How are ADHD Symptoms Different in Girls and Boys

Because not all cases of ADD are alike and females may lack some classic symptoms (most notably, hyperactivity), too many girls remain undiagnosed.

When people imagine attention deficit hyperactivity disorder (ADHD), also referred to as attention deficit disorder (ADD), they may picture a hyperactive, disruptive child—often a boy. But such stereotypes overlook half of the population that also deals with this neurodevelopmental disorder: females.

ADHD may be the most common learning and behavior problem in children (affecting 11.4% of them, according to the CDC), but it’s also a common problem in adults. If left undiagnosed and untreated, it can contribute to numerous potential obstacles throughout a person’s life.

Children with ADHD may struggle with everything from poor academic performance to making friends. And adults with ADHD may experience underachievement at work, relationship problems, substance use disorders, or obesity.

Because not all cases of ADHD are alike and females may lack some classic symptoms (most notably, hyperactivity), too many girls remain undiagnosed. These issues can then create a domino effect that prevents them from fulfilling their true potential.

However, when you recognize female ADHD symptoms, you’re more inclined to seek help for your daughter (or yourself), and you’re more likely to get more effective treatment.

HOW ADHD AFFECTS GIRLS AND WOMEN

According to an expert consensus published in 2020 in the journal BMC Psychiatry, the ratio of ADD/ADHD diagnoses in boys to girls ranges from 3-1 to 16-1. This discrepancy led the authors to conclude that “a large number of girls with ADHD are likely to remain unidentified and untreated, with implications for long-term social, educational, and mental health outcomes.”

Amen Clinics has identified 7 types of ADD/ADHD, each of which correlates to an underlying brain pattern, as seen on brain SPECT scans. Females often have a type called Inattentive ADD, which does not involve hyperactivity.

Take Sara, for example, one of thousands of children with ADHD who have been treated at Amen Clinics. Sara was 8 years old when her parents brought her to Amen Clinics because they were concerned about her inability to pay attention.

Her parents had a list of complaints about their daughter’s behavior, including:

  • Taking three to four hours to finish homework assignments that should have taken just a few minutes.
  • Acting spacey and being a daydreamer
  • Having a very messy room
  • Having poor social skills
  • Ignoring other kids on playdates
  • Not complying with her parents’ routine requests

According to Sara’s teacher, she appeared to be intelligent but didn’t perform up to her potential. In class, Sara’s mind wandered, and she didn’t pay attention. Her tests and homework assignments were filled with careless mistakes.

These were all hallmarks of Inattentive ADD. A SPECT scan and neuropsychological testing confirmed it. With appropriate treatment, Sara’s behavior and schoolwork improved after less than one week.

Recognizing the ADHD symptoms in girls like Sara is the first step to getting an accurate ADHD diagnosis.

ADHD SYMPTOMS IN FEMALES

ADD symptoms in females tend to differ from the disruptive behavior seen in boys. Girls often experience more symptoms of inattention

While Inattentive ADD is the second most common type of this condition, it can also more easily be overlooked. That’s because, instead of acting out with disruptive behaviors, people with this type may be quieter and more introverted. They may be mislabeled as a daydreamer, “spacey,” unmotivated, lazy, or slow.

Inattentive ADD types can show classic ADD/ADHD symptoms, like short attention span and poor impulse control. But there are additional common signs of Inattentive ADD, including:

  • Trouble focusing
  • Being easily distracted
  • Disorganization
  • Poor follow-through
  • Trouble listening when others are speaking
  • Problems with time management
  • A tendency to lose things
  • Making careless mistakes/poor attention to detail
  • Forgetfulness
  • Excessive daydreaming
  • Complaints of being bored
  • Appearing unmotivated or apathetic
  • Being tired, sluggish, or slow moving
  • Appearing preoccupied

One significant difference in how the ADD/ADHD brain works relates to how it performs during moments of attempted concentration. Typically, the act of concentration increases blood flow to the brain, especially to the prefrontal cortex (PFC). But in an ADD/ADHD brain, blood flow can actually decrease.

In Inattentive ADD, the brain at rest appears healthy. When the person tries to concentrate, however, there is often decreased activity in certain regions of the brain. This tends to affect the underside of the prefrontal cortex, cerebellum, and basal ganglia, which can impact tasks like judgment and impulse control.

TREATING INATTENTIVE ADD IN FEMALES

These brain changes are one reason why females with ADD are more likely to experience life-altering consequences, such as teenage pregnancies. (They also tend to have more children overall.)

In addition, they may have relationship and work problems, leading to outcomes like divorce and poor work performance. These kinds of issues can lead to greater life instability and unhealthy coping strategies, like self-medicating with substances—legal, illegal, and/or prescribed.

Furthermore, females with ADHD may show signs of coexisting mental health issues. Anxiety disorders, depression, and sleep problems are not uncommon, which can complicate their diagnoses. A brain SPECT scan is helpful to avoid the misdiagnosis of mood disorders or other issues.

Without diagnosis and appropriate treatment, girls, teens, and adult women are likely to experience additional problems that will impact their well-being and behavior—and could even reduce their lifespan. In addition to the mental health issues listed above, these include:

Women who do not receive the proper treatment for ADD can enter a downward spiral marked by low self-esteem and high stress levels. They may feel like a failure or defeated in life, blame themselves, or engage in destructive behaviors like self-harm.

ADHD TREATMENT FOR FEMALES

Getting an appropriate customized treatment plan can stimulate more focus, organization, and motivation, making everyday life easier. Effective treatment for ADHD can include stimulant medications, but there are other solutions, including all-natural alternatives. These can include:

  • A high-protein, low-carbohydrate diet
  • Regularly scheduled intense exercise
  • Supplements, such as 500 mg of L-tyrosine twice daily
  • Neurofeedback
  • Behavioral interventions
  • Psychological strategies

ADDRESSING ADHD IN GIRLS

As the Child Mind institute points out, ADD/ADHD in girls is often called a “hidden disorder” because it so often goes undetected. Getting diagnosed with ADHD, especially at an early age, will help parents and teachers create the right conditions for a lifetime of increased success.

The Institute recommends, for example, providing a place without distractions for your child to complete classwork or homework. If she has extra energy, she might take a run before sitting down to do her work.

Encouraging expression and socialization is also important. She might respond well to activities, clubs, or groups, as long as her differences are respected there. And let her know she should speak up about her emotions and any challenges she’s experiencing.

In addition, if your female child is struggling with Inattentive ADD, there are certain attitudes and approaches that will be helpful for you to implement as a parent:

  • Set up a system that rewards good behavior and withholds privileges as a consequence of negative behavior.
  • Establish fair and realistic expectations. Provide straightforward directions, with simple and clear instructions.
  • Create a written checklist for your child to track her goals. This helps her feel a sense of accomplishment when she visually sees she’s reaching her objectives.

CREATING BETTER OUTCOMES FOR WOMEN WITH ADHD

Ultimately, when it comes to ADHD in females, there are both challenges and upsides. For example, according to a study in the Journal of Clinical Psychiatry, women experience more severe ADD symptoms than their male counterparts.

On the other hand, Inattentive ADD is usually very responsive to treatment. It’s often possible to improve a person’s entire life, as long as the disorder is properly diagnosed and treated—and the earlier, the better.

We can all take some necessary first steps by ending the stigma, increasing awareness, and understanding the unique needs of females with ADHD. Taking effective steps toward healing will help these girls and women, once erroneously dismissed as ditzy or underachieving, demonstrate just how resilient and accomplished they can be.

We Are Here For You

ADD/ADHD and other mental health conditions can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry. 2020 Aug 12;20(1):404. doi: 10.1186/s12888-020-02707-9. PMID: 32787804; PMCID: PMC7422602.

Robison RJ, Reimherr FW, Marchant BK, Faraone SV, Adler LA, West SA. Gender differences in 2 clinical trials of adults with attention-deficit/hyperactivity disorder: a retrospective data analysis. J Clin Psychiatry. 2008 Feb;69(2):213-21. doi: 10.4088/jcp.v69n0207. PMID: 18211131.

Child Mind Institute, How to Help Girls with ADHD by Rae Jacobson, https://childmind.org/article/how-to-help-girls-with-adhd/

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