In a podcast, ADHD in women was discussed with Prof. Davida Hartman, a chartered psychologist. Maria Cohut, a features editor, shared her experience of receiving a late ADHD diagnosis, highlighting the challenges women face.
Cohut recalled a moment at work where her multitasking abilities surprised a colleague, revealing how her brain functions differently. She attributed her late diagnosis to societal norms and the lack of awareness about ADHD during her upbringing, noting that neurodiversity wasn’t widely recognized when she was growing up, and the hyperactive stereotype didn’t fit her experience as a quiet, high-achieving student.
Why the delay in women’s ADHD diagnoses?
Prof. Hartman explained that the focus on a narrow ADHD presentation, typically seen in hyperactive boys, overlooks how ADHD manifests in women and non-binary individuals. She emphasized the medicalization of ADHD within a deficit-based framework that fails to capture the diversity of ADHD experiences and the overlap with other neurodivergences.
She emphasized the impact of societal expectations on women, often leading them to mask their ADHD traits to conform. This masking, whether conscious or unconscious, can cause significant mental health strain and shame.
ADHD traits in women and the role of perimenopause
When asked about ADHD presentation in women, Prof. Hartman clarified that ADHD itself doesn’t differ between genders, but societal expectations and cultural conditioning can influence how it’s expressed and perceived. She stressed the importance of language in shaping understanding, preferring “traits” over “symptoms” to move away from a pathologizing framework.
She highlighted the concept of masking and its mental health toll, especially when individuals feel they must constantly perform focus or hide their true selves. This can lead to a breaking point where the effort becomes unsustainable, particularly during life transitions like perimenopause.
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The discussion turned to perimenopause and its potential impact on ADHD traits. Prof. Hartman suggested that while ADHD traits may not intensify, the emotional and executive functioning challenges during this period can make managing ADHD more difficult. Hormonal changes and increased demands can exacerbate existing difficulties, making it harder to maintain coping mechanisms.
Distinguishing between perimenopause symptoms and ADHD can be complex, but Prof. Hartman stressed the importance of a rigorous assessment that considers an individual’s history, including evidence of traits before the age of 12. This involves gathering collateral information and recognizing that genetic factors often mean family members may also exhibit undiagnosed ADHD traits.
The conversation concluded with a focus on the need for better professional education and screening for neurodivergence in mental health services to improve identification and support for women with ADHD. Prof. Hartman advocated for a neurodiversity-affirming approach that recognizes the strengths of ADHD and moves beyond a deficit model.
The impact of perimenopause and the importance of self-acceptance
Prof. Hartman emphasizes the importance of a rigorous assessment that considers an individual’s history, including evidence of ADHD traits before the age of 12. This wide-ranging approach ensures an accurate diagnosis and appropriate support, even when historical evidence is difficult to obtain due to family relationships or lack of awareness.
Medication and self-management strategies
The discussion turns to the role of medication in managing ADHD. Prof. Hartman explains that while medication can be beneficial for some individuals, it is not a one-size-fits-all solution. The decision to use medication should be based on individual needs and preferences, and it is essential to have realistic expectations about its effects. She acknowledges the evolution of her own perspective on medication, moving from initial skepticism to recognizing its value for many individuals.