ADHD’s severity in women and girls is often overlooked

May 31, 2018

Women are often seen as talkative by nature, but the reality is, sometimes it can be more than that. Unfortunately, because of this stereotype, many people, doctors included, assume women don’t suffer as much from attention- deficit/hyperactivity disorder (ADHD) as men. Furthermore, new findings suggest the medical community doesn’t appreciate the frequency and severity of ADHD in women and girls at all, says Stephen Hinshaw, a professor of psychology at the University of California at Berkeley and co-author of the new study.

“Boys and girls are similarly afflicted and impaired by the symptoms of the disorder,” Hinshaw says. “Girls appear to be as affected as boys, if not more so in some instances.”

ADHD affects an estimated 3 percent to 5 percent of American children, possibly as many as 2 million kids. Three boys are diagnosed with the disorder for every 1 girl.

However, several researchers have argued that many affected adult women, as girls have been left behind, largely because they are less likely to be hyperactive and more likely to have trouble paying attention. “The hyperactivity tends to come to the attention of teachers and parents, and gets kids in trouble with their peers,” while a lack of attention is less noticeable, says Nadine Kaslow, chief psychologist at Emory University School of Medicine.

In the UC-Berkeley study, researchers enrolled 228 girls aged 6 to 12 in day camps held from 1997 to 1999. Of the girls, 140 had ADHD and were specially recruited; the others, who weren’t diagnosed with ADHD, were told the camps were for “enrichment.”

The girls with ADHD went off their medications for the six-week day camp periods so researchers could observe their “natural” behavior.

Researchers watched the girls closely and found those with ADHD were often socially isolated and uninterested in following directions.

The girls with ADHD weren’t as physically aggressive as boys with the disorder, but Hinshaw says they were more likely to engage in what is called “relational aggression”, which is described as getting back at someone by excluding them from an activity or social group, or spreading rumors rather than directly aggressing against them.

The girls scored as poorly as boys on tests of their abilities to set goals, alter strategies in response to changing situations, and make plans.

Kaslow praises the study and says more attention to the ADHD problems of girls will help them later in life. “This really underscores the importance of teacher, parents, and pediatricians paying attention when girls aren’t doing as well as one thinks they should be,” she says. “The longer these problems go untreated, the worse kids feel about themselves, the more social difficulties they have, and the harder life becomes for them.”

Some adult women appear in her office with cases of ADHD that have been undiagnosed since childhood, Kaslow says. “They didn’t know they had it, but they knew they struggled more to organize their work and their thinking. Sometimes teachers would say these kids weren’t that smart, but it’s not an intelligence issue. It’s about an ability to organize it, and get it all together.”

The good news is that ADHD drugs appear to work as well in girls as in boys, Hinshaw says. “ADHD is a serious, but treatable, problem in girls.”

If you’re a woman or young girl suffering from ADHD, know that you have options and treatment available to you. Consult with a healthcare professional to explore your options.