“Women with ADHD Are Caught In an Endless Cycle”
“We are calling on all women with ADHD, those who care about them, and those who provide care for them to sign our petition to develop gender-equitable ADHD diagnostic criteria. Gender-equitable criteria will allow us to better identify women with ADHD and help them to receive the treatment they need.”
The following is a personal essay reflecting the opinions of the authors.
May 5, 2024
Every ADHD expert that we know believes that girls and women with ADHD are underdiagnosed and misdiagnosed.
In 1994, a meeting of ADHD experts was convened at the National Institute of Mental Health (NIMH) to make recommendations about ways to better meet the needs of girls. This committee strongly recommended the creation of diagnostic criteria designed to better identify girls with ADHD. More than a generation later, this recommendation remains largely ignored, despite the clear and compelling need for such a change.
It is well documented that untreated ADHD in women leads to potentially disastrous consequences starting in adolescence with anxiety, depression, low self-esteem, and unplanned pregnancies followed by academic failure, psychiatric hospitalization, and suicide. Women with ADHD are more likely to face divorce, to become single parents who raise challenging children with ADHD, to experience domestic violence, and to struggle with income insufficiency — which, in combination, trigger the destructive spiral of intergenerational ADHD challenges.
[Read: Wanted — ADHD Research on Women & Girls]
Better identification and treatment of women will have a positive cascading effect, benefitting women by increasing self-esteem, improving employment, and building stronger parenting skills that, in turn, benefit their children.
Today, as APSARD (The American Professional Society for Attention and Related Disorders) is undertaking worthy effort to develop the first U.S. adult ADHD guidelines, we urge its leaders not to overlook the longstanding need for better identification of ADHD in women. We are calling on all women with ADHD, those who care about them, and those who provide care for them to sign our petition to develop gender-equitable ADHD diagnostic criteria. Gender-equitable criteria will allow us to better identify women with ADHD and help them to receive the treatment they need.
The effort to create more gender-equitable ADHD criteria has been thwarted by “lack of research evidence” to support such changes. We are caught in an endless cycle: there is minimal investment in research on gender differences in ADHD, resulting in limited evidence-based knowledge about gender differences.
Now, as APSARD works to recommend new adult ADHD diagnostic guidelines, we urge them to consider the long-overdue need to develop guidelines that are better suited to correctly identify females with ADHD. This guideline process can massively advance gender-equity if APSARD leaders are forward-thinking enough to take the needed steps. Alternatively, if gender is ignored, the guidelines could calcify historically male-biased approaches to describing and diagnosing ADHD.
[Read: ADHD Symptoms in Women Aren’t ‘Hidden.’ They Are Misinterpreted.]
We urge APSARD, as part of its adult ADHD guidelines, to acknowledge that current diagnostic approaches are not fully gender-equitable, and to propose more gender-equitable criteria for further study. Once such recommendations are made by a well-respected organization, it becomes more likely that research dollars, including funding from President Biden’s Executive Order on Women’s Health, will be allocated to research studying these proposed criteria.
We call on APSARD to take the first step in this long-overdue process by identifying gender-equity as a priority and by proposing more gender-equitable diagnostic criteria. Once this exciting first step is undertaken, the criteria can be tested and improved through a process that makes them evidence-based. Please sign our petition and share it widely through your networks.
Petition to APSARD: Improve Gender-Equity in the Diagnosis of Adult ADHD
We Demand Attention: A Call for Greater Research on ADHD in Women
Intro: Top 10 Research Priorities
- Sex Difference in ADHD
- The Health Consequences of Delayed ADHD Diagnoses on Women
- How Hormonal Changes Impact ADHD Symptoms in Women
- How Perimenopause and Menopause Impact ADHD Symptoms, and Vice Versa
- The Elevated Risk for PMDD and PPD Among Women with ADHD
- The Safety and Efficacy of ADHD Medication Use During Pregnancy and While Nursing
- How ADHD Medication Adjustments During the Monthly Menstrual Cycle Could Improve Outcomes for Women
- The Long-Term and Short-Term Implications of Hormonal Birth Control and Hormone-Replacement Therapy Use Among Women with ADHD
- How and Why Comorbid Conditions Like Anxiety, Depression, and Eating Disorders Uniquely Impact Women with ADHD
- Early Indicators of Self-Harm, Partner Violence, and Substance Abuse Among Girls and Women with ADHD
Michael Morse, M.D., is the director of psychiatric education and training at The Chesapeake Center — ADHD, Learning and Behavioral Health in Bethesda, Maryland. Kathleen Nadeau, Ph.D., is founder and director of The Chesapeake Center.
SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
