Most Women With ADHD Get an Accurate Diagnosis in Their Late Thirties or Early Forties

A few months ago, I learned that my eldest daughter, Danni, now 36, was newly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

Looking back, I can appreciate how my daughter’s developmental needs as a young, timid, and anxious little girl struggling with ADHD were not met.

She had little opportunity, as a child, to ask for help because she was living with an older brother with ADHD. And my son’s disruptive, attention-grabbing and aggressive behavior typical of boys with ADHD left little room for other siblings’ needs. He was five years old when diagnosed with ADHD and remained under the care of a pediatrician until he left high school at age seventeen.

Danni recalls her life growing up as being a living hell inside her head.

Externally she presented as a woman with her shit together. But, according to Danni, it was all a façade. She was, under the surface, treading water every day, desperate not to be consumed by feelings of failure, sadness, and chronic low self-esteem.

As a parent, I’m heart-sore that I missed the clues. But on another level, it makes perfect sense to me. I matched up with many of the symptoms of ADHD as a young girl growing up. Perhaps, it explains why I normalised what I saw in my daughter’s formative years.

Because how a female like Danni exhibits ADHD can be different from that of a male.

So what is ADHD, and how does it affect girls?

ADHD is typically broken into three sub-groups:

• Inattentive type: predominantly inattentive symptoms (getting distracted, having poor concentration and organisational skills)
• Hyperactive-impulsive type: predominantly hyperactive/impulsive symptoms (never seeming to slow down, talking and fidgeting, difficulties staying on task, interrupting, taking risks)
• Combined type: a mix of hyperactive/impulsive and inattentive symptoms

Other common symptoms in girls

• Daydreaming a lot
• Being easily distracted
• Being forgetful
• Having trouble following instructions
• Appearing not to be listening when spoken to
• Starting tasks but not finishing them
• Having trouble paying attention to details
• Appearing spacey or absent-minded
• Trouble maintaining and forming friendships
• Being overly sensitive
• Having low self-esteem
• The habit of abandoning tasks midway
• Distracted or slow movements
• Difficulty completing school homework
• Disturbed Sleep

Can’t stay organised, focused or self-regulate?

ADHD is not a behavioural condition; it’s not a mental illness, or even a specific learning disability. It’s a developmental impairment of the brain’s self-management system or executive function — your ability to stay organised, keep focused, and self-regulate.

Monash University professor of cognitive neuroscience Mark Bellgrove says it’s generally thought ADHD involves a fundamental disruption to neurotransmission. “We think in ADHD that dopamine and noradrenaline levels in the brain are probably reduced.”

The trouble with girls

ADHD in girls is often characterised by daydreaming, disorganisation, and forgetfulness rather than the hyperactive and impulsive behavior more commonly seen in boys with ADHD. Though that’s not always the case.

It’s mostly all happening on the inside for girls with ADHD. Some might seem messy, lost in thought, impulsive or sad. Girls with the condition may also be more prone to anxiety and depression.

Girls grow up to be women, and women with undiagnosed ADHD may experience anxiety and depression at a higher rate because of the constant overcompensating of what they’re doing to keep up with gender norms.

According to ADDitude Magazine, too many women grow up being called lazy, selfish, spacey, or dumb because their symptoms are ignored or disregarded.

So, are girls with ADHD overlooked? Compared with boys, girls more frequently present with inattentive symptoms rather than disruptive behaviors or problems in school. It has been suggested that this could lead to a gender-based referral bias.

Studies show that women with ADHD tend to have very low self-esteem. They also seem to have more emotional and psychological distress compared to adult men with ADHD.

COVID pandemic — a tipping point

The pressure on women to juggle everything seamlessly — family, work, social life — can cause tremendous stress for anyone, particularly those who struggle daily with things like attention, memory, decision-making, organisation, and emotion regulation.

Women with ADHD need daily routines and structures to enable them to function. During a pandemic, for women who struggle with self-regulation and controlling impulsivity, those external structures are even more critical.

The restrictions, forced isolation, and home-schooling during COVID-19 have triggered increased anxiety, depression, and self-doubt in women.

The upside is that the COVID pandemic pushed women like my daughter Danni to seek a more thorough medical diagnosis.

Getting help and treatment options

In our chat yesterday, Danni shared, “Mum, under the surface, there’s all this self-loathing. Just about everything in my life makes me anxious! But now, being on medication, that’s all changed. For the first time, I can stay put. I can hold a thought. I can think things through. I can concentrate. I can study. I can sit in a bath and relax without my thoughts tormenting me. I’m not a razors-edge away from collapse anymore. My brain is working for me — not against me. I can’t go back to how I was without the medication.”

ADHD medications are called psychostimulants. They directly target the brain molecules that control attention and behaviour symptoms.

Drugs are only part of it. Danni has been under a gifted psychologist for some years to learn stress management, coping strategies, self-esteem, and life-management skills. She could not have come this far without ongoing professional help.

Being open with loved ones

Sharing her ADHD with her husband and four young children was massive for Danni!

They may not be old enough to understand mum struggles with self-regulation and controlling impulsivity, but it’s enough for them to know mum’s brain works differently.

What has surprised Danni is that her children — aged 14, 12, 10 and 5 — have embraced their mum’s up-until-now hidden struggles being ‘neuro-divergent’. They now talk openly about it around the family table.

The gift of understanding what’s going on

Once a woman knows she has ADHD, she can feel more empowered to take steps to get help and make changes in her life that will enable her to better manage the symptoms of the condition.

The genetic link appears to be strong. Experts explains that the closer someone’s genetic relationship is to a child with ADHD, the more likely it is that the relative also shares the disorder.

Which brings me back to my son. His five year old daughter has a host of symptoms that suggest hyperactive ADHD. He and his wife understand the challenges for their daughter — and for themselves as parents!

I won’t go into detail on the lengths to which my daughter had to go to get a psychiatrist to diagnose her, get a script written, and then find a doctor willing to oversee her ongoing medication.

It’s a broken system here in Australia, and how that process didn’t break my stressed-to-the-max daughter is a testament to her sheer willpower to get answers and get well.

Danni’s recent diagnosis of ADHD has given her an understanding of what drives her behavior. She appreciates why her brain functions the way it does. And how, with the help of medication, there is real hope she can dial down her anxiety and inner torment such that she can, with support, let the good stuff in!

If this information was helpful to you, perhaps you’d consider treating me to a cup of coffee.

Love, light & laughter