Neurodiversity Celebration Week: 5 Reasons why ADHD gets misdiagnosed in women

This week is Neurodiversity Celebration Week - a worldwide initiative that challenges stereotypes and misconceptions about neurodevelopmental disorders and learning disabilities. To mark the week, we hear from Executive Coach, Leadership Development Trainer, and Author, Jo Banks discusses ADHD and why it often gets misdiagnosed in women.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects people of all genders, ages, and backgrounds. However, studies suggest that ADHD is often underdiagnosed or misdiagnosed in women, with many females living with the condition without realising it. This gender bias in diagnosis has significant implications for women’s mental health, self-perception, and overall well-being. There are a number of factors contributing to the misdiagnosis of ADHD in women these include:

Misdiagnoses/Under Diagnoses

I’m coaching an ever-increasing number of women who have or are in the process of getting a formal ADHD diagnosis. Previously they have been diagnosed with anxiety, depression, early menopause or other mental health issues. All have commented that their doctors never even considered the possibility of ADHD, and as they knew so little about it themselves, it didn’t occur to them either.

However, once they fully understood how ADHD manifests in women – which is often markedly different from men – I have been able to support them in getting a formal diagnosis as well as helping put interventions in place to manage their symptoms. Therefore, I aim to raise awareness. There are too many people struggling unnecessarily, and whilst ADHD is incurable, there are many benefits if the symptoms are managed correctly.

How ADHD symptoms differ in women

Stereotypical symptoms & diagnostic criteria

ADHD is commonly associated with hyperactivity, impulsivity, and disruptive behaviour, which are more prevalent in males. This stereotype has shaped the diagnostic criteria, making it less sensitive to the manifestations of ADHD in females. Women with ADHD tend to exhibit symptoms that differ from the classical presentation, such as internalised struggles, daydreaming, disorganisation, and emotional dysregulation. These atypical symptoms are often overlooked or attributed to other conditions like anxiety or depression, leading to misdiagnosis or missed diagnosis.

Masking & camouflaging behaviours

Women with ADHD are more likely to develop coping mechanisms that mask their symptoms, often due to societal expectations or pressure to conform. Growing up, girls are often told to ‘be a good girl’ and to ‘act ladylike’. They are taught that overenthusiastic or unruly behaviour is unattractive, so they learn to bury their hyperactivity, impulsivity and potential disruptiveness. This camouflaging behaviour, or ‘masking,’ allows them to blend in and compensate for their attention difficulties.

However, it also makes it harder for clinicians to recognise the underlying ADHD symptoms, as these women may appear competent, organised, and successful on the surface. The effort required to maintain this facade can be mentally exhausting and may contribute to feelings of inadequacy or anxiety.

Hormonal influences & life transitions

Hormonal fluctuations during puberty, menstruation, pregnancy, and menopause can exacerbate ADHD symptoms in women. These hormonal shifts can lead to changes in attention, mood, and overall cognitive function. As a result, women may seek professional help during these periods, revealing symptoms that have been present but less noticeable in other phases of their lives. Unfortunately, these symptoms can be misinterpreted as hormonal imbalances or unrelated mood disorders, further delaying an accurate ADHD diagnosis.

Social & cultural factors

Societal expectations and gender norms can influence how ADHD is perceived and diagnosed. Girls are often expected to be more compliant, organised, and quiet compared to boys, making it easier for their symptoms to go unnoticed. In addition, the prevailing stereotype of ADHD as a disorder primarily affecting young boys can lead to biases in assessment and diagnosis. Consequently, girls and women with ADHD may face scepticism or disbelief from healthcare professionals, friends, family, or even themselves, which hampers their access to appropriate support and treatment.

Lack of awareness & education

Limited awareness and knowledge about the unique presentation of ADHD in women contribute to the misdiagnosis problem. Healthcare professionals, educators, and the general public may be less familiar with the specific challenges faced by women with ADHD, leading to missed opportunities for early identification and intervention. Raising awareness about the diverse symptoms and experiences of ADHD in women is crucial for reducing misdiagnosis and ensuring proper support.

The future

The misdiagnosis of ADHD in women is a complex issue with multiple contributing factors. Stereotypical symptoms, masking behaviours, hormonal influences, social expectations, and lack of awareness all play a role in this gender bias. Recognising and addressing these challenges through improved diagnostic criteria, education, and awareness is essential for ensuring that women with ADHD receive timely and appropriate support.

By empowering women to understand their unique experiences and advocating for gender-inclusive approaches to diagnosis and treatment, we can help close the gap in ADHD identification and provide much-needed support for those affected. If you think you or an adult close to you (regardless of gender) may have ADHD, I recommend visiting the ‘Right to Choose’ page on the Psychiatry UK website: https://psychiatry-uk.com/righ... for more information on diagnoses.

ADHD in the workplace

As an inclusive employer, it is important to consider the huge benefits of cultivating neurodiversity in the workplace – from creativity and out-the-box thinking, to hyperfocus and incredible productivity levels to solution-focused problem-solving.

This neurodiversity celebration week, make sure you think about:

• Have a ‘living’ ED&I policy, i.e. one that people know about and use
• Train ALL staff on neurodiversity
• Have Occupational Health/ EAP available
• Offer a safe place to talk freely without judgment
• Consider having Neurodiversity Champions

Available training and support for the workplace:

Jo Banks can deliver two training sessions to support HR professionals, Managers and the wide workforce on the topic of neurodiversity:

• General neurodiversity awareness (available to all employees)
• How to manage neurodivergent employees (Managers)

Jo is also able to provide coaching for neurodivergent (diagnosed and undiagnosed) employees on a 121 basis to help manage symptoms, navigate workplace complexities, and be more productive and happier overall.

For more information on Jo’s coaching or other services, please email jo@jobanks.net or visit her website here.

Get in touch

For further information on the Events, Webinars, Roundtables and Insights Macmillan Davies have held, please visit our website.

To discuss the current HR market or if you would like to discuss any ideas for future events, please contact Kerry White, Associate Director directly kwhite@mdhr.co.uk