Understanding ADHD in Girls
Historically, ADHD has been more often diagnosed in boys than girls. For many, the stereotype of a child with ADHD is still a noisy, impulsive, hyperactive boy. Girls with ADHD can present differently and so often face unique challenges. As a result, they have frequently been underdiagnosed or misdiagnosed. While boys with ADHD often display hyperactivity and impulsive behaviour, girls with ADHD may exhibit more internalised symptoms, such as daydreaming, inattention, and difficulty organising tasks.
The symptoms of ADHD in girls often don’t emerge until puberty, a time when most young people start to experience emotional ups and downs. So the ADHD symptoms are often put down to ‘being a teenager’. ADHD symptoms increase in girls when they reach puberty because the hormonal fluctuations that take place during a girl’s monthly cycle can trigger or exacerbate her ADHD symptoms.
What are the characteristics of ADHD in girls?
Some characteristics of ADHDin girls might include:
- Daydreaming quietly in class
- Feeling sad or anxious
- Being scatterbrained
- Talking incessently
- Being ‘silly’ or ‘
- Being a perfectionist
- Shyness
- Trouble maintaining friendships
- Picking at their nails/skin; fiddling with their hair
- Not paying attention
- Nosiness
Girls with ADHD often develop coping mechanisms to mask their social difficulties, imitating neurotypical behaviour to fit in. For example, it could be perfectionism; going over and over homework to make sure she gets a good mark or repeatedly checking her school bag many times to make sure she has everything she needs. This camouflaging can make it difficult for others to recognise that she is struggling.
According to research conducted at Harvard University, 45 percent of girls with ADHD have another serious condition, such as clinical depression or crippling anxiety (the co-existing disorders in girls with ADHD tend to be internalised- ie not seen by others, but are not restricted to these). This can influence diagnosis and diagnostic accuracy. Eating disorders have also been linked to ADHD in girls and women.
Girls can internalise their challenges, masking their ADHD and turning their frustrations on themselves rather than others. This can lead to anxiety, stress and low self-esteem – and missed diagnostic and treatment opportunities.
How you can help your daughter
Build on her strengths – it’s easy to lose sight of your strengths when you feel under pressure (from school work, tricky social situations etc) but she will have strengths. Don’t let her forget them. Get her to list her strengths and put them up in her room so she can see them and remind herself of them daily. Help her develop her strengths and talents.
Communication – create an open and non-judgmental environment where she feels comfortable discussing her challenges. Focus on solutions rather than the problems when communicating with your daughter. For example, ‘What could help you go to bed on time?’ rather than ‘Why are you staying up late?’
Structure – the executive functioning skills, such as organisation, planning and time management can be particularly challenging for girls with ADHD. Clear routines and consistent schedules are really helpful. Provide a structured and organised environment to help her manage her time and tasks; for example, using visual aids, such as charts, schedules, and reminders, to help her organise her tasks and manage her time.
Sleep – have a night time routine that encourages healthy sleep. See our ‘Why teenagers need their sleep’ support leaflet.
Physical activity – regular physical activity is beneficial particularly if your daughter is hyperactive. Exercise helps alleviate the ADHD symptoms and has positive effects on attention and overall wellbeing.
Be consistent – have a few clear, fair, agreed rules. If there are consequences to breaking these rules, they must not come as a surprise and should be imposed quickly, without delay.
Conclusion
Diagnosis and support should always be based on an individual’s specific needs and characteristics. So it’s important to recognise the diversity of ADHD and understand that the presentation of ADHD can vary widely amongst individuals. This includes gender related differences in how ADHD can present in a child or young person. Increased awareness and education about ADHD in girls can only help in getting earlier and more accurate diagnosis, leading to better support and outcomes for individual’s and their families.
We are here to help
We are here to support and care for you as a family. We work with children and teenagers, along with their families, diagnosing and treating those who have developmental disorders like ADHD. As child psychiatrists, we have medical degrees which allow us to prescribe medication (if appropriate) as well as delivering therapy. If you have concerns, do get in touch. We can chat over the phone and establish what the issues are.
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