Characteristics for certain diagnoses tend to be the same for any gender. The symptoms of a bad cold can be a stuffy nose, a bad cough, sneezing – the list goes on and on. It doesn’t matter whether the person afflicted is a male, female, or anywhere in between.
Other diagnoses, however, do classify between genders, and if overlooked can lead to serious problems for those afflicted. One of said diagnoses is Attention Deficit Hyperactivity Disorder (ADHD), which up until recently did not have its own set of individualized characteristics between boys and girls.
“These studies [on ADHD] were based on really hyperactive young white boys who were taken to clinics,” says Dr. Ellen Littman, author of the book Understanding Girls With ADHD, “The diagnostic criteria were developed based on those studies. As a result, those criteria over-represent the symptoms you see in young boys, making it difficult for girls to be diagnosed unless they behave like hyperactive boys.”
Three times as many boys have been diagnosed with ADHD than girls during childhood. The numbers tend to even out in adulthood, but the staggering comparison still suggests that improvement needs to be made in the way that doctors are diagnosing children, especially girls.
A girl with ADHD will exhibit different symptoms in comparison to a boy. In a boy, hyperactive behavior may include having trouble staying still, being impulsive, and more often than not, causing disruptions in a school classroom. In a girl, the hyperactive behavior may be channeled into a more productive output, such as becoming the teacher’s assistant or being regarded as an extremely social student.
“Often, if girls are smart or in supportive homes, symptoms are masked,” says Sari Solden, author of the book Women and Attention Deficit Disorder. “Because they’re not hyperactive or causing trouble for other people, they’re usually not diagnosed until they hit a wall, often at college, marriage, or pregnancy. A lot of things that are simple and routine to other people—like buying groceries, making dinner, keeping track of possessions, and responding to emails—do not become automatic to these women, which can be embarrassing and exhausting.”
If unaddressed, characteristics of ADHD may not completely reveal themselves until the later milestones in a girl’s life – for example, when they’re in college or living on their own. Instead of being more impulsive as a boy would be, girls tend to be more scatterbrained, forgetful of objects, and introverted. Left to run rampant, the symptoms can easily lead to mental health problems.
“They’ve alternately been anxious or depressed for years,” says Littman. “It’s this sense of not being able to hold everything together.” According to a 2016 report, triple the number of women who’d self-reported having ADHD were reported to have health problems such as insomnia, chronic pain, suicidal ideations, or general anxiety disorder than those who self-reported not having ADHD. Double the number of women were susceptible to substance abuse, smoking, and severe poverty.
“For a long time, these girls see their trouble prioritizing, organizing, coordinating, and paying attention as character flaws,” says Solden. “No one told them it’s neurobiological.”
The statistics on women with mental health problems related to the missed diagnoses can easily be reduced by a wide margin. For one, the symptoms for diagnosing ADHD can be revised so that there are distinct markers for diagnoses between boys and girls. Second, greater supports can be in place for those that do go undiagnosed, which can mean anything between educating the greater public so there are fewer women who slip through the cracks to providing resources to those who have been diagnosed and are perhaps struggling in the adult world. Regardless of what is done, the figures can and should be easily reduced.
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