Women with ADHD
There is a misunderstanding that ADHD is a behavioural disorder that primarily affects males. Females with ADHD remain more likely to be unrecognised or mis-identified, leading to lower rates of referral and treatment for ADHD. Women with ADHD often complain of feeling “different" to other girls or women. Most lack self –confidence, feeling disorganised and overwhelmed by their lives and may observe a lifetime of unexplained failures or relative underachievement.
Sensitivity to criticism (often from themselves) or rejection is common and many identify with the description of rejection sensitive dysphoria (LINK TO RSD PAGE). Girls with ADHD are less likely to be diagnosed than boys, possibly because their behaviour is less disruptive, so their symptoms are less likely to be brought to the attention of others. To avoid feeling criticised, women and girls may try to compensate for their difficulties by either focusing on the needs of others or by working hard and striving for perfection. At school this means that girls are more likely to compensate with hard or last minute work as, especially if they are prone to being uncomfortable with criticism, they will strive hard to submit work to avoid disapproval from teachers. This results in their teachers not noticing the difficulty that the home work caused. This is elaborated on in a November 2020 Cosmopolitan article 'Why are so many women only diagnosed with ADHD in adulthood?' which Dr Sally Cubbin featured in.
Many women with ADHD are affected by changes in hormone levels both within the menstrual cycle and around the menopause. Women with ADHD may suffer from significant premenstrual dysphoria syndrome also called pre menstrual tension PMT and ADHD symptoms appear to worsen at these times. Drug treatments do not work as well at these times so for about one week of each month, even behavioural strategies may be less effective and symptoms may be more impairing.
Females with ADHD tend to become sexually active earlier than their peers and have an increased number of sexual partners. Rates of teenage unplanned pregnancies are also elevated.
Dr Cubbin is passionate about improving ADHD treatment for women. She has participated in the development of consensus statements with other health care professionals on ‘Treatment of ADHD in women’.
ADHD was traditionally thought to just affect children and teenagers. Now it is recognised that most people with ADHD do not ‘grow out of it’ and it usually continues into adulthood.
Rejection Sensitive Dysphoria (RSD)
RSD is a form of emotional over-reactivity and is described as the exquisite sensitivity to teasing, rejection or criticism.