Over the years, more has been written about attention deficit hyperactivity disorder (ADHD) in women and girls. From Nadia Sawalha opening up about her experience to Zoe Ball and Sheridan Smith talking about their diagnoses, high-profile individuals have helped raise awareness of the condition that has long been associated with men and boys.
“ADHD is a neurodiverse or neurodevelopmental lifelong condition where the brain of the individual has developed differently to most ‘typical’ people,” explains GP Dr Aarthi Sinha from Church Crescent Medical (churchcrescent.co.uk). “This causes various symptoms affecting their behaviour, from restlessness to trouble concentrating, which can differ in adults and children.”
It is estimated that 3 to 4% of adults in the UK have ADHD, with the male-to-female ratio being around 3:1. But this doesn’t necessarily mean that women are less likely to have ADHD – they may be going undiagnosed. Demand for an ADHD diagnosis is high, and there has been a 51% increase in prescriptions for ADHD medication, but Dr Sinha is keen to stress that the recent rise doesn’t mean that there is an “overdiagnosis” of the condition. “This is just unrecognised ADHD and increased awareness among the public and in the healthcare profession, leading to a growing number of ADHD cases,” she explains.
Dr Anita Raja (dranitaraja.com) adds, “We saw a rise in ADHD diagnoses in women during the pandemic; many of these were due to missed diagnoses during childhood. “Thanks to raised awareness of the discrepancies in diagnoses between men and women, a lot of women are now more mindful of their requirements and are seeking answers as to why they may have set patterns of behaviour.”
‘I have learnt to embrace my ADHD. It’s part of who I am’
Hayley Smith, 36, from marketing and PR firm beyellow.life was diagnosed with ADHD last year. Here, she tells her story...
“I felt very broken for a long time. I kept thinking, ‘Why am I not listening to people? Why am I not processing? Why can’t I focus?’ But it hadn’t even occurred to me that I could have ADHD because I didn’t understand enough about it – I’d always associated it with boys and men. As a result, it made my anxiety worse and I would get really sad. I just knew there was something different about me.
“That all changed last year. I was seeing a psychotherapist and, a few sessions in, he said, ‘Have you ever considered that you may have ADHD?’ He matched the symptoms with my behavioural patterns and it was like a light bulb went on in my head. Suddenly everything made so much sense. For the first time in my life, I felt really seen.
“Getting a diagnosis has changed my life. While I’ve chosen not to go on medication, I have learnt to embrace my ADHD. It’s part of who I am and I don’t want to dampen that. Being aware of it has allowed me to put the steps in place that are needed to help with things such as my focus and concentration. It’s made me more forgiving of myself, too.
“It’s also changed my relationship. My husband used to get frustrated when I forgot things or wasn’t listening. It was detrimental because he just thought I was being a bad partner. Now it makes sense to him and I can be more observant, too. Yesterday he was talking to me and I said, ‘I’m really sorry but I have no idea what you just said. Could you repeat it, please?’ Being aware has really made a difference.”
Five things you should know about ADHD in women
1. Symptoms
ADHD looks different in everyone, though there are some things to look out for. “There are two main categories of symptoms: trouble concentrating or focusing with inattentiveness; and hyperactivity and impulsive behaviour,” explains Dr Sinha. “Symptoms in women may include feelings of inadequacy or worthlessness, a lack of motivation, failing to meet deadlines, perfectionism, tearfulness, hypersexuality, shyness, eating disorders and difficulty switching off,” adds Dr Raja.
2. Diagnosis
Compared to men, ADHD may manifest itself differently in women. "Girls and women can often have more subtle symptoms of ADHD with mainly a lack of focus and problems with concentration,” adds Dr Sinha. “They are also more effective at masking symptoms. A combination of these factors mean that girls and women are often diagnosed later or, in many cases, can have a missed diagnosis, which may only be considered at a time of crisis. This is not ideal.”
3. Age
The average age for an adult woman in the UK to be diagnosed is 36-38, as their symptoms often go undetected. “ADHD can be very severe, causing low mood, difficulty maintaining a job and difficulties in relationships and social interactions,” explain Dr Sinha. “A diagnosis is often a relief. People suddenly understand themselves better, good news for mental and physical wellbeing.”
4. Menopause
The menopause can also cause a worsening of symptoms. Some may feel their ADHD is better when their oestrogen levels are higher, though during the menopause oestrogen levels decrease. Along with the other physical changes that come with the menopause, those with ADHD may find issues with concentration as well as low mood and anxiety. With that in mind, treatment, including HRT, is available to help combat symptoms of the menopause.
5. Treatment
If you think you or someone you know has ADHD, help is out there. “The main goal of any treatment for ADHD is to support that individual with daily aspects of their life. This can be done through a combination of therapy and medication,” explains Dr Sinha. “There are five medications licensed to treat ADHD. The medicines generally work by acting on parts of the brain and various hormones to improve attention, concentration and focus.”