Why ADHD can go undiagnosed in girls and women

We all know the kids who blurt out answers in class, can’t focus or follow instructions, and can’t sit still. These are often boys, and they may be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

But girls can have ADHD too -- a type known as Inattentive ADHD. They often go undiagnosed.

Kathleen Smith, mental health writer and licensed therapist in Washington DC, tells Press Play that ADHD symptoms are internal for girls, versus external for boys.

She explains that a girl with ADHD might have difficulty concentrating in class; and a woman might constantly lose her keys, be late to work all the time, and have a messy workspace.

“ADHD can manifest in women in a subtle way. And we mislabel it as someone being messy or spacey, when there's really a lot more going on there than just a character flaw,” Smith says.

What should teachers and parents look for in kids?

Smith says teachers often overlook ADHD in girls because they’re used to keeping an eye on boys who are fidgety and disruptive.

But a girl might have ADHD if she:

  • Has trouble keeping up with her assignments
  • Has trouble making friends because she's not a very good listener
  • Loses her schoolwork all the time
  • Gets upset because she can't seem to follow what's going on, or can’t follow a conversation with someone

How can adults distinguish between being spacey or having a verifiable disorder?

Smith suggests adults might have ADHD if they can't do their own work because they’re distracted by coworkers’ conversations and want to help them, or they’re easily upset about their own disorganization and tardiness.

“We don't often think of ADHD as being an emotional challenge as well, but it can be. So anything that's related to the executive functioning part of the brain -- if someone has a lot of challenges associated with that, then it might be ADHD,” she says.

Smith points out that adults usually have a long history of struggling with these problems, and it can damage their self-esteem and lead to depression and anxiety.

Also, a person is more likely to have ADHD if their relative has it too.

How can adults with ADHD minimize distractions at work?

Smith says it’s important for adults to know their rights and ask for accommodations, whether that be their own space, or more leeway in what time they arrive to or leave work.

What’s the treatment?

Smith points to medication. The caveat is that stimulants are often used to treat ADHD, and they can have side effects like causing anxiety or interfering with sleep. However, there are non-stimulant medications as well.

People with ADHD can work with a therapist to change behaviors and keep things under control. And not beating themselves up over the symptoms - - fixing the toll that ADHD has on self-esteem -- makes a big difference.

The good news is that kids, especially girls, can grow out of ADHD. “Researchers are still learning a lot about it, and we have a lot of questions. But sometimes the brain just changes, and people just lose the symptoms that they struggled with as a kid,” Smith says.

--Written by Amy Ta, produced by Yael Even Or