What does an ADHD diagnosis mean for a woman - or a girl?

ADHD in girls and women: The Lost Girls

ADHD, especially in girls and women, is certainly a hot topic bouncing around the internet right now. And in typical bot-fashion, fueled by AI infiltrating everyone’s writing and research, there is a lot of repeated content, recycled into new posts and headlines, that isn’t really getting us women with ADHD any closer to new breakthroughs or relevant help.

Just Google “The Lost Girls - ADHD” and you will tap into the growing body of literature describing the experience of women realizing that they have ADHD when they are around 40 years old. The simple math is as follows:

ADHD is a neurological disorder, the is highly inheritable, with genetic and biological markers in the brain, and it exists from early infancy and persists through the lifespan. In children, ADHD diagnosis shows up as between 2:1 up to 10:1 boys to girls. By the time we get to adulthood, ADHD diagnosis is about 1.5 : 1 men to women. Since ADHD is a lifelong condition, the logical conclusion (which many researchers are becoming aware of) is that a significant amount of girls with ADHD are not diagnosed as children.

For a good review of this situation - CADDA has a 2021 paper “Girls and Women with ADHD: our missed forgotten and most vulnerable”

So - there is certainly a problem with misdiagnosis, which is the main focus of the medical research community. 

What I want to point out, is that there is a deeper and more pervasive problem that emerges from misdiagnosis on that scale (i.e. failing to diagnose nearly 50% of girls who have ADHD for the past 40 years). Proper clinical research is done only on subjects that have a clinical diagnosis of ADHD. Diagnostic tools (inventories and scales) and medical treatment studies are also only done on clinically diagnosed subjects. So, the last 40 years of research on ADHD has been done largely on boys.

The importance of this cannot be understated - because while it may be great that the medical community is recognizing that many more girls have ADHD, the treatments and interventions we currently have are NOT researched in any long term way in the female body. A general problem with medical research also enhances the magnitude of this problem - male rats are used up to 6 times more commonly in medical studies, sometimes over 80% of studies are done using male rats only.

So, basically, the main body of accepted research is not informed by the female context, namely, the presence of estrogen and progesterone, female puberty, menstruation, pregnancy, breastfeeding, peri-menopause, and menopause. 

Where I have arrived at with this state of affairs is as follows:  When I look for appropriate or effective intervention to support my mental health and functionality, I do not look to modern pharmacological answers or psychiatrists or doctors. (Full disclosure, I did do a lot of that in the past twenty years, for what was diagnosed as a major depressive disorder: Anxious type, and no prescription treatments helped, and I generally had to go off them because the side-effects were too severe.)

Like any decent wellness blog - here’s my health disclaimer: This site’s content is for informational purposes only and does not constitute medical advice, diagnosis or treatment.

So, this is all my opinion (and I am definitely NOT a doctor, or any type of health care professional. I am a mother with ADHD. I also have a honors degree in Psychology, specializing in infant development and psychometrics - so, I have an ease at reviewing research in this area).

(For the more meticulously logical of you - you may be skeptical of my criticism of the entire body of research that forms the diagnostic context for ADHD - so then how do I even know that I have it? Great question - I do accept that I have the psychological construct that we call ADHD, simply on the basis that it makes the most sense, especially when I observe my younger daughter, who I also believe has ADHD (as does my father) - And I was officially diagnosed by a GP (who, over the phone told me “I think you know more about this subject than I do!) and who gave me a bunch of inventories (meant for school aged children), gave me a bunch of blood tests to rule out other diagnoses, and then said "Yes, definitely ADHD". She then put me on short acting Ritalin - which was hellish, and I went off it after five days. But, I did accept the diagnosis as useful. I think sometimes philosophical criticism has to find a boundary, and practical considerations must take over).

What I have a huge urge to consider, in a series of blog posts that will show up here - at random, unpredictable intervals - because, hey I’m a mother with ADHD - are the ways I have learned to hack my life and find my lane. I also want to share my failures, my mistakes and hear from you and other mothers with ADHD, who have children with ADHD, about how we’re all getting through the day to day.

So, stay tuned - for more thoughts, about matcha tea, mindfulness-based stress reduction, ocean plunging, trees, and more!