Adult women have been catching up in recent years when it comes to the number of diagnoses of ADHD. We asked two experts how this is possible. “Children who show difficult behavior to the outside world are simply noticed earlier.”
The fact that it can take so long for women to receive the correct diagnosis is because until recently there was little knowledge about ADHD in women. That says Sandra Kooij, psychiatrist and expert in the field of ADHD.
This is due to a lack of research on this group. For a long time it was unclear that the female body is structured differently from the male body and can therefore respond differently to medicines, for example.
“But a woman is not a small man. She is also a human being, requiring more knowledge and more research,” says Kooij.
“The fact that this has not or hardly happened so far also has to do with the fact that women have a hormonal cycle, which can disrupt the outcome of any research. As a result, women are generally often excluded from research.”
Based on research in boys
In addition, ADHD is originally a childhood diagnosis, says Nanda Lambregts-Rommelse, professor of Neurobiological Developmental Disorders at Radboud University. “And it’s a diagnosis based primarily on research in boys.”
With ADHD, people quickly think of that one busy boy in the classroom. And that’s where things go wrong, says Lambregts-Rommelse. “Boys with ADHD show busy behavior and thus ask for attention, while girls with ADHD pull in more. They are more anxious and sad.”
Girls can be busy too
ADHD is basically a “disinhibition problem”, explains the professor. The best way to recognize that problem differs slightly between boys and girls. The Handbook of Mental Disorders describes these characteristics, but does not narrow them down to gender or age.
“Boys with little brake often show over-moving, impulsive, unconcentrated and explosive behavior and are therefore experienced as annoying disruptors,” says Lambregts-Rommelse. “While girls with little brake are often too focused on contact with others and are seen as ‘sociable chatterboxes’.”
As a result, it is less visible that these girls also have difficulty concentrating and have little control over their emotions. “It is therefore not the case that girls cannot show busy behavior. But children who show difficult behavior to the outside world are simply noticed earlier,” says the professor.
Hormonal mood swings play a role
Kooij says that 30 percent of women with ADHD more often suffer from the ADD subtype. “Those are dreamy, indecisive, chaotic and forgetful girls.”
According to Kooij, these are – often contrary to expectations – women who go through life on the basis of lists and schedules. “They seem very organized. But if they don’t, they get bogged down in a chaotic mess.”
Women who were not seen at a young age that they might have ADHD, still run into it later in life. According to Kooij, recent research shows that this often happens when women go through menopause.
“That has to do with the fact that they then suffer more from hormonal mood swings,” explains Kooij. “As a result, they can no longer continue in the same way.”
The importance of sharing knowledge
“Women with ADHD always keep going and don’t realize that they exhaust themselves as a result,” says Kooij. “They work themselves over the head five times, get overwrought and can eventually even suffer from heart problems.”
Kooij has set up a network to detect ADHD in women earlier. She founded it together with cardiologist Janneke Wittekoek and gynecologist Dorenda van Dijken. The reason for this was that they often saw ADHD, heart complaints and mood swings in the same patients. The aim of the network is that sharing knowledge with professionals and patients helps to recognize these complaints more quickly.
Lambregts-Rommelse advises women who think they may have ADHD-related complaints not to let themselves be turned away from care providers too easily. “Don’t sell yourself short, get yourself checked out properly. Don’t settle for diagnoses like ‘it must be menopause’ or ‘maybe you’re overworked’. In addition: if your children have ADHD or it runs in your family, chances are bigger that you have it too.”