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Women and the later life diagnosis

Published: 14 Jun 2019 | ADHD & Me

The truth is that women are less likely to be diagnosed with ADHD than men for a number of reasons.

Of the women who do get diagnosed, research indicates that women are often diagnosed later in life rather than in early childhood, even for severe cases [1] [2]. We review the stories of those diagnosed from their late teens to their early 60s.

The earlier you’re diagnosed with ADHD the better. For some, however, ADHD symptoms only really come to the fore in later life. We highlighted recently how boys are between five and nine times more likely than girls to be diagnosed and treated for ADHD, depending on the setting [3].

ADHD has the perception of misbehaving boys running around the classroom. We know now that there are many other factors at play when we talk about ADHD – not just the obvious.

Many girls develop very effective coping strategies for ADHD, as highlighted by a physician at a recent meeting we attended. For example, they may put in extra effort revising for tests, develop their organisational skills or use other techniques to help them focus (fidgeting, routines, tics) without being aware.

These activities are what can be described as those living on the edge with their ADHD. From the outside, they are performing well and coping. In reality, they are exhausted and frustrated by how others seem to get by without putting all this extra physical and mental effort in.

At some point, the wheels can fall off. Years of developing coping strategies and trying to calm the mind in many ways work up to a point but eventually you can reach burnout and total frustration. Sometimes patterns can occur where the symptoms come to the fore; missed dental appointments, missing a friend’s birthdays, missing an important deadline at work and so on.

If the symptoms persist and persist, that’s often when a person recognizes something isn’t right themselves or when those close to them must have ‘the conversation’. For some it’s a light bulb moment and probably something they’ve thought deep down may be a problem but never sought help before. For others, it’s a slow realization of a problem that may have been ignored for years if not decades. So, what’s it like for women being diagnosed beyond their teenage years?

Arielle, diagnosed at 19

I didn’t show the classic signs people think of when they hear about hyperactivity. Instead of bouncing off the walls, I simply fidget constantly. I slept through most of school, but, if I was awake, I never was an attentive listener. 

An extract from The Guardian. Read the full article here: ‘I assumed it was all my fault’: the adults dealing with undiagnosed ADHD.

 

Maeve, diagnosed at 27

People think ADHD means you're bouncing off the wall, which for me isn't the case, I'm just restless. When someone hears the H, for Hyperactive, they picture someone screaming all the time, but I see it more as occasional bursts of excited energy. Those moments feel great to me. "

Read the full feature on BuzzFeed.com – a really interesting interview with 3 people diagnosed with ADHD in their twenties.

 

Victoria, diagnosed at 30

" Having been one of those people who thought it was an excuse for boys’ ‘naughty’ behaviour, it has been a revelation to learn about and understand it” … “I wish more than anything that the media, schools and other agencies were educated better on the topic and it became as understood and supported as autism. I think this would give families, friends and the rest of society the means to assist in and improve the lives of those who have it. "

Read the full article in The Guardian here.

 

Amy, diagnosed at 40

" I questioned myself constantly. I struggled to stay on top of things, to stay organized. Despite my best efforts, my room was always a mess, my car was dirty and important items went missing. I hid it from everyone (well, except for my roommates, because, as it turns out, you can’t magically make yourself organized by simply saying “I’m a neatnick.” They find out eventually that you are in fact a clutteraholic) "

" My brain is just wired differently. What an incredible gift to realize this. I only wish I had learned it at 9, instead of at 40. If only I had known then what I know now, maybe my self-talk would have been different all these years. Maybe I would have reached out sooner, would have tried to stop managing it with just “better organizational practices. "

An extract from How I Was Diagnosed With ADHD at 40. Read her full blog here at themighty.com

 

Tracey, diagnosed in her 50s

" I’m still fast. And I talk a lot. But I’ve done that for half a century. It makes make me more mindful! But, I’m not out of the woods yet. I’m still learning about my ADHD symptoms and I realize it explains a lot. Mornings are still very much an effort for me "

An extract from The Long Road to My ADHD Diagnosis. Read the full article here on add.org

 

Zophia, diagnosed at 63

" Everyone told me there was nothing wrong with me,” she said. “But I had such yearning, such anguish inside. I wanted to excel, but something was holding me back.” Zophia flipped on the TV one Saturday morning, and the host launched into a frank confession about her own ADHD. “The more I heard, the more I knew she was talking about me, too."

An extract from Inside the Aging ADHD Brain. Read the full article here on Attitude.com

 

A final note – no regrets

Having researched this topic, I’m very comforted to know that people are sharing their experiences of ADHD across all age groups. I believe it’s important to break the stigma surrounding ADHD, no matter what age you are.

A recurring theme in many of these articles is regret. Amy (above) says “I only wish I had learned it at 9, instead of 40’’. My view is that sufferers should have no regrets. Of course, it can be frustrating to learn many years later that you have the condition. The emphasis should always be to get those with ADHD diagnosed as early as possible. As we know though, some of the characteristics of ADHD (forgetfulness) can mean the symptoms are ignored or lead to the thinking akin to “I’ll get this checked out another day”.

With this in mind, sufferers shouldn’t be frustrated with themselves for not getting a diagnosis earlier; the important thing is to get the correct diagnosis no matter what your age.

It is critical, however, that we stop thinking of ADHD as a condition that predominantly affects men. This is simply not the case. We must continue to look out for the child whose symptoms are not quite as obvious.

  1. Nussbaum NL (2012) ADHD and female specific concerns: a review of the literature and clinical implications. Journal of Attention Disorders, 16 (2):87-100.
  2. Quinn PO, Madhoo M (2014) A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord, 16 (3)
  3. Gaub M, Carlson CL (1997) Gender differences in ADHD: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry, 36 (8): 1036-1045.