Imagine you are a teacher looking over your 2nd-grade classroom during silent reading time. Most of your students, although occasionally chatty, have the ability to unwind after recess while you grade papers. One student, Lisa, doesn’t seem to be focused on her book, instead staring at a spot on the wall while absent-mindedly twirling her hair. Another student, John, is very obviously not reading. He keeps getting up from his chair, talking to other students, and creating a makeshift catapult from a ruler and eraser. Both John and Lisa got minimal work done. But as the teacher, which student might you recommend get evaluated for ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) affects millions of individuals worldwide, with an estimated 6 million children diagnosed in the United States alone, according to a survey from the Centers for Disease Control and Prevention. Of these 6 million, boys are significantly more likely to be diagnosed than girls, with almost twice the amount of diagnoses.
However, research has suggested that this discrepancy in diagnosis rates could be due to a disparity in symptomatology between genders, rather than an innate difference in frequency. While ADHD typically presents as hyperactivity, aggression, and rule-breaking in boys, women are more likely to have an “internalized” profile of symptoms such as higher levels of anxiety, daydreaming, and inattentiveness – symptoms that can be misattributed or just overlooked altogether. Because these traits are less likely to be disruptive to others, women are at a disadvantage in getting timely care for their ADHD.
The stereotypical face of ADHD.
Image Source: Catherine Delahaye
So, what happens to the women who go undetected until adulthood? A recent study in the Journal of Attention Disorders sought to understand this experience. Researchers interviewed 8 adult women who had received late diagnoses and then analyzed the participants’ responses to find common threads.
Before receiving a diagnosis, the participants echoed the sentiment that they thought there was “something wrong with [them]”, or that other people had to “put up with [them], rather than enjoying [their] company.” Women with ADHD are more likely than men to experience low self-esteem and social difficulties. Additionally, the subjects reported issues maintaining friendships, regulating their emotions, and staying academically motivated.
While seeking a diagnosis, many of the women in the study reported feeling that they weren’t being taken seriously by their providers. Some were even told that they weren’t “hyperactive enough” – even though not all forms of ADHD include hyperactivity. Stereotypes about who ADHD affects and how it presents seemed to leak even into assessments led by supposed “experts”.
This study reveals a compelling narrative: pre-diagnosis, the participating women had generally low self-esteem and academic performance. Although diagnosis comes with its own challenges (such as facing stigma), all participants reported that they benefited from receiving one. Moving forward, it’s important to keep in mind that just as “the squeaky wheel gets the grease”, it wouldn’t hurt to check on the other “wheels” from time to time.
Featured Image Source: NDABCREATIVITY
