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Understanding and Recognizing ADHD in Women

Understanding and Recognizing ADHD in Women

Understanding and Recognizing ADHD in Women

ADHD, or Attention-Deficit/Hyperactivity Disorder, is a neuropsychiatric disorder characterized by persistent inattention, with or without hyperactivity. Importantly, it causes deficits in executive function. Executive function refers to our brain’s ability to carry out self-directed actions, such as identifying and achieving goals. Being able to complete goal-oriented activities is integral to success in both personal and professional arenas. When ADHD goes undiagnosed and untreated, it can be horrifically disabling given the impairments it causes in occupational, academic, and social functioning.

This may be especially true in women given societal expectations of the female gender. Women with ADHD often describe hitting a “terrible wall of shame” as they get married and have kids. At this time, “society expects tremendous feats of memory and organization from moms, from keep track of…teachers and pediatricians to organizing meals and multiple schedules.”[1] The sleep deprivation commonly experienced by parents of young children doesn’t help.

To make things even harder for women with ADHD, hormones may play a role. It is thought that drops in estrogen levels may worsen ADHD symptoms. Consider the breastfeeding mom[2] with ADHD who is already struggling with how best to care for a new baby in addition to her other responsibilities. She now has an extra handicap. And hormone variation not exclusive to new moms. Estrogen fluctuations happen across a woman’s lifespan. Is menopause causing you to become scatterbrained or has it just uncovered your ADHD?

Thinking of the new mom, it’s easy to see how ADHD might go hand in hand with other psychiatric disorders. Juggling childcare responsibilities is already a feat, even for moms without ADHD. When a job, the care of aging parents, an ever-pinging cell phone, and other activities are added to the mix, cognitive challenges caused by ADHD can understandably lead to emotional distress. The emotions which follow are often diagnosed as depression and anxiety.

ADHD is likely underdiagnosed, and more so in women[3]. This happens for multiple reasons.

  1. Girls with ADHD tend to exhibit the inattention subtype, which can lead to the assumption they are “just being ditzy” vs boys who more often exhibit the hyperactive subtype, resulting in being sent to the principal’s office more and thus more likely to be identified as having a problem.
  2. ADHD in women and girls is often misdiagnosed and treated as depression and anxiety.
  3. Women may be more motivated to hide their ADHD, and many are able to figure out ways to compensate.
  4. Historically, because ADHD has been diagnosed more often in boys, the DSM-5 criteria[4] and common screening surveys are skewed toward how ADHD presents in males.

If you suspect you might have ADHD, try taking this screening test for women. Here is a related self-test better suited to girls. Because these are just screening tests, a high score does not mean you have ADHD. However, if you do score highly please see your doctor to discuss your concerns and get started on the road to feeling better.

Reference: Why ADHD in Women is misdiagnosed, underdiagnosed, and undertreated and related articles.


[2] breastfeeding causes a low estrogen state. Estrogen level fluctuations also occur during every menstrual cycle, thus affects women from menarche to menopause, effects being most prominent at those 2 endpoints.

[3] As an aside, there are also racial disparities in diagnosis. A black child with ADHD is more often misdiagnosed as having ODD or just “poor home training.” Asian children with ADHD often go undiagnosed due to cultural stigma regarding mental health diagnoses.

[4] DSM-5 guidelines provide the standard criteria by which physicians determine psychiatric diagnoses.

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Eileen West, MD
Eileen West, MD about 12 hrs ago

The scenario plays out like this… you’re sitting at home watching reruns of Friends when your vision blurs. Minutes later your head feels like it's set in a vice, and someone is cranking the lever. With your head throbbing, the nausea kicks in. After making a bathroom stop (goodbye lunch), you climb into bed and pull the covers over your face, lying still in the dark. Can you relate? This is called migraine, and sadly this illness is all too common. ● Approximately 39 million people in the US and 1 billion people worldwide have migraines ● Most people with migraine have 1 to 2 attacks per month which can extend from 4 hours to 3 days ● 36 billion is spent each year on healthcare and loss of productivity due to migraines Add onto those staggering stats this surprise—WOMEN are at greatest risk. Studies show that 8 out of 10 people with migraine are females. While research isn’t fully conclusive as to why, the data points to women’s hormone levels changing. ➡️ If you are battling migraines, please know that you do not need to suffer alone. At Eileen West, MD, and Associates, we are here to help you find the right treatment to prevent migraines and make them less painful. You have a life to lead. We’re here to help you on that journey and provide exceptional care. ⭐️ June is National Migraine & Headache Awareness Month. Share your migraine questions below… We’d love to help. #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfaxdoctor #fairfax #fairfaxva #fxva #dc #washington #loveVA #fairfaxcounty #virginia #northernvirginia #nova #dcarea #dmv #va #nham

Eileen West, MD
Eileen West, MDabout 2 days ago

IT’S SELF-CARE SUNDAY. We’re back this week to focus on the importance of self-care and giving you tips on how to practically care for the physical, mental, emotional, & social parts of you. Today’s self-care tip is simple but necessary: Find Ways To Relax Our American society prides itself on doing, doing, doing. Here’s the truth - busy doesn’t equal beneficial. We need a balance of work, play, and rest. Your mind, body, and emotions need periods of relaxation in order to refuel. Here are 10 Ways You Can Relax: ● Meditate ● Do Yoga ● Get a massage ● Take a nature walk or hike ● Journal ● Swim ● Listen to calming music ● Sit in the sun ● Color ● Read a book Self-care isn’t selfish, it is essential. Your brain and body need downtime. Do yourself a favor & RELAX. ➡️ What is your favorite way to relax? Tell us in the comments. #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfax

Eileen West, MD
Eileen West, MDabout 6 days ago

More than 80% of women experience hot flashes during menopause. Hot flashes can occur during the day or night and have a range of severity. If you fall into the category of moderate to severe, here are 6 tips to help you find relief: 1. Keep the temperature in your home cool. 2. Reduce stress with yoga, tai chi, meditation, biofeedback, acupuncture & massage. 3. Eliminate hot drinks, hot foods, alcohol, caffeine, and cigarette smoking 4. Wear light, breathable clothing during the day and to bed. 5. Sleep with cooling products, including sprays, gels, and a cool-fabric pillow. Use layered bedding that can be easily removed during the night. Cool down with a bedside fan. 6. When a hot flash is starting, try “paced respiration”—slow, deep, abdominal breathing, in through your nose and out through your mouth. Breathe only 5 to 7 times per minute, much more slowly than usual. ➡️ There are some prescription treatments to help with menopausal symptoms. Talk with your primary care doctor to discuss the best path for you. If you currently are seeking a provider, we are here to advocate for your total wellbeing and provide knowledgeable and personal care. Please reach out to schedule an appointment and learn more about how we can help! References: The North American Menopause Society (mnflashes.pdf), Stat from National Library of Medicine #youdeservebetter #msmedicine #fairfaxphysician #conciergemedicine #lifestylemedicine #doctorsofinstagram #femalephysician #womenshealth #fairfaxdoctor #fairfax #fairfaxva #fxva #dc #washington #loveVA #fairfaxcounty #virginia #northernvirginia #nova #dcarea #dmv #va #menopause

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