Sir Alexander Crichton first noted what would later be called attention deficit hyperactivity disorder (ADHD) in 1798. And in true patriarchal fashion, it only took 224 years for women to enter the conversation. For those two centuries prior, female diagnoses were widely misunderstood—or missed altogether.
In the last few years, there has been a sharp increase in adult women diagnosed with ADHD. But women in their 30s and beyond weren’t magically developing this disorder overnight. It was there the whole time, hiding in plain sight.
Indeed, ADHD symptoms and treatment were born in a male-dominated medical world. And unfortunately, this male-centric perspective altered the efficacy and accuracy of women’s health—until now.
The Rise Of ADHD Cases Across The U.S.
The Attention Deficit Disorder Association is a nonprofit group that helps adults manage their ADHD symptoms. The organization’s membership doubled between 2019 and 2021. While this could have been an attempt to ease pandemic isolation, a study published in the JAMA Network Open suggests otherwise.
The study found that annual adult ADHD diagnoses increased by 43% between 2007 and 2016. Even more astounding is data from the CDC that show a whopping 344% increase in women between the ages of 15 and 41 filling ADHD medication prescriptions from 2003 to 2015.
Despite the number of female diagnoses rising, stats like these from 2006 reported that ADHD was more prevalent in males (5.4%) than females (3.2%). Today, we know that might not have been the case—doctors were just overlooking female symptoms.
How ADHD Affects The Brain
ADHD is a neurodevelopmental condition that affects the pre-frontal cortex and limbic system. As a result, those with ADHD struggle with attention, organization, memory, and emotional regulation. ADHD brains also have low levels of norepinephrine, a neurotransmitter for dopamine (the “pleasure and reward” chemical).
There are three types of ADHD: hyperactive-impulsive, inattentive, or a combination. Hyperactive-impulsive is the easiest to spot (think squirming, fidgeting, etc.) and is the most dominant diagnosis for males. Inattentive ADHD is far more elusive and, you guessed it, the most common form found in female patients.
With inattentive ADHD, symptoms are often silent. They include struggling to focus, sensory overload, disorganization, memory issues, difficulty planning, and problems with juggling multiple tasks. Inattentive ADHD also makes it harder to process information, particularly when it’s something uninteresting.
What Makes Female ADHD So Easy To Miss?
That’s the million-dollar, multi-answer question. For starters, women’s internalized ADHD symptoms are harder to notice. Even how they express impulsivity, a more external symptom, looks different. Impulsivity in female ADHD might look like excessive talking, self-harming activities, unhealthy self-discipline, and an inability to maintain healthy relationships.
Additionally, female ADHD patients often have comorbid psychiatric disorders, including depression, anxiety, and obsessive-compulsive disorder. Doctors might take note of these symptoms first and treat the comorbidity, not ADHD. And while these comorbidities can be separate from ADHD, they can also be a direct result of suppressing and overcompensating for symptoms.
Society encourages women to be pleasant, flexible, and capable of managing stress discreetly. Consequently, women with ADHD try to mask their symptoms by overworking, impulsively overextending their resources, or seeking a boost for their depleted dopamine levels via food, sex, or substances.
Untreated ADHD worsens symptoms of anxiety, depression, and OCD. Female patients often have lower self-esteem. They make friends quickly but struggle to keep them. Moreover, they often have more volatile—sometimes even abusive—romantic relationships.
The Sexism Behind The Missed Symptoms
The stereotype that ADHD affects boys more than girls and a societal expectation for girls to be more mature have caused women to go undiagnosed for decades. They suffer through and suppress their symptoms, internalizing them as personal defects instead of an easily treatable and common disorder.
Such is the case for many facets of women’s health, including perimenopause and menopause. And considering ADHD and low estrogen levels are directly linked, it’s essential for women in midlife and beyond to seek appropriate treatment, whether medication, therapy, or both.
ADHD entangles some of the most complex, misunderstood concepts of well-being: mental wellness, trauma response, hormonal regulation, and environmental influence. Its symptoms have tangible, potentially detrimental effects on people’s lives. Women deserve the opportunity to receive accurate, effective diagnoses and treatments.
Women’s health has come a long way from the knee-jerk “hysteria” diagnoses of the late 1800s to the benzo prescriptions of the 1950s. But we still have further to go. ADHD is just one example of women’s health being ignored, misdiagnosed, or mistreated.
However, this steep rise in ADHD diagnoses indicates progress. Medical professionals are starting to listen to and help their female patients. At the same time, women are beginning to advocate for themselves and their health.
The sexist tradition of women suffering in silence is on its way out. And we can’t wait to experience the women’s wellness boom that will take its place.