The perception that attention deficit/hyperactivity disorder (ADHD) is a predominantly male or boy condition is shifting as we uncover the sex and gender differences in how ADHD presents and gender biases that can mask the diagnosis in girls and women. We’ll dive into five common ways in which ADHD can manifest for women.*
- Symptoms of inattention without hyperactivity or impulsivity. Symptoms of inattention commonly occur for both men and women with ADHD. However, women more commonly present with predominantly inattentive ADHD symptoms or combined type than hyperactive or impulsive symptoms (Young et al., 2020).
While symptoms of inattention may appear more subtle than hyperactive symptoms to an outside observer, such as a teacher, these symptoms are no less impairing to the individuals that experience them. In fact, some studies suggest ADHD symptoms can be more impairing for girls and women, resulting in more social, academic, occupational and self-esteem difficulties (Elkins et al., 2011).
- Hyperactivity/Impulsivity expresses in different ways. Men with ADHD, on average, tend to exhibit more hyperactivity and impulsivity than women (Hinshaw et al., 2022), conforming to traditional expectations of the manifestation of ADHD.While women typically exhibit inattentive symptoms of ADHD, it is also true that hyperactivity symptoms can present differently for women. Even when women exhibit more stereotypical hyperactive/impulsive symptoms, they are more likely attributed to another diagnosis due to gender biases that exist in diagnoses (Hinshaw et al., 2022).
- Emotion dysregulation can feel more prominent. Both men and women with ADHD are more likely to experience “big emotions” or low frustration tolerance (Shaw et al., 2015; Bunford et al., 2018); however, symptoms of emotional dysregulation and emotional lability are more prominent in women with ADHD (Young et al., 2020). Emotion dysregulation in women is also more likely to be attributed to another disorder, such as depression or a personality disorder in adulthood (Young et al., 2020).
- Use of elaborate coping strategies. Symptoms of ADHD may also vary for women because women are more likely to have compensatory strategies for their ADHD, compared to men, masking some of their symptoms (Mowlem et al., 2019). This can look like needing to maintain a structured routine, over-scheduling, or creating elaborate to-do lists.
These examples of symptoms are not intended to be diagnostic. It’s important to recognize that ADHD symptoms can vary widely among individuals and these symptoms are not exclusive to women. Having any one of these symptoms does not mean you have ADHD. Considerations, such as number of symptoms, frequency, duration, settings that these symptoms occur, daily level of impairment, and the reason why some of these symptoms occur can influence a diagnosis.
Though women living with ADHD may have numerous compensatory strategies, having access to tools for managing and treating ADHD can be the difference between thriving and making it through. The newly launched EndeavorOTC offers an effective, safe, non-drug option to treating ADHD in adults that’s available to download on your mobile device right away. In addition to EndeavorOTC, we recently shared a number of other ADHD management mobile apps that can be very helpful for playing to your strengths and improving what is challenging.
*Note, while this article predominantly discusses differences in terms of men and women, it is important to note that there are both sex and gender influences on ADHD presentation. Scientific papers vary on which term they use.