Females tend to have Inattentive type ADHD, which is much more subtle than the Hyperactive type. These girls are usually quiet and dreamy with a tendency to doodle in class while appearing to be listening. While they procrastinate, they make sure to get their projects completed on time by spending hours doing them at the last minute. They will, however, be overwhelmed about the demands made on them as they progress through school and many will seem anxious and depressed as a result.
Like boys with Inattentive type ADHD, they may be poor timekeepers or over-compensate by being really early for everything. They usually seem to be organized when, in fact, they are not. They are often perfectionists, which is the reason that they appear very organized. At the same time, they have poor listening skills and find it difficult to follow instructions. They experience stress in a more intense way than their non-ADHD peers, but this is usually internal, not obvious at school. This takes its toll on them and these girls often have emotional outbreaks once they are at home.
Girls and women have more intense relationships and dramatic conflicts with friends, usually preferring to have one best friend. This will continue into adulthood when they are liable to develop Anxiety Disorder because of the pressures they put on themselves – to fit in, to get through school, to be accepted, etc. Some develop obsessive compulsive traits.
Some girls may have the combined Hyperactive-Inattentive type ADHD and these girls differ from their inattentive peers in that they will have a higher activity level, be excitable and emotional, interrupt others frequently and jump from topic to topic during conversation. They are more likely to be aggressive towards teachers they don’t like and may adopt a “silly” personality to mask their deficits. They get noticed, but still are usually not identified as having ADHD.
What all females with ADHD share are the following symptoms:
- not achieving at ability level
- having sleep problems (getting to sleep, staying asleep, quality of sleep)
- finding it difficult to concentrate during conversations, which affects friendships
- typically experiencing stress more acutely than their non-ADHD peers
ADHD in females of all ages also has links to emotional dysregulation and mental health problems. This may have a biological basis because research has shown that changes of estrogen levels in the brain can greatly affect girls and women with ADHD symptoms, making them more susceptible to severe premenstrual mood swings, depression and/or anxiety. During adolescence, girls with ADHD may lack the necessary coping strategies and as a result, they have more impairment on measures of social, school and family functioning than girls without ADHD. Maintaining friendships in adolescence is impaired/hindered by their forgetfulness, missing dates with friends, apparent lack of interest in what their friends have to say, the appearance of self-centeredness, all of which makes maintaining friendships difficult for them.
If a girl with ADHD is left undiagnosed and untreated as she enters young adulthood, she will almost inevitably encounter a range of adjustment problems that can lead to additional disorders such as eating disorders (bulimia, anorexia), or personality disorder. Other behaviours typical of these girls include early sexual activity driven by a need to feel good, a misguided sense of wanting to be liked and to be popular. This sometimes impulsive behaviour leads to unprotected sex, a higher ratio of teenage pregnancies, sexually transmitted infections and an early smoking habit developed during their school years.
This results in undiagnosed ADHD in adult women who may be single parents, be undereducated, underemployed or unemployed, suffering from sleeping disorders, experiencing constant stress due to difficulty managing the demands of daily life expected from society.
Those who have a high IQ can very well reach university before they begin having difficulties. Many may appear to have successful careers, but the internal struggles still cause them to be less resilient than their colleagues. Burnout is a common occurrence for these women and some may even be lucky enough to get an ADHD diagnosis when this happens. However, they are more likely to be misdiagnosed. Who would even entertain the thought that women in high profile positions could possibly have ADHD?
This is the dilemma that many women are facing. While the typical indicators for women may differ depending on their ability to compensate for their difficulties, there are a few that all women share:
- the tendency to change jobs frequently
- having to work longer on projects than their non-ADHD peers
- always seeming to be on the outside looking in
- comfort eating and/or comfort drinking alcohol
- overexercising or none at all
- difficulties in their marriages, divorce, etc.
- struggling as mothers to fit the mold
- forgetful, easily distracted and often late