The first thought that comes to mind for most people is a hyperactive young boy who is unable to sit still in class, who has ADHD. Thousands of adult women were left undiagnosed, and many for years. Women in New York who have for years struggled with attention, disorganisation, emotional overloads and/or mental noise may not have tried to take a closer look at the cause: ADHD.
Many people don’t realize that adult women can have ADHD, too. In recent years research has indicated that ADHD is not just a boy’s condition, but affects men and women almost on an equal basis when they grow into adulthood; however women have historically been diagnosed after men, are under-diagnosed and often not diagnosed at all. Being aware of why it occurs is the first step to the right help.
Why ADHD in Adult Women Goes Unrecognized for So Long
This is simple: almost the whole of our medical understanding of ADHD stems from work with young boys. The symptoms which are used to define ADHD in clinical advice – visible hyperactivity, convulsive outburstings, disruptive conduct – the traits which emerge most of the time in boys. The system doesn’t exactly work the same for girls and women, and was not built for them.
An estimated three children out of every two, diagnosed with ADHD, are boys when compared to girls. That gap sorely shrinks when they’re grown, yet the harm is done. Children who do not get a diagnosis when they are children are likely to be misdiagnosed as adults when they have ADHD, believing it is their personal failure, a lack of will or simply anxiety.
There are multiple reasons for the diagnostic gap for women:
- Internalized symptoms – Women who have ADHD tend to be more inattentive, daydreamy, emotional, disorganized, which are less visible behaviors than hyperactivity. These symptoms are so easy to miss.
- Masking and compensation – With effort, perfectionism and over-preparation, many women are learning to manage their ADHD symptoms. They are good-looking on the outside. They are tired of their inner thoughts.
- Misdiagnosis – Anxiety and depression often go hand in hand with ADHD; there is often treatment of these conditions without addressing the underlying issue.
- Social expectations – Women are socialized to do the Three S’s: housework, emotional work, and work at their vocation. All of these are not always noticed as a symptom pattern, but are thought of as stress.
For women in New York who’ve been diagnosed with anxiety and/or depression multiple times but not found to be any better, it’s worth considering consulting a doctor who might suspect your patient has a case of undiagnosed ADHD.
ADHD Symptoms in Adult Women: What to Look For
In adult women, the symptoms of ADHD can vary from what you’d expect. Women with hyperactivity tend to experience a type of restlessness internally, with a sense of fast thought, of having a hard time relaxing, of being pushed and pulled, of urges, etc., rather than physically being hyperactive.
There are some common symptoms that typically appear in women with ADD/ADHD:
- Persisting attention problems in tasks not immediately interesting
- Losing time, not meeting deadlines and forgetting appointments repeatedly
- Sad but important reasons for avoiding clutter at your home or office
- Initiating a number of projects with the inability to complete any of them. Initiating many projects and not completing any of them
- Denial of others’ needs and interests because focused on a special interest
- Emotional sensitivity, a tendency to change moods and trouble controlling anger
- Often feeling overwhelmed by normal everyday requests
- Failure to follow through – not because they don’t care, but they are not cognitively organized enough to do so, and couldn’t get the attention they need to follow through
- Developing a sense of inadequacy as a result of years of not being good enough
- Lack of sleep, which is invariably associated with the inability to meditate at night time
This is often seen as a story of endless frustration-women constantly running at full speed and yet always getting further behind. This isn’t a character flaw. This is the ADHD that goes untreated in a woman.
Types of ADHD in Women
ADHD comes in three forms: knowing which type is yours is important when diagnosing and treating it.
1. Inattentive ADHD in Women
It is the most common presentation and is most often overlooked in female adults. Women with inattention ADHD do not exhibit hyperactivity. Rather, it manifests as lack of attention, memory lapses, mental cloudiness and organizational problems. It is quiet and internal, and doesn’t usually raise red flags within educational or work environments.
2. Hyperactive-Impulsive ADHD
It is less frequent in females but can be seen in a few. Symptoms include talkativeness rather than listening to another person, inability to sit still, constant movement and impulsive choice making in relations and finances.
3. Combined Type ADHD
A combination of inattention and/or hyperactivity-impulsivity symptoms. A number of girls who had combined type ADHD in childhood were termed “difficult” or “high energy” without their behavior being associated with ADHD.
ADHD in Middle-Aged Women: The Hormonal Factor
Middle aged women should be given special attention for ADHD. Estrogen has a strong effect on the regulation of the neurotransmitter most closely related to ADHD: dopamine. For some women, during perimenopause and menopause, the surge of hormonal changes leads to a sudden and dramatic worsening of symptoms of ADHD where they may have previously been well controlled.
Many women during their 40’s and 50’s say they are having trouble concentrating when they are trying to remember things and emotional regulation problems – and they are ignored or told it’s just a part of menopause. In most instances, it is both. As older females approach or have made it through menopause, their ADHD may need a reevaluation or reassessment regarding diagnosis and treatment – neurological changes are quite real and significant.
An evaluation for ADHD may be a good idea if you think your cognitive abilities have decreased significantly over the past several years and that health is an issue.
ADHD in Adult Women Treatment: What Are the Options?
When you have an accurate diagnosis, there is a door that will open to a treatment which will actually work. Adult ADHD treatment is usually a combination of treatments, depending on the presenting symptoms, lifestyle and other common conditions.
Medical treatments for ADHD are the best studied and most effective, and consist of stimulants like amphetamine salts or methylphenidate. There are also non-stimulant choices for women who can’t tolerate stimulants or who have special medical factors. Women should work with an ADHD specialist psychiatrist to learn about how both hormone fluctuation during the menstrual cycle and menopause can impact the effectiveness of any medication which may be used to treat ADHD.
Routine psychiatric evaluation and care is the bare building block of the correct treatment. This is not a quick checklist (15 minutes or less). A skilled psychiatrist will evaluate your case thoroughly, eliminating conditions that look similar to ADHD, testing for other disorders such as anxiety and depression, and develop a treatment strategy individually for you.
Behavioral Strategies Useful Practical Tools – Time Blocking, the Structure of the Environment, Routines that Work for the ADHD brain makes a huge difference! It is best to use these patients in conjunction with psychiatric treatment, not in lieu of treatment.
Therapy: Cognitive behavioral therapy (CBT) adapted for ADHD addresses the thoughts, avoidance patterns and emotional dysregulation that are only partially treated with medications.
Getting an ADHD Diagnosis for Women in New York
Consider a professional ADHD evaluation if you’re reading this article and you can identify yourself in it, and you live in either New York or New Jersey. The diagnosis of ADHD in women isn’t something that can be taken from an anxiety checklist and pasted onto a girl who isn’t anxious, it needs to be done by someone who understands that symptoms in girls and women differ from the textbook example, and who will not just shrug them off as anxiety.
Dr. John C. Shershow, M.D. is an adult ADHD psychiatrist in New York/New Jersey. He is experienced with working only with adults (not children), so instead of focusing on the way this condition looks in children, his focus involves how ADHD looks in adults. No matter your schedule or location in New York or New Jersey; appointments are available through this telemedicine option and it’ll make it easy for you to access.
There’s no need to start over with a diagnosis. It’s about finding a pattern to the explanation and treatment regimen that fits at the end of the day.
Make an appointment for an evaluation for ADHD right away. Call (212) 265-4310.
Frequently Asked Questions (FAQ)
Q. Why are so many women with ADHD diagnosed late?
Considered less disruptive, girls with ADHD tend to display inattentive behaviors, reducing their likelihood of being identified at school settings. Pressure social obligations also place on girls and women to compensate and conceal their signs and symptoms for years, and even years, prior to asking for aid.
Q. What are the most common ADHD symptoms in adult women?
Sexual version of ADHD presents with a range of the most common ADHD symptoms in women which are chronic disorganization, poor time management, emotional sensitivity, mental restlessness, sleep problems and persistent low self-esteem despite strong efforts.
Q. Can ADHD get worse for women as they age?
Yes. In older as well as middle aged women, ADHD frequently gets worse in perimenopause and menopause due to the drop of oestrogen, which directly results in disorder in dopamine regulation. This is the reason for most women to have their diagnosis done for the first time at the age of 40 and 50.
Q. What is inattentive ADHD for females?
One form that is most often overlooked is inattentive ADHD in women. They have challenges in sustaining attention, encounter forgetfulness and memory lapses, have trouble thinking clearly and/or organizing thoughts.
Q. How is ADHD in women different from ADHD in men?
Women are more likely to have inattentive symptoms and to experience emotional dysregulation and internalized distress. Hyperactive and impulsive behaviors are more often when a child is a boy. Also women mask symptoms better – thus delaying diagnosis and therapy.
Q.What are the treatment options for ADHD in adult women in New York?
Treatment for ADHD in adult women involves psychiatric, medication (stimulant or non-stimulant) cognitive behavioral, and behavior strategies. A psychiatrist in New York will be able to get a full history of your background and develop an individual treatment approach.
Q. Can anxiety be caused by undiagnosed ADHD in women?
Yes. Women with ADHD often have anxiety as well. Many times the anxiety is a side-effect of all the years of functioning without realizing the “why”. Once the ADHD is treated, symptoms of anxiety will often also decrease.
Q. Does Dr. Shershow see women with ADHD in New Jersey?
Yes. Dr. Shershow diagnoses and treats adult ADHD for women in New York, New Jersey and by telemedicine in both states.