Attention-deficit hyperactivity disorder, commonly referred to as ADHD, can have very different effects of children and adults based on their biological sex. In fact, ADHD is exhibited differently in females than it is in males. Because of this difference, ADHD is more commonly diagnosed in males, yet research has found that it affects both sexes at similar rates. However, current research on ADHD primarily focuses on external behaviors because they are the easiest to identify, categorize, and quantify. Since external behaviors are often exhibited by males with ADHD, this inadvertently excludes the female experience of ADHD. Since most women internalize ADHD, their sense of self and qualitative life management skills are impaired. Thus, research that focuses less on behavior and more on the level of impairment would be beneficial for acquiring data on ADHD in females.
ADHD in Males
To understand the different ways ADHD affects females, one must first understand how ADHD affects males. ADHD in males is mostly exhibited through their hyperactivity and is more easily diagnosed because of this. In fact, the disorder itself is defined through the hyperactivity of males and when many people hear the term ADHD, they envision hyperactive boys. This is because males with ADHD generally externalize their disorder by showing higher rates of oppositional defiant disorder and conduct disorder. Oppositional defiant disorder is defined by patterns of anger, irritability, arguing, defiance, or vindictiveness toward authority figures that is frequent and persistent. Conduct disorder is a pattern of behavior that ignores age-appropriate social norms or the basic rights of others. These external behaviors interfere with surrounding individuals and are the easiest to identify and research. The majority of research done on ADHD uses these external behaviors to obtain more information about how ADHD affects individuals.
ADHD in Females
ADHD in females is often underdiagnosed because it is harder to identify than it is in males. While most males exhibit hyperactivity as a primary symptom, females tend to exhibit the attention deficit part of ADHD. They also tend to internalize their disorder and can experience separation anxiety disorder as a result. Separation anxiety disorder is excessive anxiety for a certain age that causes extreme distress and impairs the daily functioning of an individual. As they continue to grow, girls with ADHD are prone to self-esteem issues, underachievement, depression, and anxiety. They may also have problems functioning in school, social spheres, or within their family.
However, women with ADHD have also been found to be perfectionists who value their intellect. Most women establish their self-esteem at a young age through academic accomplishments. This pattern of establishing self-esteem continues into adulthood, however academic success is now much harder to obtain. As a result, women with ADHD will start to question their abilities and compare themselves to others around them who they perceive as being more successful. To attain success, women with ADHD will become obsessive with preparations, relentlessly self-monitor themselves, and often experience anxiety. If they fall below the standards they’ve set for themselves they will feel demoralized and undeserving of compassion.
Because ADHD is harder to notice in females, many females with ADHD go undiagnosed and untreated. Generally, ADHD in females is not normally diagnosed until adulthood and is usually brought on by a woman recognizing similar behavior between herself and her recently diagnosed child. However because women often do not receive a diagnosis, they blame themselves for their inability to accomplish daily tasks and constantly anticipate the criticism that comes with being unorganized, unmotivated, or late. When their frustration about their inability to accomplish daily tasks eventually leads to emotional outbursts directed at their partner or children, they feel regret and blame themselves for flawed character.
If ADHD continues to go undiagnosed into adulthood, women often develop mood disorders such as depression and anxiety. Thus women are often misdiagnosed with mood disorders that are then treated independently while the primary cause, ADHD, continues to go undetected. Women with ADHD are also prone to developing Borderline Personality Disorder which affects the way women perceive themselves and others. There can also be physical manifestations of the anxiety caused by ADHD such as headache, nausea, nail-biting or cuticle-picking. Women with ADHD are also prone to substance abuse, compulsive behaviors, hypersensitivity, physical and/or sexual abuse, and may even have similar symptoms to PTSD.
Undiagnosed ADHD in women can create a cocktail of psychological disorders that continue to increase their psychological distress as their daily responsibilities increase. Because of their low self-esteem, self-care is not an option and they often become accustomed to functioning with minimal sleep, inconsistent eating patterns, and chronic stress. However, this can cause them to depend upon prescription drugs to function and some may choose to use recreational drugs or alcohol as a substitute. Women with undiagnosed ADHD are also more likely to inflict self-harm because of their hopelessness and impulsivity. They are also more likely to suffer from suicidal thoughts or attempts.
If you find yourself relating with some of the behaviors listed below, you may have ADHD. As a woman, you can also take this quiz to obtain further insight that you can share with an ADHD psychiatrist at NJ Family Psychiatry & Therapy. If you suspect that your daughter may be affected by ADHD, you can have her take this quiz for insight.
- Chronic anxiety
- Low self-esteem
- Inattentive symptoms
- Internalized symptoms
- Eating dysregulation
- Late adolescent onset
- Chronic relationship problems
- Perfectionist behavior
- Frequent irritability
- Chronic restlessness
- Reluctance to read
- Sensory hypersensitivities
- Episodes of rage or tears
- Intense PMS symptoms
- Picking behaviors (such as skin picking, cuticle picking, etc.)
If you are a female and you suspect that you or your daughter could be affected by ADHD, schedule a psychiatric consultation with one of our ADHD psychiatrists at NJ Family Psychiatry & Therapy today.