Why Does ADHD in Females Often Go Undiagnosed?
My struggle with ADHD has been going on for as long as I can remember, since I was in grammar school in the 1970’s. Back then only boys were getting diagnosed with ADHD, however, the numbers grew in the 80’s and 90’s. It was usually the hyperactive boys, getting in trouble with the teacher, yelled at for disrupting classes, not turning in assignments, having explosive emotional episodes, etc. The girls with ADHD were there too, but girls are taught from a younger age what it means to behave and act “normal”. When we struggled we didn't ask for help nor did we act out. We simply internalized and ate all of our emotions. We have not come a very long way since then, unfortunately. ADHD plays out differently in all individuals, especially in boys and girls which carries into adulthood. Today, girls still go under the radar for ADHD and women in their mid ages are still undiagnosed. It is researched and documented that “a staggering 50-75% of women go undiagnosed” (Clinical Partners, 2016).
ADHD in Males vs. Females
Women are born to be the caretakers in our world. We are taught from an early age to be a good girl and not to act out, or cause problems. Many girls tend to play more quietly and cautiously with their peers. We learn over time to take care of others and put ourselves on the back burner. This is reinforced throughout our lives. Women learn to become internalizers with their emotions, not wanting to burden others. They learn to mask extremely well, not to cause the spotlight on them, nor draw attention to themselves. When girls and women internalize and struggle within, they can wreak havoc within their bodies, physically and emotionally. Many girls and women suffer from anxiety and it builds up over time. Many times this inability to feel good or cope properly causes depression. Eating disorders are common, addiction is common, as well as substance abuse, self harm, and at times even suicide. Research from Canada’s Archives of Suicide Study, reiterated by Lilly Constance on ADDitude magazine, states, “One in four women with ADHD has attempted suicide”(Constance, 2022). Boys who exhibit their hyperactivity externally are still getting diagnosed faster. Boys seem to be more impulsive, physically and emotionally, where girls tend to internalize. The boys that don't have that hyperactivity and are more inattentive are also not picked up as quickly; although faster than girls. As time goes on the boys that turn into men, seem to turn their fear into anger. Women who internalize seem to get more anxious, they continue to internalize and cause themselves more anxiety and more hyper activity within their brains. Boys are diagnosed three times more than girls. Doctors pick up on it by their hyperness, impulsivity, their restlessness (Medical news today, 2021).
Why ADHD in Females Often Goes Undiagnosed
It is still believed that women who are strong, determined, go-getters, can own their own home and excel in business can not have ADHD. This is NOT true. Many women with type A personalities have learned to cope and mask to make themselves do better. They try to prove to themselves and others they are good enough and worthy enough. However, by doing this and taking on so much stress, their internal hormones change. Their estrogen can go down, their cortisol can go up. Making their lives unmanageable and feeling like they have lost all control. We can be crumbling on the inside and, on the outside, people think we are perfectly fine and well adjusted, even happy. Women who continue to be undiagnosed, can become more anxious, more depressed, more overwhelmed and simply lose their gumption for life. We all deserve huge, golden, and shiny Emmy awards for the performance we put on.
What Can an ADHD Coach Do to Help Someone with ADHD?
A certified ADHD coach knows how the ADHD brain is wired differently. They slowly provide you information and research helping the client put their personal stories together. We begin to heal and forgive ourselves for not knowing, not understanding, and realize that many of our struggles come from ADHD and not learning the coping skills nor mechanisms to strive. A coach helps you put all those scattered pieces together and connect the dots. “A-ha” moments begin and validate the client. The client begins to unveil all the layering they have built around them in self protection and they start to reach within and comfort their inner child. The coach partners with the client and assists them with their thoughts and beliefs. Challenging them to dig deeper and get to the real root of issues. Medication is not the only key to helping ADHD, in fact many people can't take medication nor does it work for them. Working with an ADHD coach can be the best solution to moving forward for a more balanced and joyful life. As individuals with ADHD, we also need to own our ADHD and want to make changes within ourselves to live a better life. Educating oneself on all the information there is about ADHD is also another key. With education comes clarity and the ability to understand how your ADHD plays out in your life. We also must guide ourselves back towards the things we are simply good at, and learn to ask for help for the tasks that we are not good at. Exerting all our energy into making ourselves great at the things we struggle with is exhausting and a lot like a dog chasing its tail. So focus on your strengths and what gives you joy!
ADHD Advocacy and Call to Action
It is time to push aside the guilt and the shame that comes with ADHD. It is time for women to ban together and demand equal treatment and answers from our Medical Professionals. It is not ok if they don't know how ADHD plays out in mid age women. It is not ok that girls are still going under the radar and women are being misdiagnosed with anxiety, depression, and even bi polar disorder. The facts, research, studies are all there. How do we get the medical professionals to step up and take action to fix the mental health crisis we are in?!
From age 42-51, I sought help for my “uncontrollable anxiety”. I went to 7 psychiatrists, 2 psychologists, 2 primary care doctors, 1 obgyn, and 1 bio identical hormone Doctor. I was misdiagnosed with Bipolar disorder twice, given mood stabilizers as well as tranquilizers to manage this anxiety. Not one person suggested I may have ADHD?!?!!? Ok what?! WHAT?!?!?!
They all missed it. Luckily, I am a fighter at heart and I don't let obstacles stand in my way. I continued to be my own health advocate and not accept the answers they were giving me. I knew there was something else going on and I continued to march on. I was working with my own ADHD coach at the time, still navigating to get properly diagnosed, and I felt like ADHD life coaching gave me the extra fuel I needed to stay on course and demand the best for me.
References
Partners, C. (2016, September 7). Why is ADHD in women undiagnosed so often? Clinical Partners - Psychiatrists, Psychotherapists & Psychologists in London and across the UK. Retrieved March 29, 2023, from https://www.clinical-partners.co.uk/insights-and-news/item/adhd-in-women-why-is-it-so-undiagnosed
Constance, L. (2022, November 17). Study: Nearly one in four women with ADHD has attempted suicide. ADDitude. Retrieved March 30, 2023, from https://www.additudemag.com/adhd-in-women-suicide-risk/
