Why More Girls — and Women — Than Ever Are Now Being Diagnosed With ADHD

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Attention deficit disorders are typically thought of as a “little-boy thing,” as Rae Jacobson noted in a piece for the Cut last summer. Consider the cultural stereotypes, for example, of ADHD: It’s a hyper boy who can’t sit still and can’t focus. In girls, on the other hand, the symptoms can look different, in part because many girls do their best to hide them. 

And so, until very recently, the signs of ADHD have often been missed in girls. But according to a study in The Journal of Clinical Psychiatry, diagnoses of attention deficit hyperactivity disorder shot up 55 percent for girls between 2003 and 2011. In those same eight years, 40 percent more boys were diagnosed. Among women ages 26 to 34, ADHD prescriptions spiked up 85 percent between 2008 and 2012 alone.

While ADHD diagnoses on their own may not seem all that troubling at first glance, experts note that ADHD plays out very differently in girls and can lead to very different, “horrendous” outcomes for women, Ellen Litman, a clinical psychologist and co-author of Understanding Girls With AD/HD, told Quartz.

Writer Jenny Anderson explains the gender differences:

Unlike boys, many of whom show hyperactivity, girls’ symptoms veer more toward inattentiveness and disorganization. Girls tend to develop ADHD later than boys. They frequently mask it in an attempt to conform to society’s expectation that they be on the ball and organized. And while some ADHD symptoms can become less intense for boys after they pass through puberty, for many girls, it gets worse.

And the biggest problem in all this is that many girls don’t actually know what they are suffering from is ADHD, leading to questions about why they aren’t able to succeed or act like their peers and a slew of self-esteem issues, potential eating disorders, being involved in emotionally abusive relationships, and — at the most frightening end of the spectrum — suicide attempts.

I think we have a lost generation of women who are diagnosed with ADHD later in life, who have had to manage the condition on their own and deal with it on their own for the majority of their lives,” Michelle Frank, a clinical psychologist specializing in ADHD, said in the same Quartz piece. “The diagnosis is a blessing and a curse: it’s a great relief, but they wonder what could have been different if they had only known.”

Much like with autism, early research on ADHD focused heavily on young white boys; just one percent of research focuses on girls. That means the American Psychiatric Association’s guidelines for ADHD were male-centric — only recently did the diagnosis criteria change from symptoms being noticeable by age 7 to age 12, to account for the later onset in girls. The irony is that reports suggest ADHD is being overdiagnosed in boys and underdiagnosed in girls.

Now adult-onset ADHD is being diagnosed in higher-than-ever rates, with it coming as both a relief and terrifying prospect for women who have spent years hiding their struggles. Many ADHD-affected women are very successful at using structure to do well, but when faced with dealing with the life-work balance, they aren’t able to cope. As Jacobson wrote in her first-person piece for the Cut, she was told to “just chill out” when she confesses her panic at the onset of a new job to a beau. “You don’t have ADD. You’re just lazy. Besides, isn’t that a little-boy thing?”

It’s not, and until society and medicine sensitize themselves to the differences and devote more time and effort to figuring out the ADHD spikes in women and girls, it might only get worse.