ADHD in women and girls can differ significantly from ADHD in men and boys. ADHD in women and girls can present with very different challenges.
We know very little about ADHD in women because so few studies have been done on this population. Women are only now being diagnosed with ADHD and treated. Most of what we currently know about this population comes from the experience of mental healthcare professionals specializing in treating women.
Information includes
Common symptoms and patterns in ADHD in Adult Women
Treatment of ADHD in Adult Women
Strategies for everyday living
ADHD and Women
The reasons behind this are unclear. Females with ADHD, who are still young girls, are not diagnosed before they reach adulthood. A woman may only recognize her ADHD when one of her kids has been diagnosed. She begins to recognize similar patterns as she becomes more knowledgeable about ADHD.
Women may seek treatment for ADHD if their lives seem out of control. Their finances could be chaotic, their paperwork or record-keeping may be poorly managed, they may find it challenging to manage their work, and they may even feel unable to handle the daily tasks such as laundry, cooking, and managing their life(5). Some women hide their ADHD by working late into the night to meet ever-increasing demands and spending their spare time “getting organized.” Women often describe themselves as overwhelmed and tired, regardless of whether their lives are in order or if they can hide the chaos.
Many clinicians find that women with ADHD have coexisting disorders and significant concerns. Women with AD/HD may suffer from compulsive eating, alcohol abuse and chronic sleep deprivation.
The rates of anxiety and depression disorders in women with ADHD are similar to those found in men with ADHD (10). Women with AD/HD seem to have a lower self-image and experience more significant psychological distress than men with AD/HD (11,12).
Women with ADHD are more likely than women without ADHD to experience depressive symptoms in adulthood, to be more anxious and stressed, to have a more significant external locus (which is the tendency to attribute success or failure to external factors, such as chance), to have a lower sense of self-worth, and to engage in more emotion-oriented coping strategies (such as self-protective actions to reduce stress), rather than task-oriented coping techniques (such taking action to solve problems).
According to studies, ADHD in one family member can cause stress for everyone(13). Women have higher stress levels because of their greater responsibility at home and with children. Recent research has shown that husbands with ADHD women are less tolerable than their wives with AD/HD. Chronic stress affects women with ADHD both physically and mentally. Chronic stress, such as that caused by AD/HD, puts women at greater risk of chronic stress-related diseases like fibromyalgia (15).
It is more apparent than ever that women with ADHD are at risk of severe health problems due to ineffective identification and treatment.
The Challenges Women with ADHD Face in Receiving Adequate Treatment
ADHD affects mood, cognition, behaviour, and everyday life. Treatment for ADHD in women can be multimodal, including medication, psychotherapy and stress management. It may also include AD/HD coaching or professional organizing.
Women fortunate enough to be diagnosed with ADHD often struggle to find a professional to offer the proper treatment. Few clinicians are experienced in treating adults with ADHD. Even fewer are familiar with the specific issues women with ADHD face. Most clinicians tend to use psychotherapeutic techniques. These approaches may help understand emotional and interpersonal problems. Still, they don’t allow women with ADHD to learn how to manage their ADHD daily or live more productive and satisfying lives.
ADHD-focused therapy is being developed to address many issues, such as self-esteem and interpersonal issues, daily stress levels, health habits and life management skills. These interventions are sometimes called “neurocognitive therapy,” which combines cognitive behavioural therapy with cognitive rehabilitation methods(5,16). Cognitive behaviour therapy primarily focuses on psychological issues related to ADHD (such as self-acceptance and self-blame). In contrast, cognitive rehabilitation focuses on improving cognitive skills (such as remembering, reasoning and understanding, problem-solving, evaluating and using judgement), learning compensatory techniques, and restructuring the environment.
Treatment of Women with ADHD – Medication Management
Women with ADHD often have more complex medication issues than men. The treatment of coexisting conditions should be considered in any medication plan. Women with ADHD are more likely to suffer from coexisting anxiety and depression, and other states, including learning disabilities(17,18,19). Women with ADHD are more likely to suffer from alcohol and drug abuse disorders, which can be present as early as age 12. A careful history of substance usage is, therefore, essential.
The medication may be complicated by hormonal fluctuations throughout the life cycle (e.g. puberty and perimenopause), with ADHD symptoms increasing when estrogen levels drop(21). Some cases may require hormone replacement to be included in the ADHD medication regimen.
To learn more about the treatment of ADHD in adult patients, please read the fact sheet.
ADHD treatment options
One or more of these treatment options may benefit women with ADHD.
Parenting training. In most families, the mother is the primary parent. The mother is expected to manage the family and household. This requires focus, organization, planning, and juggling many responsibilities. ADHD interferes with many of these abilities and makes it difficult for mothers with ADHD to do their jobs.
A woman with ADHD may also face more parenting challenges because ADHD is hereditary. Some women may require parenting and household management training for adults with ADHD. Parents with ADHD can also benefit from the evidence-based programs that have been proven successful in managing children with ADHD. Recent research has shown that these parent-training approaches may be less effective when the mother exhibits high AD/HD symptoms. It may be necessary, therefore, to integrate adult AD/HD management strategies into parenting programs for mothers with AD/HD.
Group therapy. Females with AD/HD have social problems that worsen with age. Women with AD/HD experience more self-esteem issues than men, and they often feel ashamed compared to other women. Women with AD/HD often feel rejected and embarrassed. Psychotherapy groups explicitly designed for women with AD/HD can provide a therapeutic environment where they feel accepted and understood by other women.
AD/HD coaching. AD/HD Coaching, a brand new profession, was developed to meet the needs of adults with AD/HD who need structure, support, and focus. Coaching is often done by phone or email. Read the resource and information sheet “Coaching and AD/HD among Adults” for more information.
Professional organizing. The organizer profession has expanded to meet the demands of the modern world. Women with AD/HD often struggle with extreme disorganization. Some women can maintain order at work but not at home. Disorganization can be widespread for some people, increasing the difficulties and challenges of AD/HD. Professional organizers can help you sort, file, store, and discard items at home or in the office. They will also set up systems which are easier to maintain. For more information, see the “Organizing Home and Office” information and resource sheet.
Career guidance. Career guidance. Just as women with AD/HD need exceptional guidance to be a parent, they can also benefit significantly from career advice. This will help them maximize their strengths and reduce the impact of AD/HD at work. Most professional and office positions require a person to perform tasks and responsibilities, which are difficult for someone with AD/HD. These include paying attention, organizing, and paperwork. A career change or a job switch can be necessary to relieve the daily stress that most people with AD/HD experience in the workplace. Career counsellors who are familiar with AD/HD can provide valuable advice. Consult the resource and information sheet on workplace issues for more information.
How women with ADHD can help themselves
Women with AD/HD can benefit from working with a professional in the beginning to develop strategies for managing stress and improving their quality of life. To reduce the impact of AD/HD, it is essential to develop strategies that are easy to use at home without the help of a professional. The following strategy would be beneficial to a woman with AD/HD(13):
Accept and understand your AD/HD issues instead of judging or blaming you.
Make a list of the stressors in your life and make changes to your life that will reduce your stress levels.
Simplify your life.
Family and friends can provide structure and support.
Get expert parenting advice.
Create a family that is AD/HD friendly and supportive of each other.
Set aside daily time for yourself.
Get enough sleep, exercise and eat well.
It would help if you focused on what you enjoy.
You can read more about it here:
AD/HD individuals have different challenges and needs depending on their age, gender and environment. AD/HD, if unrecognized or untreated, can have significant mental health and educational implications(1). Women with AD/HD should receive an accurate diagnosis that addresses symptoms and other important issues regarding functioning and impairment. This will help determine the appropriate treatment and strategy for each woman with AD/HD.