Our view of ADHD needs to change – the disorder presents differently in women and girls

Girls and women could be missing treatments for a condition causing depression, anxiety and severely disrupting their education and lives

I first sought help for my mental health when I was eighteen. Freshly moved into university accommodation, the anxiety and depression I’d been suffering with for years had worsened in the face of homesickness. I was prescribed the antidepressant sertraline by my doctor and shooed out the door.

Last summer, after four years on medication, I reached a breaking point. Realising that my symptoms encompassed more than just the general anxiety I’d been led to believe I suffered from, I embarked on some research. After some deliberation, I realised that it was likely ADHD.

Conditioned by stigma and societal misunderstanding of the condition, I completely shut it down. “I don’t have ADHD,” I thought. “I don’t bounce off the walls like the boys in my class used to.”

My entire life, I’ve felt that my brain was wired differently. I’ve had an odd eye tic since I was little, I’ve had jittery legs, felt driven by a motor, and been so mentally hyperactive that I’ve tripped over my own sentences and interrupted others without meaning to. I’ve experienced mood swings; emotional outbursts, the noises in my head are tiny but so overwhelming that I’ve cried.

Suppressing my suspicions only went so far. They came back to bite, and during the third lockdown, I approached the subject with my mum. Suspecting that she would perhaps not understand ADHD, I didn’t expect to get far, but she revealed that she too believed that she had it.

ADHD is largely genetic, and children of ADHD parents are more likely to have it. Taking a medically approved test to assess ADHD in women, I scored 65 out of 72. My mum received a similar mark, and we realised that our brains were much more alike than we initially thought.

My mum and I aren’t the only mother and daughter pairing united by this realisation. A woman I contacted about her experience, Hester Grainger, has two children with ADHD and decided to get tested after their diagnoses: “The doctor asked me if I had ever been diagnosed, so I decided to find out whether I had ADHD, too. I had always been a bit hyper, full of life and 100 miles an hour, but I hadn’t thought anything of it.” Grainger was also diagnosed with the condition.

Despite our relatively joint realisation, mum and I are now at different stages with our diagnoses. I sought a diagnosis through Right To Choose, meaning that the NHS will fund the private assessment I’m due to undertake. Current waiting times on the general NHS waiting list are dire, and according to ADHD Action one-third of adults have been waiting for an assessment for at least thirteen months.

I’ve likely lost a portion of my life to ADHD. If I had sought help whilst I was at school or even still studying at university, I might have been able to perform better. Instead, I left every task until the last possible minute, and I always felt that I could’ve performed so much better. At the same time, I was struggling with symptoms of depression and anxiety that I didn’t realise could be related to ADHD. I’ve probably spent weeks of my adult life in bed, suffering from what I now recognise as a lack of dopamine. That said, I feel hopeful that the right medication could change my life.

Mum has a different view on the matter. At fifty, she feels that a diagnosis would do little for her: “I’ve already made so many mistakes in my life. I don’t want to receive an ADHD diagnosis and realise that, all along, there was something I could’ve done. It won’t help.” She feels that ADHD has impacted her finances, causing her to make poorly informed decisions and spend impulsively.

Her response came as no surprise, ADHD is chronically underdiagnosed in women. Whilst ADHD in boys and men is more outward, ADHD in girls and women is characterised by mental hyperactivity. Two to 10 times more boys than girls are diagnosed with ADHD, according to a 2018 King’s College London study.

The approach to mental health services in the UK needs to change. My doctor did not consider my symptoms of depression and anxiety as a consequence of ADHD, a bit of deeper digging might change the lives of young women suffering symptoms of ADHD.

Societal interpretations of ADHD also need to change, I shut down any inch of suspicion that I could be suffering from ADHD because I didn’t believe that I fitted the outwardly hyper, socially disruptive image of a person with ADHD. These interpretations were largely based on ADHD in men, the condition presents completely differently in women.

It took us a while to piece the puzzle together, but the process has brought us closer together. Mum and I have often had similar thought processes, but put it down to mother-daughter likeness. I understand her thoughts and actions, and she mine. It’s been nothing short of liberating.