This article is from the WebMD Feature Archive

Adult ADHD is a sly condition that can secretly affect people for years without their knowledge. Lori-Lynn Dale knows first hand. In her senior year in college, she not only completed her studies, but also managed three jobs and cared for a new baby boy. Dale seemed to handle herself beautifully, but inside the young mother felt alone, tired, and overwhelmed.

Besides staying awake for days to finish projects, Dale admits to alcohol and drug abuse to ease frustration, and to using "underhanded tactics" to get her way. Her manipulative behavior and fear that someone would find out that "something was really wrong" with her made it difficult to make and keep friends. She did not want anyone to know about her shortcomings.

"I was out to prove that I was just like everybody else," says Dale. "It was a huge cost to my personal development and my self-esteem."

Dale did not feel relief until she was in her 30s. That's when she became sober and was diagnosed with adult attention deficit hyperactivity disorder (ADHD).

In many ways, Dale's story illustrates the significant impact of adult ADHD on women. Women with the disorder tend to suffer in silence compared with their male counterparts, says Patricia Quinn, MD, director of the National Center for Gender Issues and ADHD, a nonprofit group. She says women often develop strategies to hide their deficiencies, but in the process, feel ashamed and have low self-esteem. They frequently find it difficult to make social connections. And, even when things are going well, they feel frustrated and besieged.

The burden is especially noteworthy given at least 4 million women have adult ADHD and many of them don't know it, says Quinn. "Women have tended to be underdiagnosed with the disorder," she explains. "We have probably not diagnosed one-half to three-quarters of the women with ADHD."

Women are apparently missed early on. "If you go to [children's] clinics and see who's getting treated [for ADHD], the ratio of males to females is as high as nine males for every one girl," says F. Xavier Castellanos, MD, director of the Institute for Pediatric Neuroscience at the New York University Child Study Center.

Research of school-aged children indicates there are actually about 2.5 boys to one girl with ADHD. Yet even this estimate may not be completely realistic, says Castellanos, citing anecdotal reports that there are an equal number of males and females with the disorder.

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