The Neglected Gender: Girls, Women and ADHD

Imagine a person with ADHD, sitting at a desk in a crowded classroom, struggling with some of the symptoms of the disorder: trouble paying attention…forgetfulness…difficulty staying quiet when the teacher or another student are talking…squirming and fidgeting.

Now ask yourself: Is the person at the desk a boy or girl?

If you imagined a boy, you’re not alone. Unless you have a daughter with ADHD, or you’re a woman with ADHD, a boy is the person most people think of when they think ADHD. But that common conception doesn’t match the scientific facts.

ADHD is not a “boy” disorder. Girls and women get ADHD, too-and the number of females diagnosed with the disorder is on the rise. In this and the next blog, I’ll be discussing the unique nature of ADHD in girls and women-and the best treatment options, many of them from my forthcoming book Finally Focused: The Breakthrough Natural Treatment Plan for ADHD That Restores Attention, Minimizes Hyperactivity, and Helps Eliminate Drug Side Effects (Harmony, May 2017).

As you know if you’ve got a child with ADHD, or you yourself have ADHD-the disorder can negatively impact school, work, family and friends. And that’s true of ADHD girls and women, too. For example…

An 11-year study showed that as girls with ADHD become women with ADHD, they have…a seven times greater risk of “antisocial personality disorder” (with symptoms including impulsivity and hostility)…a seven times greater risk of a “mood disorder” such as depression and bipolar disease…are three times more likely to have an eating disorder or addiction…and are twice as likely to have an anxiety disorder. (Biederman et al., 2010)

How many girls and women are we talking about? Studies show that approximately  two to three percent of girls and women have ADHD-in other words, millions of people. In fact, a recent study showed the rate of diagnosed ADHD rising rapidly in girls and women, as more clinicians become savvy to the fact that ADHD is a gender-neutral disorder. (Williamson et al., 2015) Bottom line: ADHD is more commonly diagnosed in boys than girls, but seems to affect women at about the same rate as men.

And here’s another surprising fact: in a recent five-year period, the biggest rise in prescriptions for adults with ADHD was among women aged 26 to 34. In fact, women far outnumbered men in their use of ADHD treatments. After age 18, the number of men using ADHD medications declines sharply-while the number of women using them rises sharply. When researchers looked at the percentage of 19- to 25-year-old ADHD women taking ADHD drugs, it was higher than the percentage of ADHD girls. (Express Scripts, 2014)

Why does the “gender gap” narrow among adults with ADHD, with more women diagnosed and treated? Experts suggest several reasons…

It might be a straightforward biological difference, with ADHD more prevalent among boys and women. It might be bias-a tendency on the parts of parents, teachers and physicians to identify ADHD-like behavior in boys and not girls. It may be that diagnostic guidelines are gender-biased, describing how ADHD manifests in boys, but not girls-and therefore more boys are diagnosed.

My opinion: the difference is explained by gender-bias, not biology. A nearly equal number of boys and girls may have the symptoms of ADHD, but girls have been neglected-not diagnosed, and not treated. Behind the boy fidgeting in his seat may be a girl with a wandering mind who needs help, too-but isn’t getting it.

That’s because girls are much more likely to have the “inattentive” sub-type of the disorder than the “hyperactive-impulsive” sub-type. A boy is more likely to be fidgeting, running around inappropriately, talking loudly or excessively, or otherwise being disruptive. A girl is more likely to be dreamy and forgetful, with careless mistakes and poor follow through in her schoolwork-and is labeled “moody” or “lazy” or “unmotivated” rather than diagnosed with ADHD.

Well, it’s time for that mistake to be corrected-it’s time for girls and women to get the help they need.

For focus and full potential,

James Greenblatt, MD

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