Written By: Erica Kornblith, PhD – Clinical Neuropsychologist, The Clinic of California
“I feel like I’m becoming an adult at 50.” – ADHD patient diagnosed in her 40’s
Attention-deficit/hyperactivity disorder (ADHD) is a brain-based condition characterized by problems with focus, organization, and/or hyperactivity beginning in childhood and negatively impacting multiple facets of life. Recent advances in brain imaging technology have revealed that these symptoms may be related in part to difference in the way ADHD brains switch from “on task” to “off-task” mode. ADHD is unfortunately associated with negative outcomes including poor peer relationships, negative self-concept, and increased risk of depression and anxiety, particularly when untreated.
ADHD is developmental (meaning folks are born with it), rather than acquired, and it was long thought to be a problem predominantly impacting boys and men. Indeed, boys are diagnosed with ADHD about twice as often as girls. However, recent research suggests that many women (approx. 4.4% of adult women, by some estimates) have ADHD as well. However, they are more likely to be diagnosed as adults: often, not until their 30’s and 40’s, and in many cases, because a child was diagnosed. Moreover, ADHD tends to present differently in women and girls: they are less likely to have difficulty sitting still or following instructions, and more likely to struggle with what education and mental health professionals call executive dysfunction, which looks like problems with planning and organization, as well as difficulty with starting and completing projects and regulating their behavior and emotions. These girls and women often miss appointments and lose important items, and struggle to prioritize tasks at work, school, or in their personal lives. These symptoms are more likely to be “silent,” and therefore go undetected, because many of these girls are not disruptive (i.e., talking out of turn or out of their seats), as boys with a gender-typical ADHD presentation tend to be.
The later-in-life diagnosis of a developmental condition lends itself to unique challenges. In general, these women tend to have a long history of problems in school, at work, and in social relationships, and have spent many years (in some cases, many decades) asking themselves why they are “different”, why they “don’t fit in” and why it seems that they have to work so much harder than their peers at basic life tasks like scheduling social events and maintaining self-care. They are also uniquely vulnerable to mental health conditions like anxiety and depression. However, these women also tend to be incredibly resilient: they have had to figure out how to meet life’s challenges creatively, using their own unique coping strategies. Many women diagnosed as adults describe their diagnoses as “life changing” because they have an explanation for their previous struggles, strategies to manage their symptoms, and access to others managing similar challenges.
ADHD is strongly associated with creativity and “outside of the box” thinking, and when managed well these features can be incredible assets. Many famous women who are creatives, athletes, and leaders have ADHD, including actress Emma Watson, gymnast Simone Biles, and filmmaker Greta Gerwig.
Take-home point: the recent surge in ADHD diagnoses among adult women is NOT a trend spurred by social media, or anything else. It is as correction of our prior incomplete understanding of ADHD.
What if I think I have ADHD?
ADHD symptoms are non-specific (that is, they could be caused by other things, like anxiety, depression, or substance use). The key with ADHD is that the problems started in or before elementary school. You might try asking your parents/guardians, if you’re in touch, or even comparing your memories to things like old report cards, if you have them. Then, reach out to a neuropsychologist for a comprehensive evaluation that can rule out other potential causes and provide personalized, specific recommendations. The Clinic of California offers these evaluations and is in-network with many private insurers.
More here: CHADD – Improving the lives of people affected by ADHD
References:
Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of attention disorders, 27(7), 645-657.
Hallowell, E. M., & Ratey, J. J. (2022). ADHD 2.0: New science and essential strategies for thriving with distraction–from childhood through adulthood. Ballantine Books.
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