often contribute to feelings of inadequacy and low self-esteem as women with ADHD compare themselves to others or feel they fall short of standards.

Why is ADHD often undiagnosed in women?

The undiagnosis of ADHD in women can be attributed to several factors. First, traditional diagnostic criteria have often been based on observations of male behaviour, leading to a bias in recognising ADHD signs in females. As a result, the less conspicuous signs often exhibited by women may go unrecognised.

Moreover, the coping strategies women develop to manage their symptoms can make ADHD less apparent. Many women with ADHD hide their difficulties, which can create an illusion of competence that masks their underlying challenges with organisation and focus.

Cultural stereotypes play a significant role in the undiagnosis of ADHD in women. Society often expects women to be nurturing and organised, and those who struggle with these expectations may attribute their difficulties to personal failings rather than a medical condition. This can delay seeking help and receiving a proper diagnosis.

How is ADHD treated in women?

The treatment of ADHD in women typically involves a multimodal approach, combining behavioural therapy, medication, and lifestyle modifications.

Medication is often a key component of treatment. Stimulant medications like Methylphenidate and Amphetamines are commonly prescribed and have proven effective in reducing ADHD symptoms. Non-stimulant options, such as Atomoxetine, may also be used.

Behavioural therapy can help women develop coping strategies, improve organisational skills, and manage time more effectively. Cognitive behavioural therapy (CBT) is also particularly beneficial, as it focuses on changing negative thought patterns and behaviours associated with ADHD.

In addition to therapy and medication, lifestyle changes can have a positive impact on managing ADHD symptoms. Regular physical activity, a balanced diet, adequate sleep, and stress management techniques can help improve focus and overall wellbeing. Women with ADHD may additionally benefit from mindfulness practices, which can enhance attention and emotional regulation.

If you would like to book an appointment with Dr Nagaraj Konappa, head on over to his Top Doctors profile today.