Attention deficit hyperactivity disorder, or ADHD, affects roughly 3 percent of adults around the world. However, many of those with the condition remain undiagnosed, especially women.
According to the National Institute of Mental Health, men are nearly twice as likely to be diagnosed with ADHD than women, but roughly 75 percent of women with the condition are undiagnosed.
Newsweek spoke to doctor and psychologist Janina Maschke to find out more about the most common, overlooked symptoms of ADHD in girls and women.
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"ADHD often presents differently in girls than in boys," Maschke told Newsweek. "Girls often internalize behavior versus boys who are more likely to externalize their behavior. This difference in symptom presentation can lead to boys being diagnosed more frequently than girls, as they externalize their symptoms and might disrupt others at school."
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These internalized behaviors may often be misinterpreted as shyness or simply a lack of interest. Here are some of the key symptoms to look out for, according to Maschke:
- Appears withdrawn and shy.
- Cries easily and seems to get upset often.
- Daydreams frequently and seems lost in her own world.
- Has difficulty maintaining focus and is easily distracted.
- Disorganized and messy in both appearance and physical space.
- Seems unmotivated and doesn't appear to be trying.
- Forgetful and often late, showing poor time management.
- Highly sensitive to noise, fabrics and emotions.
- Hyper-talkative with lots to say but not good at listening.
- Makes "careless" mistakes frequently.
- Might often slam doors shut.
- Struggles with completing tasks.
- Shifts focus from one activity to another frequently.
- Takes time to process information and directions, often seeming like she doesn't hear you.
- Verbally impulsive, often blurting out and interrupting others.
The severity and type of ADHD symptoms may also fluctuate throughout the menstrual cycle, making them appear sporadic and inconsistent.
"During the premenstrual phase ADHD symptoms often worsen and become more prominent, as estrogen levels decrease during this phase," Maschke said. "Oestrogen increases dopamine, and when estrogen levels drop, this impacts dopamine production, which in turn affects ADHD symptoms."
While it is too early to say whether dopamine levels directly cause ADHD, numerous studies have suggested that low levels of dopamine may contribute to ADHD symptoms.
"It is also important to get a better understanding of how hormonal changes can impact ADHD symptoms, as this can be crucial for women, along with their physicians, psychologists, partners and friends when it comes to understanding and managing ADHD effectively throughout the different stages of life," Maschke said.
So, what should you do if you or someone you know suspects they may have ADHD?
"It is important to seek a professional evaluation," Maschke said. "As a first step, it can be good to start by consulting with a pediatrician or a mental health specialist who can conduct a thorough assessment. This process typically involves clinical interviews, behaviour rating scales, as well as input from teachers and parents [if the patient is under 18.]"
Maschke will be unveiling more about how women can identify and manage their symptoms of ADHD in her upcoming book, A Feminist Guide to ADHD, which will be published on October 8.
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