‘Silent struggle’: Dubai clinics report surge in ADHD cases among women
Most adult patients seeking assessment for attention deficit hyperactivity disorder in Dubai are women, clinics have reported.
Experts said the challenges of the Covid-19 pandemic and greater awareness have contributed to more women seeking support after enduring a “silent struggle” with the condition.
Dr Ioannis Delipalas, medical director at Thrive Wellbeing Centre, told The National there had been a noticeable change in the past two years, as previously his ADHD patients were mostly men.
“About 60 per cent of [new intakes] are women seeking out an assessment compared to before. This is huge,” he said.
About 75 per cent of those women will receive an ADHD diagnosis, he said.
At Sage Clinics, a mental health centre that opened in Downtown Dubai in 2022, resident psychiatrist Dr Zeeshan Ahmad said about 65 per cent of those seeking ADHD assessments are women, 87 per cent of whom had it diagnosed.
ADHD is a neurodevelopment condition with three types: hyperactive and impulsive, inattentive and a combination of the two.
Key symptoms of the hyperactive type are being unable to sit still, poor concentration and excessive talking and movement.
Signs of the inattentive form of the condition are a short attention span, forgetfulness and difficulty sticking to time-consuming tasks and following instructions.
While there is no known cause, scientists say there are differences in the brains, nerve networks and neurotransmitters of people with ADHD. Cleveland Clinic describes it as “a long-term, chronic brain condition that causes executive dysfunction”, leading to a decreased ability to manage emotions, thoughts and actions.
Historically, it has been associated with young boys, who typically have clear symptoms. “We all know the stereotype of ADHD as a typical seven, eight or nine-yearold boy yelling, screaming, throwing things at mum, throwing a tantrum,” said Dr Delipalas.
“That was the reason why young boys or male teens
were able to be diagnosed earlier compared to women.
“With time, we discovered that there can be a more diversified clinical picture of ADHD.
“In females, we know for sure that the inattentive type dominates the clinical picture.
“We typically have a silent girl who cannot focus in the classroom, she may daydream and she goes unnoticed.
“This going unnoticed follows her for many years to come, until, at some point, in her late 20s or early 30s, it needs to be addressed.”
Dr Saliha Afridi, founder and chairwoman of local mental health clinic The LightHouse Arabia, said the number of adults making appointments for an ADHD assessment at the centre increased elevenfold between 2021 and last year.
Although Dr Afridi was unable to share gender-specific statistics, the increase in cases reflects a global trend of rising diagnoses among adults, particularly women.
A significant increase in diagnoses among adult women was recorded in a US study of more than three million patients.
The number of those aged 23 to 49 receiving a diagnosis from 2020 to 2022 nearly doubled, according to the report by Epic Research, released last year.
Experts largely agree the reasons for the increase include the Covid-19 pandemic, as women were less able to manage their symptoms, as well as the proliferation of telehealth services and rising awareness, prompted by social media.
Research on women with ADHD is also still catching up, as the majority of studies carried out have been conducted on boys and men.
Global statistics show boys are more likely to receive a diagnosis in their younger years, while the average age for women getting diagnosed is in their mid-30s.
The ratio of boys to girls with ADHD in childhood is about three to one, but in adults there is a 50:50 split between the genders, according to a study in the Journal of Attention Disorders last year, suggesting the prevalence is equal across genders, but that women are just more likely to have it diagnosed later.
Dr Romena Toki, a clinical psychologist at Sage Clinics in Dubai, says for many women and girls, the diagnosis will come after years of “silent struggle”.
“Despite being immensely hardworking, bright, creative and so on, they may often be branded as the ‘day dreamers’, ‘disorganised’, ‘careless’ or ‘unreliable’,” she said.
“The responsibility is entirely always on them to perform the same as those around them, without any adjustments.
“In many ways, they often do seem to manage well, but beneath the water’s surface, they’re fiercely swimming on overdrive.” Women are also more prone to what experts call “masking”, how people compensate for or cover up their symptoms due to societal expectations.
Receiving a diagnosis from a trained professional is vital, said Dr Delipalas. Comprehensive diagnosis includes an initial psychiatric consultation to rule out other conditions that may need to be addressed before a screening.
Dr Delipalas warned that this is not like those freely available on the internet.
If this is positive, then the third stage is a referral to a psychologist who is trained in measuring psychometrics in neurodevelopment conditions.
Medication is available to manage the condition, with the use of such stimulants closely monitored and tailored for each patient, Dr Delipalas said.
Cognitive behavioural therapy can be applied for people with ADHD and comprehensive medical support is available in the UAE, he said.
“It’s very important when someone seeks out assessment to rule in or rule out ADHD to also have access to reliable and scientific resources,” he said.