Unmasking Adult ADHD: Exploring the Surge in Interest and Challenges in Diagnosis
In recent years you may have noticed, as I have, there has been a notable surge in interest surrounding adult Attention-Deficit/Hyperactivity Disorder (ADHD). Once thought to be a condition primarily affecting children, ADHD is now gaining recognition as a condition that persists into adulthood. This increased awareness is shedding light on the unique challenges adults face when living with ADHD. Additionally, there is growing recognition of the specific hurdles in diagnosing ADHD in females, whose symptoms often differ from their male counterparts.
Several factors contribute to the rising interest in adult ADHD. As our understanding of ADHD has evolved, it has become clear that the disorder is not limited to childhood. Many individuals continue to experience symptoms well into adulthood, impacting various aspects of their lives, including work, relationships, and personal development. Symptoms were often dismissed or downplayed perhaps from fear of being judged or our children being labelled and disadvantaged. Perhaps we used phrases such as “he’s just an energetic boy” or “she’s a daydreamer”. For females the symptoms may not have even been recognised as concerning but simply assumed to be part of her intelligence (or lack there of). Ironically, in some cases, efforts to avoid one label (the dreaded ADHD) meant that children received another - “dumb”. However, the stigma surrounding mental health issues is gradually diminishing, prompting more adults to seek help for conditions like ADHD. Increased awareness and acceptance in current times encourage individuals to explore the possibility of ADHD and seek appropriate interventions.
Part of the reason we have increasing awareness has been the publication of ongoing research uncovering the neurobiological basis of ADHD and its impact on brain function. This research deepens our understanding of the condition and helps to destigmatise it, emphasizing that ADHD is a legitimate neurodevelopmental disorder. It is no longer the diagnosis for “naughty little boys”. While strides are being made in recognising adult ADHD, research is showing the prevalence of ADHD among females and revealing the specific challenges diagnosing the condition in females poses. You see, the traditional understanding of ADHD (and the corresponding diagnostic criteria relied upon by health professionals) has been based on male-centric symptoms, often leading to underdiagnosis or misdiagnosis in females. Here are some key challenges:
Presentation of Symptoms: ADHD symptoms in females may differ from the classic hyperactive and impulsive behaviors commonly associated with the disorder. Females with ADHD often exhibit inattentiveness, internal restlessness, and emotional dysregulation, which can be overlooked or attributed to other factors.
Coping Mechanisms: Girls and women with ADHD may develop coping mechanisms that mask their symptoms. They might compensate by working extra hard, being excessively organised, or avoiding situations that trigger their difficulties. These adaptive strategies make it harder to recognise the underlying ADHD.
Coexisting Conditions: ADHD in females often coexists with other conditions such as anxiety and depression. The presence of these comorbidities can complicate the diagnostic process, as symptoms overlap and may be attributed solely to the accompanying conditions. This is also a problem with diagnosing adult men as well.
Societal Expectations: Societal expectations regarding behaviour and performance may contribute to the underdiagnosis of ADHD in females. Girls are often expected to be more organized and compliant, and their struggles may be dismissed or attributed to personality traits rather than an underlying neurodevelopmental condition.
Hormones: More and more research is showing how female hormones influence executive functioning leading to things such as “baby brain” and the brain fog women report experiencing during perimenopause. These changes can look a lot like ADHD however it is unknown just how changes in hormones interacts with the ADHD brain. We know that women in perimenopause, for example, report an increase in ADHD-like symptoms but what we do not know is if this increase in symptoms indicates ADHD “unmasked” by the hormonal change or if the hormonal change causes similar symptoms in women who do not have an underlying diagnosis of ADHD. This is an identified area for research which I personally hope to undertake in 2024 so watch this space!
The increased interest in adult ADHD reflects a positive shift in recognising and addressing neurodevelopmental disorders beyond childhood. However, it is crucial to acknowledge the specific challenges in diagnosing ADHD in females. As awareness continues to grow, it is hoped that healthcare professionals will adopt a more nuanced and inclusive approach to diagnosis, ensuring that all individuals, regardless of gender, receive the support and understanding they need to manage and thrive despite their ADHD.
In summary, the increased interest in adult ADHD is primarily due to the publication of research identifying the problems with diagnosing ADHD in adults (particularly females). While this is a good thing, until we know more, it makes accurately diagnosing ADHD in adults extremely difficult. If you are experiencing symptoms you think may be consistent with ADHD, it is important that you seek advice from a qualified and trained health care professional such as a psychologist or psychiatrist who understands the problems surrounding the current diagnostic criteria as it applies to adults and in particular females.
If you would like to discuss your own experience further, you can make an appointment with Penelope here.
