This ADHD Awareness Month, learn harder-to-spot signs that women, girls more often experience

October is Attention Deficit Hyperactivity Disorder (ADHD) Awareness Month, an opportunity to help develop better understanding of ADHD and to connect people in need with support. It is also a time to share information that helps people recognize that they or their loved ones might be experiencing ADHD. That has historically proven more challenging for girls and women with ADHD.

Boys are diagnosed with ADHD at a rate of over twice as often as girls, according to recent research. While that gap of diagnoses among genders narrows some with age, untreated ADHD can lead to significant challenges for girls and women. Research shows that girls and women with ADHD tend to be at a higher risk for:

• Eating disorders
• Anxiety
• Depression
• Suicidal thoughts and attempts
• Dying younger compared to boys and men with ADHD

Knowing signs to look for can help you determine if a loved one in your life could benefit from an ADHD screening. Centerstone’s Focus Clinic screens young patients for ADHD and works with individuals, families, and guardians to build treatment plans tailored to individual needs. Alicia Williams, the clinic’s program coordinator, and Erin Davis, a psychiatric nurse practitioner shared some advice about what girls and women with ADHD often experience, and how treatment can help.

Hyperactivity is not the only symptom of ADHD

Fidgeting, impulsiveness, and acting out in classroom or dinner table settings are frequently how educators or parents and guardians notice that young boys are exhibiting behavior that could be tied to ADHD, and they aren’t wrong. But Davis said the way ADHD symptoms often present in girls and women mean their issues can fly dangerously beneath the radar.

“Almost all studies on ADHD have been performed on pre-pubescent boys and there is a significant amount of information that gets missed because of that,” said Davis. “Women are conditioned early on that they should be ‘socially appropriate.’ So, at school, they may be able to sit still and not disrupt class, but, on the inside, they may be completely lost, confused, or daydreaming.”

Williams said women and girls are often more conditioned to developing people-pleasing tendencies and expectation-meeting strategies, and they are also often taught to internalize their feelings, which can create anxiety. “ADHD is a self-regulation disorder, and anxiety can create a sense of urgency which activates the brain and makes taking action easier,” she said. “Females are more likely to exhibit inattentive symptoms as well, which are often not recognized in school. Disruptive behavior is much more noticeable.”

Women and girls often experience ADHD more internally than men and boys. Here are signs to look for in your loved one, or yourself:

• Overthinking tasks and everyday decisions
• Difficulty getting started on projects that aren’t interesting or engaging
• Knowing what needs to be done but feeling unable to take action
• Feeling emotionally overwhelmed when multiple things happen at once
• Trouble staying present and focused during conversations
• Perfectionism and fear of making mistakes
• Chronic feelings of rejection or feeling like you’re “not enough” or “too much”
• Struggling to manage time, prioritize responsibilities, and follow through on tasks

Evaluation and treatment for ADHD can be life-changing

Clinicians who specialize in treating individuals with ADHD can help them develop a tailored treatment plan that helps them build routines, structure, and coping skills suited to their needs. Medication can also help regulate levels of dopamine and norepinephrine, brain chemicals that, when off, can make it harder to start tasks, pay attention, stay organized, and manage emotions. “Having your brain be calm and feel quiet for the first time is a feeling that is extremely powerful and hard to describe,” Davis said. “I have seen ADHD treatment help girls come back from extreme levels of behavior or mood issues who now are doing phenomenally in school, developing good relationships with their family, and becoming independent members of society.”

Medication isn’t the only way to address ADHD, but it can help when coping skills are unavailable 

Like many women with ADHD, Davis was diagnosed later in life. Before that, she graduated high school, completed boot camp and Advanced Individual Training in the U.S. Army, and earned undergraduate, graduate, and post-graduate degrees, all without medication. For structure and dedicated mental processing time, she ran. But after breaking her foot in her 30s, the daily demands of chores, schedules, and kids’ appointments became overwhelming. “Medication helped me understand that I can slow down sometimes and be more present,” she said.

Williams compared ADHD to diabetes. When a child with diabetes has low blood sugar and acts out, you treat the condition rather than punish the behavior. Likewise, she said, ADHD-related challenges are not deliberate misbehavior. Effective treatment often combines medication, education, and practical support strategies, helping people better understand how ADHD affects the brain and replace self-blame with self-awareness.

In seeking help for your child, you might learn that you could benefit from help as well.

ADHD, Davis said, is the second-most inherited genetic trait, behind height. As understanding about ADHD widens and more families and guardians seek care for their children, members of older generations are learning that they might have been living with ADHD themselves.

“It is one of my favorite things to watch the light bulb come on for a parent when talking about their child,” Davis said. “I love to educate about ADHD and during an evaluation, when I’m going over symptoms of ADHD like disorganization, motivation, procrastination struggles, big emotions, and social discomfort, I’ll sometimes see a mom say, ‘Um, can that happen to adults?’”

Williams said she’s experienced a mix of parents who assume they’ve lived with ADHD and others who were floored by the realization, especially when they bring in a hyperactive boy for evaluation and treatment only to learn more about internalized symptoms of ADHD. “They had no idea these things they’ve experienced their whole life are consistent with ADHD,” Williams said. “I have had some parents literally cry when suddenly their life experiences make sense.”

There is help available to evaluate and treat ADHD regardless of age or gender. If you see yourself or a loved one in this story, Centerstone’s trained counselors are here to help. Call 1-877-HOPE123 (1-877-467-3123) or visit our website to learn more about our counseling services.