What ADHD Looks Like, and What It Doesn’t

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Debate captain, model UN delegate, editor-in-chief of the school newspaper, and female. Does this sound like someone who has ADHD (Attention Deficit Hyperactive Disorder), to you? Most people would say “No.” Maybe that’s why I went undiagnosed for 17 years.

Once someone diverges from the commonly accepted notion of what ADHD ‘looks like,’ it’s much easier for others to discount their struggles telling them, instead, that they ‘just need to try harder’ or are ‘just oversensitive.’ What people don’t realize is that behind the good grades, behind the accomplishments, and behind that ‘quiet’, ‘conscientious student,’ there is someone else. 

This is the overlooked and often unknown reality many women with ADHD face. It is estimated that approximately four million women around the world are living with undiagnosed ADHD. One of the main reasons for this phenomenon is that research funding has predominantly focused on studying children at the average age of seven. Females, however, often present symptoms of ADHD much later than their male counterparts, since their symptoms increase as their estrogen levels rise.

The lack of awareness regarding gender differences in the manifestation of ADHD means the majority (including parents, teachers, and even clinicians) are not attuned to the more nuanced presentation of ADHD in females. Male ADHD symptoms continue to be the benchmark against which females are assessed, thus causing many girls, such as myself, to fall through the cracks. This referral bias has engendered an entire ‘lost generation’ of girls, plagued with feelings of inadequacy from a disorder they don’t even know they have. This is further evidenced by surveys conducted by the Centers for Disease Control and Prevention, which shows, “Boys were more than two times as likely to have ever been diagnosed with ADHD, as compared with girls.”

Even when girls are fortunate enough to obtain a referral, we face the likelihood of being misdiagnosed and mistreated for another disorder whose symptoms mimic those of ADHD (such as depression, anxiety, and obsessive-compulsive disorder). Furthermore, many women with ADHD present coexisting conditions that may mask their ADHD symptoms. Consequently, this prevents females from receiving the treatment they need, exacerbates the effects of ADHD, and leads to more significant challenges in the future.

Females with ADHD are more prone to eating disorders, obesity, anxiety, depression, low self-esteem, and are even more likely to self-harm or commit suicide. The mitigation of these calamitous effects lies in early diagnosis which, given the inordinate obstacles women with this disorder face, is challenging, to say the least.

Gender roles dictate that women be passively compliant, organized, work cooperatively with others, and not show excessive outward displays of emotion. This immense pressure placed on women with ADHD, coupled with our inability to conform to societal expectations, can leave us feeling like constant failures riddled with the shame and fear of being discovered as ‘impostors.’  We often therefore go to great lengths to mask our perceived ‘flaws,’ internalizing our pain, and placing a ‘ cape of invisibility’ over our disorder. Doing so only further alienates us from our peers and worsens our silent suffering.

Even though most of the students at my school carry backpacks, my backpack seemed to weigh as much as twenty times its true weight. But that was three months ago, before my diagnosis. Since then, my circumstances have vastly improved. I still, however,  face discrimination because I don’t fit the ‘ADHD archetype.’ I have been told, “You can’t have ADHD, you’re smart,” “only little boys have ADHD, so it’s impossible for you to have it”, “you’re just lying to get extended time on tests”, and “you probably just want Adderall to lose weight.”

Until we increase public awareness, these pervasive gender stereotypes will continue to paint a one-dimensional, misinformed  picture of a complex disorder, and women with ADHD will continue to be marginalized, misrepresented, and misunderstood. ADHD doesn’t discriminate based on gender, socioeconomic status, or any other factor: so why are we still treating it like it does?

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