For women, gender disparities in ADHD diagnoses can be deadly

It’s long been assumed that the disorder primarily affects young boys, leading to the widespread misdiagnosis of women who can face significant challenges as a result. But that may be changing.

[Photo: Yana Iskayeva/Getty Images]

It was long assumed that boys were more likely to have attention-deficit/hyperactivity disorder (ADHD). But recent research suggests girls have been widely underdiagnosed—with sometimes devastating consequences.

Now, many women who have long suffered from mental health conditions and everyday challenges are identifying ADHD as the underlying cause.

“Women are much more likely to have what’s called ‘inattentive ADHD,’ versus ‘hyperactive ADHD,’” says Dr. Sarah Greenberg, a licensed psychotherapist and the vice president of expertise and strategic design for neurodivergence nonprofit Understood.org. “The hyperactivity is really visible to others in the room, whereas for inattentive ADHD that hyperactivity is internal. It might look like daydreaming or staring into space. But I can assure you, there’s a lot happening in the brain.”

Dr. Greenberg says that undiagnosed ADHD can create challenges in childhood, from social to academic, leading to lots of self-doubt. Coupled with the over-thinking tendencies of those with inattentive ADHD, many are instead diagnosed with anxiety or depression. That misdiagnosis can have serious consequences, as untreated ADHD has been associated with everything from higher rates of substance abuse to divorce, car accidents, even suicide attempts.

Women with ADHD are Often Misdiagnosed

According to a study conducted by Understood.org, 72% of women with ADHD have at least two other mental health conditions, like anxiety or depression, and 44% were diagnosed with anxiety, depression or another mental health condition first. 

Furthermore, 89% say they originally attributed ADHD symptoms—like disorganization, overthinking and chronic lateness—to personal character flaws.

“’Hysteria’ was a label given to women for a range of things, from insomnia to anxiety, and the theory rested on uterine imbalance,” explains Dr. Greenberg. “We don’t use that label anymore, but what has persisted is women are more likely to get diagnosed with an emotional disorder rather than ADHD, which is a brain difference.”

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