5 Ways that ADHD Misdiagnosis Impacts Women

By Jessica Flannery, PhD

Adult ADHD in Women

woman sitting with her hand on her chin and thinking

The underdiagnosis and misdiagnosis of ADHD in women can have significant impacts on women’s lives.

5 Impacts of Misdiagnosis or Underdiagnosis of ADHD in Women

  1. Increased academic and occupational challenges

    Many women and girls with ADHD struggle with academic and occupational challenges, which can erode their self-esteem and mental well-being over time (Young et al., 2020).

  2. High acuity of symptoms before receiving appropriate care

    Underdiagnosis and misdiagnosis of women with ADHD can result in women not receiving timely or appropriate intervention. This can manifest as greater impairment and acuity of symptoms before women seek or receive appropriate treatment.

  3. Decreased self-esteem and increased rates of comorbidities

    ADHD misdiagnosis can contribute to lower levels of self-esteem and increased comorbid or secondary mental health difficulties, and higher risk for self harm behaviors (Biederman et al., 2008; Nigg et al., 2020).

  4. Increased social impairment

    ADHD’s social impairment is thought to be harder for women due to societally imposed gender biases on the expectation of how women should act socially (Young et al., 2020; Elkins et al., 2011).

  5. Less effective treatment

    Misdiagnosis of ADHD can also influence the efficacy of treatment for other comorbidities. For example, ADHD symptoms may impair an individual’s ability to implement treatment skills for depression or anxiety (e.g., remembering to do assigned practice between sessions) and can undermine treatment progress if ADHD symptoms are not addressed.

Advocating for Proper Evaluation

It’s important for women and their loved ones to be proactive in seeking an accurate evaluation when ADHD is suspected. Initiating conversations with healthcare providers and advocating for thorough assessment can help bridge the gap in understanding and ensure that women with ADHD receive the support and treatment they need to thrive.

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.

References

  1. Biederman, J., Ball, S. W., Monuteaux, M. C., Mick, E., Spencer, T. J., McCREARY, M., Cote, M., & Faraone, S. V. (2008). New insights into the comorbidity between ADHD and major depression in adolescent and young adult women. Journal of the American Academy of Child and Adolescent Psychiatry, 47(4), 426–434. https://doi.org/10.1097/CHI.0b013e31816429d3
  2. Elkins, I. J., Malone, S., Keyes, M., Iacono, W. G., & McGue, M. (2011). The impact of attention-deficit/hyperactivity disorder on preadolescent adjustment may be greater for girls than for boys. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 40(4), 532–545. https://doi.org/10.1080/15374416.2011.581621
  3. Hinshaw, S. P., Nguyen, P. T., O'Grady, S. M., & Rosenthal, E. A. (2022). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of child psychology and psychiatry, and allied disciplines, 63(4), 484–496. https://doi.org/10.1111/jcpp.13480
  4. Mahone, E. M., & Wodka, E. L. (2008). The neurobiological profile of girls with ADHD. Developmental disabilities research reviews, 14(4), 276–284. https://doi.org/10.1002/ddrr.41
  5. Nigg, J. T., Sibley, M. H., Thapar, A., & Karalunas, S. L. (2020). Development of ADHD: Etiology, Heterogeneity, and Early Life Course. Annual review of developmental psychology, 2(1), 559–583. https://doi.org/10.1146/annurev-devpsych-060320-093413
  6. Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., Tierney, K., … Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC psychiatry, 20(1), 404. https://doi.org/10.1186/s12888-020-02707-9