ADHD underdiagnosed in women
Katie Fisher always had a sense something wasn’t quite right.
In school, she was chatty and outgoing, but also forgetful and found it hard to focus: ‘‘When I was a kid simple things were difficult for me, things that weren’t for others.’’
In her teen years, the Auckland woman struggled with anxiety and mental health problems that became difficult to manage later in life.
In 2021, it reached crisis point for the 31-year-old.
‘‘I [haven’t] slept for 48 hours, and I am in tears because I can’t stop thinking about cleaning out the linen closet.’’
It was recommended she visit a health practitioner, who asked if she had considered she might have attention-deficit, hyperactivity disorder (ADHD).
Fisher, of Pt Chevalier, hadn’t – she’d never heard of ADHD in women, but felt angry when the question was raised.
‘‘I was angry because I might have this thing that nobody knows about or talks about, and it felt kind of shameful.’’
Her mother later said they had tried to get her tested in the 1990s, but were told ‘‘girls don’t have ADHD’’.
Royal Australian and New Zealand College of Psychiatrists fellow Dr Sarah Romans said there were many myths surrounding ADHD in women.
Recently she had encountered a client who was told she couldn’t have ADHD because she had earned a university degree, Romans said.
Fisher’s story is not uncommon. Many women Stuff spoke with learned they had ADHD after years of adversity.
Romans said ‘‘without a doubt’’ ADHD was underdiagnosed in Aotearoa and her ‘‘clinical hunch’’ was it was even more underdiagnosed in women.
‘‘It is unusual for women, particularly those who have the inattentive subtype, to be picked up before they leave high school.’’
Victoria University of Wellington PhD candidate Barbara Ferguson is researching the experiences of women with ADHD in Aotearoa.
Ferguson said women with ADHD were an ‘‘underresearched and misunderstood population’’.
Gender bias and the stereotype of the ‘‘hyperactive naughty boys still prevailed’’ and had left women underdiagnosed, Ferguson said.
She said some ADHD symptoms in women were often mistaken for other conditions, such as mood or personality disorders.
Auckland District Health Board figures showed during the past 10 years, 1410 people were diagnosed with ADHD. Of those, 370 identified as female, of whom almost a third were diagnosed when they were adults.
Of the 2554 people diagnosed with ADHD through Counties Manukau DHB during the past 10 years, 519 were female. Of those, 34% were not diagnosed until they were adults.
At Waitematā DHB, about 350 of the more than 1700 ADHD diagnosis during the past 10 years were female.
Hannah Young, a 35-year-old from West Auckland, was diagnosed with ADHD at 33.
Young said she did not fit the stereotypical description of a child with ADHD. She was chatty and hyperactive, but did well academically.
She said instead of people thinking there might be something biologically wrong, they assumed that was ‘‘just how she was’’.
‘‘I think if there had been more awareness on how it presented in girls when I was a child I could have been picked up.’’
She said the diagnosis had been eye-opening.
‘‘Sometimes it’s like a wall between me and the work, but the medication puts a door there.’’
This role is Public Interest Journalism funded by NZ On Air.