There is a movement afoot among parents, educators, and therapists to create a separate diagnostic protocol for ADHD in girls and boys. This is because it is widely acknowledged that the current diagnostic criteria are biased toward symptoms exhibited by boys. Not only do the experienced symptoms of this disorder vary from person to person and from gender to gender, but the outward expression of those symptoms can vary as well.
All cases of ADHD consist of some mix of inattentiveness and/or hyperactivity and impulsivity. Some young people experience a mix of the two sets of symptoms (called “combined ADHD”), while others experience only inattentiveness (once referred to as “ADD” but now called “inattentive ADHD”) or only hyperactive and/or impulsive symptoms (called “hyperactive-impulsive ADHD”).
Since the hyperactive-impulsive symptoms of ADHD are the easiest to identify, those with combined ADHD and hyperactive-impulsive ADHD are more frequently and accurately diagnosed than those with inattentive ADHD. These symptoms include fidgeting, speaking out of turn, talking excessively, interrupting, difficulty engaging in relaxing activities, and other highly visible symptoms. Girls with ADHD tend to have the inattentive variety with much more subtle symptoms.
Adolescent girls and young women are therefore often misdiagnosed as having primarily a depressive or anxiety disorder when the underlying problem is a long-term struggle with ADHD. In addition to presenting subtle or easily misinterpreted symptoms, adolescent girls and young women with ADHD may go undiagnosed for other reasons as well. Females may work harder than males to hide academic difficulties. As part of their efforts to please, bright girls may work very hard and successfully to compensate for their ADHD, delaying the identification of the disorder until academic or work challenges reach a point where the ADHD becomes disabling. Sometimes this does not occur until adolescence or young adulthood.
ADHD in Girls: Next Steps
If you suspect that your daughter may have undiagnosed ADHD, exploring this diagnosis through testing from a professional educator or psychologist may be in order. Undiagnosed, the difficulty completing tasks, focusing, and staying organized can lead a young woman to feel confused, frustrated, depressed, and “dumb.” However, when properly diagnosed ADHD in girls can be effectively addressed through coaching, instruction, counseling, accommodations, diet, and sometimes medication. It can be an enormous relief for a young woman to realize that there is an explanation for her longstanding social, emotional, and learning difficulties, an explanation that leads to effective ADHD treatment.