Understanding ADHD in girls: What you need to know

ADHD in girls looks different to ADHD in boys. And because of that, girls with ADHD are generally underdiagnosed and undertreated – their symptoms are overlooked, or underdiagnosed, or they are misdiagnosed with another comorbid psychiatric disorder. This leaves them at a severe disadvantage, which left untreated, could carry into adulthood. So, what are the key symptoms and complications of ADHD in girls?

Distinct symptoms and why it goes under diagnosed

There are three types of ADHD: inattentive only, hyperactive-impulsive, and thirdly, a combination of the two. ADHD is often missed in girls because they’re more likely than boys to have inattentive ADHD, the main symptoms being poor attention to detail, limited attention span, forgetfulness, difficulty starting or finishing tasks, and distractibility. With girls, it can also look like:

• daydreaming in class
• apparent ditziness/silliness
• feeling anxious or sad (emotional disregulation)
• picking at cuticles or skin
• being a perfectionist
• difficulty making and keeping friendships
• risk-taking
• chronic disorganisation
• trouble following directions

Hyperactivity is demonstrated differently too: a girl may be excessively talkative, compared to a boy with ADHD who blurts out answers or taps away at his desk. Because many of the symptoms of ADHD in girls are less visible or more subtle than boys, they are more likely to use coping strategies (such as working harder, or avoiding people or challenging tasks) that help hide their symptoms.

This has significant consequences for her, such as:

• Poor academic performance. This often only gets noticed when she struggles in high school. A late diagnosis means that she didn’t get the accommodations to help her succeed.
• Difficulty making and keeping friends. Friendships amongst girls are more complicated, requiring more understanding of social cues, greater bonding, greater self-control, all of which can make maintaining friendships difficult for girls with ADHD.
• Low self-esteem. In an article published by Child Mind Institute, experts say that a late or missed diagnosis may jeopardize girls’ and young women’s self-esteem and, in some cases, their mental health, since “…girls are more likely to blame themselves turning their anger and pain inward. Girls with ADHD are significantly more likely to experience depression, anxiety and eating disorders than girls without”.
• A misdiagnosis with a different mental health condition. Women with ADHD are often misdiagnosed with depression, anxiety or bipolar disorder – which are also common co-morbidities – which means that they will receive treatment that doesn’t work for their symptoms and they continue to look for answers.
• Hormonal effects on ADHD. The menstrual cycle has a significant impact on ADHD symptoms, and ADHD medication also makes it more likely that she’ll have premenstrual syndrome (PMS). PMDD, a severe form of PMS, disproportionately affects women with ADHD and autism. Further reading: How to help your daughter with ADHD manage her period & PMS

Girls with ADHD often go undiagnosed, with estimates suggesting that between 50 to 75% are affected. However, increased awareness of the unique symptoms in girls can lead to improved diagnosis, treatment, and support, ultimately leading to significant improvement in academics, relationships, and overall mental health and well-being.

References

1. Ali, Z. (2023). ADHD in girls: How is it different? Medical News Today . Accessed on 3 July 2023.
2. Connolly, M. (2019). ADHD in Girls: The Symptoms That Are Ignored in Females. . Accessed on 3 July 2023.
3. Jacobson, R. (2023). How Girls With ADHD Are Different. Child Mind Institute. Accessed on 3 July 2023.
4. Mandriota, M. (2022). What I Wish People Knew About Gender and ADHD. Psych Central . Accessed on 24 July 2023.
5. Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3), PCC.13r01596.
6. Raypole, C. (2021). Attention Deficit Hyperactivity Disorder (ADHD) in Girls: Symptoms, Treatments, and More. Healthline . Accessed on 3 July 2023.