A girl with ADHD may be labeled Chatty Cathy -- the enthusiastic school-aged girl who is always telling stories to friends. Or she could be the daydreamer -- the smart, shy teenager with the disorganized locker.
But what happens when she grows up? Or when her ADHD isn't diagnosed until she's a woman? Is her experience different from what men with ADHD go through?
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ADHD has not been widely researched in women. Much more is known about how it affects children. But there seem to be some patterns that differ between men and women with ADHD.
Women, Men, and ADHD
The issues adults with ADHD have mirror those in the population as a whole, says Stephanie Sarkis, PhD, a psychotherapist in Boca Raton, Fla.
For example, she says men with ADHD tend to have more car accidents, suspensions in school, substance abuse, and anger and behavioral issues, compared to women with ADHD. But men are more prone to these kinds of issues in general, regardless of ADHD.
Women with ADHD are more prone to eating disorders, obesity, low self-esteem, depression, and anxiety. But they do in the general population, as well.
These challenges also often play out in different areas of their lives. Men with ADHD may have problems at work, unable to complete their tasks or getting mad too easily at subordinates, says Anthony Rostain, MD, professor of psychiatry and pediatrics at the University of Pennsylvania School of Medicine.
Women, on the other hand, are more likely to see conflicts at home. Kathleen Nadeau, PhD, a clinical psychologist and director of the Chesapeake ADHD Center of Maryland in Silver Spring, says her female ADHD patients, especially mothers, come to her in a “constant state of overwhelm.”
“Society has a certain set of expectations we place on women and ADHD often makes them harder to accomplish,” Nadeau says. She points to women's traditional societal roles. “They are supposed to be the organizer, planner, and primary parent at home. Women are expected to remember birthdays and anniversaries and do laundry and keep track of events. That is all hard for someone with ADHD.”
Roots in Childhood
Many women with ADHD remember having these issues for a long time. “A lot of women tell me that (in school) they would look straight at the teacher so they wouldn’t get in trouble, but had no idea what was going on,” Nadeau says. “They are underfunctioning, but bright ... their symptoms are more subtle.”
ADHD is one of the most commonly diagnosed behavioral disorders in children, and it is a chronic, often lifelong condition. It affects an estimated 3% to 9% of U.S. children.
The hallmarks of ADHD are hyperactivity, lack of focus, and impulsive behavior.
But there are different shades of ADHD. The most pronounced is the hyperactive-impulsive form, where children have trouble sitting still and completing tasks like school work. They may be overly emotional or randomly blurt out inappropriate comments. Another type of ADHD is inattentive, with symptoms like lack of focus, forgetfulness, boredom, difficulty with organization, and daydreaming.
Though there are always exceptions to the rule, many experts say boys tend more toward hyperactive-impulsive and girls toward inattentive symptoms. “Females tend to be more the inattentive type and internally distracted by thoughts and guys tend to be more hyperactive,” says Fran Walfish, PsyD, child and adult psychotherapist in Beverly Hills, Calif. “I have seen boys who are dreamy and some girls who are hyperactive, but those are the exceptions.”