17. How ADHD Differs in Men and Women 🤯

Photo by Dương Nhân

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals of all ages and genders. It is characterized by inattention, hyperactivity, and impulsivity. While ADHD has historically been considered a disorder that predominantly affects boys and men, recent research has shown that ADHD symptoms in women can manifest differently than in men. Understanding these differences is crucial for appropriate diagnosis and treatment.

This is an aspect of neurodivergence that I had never thought about before. Listen until the end of the episode, and tell me if this isn't the ADHD public service announcement of 2023! It's at least in the top five!- I say that because If you google adult ADHD, this is not something I've come across until recently. This is vital information! Every other article about ADHD is all comorbid disorders, this- and your amygdala, that. Nobody cares.

Did you know ADHD and its symptoms express differently in Men than in Women?

Studies have shown that even though women may suffer more from ADHD, they are rarely diagnosed, often diagnosed later in life, or misdiagnosed! Why is that?

The standard criteria for diagnosing behaviors associated with ADHD is a bit outdated. That's because it's explicitly designed to address neurodivergent symptoms in men and boys. As mentioned earlier, that's a problem, and let's talk about why. 

First, let's go over the 3 types of ADHD.

• ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors, inattention, and distractibility.

• ADHD, impulsive/hyperactive type. This is the least common type of ADHD, characterized by impulsive and hyperactive behaviors minus inattention and distractibility.

• ADHD, inattentive and distractible type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.

The first and third type of ADHD is where our story begins. The first type of ADHD, the combined type, is thought to be the most common, and it sort of is. I say "sort of" because this type predominantly affects men. In contrast, the inattentive/distractable type is now believed to affect women disproportionately, and this defies the biased trend.  

As touched on earlier, this is probably not something new; women have likely always had ADHD, but medical professionals have largely unnoticed or dismissed type three ADHD (inattentive, distractable type) as a dominant threat. I'll try my best to further describe what this means. 

To summarize this topic, women may be more likely to present with symptoms of inattention rather than hyperactivity. 

Inattention 

It's a typical O.G. ADHD symptom. Both men and women experience inattention, but as we'll find with all symptoms, The only difference is whether they express it internally or externally. 

For example, when it comes to inattention, women may need help overcoming procrastination, might experience difficulty starting tasks, and be more forgetful. Women may also need help keeping track of their belongings, engaging in conversations, not interrupting others, and maintaining routines. 

Men with ADHD, on the other hand, can be more prone to externalizing their inattention. They may struggle with impulsivity, distractibility, and difficulty with self-regulation. Men with ADHD may also be more likely to engage in risky behaviors and have problems inhibiting their actions. Boys and men show inattention with hyperactivity; they will fidget more, drum on things, bite their nails, etc. 

Men also become impatient more frequently.

Another example:

Disorganization

Women with ADHD may struggle with disorganization. It creates difficulty prioritizing and breaking down large tasks into manageable steps, which can contribute to becoming emotionally overwhelmed. 

Men with ADHD, on the other hand, may struggle with similar disorganization, like keeping their living spaces clean, because *Beavis and butthead drop*.

You're listening to this right now and might think this is confusing! Those sound like the same things, but just said differently! Let's break it down for clarity. Nancy is a mess. She's always late for work, can never find her car keys, and her purse is packed with deodorant, a dental hygiene kit, and a half-full perfume bottle that must've been upside-down because every piece of gum she has in there; it tastes heavy of Chanel No. 5.

Chanel is too fancy; whatever the equivalent is to Axe body spray is for women, that's what it tastes like. If you walk into her apartment, you'd never tell her life is a hot garbage mess. It's neat, and it smells like pumpkin spice lattes. This is why her doctor doesn't diagnose her with ADHD. She got good grades in school too. How does she keep it together!? Freaking the fuck out, that's how! 

She repeats poor self-talk and uses shame cycles to trigger adrenal responses to fuel what look like effective coping mechanisms. She calls her friends to emotionally dump and cries at the drop of a hat. Not just at sad movies but cute things. She cleans the best when she's in an argument with someone. So she gets shit done, but there's little attention to conscious planning. She has to initiate through almost neurotic behaviors. 

Then there's James. James always has his car keys, attends work on time, and doesn't carry a bag full of toiletries. But there is a can of Axe body spray in the cupholder of his daily driver. The deodorant has seen the transition of winter, spring, and into the heights of summer. He wonders if it could explode while baking in the hot July sun daily. Oh well. Fuck it. And that's John’s Disorganization.

If you walk into his apartment, it looks like his car. Power tools are on the dining table, and the laundry basket is on the couch. He never loses his keys because he throws them onto the same pile of magazines every day. He's always on time to work because if he sleeps in, he skips the shave and shower that day. His mom visits and reminds him that he has stayed the same since high school after looking around his place. He laughs, maybe rips a fart, I don't know.

This is what ADHD looks like to most people, and it's the archetype of the condition. So Nancy is overlooked, and John is headed to his first evaluation, where his doctor makes it rain Adderall on him. 

But Nancy is experiencing disorganization just as bad. Still, she can't help but beat herself up over having a dirty place. What will people think of her!?

Hyperactivity and Impulsivity x Emotional dysregulation 

I hope that up until this point, I've somewhat established that women with ADHD may experience emotional dysregulation in more internalized ways than men, which is inattention taking the place of hyperactiveness. Women struggle with self-doubt, negative self-talk, and difficulty with self-compassion. As a result, they may also experience higher anxiety, depression, and moodiness than men. Additionally, women may experience more frequent emotional meltdowns triggered by stress, overwhelm, and frustration.

Men have physical restlessness more than mental fatigue and exhibit hyperactivity and impulsivity in overt ways, fidgeting, tapping their feet, or performing other physical movements to relieve restlessness. 

Why is Understanding Gender Differences in ADHD Symptoms is Important?

ADHD is often missed or misdiagnosed in women because its symptoms may not fit the traditional stereotype of hyperactivity and impulsivity. Women may also be more likely to develop coping strategies to manage their symptoms, which can lead to burnout or anxiety. On the other hand, men may be overdiagnosed with ADHD due to their more apparent signs of hyperactivity and impulsivity, while their inattention may be overlooked.

The exact reasons ADHD symptoms may differ based on gender are not entirely clear, and the topic is still a subject of ongoing research. However, several factors might contribute to the differences in symptoms observed in women and men.

The most obvious factor is the role of hormonal and neurobiological differences between genders. Evidence suggests that estrogen, a hormone present in higher levels in women, may have a protective effect against ADHD symptoms. Additionally, studies have indicated that there may be differences in how male and female brains are structured and function, which could contribute to differences in how ADHD symptoms manifest.

Social and cultural factors may also influence the differences in ADHD symptoms between genders. For example, women are often socialized to be more quiet and compliant, which could lead to their symptoms being overlooked or interpreted as something else. Many indicators of neurodivergent women are written off as personality traits, and Inattentiveness evolves into talking too much. Being forgetful is called being a ditz.

Women are socialized to be seen and not heard. And that their physical appearance and cleanliness are imperative.

On the other hand, men are often socialized to be more aggressive and assertive, which could contribute to their symptoms being more overtly noticeable.

To put this concept in another way, women live in a world of "you shouldn't," and men live in a world of "you should." It shows in the ways our ADHD symptoms manifest.

Diagnosis and Treatment

If you are experiencing symptoms of ADHD, it is vital to seek professional diagnosis and treatment. A healthcare professional can perform a thorough evaluation that may include clinical interviews, observation, and assessment of symptoms. Treatment options may include medication, therapy, lifestyle changes, and support groups.

Conclusion

ADHD is a complex neurodevelopmental disorder that can affect individuals in many ways. By receiving proper diagnosis and treatment, individuals with ADHD can learn to manage their symptoms and improve their quality of life.

If you think you have ADHD, don't forget to visit the Abundant website at abndtadhd.com. There you can find resources like the ADHD symptoms quiz, which is based on the questionnaire you'll take with a doctor to Determine if you have ADHD. You can also find methods and techniques to help you better manage your ADHD symptoms.

Did you find today's episode to be informative? If so, let me know by liking and subscribing to this show! And remember to give this show five stars; it really helps the show! Until next time, much love, D.C. out!