How ADHD symptoms in undiagnosed women are explained away

#JennhasADHD #AdultADHD #UndiagnosedADHD #ADHD #ADHDSymptoms

Under diagnosis and misdiagnosis in adult women appears to be quite high for undiagnosed women with ADHD.

There is a few reasons for this – once upon a time, the classic general perceived characterization of ADHD is that it was about ‘hyperactive behaviour’ of young boys, who cannot sit still or pay attention. This is most likely something we have all heard or a variation of it. ADHD for most part of it’s public understanding has been plagued with stigma. Making it hard for Adults in general to get diagnosed with the disorder.

The other reason is the historical and general characterization of women.

ADHD especially in young girls have historically been explained as character traits rather than a mental health diagnosis. A reflection of a persons behaviour than their psychology. An example of this is a girl would be labelled as a day dreamer, spacey, forgetful, chatty and so on. Meaning a young girl presenting these more known as inattentive traits have been completely written off as something “Girls do” and were treated accordingly (often with behavioural punishment).

For those of us who present with more hyperactive traits, often are more prone to bigger risk taking behaviour or end up in situations that they otherwise may not have been experiencing if impulse control wasn’t such a big issue – when these symptoms are present, women are often labelled as “loose, crazy” – but it is actually just untreated and undiagnosed ADHD hyperactive or combined.

Often women living with chronic mental health conditions have to suffer under as being seen as Crazy – “Off the hook” “Emotional” “Bitchy/Moody” “Over sensitive” “Controlling”. There is no end to the tropes you can probably imagine where you have seen this character type played out.

For undiagnosed women, this on going distress creates feelings of inadequacy and chronic stress can lead to having serious consequences. And later developing other co morbidities as a result of trying to cope and potential to resort to negative coping mechanisms.

Not only is there obvious underlying sexist stereotyping of women happening here, there is also a severe lack of understanding about the presentation of ADHD in general that defaults to ableist regarding getting potential help too.

There is a lot of labels, tropes, types, casts, misunderstanding, assumptions and stigma attached to many things in life, but these are obviously very problematic for anyone who is not neuro typical.

With emotional dysregulation and rejection sensitivities also being present and not in the diagnostic traits required for formal diagnosis, the ability to correctly diagnose becomes harder as these symptoms in women look like other psychiatric disorders diagnosis traits on the surface, but have actually only been exacerbated because of living untreated and undiagnosed. Whether there is other co morbidities also not being identified properly because of this issue is yet another problem.

ADHD is not gender biased. It affects all genders equally, it just presents differently in every individual. Inattentive ADHD symptoms are often the most misunderstood and misdiagnosed by medical professionals who mistake these traits for mood disorders, anxiety and so forth. Grown adult women seeking diagnosis not only have most likely the life experience of being treated this way, but as adults are only diagnosed as depressed and anxious. That their symptoms presentations are too “High functioning” because they are just simply considered ‘overwhelmed with life’, nothing more.

It is also considerably harder again for older women to get diagnosed because of the characterization of menopause and it’s presentations. Many symptoms looking similar from short term memory loss, inattentiveness and emotional dysregulation. Suddenly a woman is written off as hormonal and the way ADHD is presenting is simply a manifestation of bodily changes. If it isn’t this, it’s just that you are simply too “Old”. That what you are experiencing is merely what life is like over the age of 60 and also written off as it is unnecessary to treat this particular disorder so late in life.

A diagnosis in ADHD is not a character trait or flaw. It is not a behavioural issue that can be changed. It is not a personality disorder. It is a neuro developmental brain disorder. It is a different neurotype. It is something that impacts all those other parts of your life, but it is no different to how tall or short someone is. It is as described by Dr. Russell A Barkley (one of the worlds leading experts on ADHD) that ADHD is a quantitative difference not a qualitative. And that is where medical professionals often go wrong with misdiagnosis. And definitely not something understood at all by the general public or even those living with the condition. This small mix up in the public view of ADHD or other psychiatric conditions is partly to blame for why the world tries to remedy it like a behavioural problem.

In what ways can ADHD present in adult women:

  • Executive deficit/Working memory deficit – struggles with ability to consistently recall or hold short term memory, poor persistence towards goals, failure to string behaviour together over time in order to achieve a task, disorganized thoughts
  • Struggles to stay on a schedule, complete time-sensitive tasks within the given time frame/time blindness
  • Failure to inhibit response to distraction or trigger
  • Less likely to re-engage with tasks
  • Emotional dysregulation/Struggles to regulate emotions, to self-soothe and self calm. Not mood related
  • Impulsive in emotions, sometimes leading to social conflict
  • Cannot internalize speech, needs to think out/externalize actions or thoughts to better understand them
  • Impatience
  • Chronic fatigue, frustration and shortness from mental fatigue, stress or over stimulation
  • Hyperactive – not suppressing irrelevant behaviour
  • Rejection sensitive dysphoria, an often strong or prolonged response to the ideas of rejection and failure, a highly co morbid trait associated with emotional dysregulation and sometimes trauma
  • Often chronic symptoms of Anxiety and Depression
  • Trouble understanding social cues, forced masking
  • Sensory overwhelm – too much going on for the physical senses leading to shutting down, anxiety and withdrawal
  • As substance abuse/self medication – adrenaline, risk taking behaviours
  • Insomnia, broken sleep, irregular sleep – slow cognitive tempo in the mornings or at night
  • Hormones – sensitivity, fatigue, concentration – With emotional dysregulation and mental fatigue, PMS and Menopause symptoms can be exacerbated

Please note this is an opinion piece based on the DSMV diagnostic criteria for Adult ADHD and my lived experience as an AFAB woman. Thank you.

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Published by Jenn has ADHD

Jenn Parker, New Zealand. ADHD Advocate and Peer.

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