MHM Magazine

Attention Deficit Hyperactivity Disorder (ADHD) is often associated with childhood, predominantly affecting boys according to current diagnostic statistics. However, ADHD in women presents distinct challenges and frequently goes undiagnosed or misdiagnosed due to its unique symptom profiles and the influence of societal expectations. Women with ADHD often experience more subtle symptoms, such as chronic disorganisation and overwhelm, which can be exacerbated by hormonal changes throughout their lives. These factors contribute to the under-identification and lack of treatment for women with ADHD. PSYCHOLOGICAL CONDITIONING & SOCIALISATION From a young age, girls are often conditioned to conform to societal norms that value quietness, compliance, and attentiveness. As a result, women with ADHD may learn to suppress their symptoms to meet these expectations, leading to internalised stress and self- criticism. Gender roles can further mask ADHD symptoms in women, who are socialised to be nurturing and organised - unlike their male counterparts, who may receive a more lenient "boys will be boys" response. This psychological conditioning drives many women to develop coping mechanisms to “mask” their symptoms. They often manifest as perfectionism, overplanning, or constant overthinking, which may lead to misdiagnoses of anxiety or depression, while the underlying ADHD remains unaddressed. PRESENTATION OF FEMALE ADHD AND MISDIAGNOSIS The presentation of ADHD in females differs considerably from that in males. Hyperactivity in boys is often overt and physical, but for women, hyperactivity tends to be more cognitive. Women report mental restlessness, making it difficult to focus on a single task. Verbal impulsivity is also common, leading to excessive talking or interrupting conversations, symptoms that may be mistaken for sociability rather than ADHD. Chronic disorganisation is another hallmark of ADHD and is particularly evident in females. Women with ADHD often face challenges in household management, such as maintaining an organised home, managing chores, or keeping track of important documents. These difficulties are compounded by societal expectations for women to maintain an orderly home. Time management issues are also prevalent, with women finding themselves running late or forgetting appointments due to time blindness. Emotional dysregulation is a significant feature of ADHD in women, leading to intense emotional reactions such as excessive frustration, sadness, or irritability in response to everyday situations. Mood swings are also common, often exacerbated by hormonal fluctuations throughout the menstrual cycle, pregnancy, By Juané du Randt Registered Counsellor & Project Lead, Goldilocks and the Bears Foundation, Cape Town ADHD IN WOMEN: UNIQUE CHALLENGES AND MISDIAGNOSIS ISSUES MHM | 2024 | Volume 11 | Issue 5 | ADHD in women: Unique challenges and misdiagnosis Issues MHM Is ue 5 | 2024 | MENTAL HEALTH MATTERS | 19 MHM