ADHD in Women

Summary

This video discusses ADHD's impact on women, highlighting that while the disorder affects both genders similarly, its presentation and societal perception differ. Women often internalize symptoms like inattention and anxiety, leading to misdiagnoses and inadequate treatment. The script emphasizes the importance of recognizing ADHD in women, seeking proper diagnosis, and understanding how hormonal changes can influence symptoms. It also calls for more research to support neurodiverse individuals better.

Takeaways

• 👩‍🏫 ADHD affects women and men similarly at a neurological level, but societal and biological factors can lead to different symptom presentations.
• 🧬 Research on ADHD has predominantly focused on males, leading to a lack of understanding of how it manifests in women.
• 🌐 Women with ADHD often internalize their symptoms, which can lead to misdiagnoses such as depression or bipolar disorder.
• 💊 Stimulant medication is effective for treating ADHD in women, but they are less likely to be prescribed it compared to men.
• 🔍 Females with ADHD may underreport their symptoms due to societal pressures and a desire to 'fit in', complicating diagnosis.
• 🌱 Women's ADHD symptoms can fluctuate with hormonal changes throughout their menstrual cycle and life stages.
• 👩‍⚕️ There is a need for more specialized healthcare providers who are knowledgeable about ADHD in women to ensure proper diagnosis and treatment.
• 🌟 The long-term consequences of untreated ADHD in women can include self-medicating, eating disorders, and mental health issues.
• 📈 More research is needed on ADHD in all genders, particularly in transgender and gender-diverse individuals to improve understanding and support.
• 💪 Raising awareness about ADHD in women is crucial for ensuring they receive the necessary support and treatment.

Q & A

What is the main difference between how ADHD presents in women compared to men?

Women with ADHD tend to show more inattentiveness than hyperactivity or impulsiveness, and are more likely to develop anxiety, self-esteem issues, and other internalizing problems. Men with ADHD tend to develop more externalizing problems like rule breaking and aggression.

Why might ADHD in women go unrecognized or untreated?

ADHD in women can be missed due to a combination of biological and social factors that lead to different presentations, and because most research on ADHD has been done in males, leading to diagnostic criteria that may not fit women as well.

How can societal expectations and pressures affect the presentation of ADHD in women?

Societal expectations for women to be organized and planful, along with less forgiveness for mistakes, can lead women to work harder to 'fit in' and 'be good,' potentially masking their ADHD symptoms.

How do hormonal changes impact ADHD symptoms in women?

Hormonal changes during certain parts of the menstrual cycle, puberty, pregnancy, post-pregnancy, and menopause can cause ADHD symptoms to change or worsen, affecting presentation and treatment needs.

Why are women with ADHD often misdiagnosed with other mental health conditions?

The DSM criteria for ADHD may not align well with how women typically present, leading to misdiagnoses such as depression or bipolar disorder, and incorrect medication prescriptions.

What is the importance of seeking out specialists for an ADHD diagnosis?

Specialists in ADHD or doctors familiar with it are more likely to recognize the atypical presentations of ADHD in women and provide accurate diagnoses and appropriate treatment.

How can internalized ADHD symptoms in women lead to underdiagnosis?

Women with primarily inattentive presentations may mask their struggles due to social pressures, leading to underreporting of symptoms and a lower likelihood of referral for diagnosis.

What are some long-term issues that women with undiagnosed or untreated ADHD may face?

Long-term issues can include self-medicating leading to addiction, eating disorders, STIs, unplanned pregnancies, chronic pain, self-harm, and even suicide attempts.

Why is it important for women with ADHD to consider their hormonal fluctuations when managing their condition?

Hormonal fluctuations can affect ADHD symptoms, and being mindful of these changes can help in adjusting treatment, such as medication dosages, at different points in the menstrual cycle.

What is the significance of more research on ADHD in women and gender-diverse individuals?

More research is needed to better understand how ADHD presents in all genders, including women and gender-diverse individuals, to ensure appropriate recognition, support, and treatment for everyone affected.

Outlines

00:00

👩‍🎓 ADHD in Women: The Invisible Struggle

The paragraph discusses the common misconception that ADHD presents differently in women, which is a myth. ADHD affects both genders similarly, with the same brain regions and neurotransmitter systems impacted. However, societal expectations and biological differences can lead to different symptom presentations. Women, especially cisgendered ones, may exhibit more inattentiveness and internalizing issues like anxiety and low self-esteem, while men may show more hyperactivity and externalizing issues. The paragraph also highlights the challenges in diagnosis and treatment, with many women being misdiagnosed with other conditions due to the male-centric research and diagnostic criteria. The speaker shares her personal journey, emphasizing the importance of recognizing and addressing ADHD in women to avoid long-term negative outcomes.

05:01

🌟 Raising Awareness and Seeking Support for Women with ADHD

This paragraph emphasizes the importance of education and awareness about ADHD in women. It points out that women's ADHD symptoms are often internalized and may be underreported, leading to misdiagnosis or dismissal of their struggles. The paragraph stresses the need for women to seek out specialists for accurate diagnosis and treatment. It also discusses the long-term consequences of untreated ADHD, such as self-medication, eating disorders, and mental health issues. The speaker shares her own experiences and the impact of ADHD on her life, including the role of hormones and the need for tailored treatment. The paragraph concludes with a call for more research on ADHD across all genders and a reminder that everyone deserves support and understanding, regardless of how their brain works.

Keywords

💡ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms such as inattention, hyperactivity, and impulsivity. In the video, ADHD is discussed in the context of how it presents differently in women compared to men, with a focus on internalized symptoms and the challenges of diagnosis and treatment. The script highlights that despite the same brain regions and neurotransmitter systems being affected, societal expectations and biological differences can lead to varied manifestations of ADHD.

💡Gender differences

Gender differences refer to the societal and biological distinctions between males and females that influence behavior, roles, and experiences. The video emphasizes how these differences can affect the presentation of ADHD, with women often showing more inattentiveness and internalizing problems like anxiety, while men may exhibit more hyperactivity and externalizing behaviors. The script points out that societal expectations of women to be organized and planful can mask the outward signs of ADHD.

💡Internalizing problems

Internalizing problems are psychological issues that are directed inward, such as anxiety, depression, and self-esteem issues. The video discusses how females with ADHD are more likely to develop these problems, which can be less visible than the hyperactivity and impulsivity often associated with ADHD. The script illustrates this through the narrator's personal experiences and the broader trend of women working harder to 'fit in' due to social pressures.

💡Executive functions

Executive functions are cognitive processes that enable goal-directed behavior, including planning, organizing, and self-regulation. The video script notes that women are often expected to excel in these areas, and when they struggle due to ADHD, they may work harder to 'fit in' and 'be good,' which can lead to the underreporting of ADHD symptoms in women.

💡Misdiagnosis

Misdiagnosis occurs when a condition is incorrectly identified as another. In the context of the video, it is highlighted that women with ADHD are often misdiagnosed with depression or bipolar disorder due to the DSM criteria being less fitting for the way females present ADHD symptoms. This can result in receiving the wrong medication or less effective treatment.

💡Stimulant medication

Stimulant medication is a class of drugs used to treat ADHD by increasing the levels of certain neurotransmitters in the brain. The video explains that despite being the first-line treatment for ADHD and being equally effective for both genders, women with ADHD are less likely to be treated with stimulant medication, which can contribute to inadequate treatment.

💡Hormonal changes

Hormonal changes refer to fluctuations in hormone levels that can affect various aspects of health, including mental health. The script mentions that for women who menstruate, ADHD symptoms may change or worsen during certain parts of the menstrual cycle or during significant life stages with substantial hormonal shifts, such as puberty, pregnancy, and menopause.

💡Comorbid conditions

Comorbid conditions are additional disorders or diseases that coexist with a primary condition. The video discusses how women with ADHD often have comorbid mental health conditions like anxiety or depression, which can be more apparent than their ADHD symptoms, leading to a focus on treating these conditions rather than addressing the underlying ADHD.

💡Self-medicating

Self-medicating is the practice of using substances or behaviors to self-treat symptoms of a condition without medical supervision. The video script warns that women with undiagnosed or untreated ADHD may resort to self-medicating, which can lead to addiction or other serious issues, highlighting the importance of proper diagnosis and treatment.

💡Neurodiversity

Neurodiversity is the concept that neurological differences, including those diagnosed as disorders, are a natural part of human diversity. The video script touches on the need for more research on neurodiversity, especially in women and gender-diverse individuals, to better understand and support the full spectrum of brain differences.

Highlights

ADHD affects women differently due to a combination of biological and social factors.

There is no 'girl presentation' of ADHD, but women tend to present differently than men.

Women with ADHD often show more inattentiveness and internalizing problems like anxiety and self-esteem issues.

Men with ADHD tend to develop more externalizing problems like rule breaking and aggression.

Females with ADHD may have less obvious symptoms, such as racing thoughts and relationship problems.

Hormonal changes can affect ADHD symptoms in women, including during menstruation and life stages like puberty and menopause.

Most ADHD research has been conducted on males, leading to misdiagnoses in women.

Women with ADHD are often misdiagnosed with depression or bipolar disorder and may receive incorrect medication.

Internalized symptoms in women with ADHD can lead to underdiagnosis and undertreatment.

Stimulant medication, the first-line treatment for ADHD, is effective for both males and females.

Hormones should be considered in ADHD treatment for women, but often are not.

Women with ADHD may face long-term issues such as addiction, eating disorders, and chronic pain if not treated properly.

Educating oneself and others on how ADHD affects women differently is crucial for proper support and treatment.

Women with ADHD may underreport their symptoms, while men may overreport.

More research is needed on ADHD in women and gender-diverse individuals to better recognize and support neurodiversity.

No one should have to go through life blaming themselves for how their brain works due to ADHD.

Transcripts

Hello Brains.

In case you hadn't noticed I am a woman with ADHD.

Which means I have the same mental health condition

as a man with ADHD --

But it does affect me differently.

[Intro music]

Before I jump into this I want to point out

That in my episode on ADHD in girls,

I had a lot of guys in the comments going

"Wait.. I have the GIRL presentation?"

There is no "girl presentation" of ADHD,

It's just that we know from research that women

-- At least Cisgendered women, we don't have

enough research yet on those who are both neurodiverse

and genderdiverse -- tend to present differently

to cismen due to a combination of

biological and social factors,

and that that difference can mean our ADHD

doesn't get recognized or treated effectively.

Also some of this may apply regardless of gender

Because everyone is different.

Anyone can have the more internalized presentation

of neurodiversity that sometimes gets missed.

So if any of this sounds familiar,

the conclusion is the same

go get checked out,

get the support you need.

OK. So let’s jump into the research.

ADHD is the same disorder no matter what gender you are

the same brain regions

and neurotransmitter systems are affected

and the same core deficits are present

But the resulting symptoms — what people actually see

can show up differently

due to the biological difference

between males and females

as well as the social differences

in the experiences of men and women.

As a result of gender and sex differences

ADHD leads to different presentations and outcomes:

For example

women are often expected to be good at organizing

planning, and other executive functions

and society is generally less forgiving

to women when they mess up.

We tend to work harder to “fit in”

and “be good” due to social pressures.

Females with ADHD tend to show

more inattentiveness

than hyperactivity or impulsiveness,

and are more likely than males to

develop anxiety, self esteem issues

and other internalizing problems,

while males with ADHD tend to

develop more externalizing problems

like rule breaking and aggression, than females do.

That's not to say that girls and women

with ADHD don't also

experience hyperactivity and impulsivity symptoms.

We do.

The symptoms are just a little less obvious.

They might take the form of

racing thoughts, speaking before thinking,

talking really quickly

risky sexual behavior

and relationship problems.

Also for those of us who menstruate,

our ADHD symptoms

may change or worsen during

certain parts of our menstrual cycle

and during certain stages of life like puberty

pregnancy, post-pregnancy

and menopause when we have these big, hormonal changes.

So our ADHD presentation

and treatment needs

may change as well.

Cool. Okay. But my doctor knows all that…right?

Probably not.

Most research on ADHD has been done in males

and the DSM criteria for ADHD

doesn’t fit the way females

tend to present as well as it does for males.

As a result,

a lot of women with ADHD

get misdiagnosed with depression or bipolar disorder

and end up getting the wrong medication

or a less effective one.

Those of us who internalize our symptoms

are far less likely to be referred for diagnosis,

less likely to receive a diagnosis

if we are referred,

and less likely to be treated

with stimulant medication even if we do

get a correct diagnosis.

despite the fact that

stimulant medication is the first-line

medication used to treat ADHD,

and works just as well

or females as it does for males.

Even if we are diagnosed

and treated with stimulant medication,

it’s really unlikely that our hormones

will be taken into consideration.

Personally, no one suspected I had ADHD

as a kid

because I was a “good kid.”

And because I was “smart.”

But the truth is,

I went to some pretty extreme lengths

to hide the fact that I was struggling

And I hated myself every time I couldn't.

Every time I came home without my jacket

Or lost the really pretty earring

someone bought me for my birthday

Or didn't get invited to parties

or couldn’t remember the question

the teacher just asked.

Despite my best efforts,

I still picked up a lot of not fun labels

spacy, messy, clumsy, weird,

forgetful, flaky, lazy, irresponsible.

But I didn’t talk to anyone about it.

I was ashamed of it.

I tried my best to hide it.

It wasn’t until my symptoms

became more obviously problematic to others —

more externalized —

when I was going through puberty

hormonal changes,

and started rage quitting conversations,

when my coping mechanisms weren’t working anymore

Because the demands on my executive function had changed

and I started doing badly in school —

that my family even noticed there was a problem. --

Even then, the first doctor my mom took me to

told her I couldn’t have ADHD.

Because I’d done well in elementary school.

Thankfully, my mom told that doctor:

"thanks for your opinion, I’d like to see a specialist."

And I was diagnosed with ADHD.

And thankfully,

she was willing to try stimulant medication to see if it helped --

— which it did. A lot.

But even after that —

it felt like no one really took my ADHD seriously,

so I didn’t take it seriously.

I didn’t ask for accommodations,

I didn’t get coaching or therapy for it,

I even went off my meds completely for a while

because someone I trusted told me I didn’t need them.

Even after I dropped out of community college,

got into a bunch of car accidents

went through a divorce,

got fired from— several jobs,

ruined my credit

developed generalized anxiety disorder

and had my first panic attack,

I was actually embarrassed to start this channel

because I was so sure that my struggles

weren’t all that bad.

Because I was comparing them

to what I saw in my brother,

and my cousin.

The symptoms that were more obvious to others.

So even once I was diagnosed,

didn’t get adequate treatment for my ADHD —

I didn’t feel like it was okay to need extra support for my ADHD —

until my frustration with my struggles

got so bad I literally started a YouTube channel about them...

And I hear from a LOT of women

that say their struggles were either

missed completely,

misdiagnosed,

or that they were treated for other mental health conditions

or years or even decades

before anyone recognized the underlying ADHD.

So, what can we do?

Educate ourselves and others on how ADHD

effects women differently

and make sure we’re getting the support we need.

Here’s what we know.

ADHD in women is typically more severe than it looks.

Symptoms are external manifestations of internal struggles.

So if we have a primarily inattentive presentation

and we’re taught to mask our struggles,

we’re not going to look “as ADHD” as we actually are.

And this isn't just true for women,

anyone who’s faced strong social and cultural pressures

to 'be good'

is likely to mask and internalize their ADHD symptoms.

And this is true for autism as well.

We may minimize how much we’re struggling.

According to research,

women tend to underreport their symptoms,

while men tend to overreport.

And if we’ve developed comorbid anxiety

or depression or other mental health conditions,

those are likely to be more obvious than our ADHD.

Because of this, we're more likely to self diagnose

AKA be the first to recognize we might have ADHD.

And we might be more afraid to go to the doctor

to get checked out,

especially if we’ve been dismissed

or misdiagnosed before.

This is why I recommend going to doctors

who specialize in ADHD or who are really familiar with it.

And remember that

whether it’s ADHD or it does turn out to be something else—

if you’re struggling, there’s a reason you’re struggling.

Our struggles being invisible to others doesn’t mean they’re imaginary.

Also—It’s just as important to get the support we need.

While our struggles might not be as

obviously problematic in the short term —

maybe we’re doing well in school,

maybe we’re not getting in trouble a lot —

The long-term issues women with ADHD face are significant.

Like self medicating, which can lead to addiction.

Or eating disorders.

STIs and unplanned pregnancies.

Chronic pain is common in women with ADHD.

Self harm

...even attempts at suicide.

The longer we go without getting the support we need,

the longer we have to figure out

how to cope on our own,

and those coping mechanisms

aren’t always gonna be healthy.

And the longer we go without understanding

why we’re struggling

the more dysfunctional beliefs we develop

about ourselves and our abilities.

Often, by the time our struggles

are obviously problematic to others,

our core beliefs about ourselves have already formed.

This was true for me,

and I’m still undoing the damage.

My terrible self esteem

set me up for abusive relationships.

My difficulties fitting in created social anxiety --

I’m still learning how to make friends.

My symptoms might not have seemed

like a big deal at the time,

but the impact they have had on my life

long term absolutely was.

And again —

hormones impact our symptoms.

Anyone who menstruates

has regular hormone fluctuations that affect our ADHD —

in addition to needing extra support during big transitions —

it’s good to be mindful of how our symptoms

are affecting us at different points in our cycle

and talk to our doctor about options.

Some people might benefit from

different doses of medication at different times of the month.

We’ll talk more about hormones in another episode,

because there's a lot to go into,

and also -- we need more research on that.

Speaking of which --

—we need more research, on all genders.

There’s not as much research on ADHD in women,

and there’s barely any on those who are gender diverse.

The research we do have

suggests neurodiversity rates are a lot higher

in the trans community,

and since both biological factors

and societal pressures impact ADHD…

it’s important we do that research

so we can better recognize and support every brain,

not just the ones we understand so far.

Because honestly...

no one should have to go through life blaming themselves

for how their brain works.

Period.

Thank you to my brain advocates

and all my Patreon brains for

supporting the work that we do --

because of you, we can keep creating content

that createss awareness about ADHD

so a lot more brains can get the support they need : )

I'm going to get some ice-cream now.

Like, subscribe, click all the things and I will see you next video!

Bye brains!