Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects a person’s behaviour and impulses. It tends to be noticeable in the early years, and most children are diagnosed before they turn 12 years old. However, in recent years, there has been an increase in adults diagnosed with this condition. We do not know precisely why this is happening, but one factor that could be contributing to this is that it has become better recognised and diagnosed.
ADHD, also known as Attention Deficit Disorder (ADD), has two main misconceptions: the first is that it only occurs in men. The second is that it is a condition diagnosed in childhood – so if you weren’t diagnosed, it means you don’t have it. ADHD can occur in men and women, and individuals can be diagnosed at any age with ADHD, including adulthood.
Three Types of ADHD
ADHD can present in diverse ways, with some of the presentation influenced by the dominant type of symptoms you might have. The complex nature of the disorder means it can be categorised into three main presentation types:
Primarily Hyperactive and Impulsive
Individuals can present with mainly hyperactivity and impulsiveness-type symptoms.
Individuals can present with inattention issues, especially around task completion, details and following instructions.
A mixture of both presentations, with a more equal distribution of symptoms between the two types.
The inattentive presentation can be more common in women, while the hyperactive presentation can be predominantly found in men. However, these are not exclusive, and a patient’s gender usually does not predict the type of ADHD they may have. Also, symptoms of ADHD can change with time, and it is not unusual for an individual to develop different traits over time.
Why Can ADHD Be Missed In Women?
Women tend to present with an inattentive presentation of the disorder, which may not be as easy to diagnose compared to the hyperactivity presentation. It is also thought that women may also have better adaptive mechanisms, which may mask the symptoms of ADHD and help them function day to day.
For example, they may display better communication skills than their male counterparts, making it more likely that their symptoms do not get picked up at a younger age. Therefore, the combination of developing better-coping strategies and the inattentive presentation – which can be more subtle, makes it more likely that they are not diagnosed at an earlier age.
On the other hand, these ADHD traits, which are more commonly found in girls and women, may also be more likely to be attributed to ‘character traits’ by others. This may be down to the fact that certain traits like hyperactivity are more easily recognisable ADHD traits. At the same time, teachers and parents may not be aware of the subtypes of ADHD and the cluster of symptoms around inattention.
Causes and Risk Factors for ADHD in Women
Over the last few decades, scientists have looked at the exact causes and risk factors for the development of ADHD. While the exact origins of ADHD remain elusive, we have learnt a lot about the condition, and research has highlighted the influence of genetics as an important factor.
In addition to genetic factors, scientists are also exploring links with the following environmental influences:
- Low birth weight
- Brain injury
- Premature delivery
- Alcohol or tobacco use in pregnancy
- Exposure to environmental risk (e.g. lead) in pregnancy or when young
What Are The Signs and Symptoms of ADHD In Women?
ADHD may present uniquely with a mixture of different symptoms across the spectrum of inattention, hyperactivity and impulsiveness. As women tend to experience inattentive symptoms more significantly, these are some of the signs to look out for:
- Constantly changing tasks or activities
- Poor organisation skills
- Easily distracted
- Short attention span
- Easily forgetting things
- Losing things
- Not being able to stick to tasks – especially if they are time-consuming
- Struggling to listen or follow instructions
- Difficulty organising tasks and deadlines
- Easily distracted or zoning out in conversation
- Being indecisive and struggling to make decisions
- May have low self-esteem
- May have other mental health conditions e.g. anxiety or depression
- Feeling inadequate
Women may also experience some of the hyperactivity and impulsive symptoms of ADHD, especially if they have a combined presentation:
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- Excessively active and not able to stay still
- Fidgeting all the time
- Acting before thinking
- Little thought of danger or consequences
- Interrupting conversation
- Talking all the time
- Inability to focus on tasks
- Restless or feeling on edge
- Extreme impatience
- Mood swings and irritability
- Inability to deal with stress
- Risk-taking behaviour, which could cause serious consequences
Because ADHD is a neurodevelopmental disorder, it means that the symptoms can also develop with time and as we get older. Classically, as we move into adulthood, some of the hyperactivity symptoms may become less apparent. While the inattention symptoms may remain and present more with organisational issues around education or work.
Living With ADHD As A Woman
ADHD can affect you in many ways – from work, and relationships to your mental health and well-being. It can have a ripple effect on several different parts of your life. While familiarising yourself with the symptoms is important, sometimes it can be difficult to notice them without real-life examples. Let’s look at how ADHD may impact your day-to-day life.
You may struggle to finish work, especially when the office is busy – choosing to come in earlier or leave later. You may have deadlines to meet, but instead of starting on tasks, you keep pushing them off or are starting new projects. Your colleagues may comment about your organisational skills; at this point, you’ve accepted it as one of your quirks, and you joke about it.
The projects and deadlines keep piling up, and you struggle to clear them. Your desk is full of papers and some important notes from a meeting – but you can’t find them as everywhere is cluttered.
You’ve always found it easy to make friends but struggled to keep them. Sometimes, you struggle to let people talk, and you blurt out responses and interrupt people. This can sometimes make friends and partners feel as if you are not listening, but you often are and just not able to control the impulse.
You also find it difficult to remember certain things or requests people have made. You tell yourself you’ll do better next time. Perhaps you note it or use one of the other coping strategies you have developed. You worry that people may feel you don’t care, but this couldn’t be further from the truth.
Simple tasks like going to your local supermarket can become arduous. You may be riddled with questions and indecision. Would the two-for-one deal be better than the 50% off, which should you go for? You find simple tasks at times paralysing. You spend far too long over this and get home to see you’ve still forgotten the main thing you went in for. Even though you are holding down a good job, little moments like this can make you feel low and inadequate.
To try and organise things better, you try to write things down at times, which leads to a lot of paper clutter. You find most areas of your life busy and exhausting. You often make decisions on things and may not have given it proper thought.
Living with ADHD can be overwhelming at times. It can create relationship problems, isolation, loneliness and other mental health issues. Women who have ADHD can also have other co-occurring medical problems, including:
- Anxiety and depression
- Alcohol and drug addiction
- Bipolar disorder
- Obsessive-compulsive disorder
- Personality disorders
- Eating disorders
- Sleep problems
How Do You Treat ADHD?
The initial step is to undergo a full assessment conducted by a qualified healthcare professional to establish a diagnosis of ADHD. This can be done by booking an appointment with your GP to discuss your concerns. Your GP will then go through your symptoms and may ask you to fill in a self-assessment questionnaire, which helps them evaluate your symptoms. You may then be referred to a specialist who performs ADHD assessments.
The positive news is that ADHD in women is far better understood, which can make it easier to get the correct diagnosis and establish the right treatment. This can include counselling and cognitive behavioural therapy (CBT) – a form of therapy that helps you manage your problems by changing the way you think and behave. There are also several medication options for ADHD. These can include stimulant medications like methylphenidate – which aims to increase activity in the part of the brain associated with controlling attention and behaviour.
ADHD medications can make an impactful improvement in symptoms, but they can also have side effects and require close monitoring and adjustment. This is why they would usually be started by a specialist, and you would need regular monitoring and follow-ups. Usually, once you are stable on your dose, then your GP can take over your care.
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ADHD and Addiction
At Castle Craig, the treatment of patients with both ADHD and addiction is approached with a multifaceted strategy. Recognising that ADHD can be a contributing factor to substance abuse, the treatment team at Castle Craig focuses on addressing both conditions simultaneously. This is achieved through a combination of therapies, including cognitive behavioural therapy (CBT), which helps patients develop coping strategies for ADHD symptoms while also addressing the thought patterns associated with addiction. Medication may also be used to manage ADHD symptoms, always considering the potential risks and benefits in the context of addiction recovery.
In addition, we offer personalised counselling and support groups, providing a space where patients can share experiences and strategies for managing both ADHD and addiction. By treating both conditions in an integrated manner, we aim to improve overall outcomes and provide a solid foundation for long-term recovery.