ADHD in girls and women can look very different from ADHD in boys and men. Girls and women with ADHD often have very different challenges.

Knowledge of AD/HD in women at this time is extremely limited as few studies have been conducted on this population(1,2). Women have only recently begun to be diagnosed and treated for AD/HD, and today, most of what we know about this population is based on the clinical experience of mental health professionals who have specialized in treating women.

Information includes:

• common symptoms and patterns of AD/HD in adult women
• treatment of AD/HD in adult women
• strategies for daily living

Impact of AD/HD in Women

Females with AD/HD are often overlooked when they are young girls(3,4), the reasons for which remain unclear, and are not diagnosed until they are adults. Frequently, a woman comes to recognize her own AD/HD after one of her children has received a diagnosis. As she learns more about AD/HD, she begins to see many similar patterns in herself.

Some women seek treatment for AD/HD because their lives are out of control -- their finances may be in chaos; their paperwork and record-keeping are often poorly managed; they may struggle unsuccessfully to keep up with the demands of their jobs; and they may feel even less able to keep up with the daily tasks of meals, laundry, and life management(5). Other women are more successful in hiding their AD/HD, struggling valiantly to keep up with increasingly difficult demands by working into the night and spending their free time trying to "get organized." But whether a woman's life is clearly in chaos or whether she is able to hide her struggles, she often describes herself as feeling overwhelmed and exhausted (6).

While research in women continues to lag behind that in adult males with AD/HD, many clinicians are finding significant concerns and co-existing conditions in women with AD/HD. Compulsive overeating, alcohol abuse, and chronic sleep deprivation may be present in women with AD/HD(7,8,9).

Women with AD/HD often experience dysphoria (unpleasant mood), major depression and anxiety disorders, with rates of depressive and anxiety disorders similar to those in men with AD/HD(10). However, women with AD/HD appear to experience more psychological distress and have lower self-image than men with AD/HD(11,12).

Compared to women without AD/HD, women diagnosed with AD/HD in adulthood are more likely to have depressive symptoms, are more stressed and anxious, have more external locus of control (tendency to attribute success and difficulties to external factors such as chance), have lower self-esteem, and are engaged more in coping strategies that are emotion-oriented (use self-protective measures to reduce stress) than task-oriented (take action to solve problems)(2).

Studies show that AD/HD in a family member causes stress for the entire family(13). However, stress levels may be higher for women than men because they bear more responsibility for home and children. In addition, recent research suggests that husbands of women with AD/HD are less tolerant of their spouse's AD/HD patterns than wives of men with AD/HD(14). Chronic stress takes its toll on women with AD/HD, affecting them both physically and psychologically. Women who suffer chronic stress like that associated with AD/HD are more at risk for diseases related to chronic stress such as fibromyalgia(15).

Thus, it is becoming increasingly clear that the lack of appropriate identification and treatment of AD/HD in women is a significant public health concern.

The Challenge of Receiving Appropriate Treatment

AD/HD is a condition that affects multiple aspects of mood, cognitive abilities, behaviors, and daily life. Effective treatment for AD/HD in adult women may involve a multimodal approach that includes medication, psychotherapy, stress management, as well as AD/HD coaching and/or professional organizing.

Even those women fortunate enough to receive an accurate AD/HD diagnosis often face the subsequent challenge of finding a professional who can provide appropriate treatment. There are very few clinicians experienced in treating adult AD/HD, and even fewer who are familiar with the unique issues faced by women with AD/HD. As a result, most clinicians use standard psychotherapeutic approaches. Although these approaches can be helpful in providing insight into emotional and interpersonal issues, they do not help a woman with AD/HD learn to better manage her AD/HD on a daily basis or learn strategies to lead a more productive and satisfying life.