Girls With ADHD Often Go Undiagnosed — Here’s Why, According to a Pediatrician
The stereotypical image of ADHD is that of a boy who cannot sit still. Thanks to media stereotypes and our own learned biases, our brains simply aren’t trained to conjure up a girl when we think of ADHD. But girls too can suffer from the condition, and many of them go undiagnosed, often with lifelong consequences.
Attention deficit and hyperactivity disorder is one of the most common neuro-developmental disorders of childhood, according to the CDC. The symptoms can include daydreaming, forgetfulness, squirming or fidgeting, talking too much, making careless mistakes, taking unnecessary risks, having a hard time resisting temptation, taking turns, and getting along with others. Depending on which combination of symptoms is most prevalent, ADHD is classified as predominantly inattentive, predominantly hyperactive, or a combination of both.
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Historically, boys are three times more likely to be diagnosed with ADHD than girls, and girls tend to be diagnosed later. The reason appears to be two-fold.
On the one hand, girls are more likely to experience symptoms of inattention, while boys are more likely to show impulsivity. Imagine a girl sitting quietly in the back of a classroom: she is in her own world, unable to follow along. But since she isn’t disrupting anyone, the alarm bells aren’t going off for the teacher, who doesn’t bring it up to the parents, who in turn don’t talk about it with their health care provider. What’s important to understand in this scenario is that, while this girl may not be actively disruptive, she is also not learning.
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Even if they do show more noticeable symptoms, girls are more likely to receive a label of “lazy” or “ditzy,” and yes, sometimes even “dumb,” further delaying diagnosis.
Although ADHD is often diagnosed in childhood, the condition is known to last well into adulthood. What might begin as gender differences in early symptoms and diagnoses persists later on in life when it comes to the conditions associated with ADHD.
For men, ADHD is more likely to co-exist with externalizing conditions such as substance misuse or conduct disorders. For women, the disorder is more likely to co-exist with internalizing conditions such as anxiety or depression. Again, there’s a clear divide along gender lines; and again, both sides are feeling the effects, although perhaps not in the same way.
For boys and girls, women and men, attention deficit and hyperactivity disorder can be a debilitating condition. Recognizing the symptoms early and obtaining an adequate diagnosis and –most importantly– appropriate treatment can be life-changing.
Editor’s note: Dr. Edith Bracho-Sanchez is a practicing pediatrician at Columbia University Irving Medical Center, a contributing editor to SheKnows, and a mom to an active toddler.
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