Hello, brains. In case you haven't noticed, I am a woman with ADHD, which means I have the same mental health condition as a man with ADHD. But it does affect me differently. Before I jump into this, I wanna point out that in my episode on ADHD and girls, I had a lot of guys in the comments going, wait, I have the girl presentation? There is no girl presentation of ADHD. It's just that we know from research that women, at least cis gendered women, we don't have enough research yet on those who are both neurodiverse and gender diverse, tend to present differently than cis men due to a combination of biological and social factors. And that that difference can mean our ADHD doesn't get recognized or treated effectively. Also, some of this may apply regardless of gender because everyone is different. Anyone can have the more internalized presentation of neurodiversity that sometimes gets missed.

So if any of this sounds familiar, the conclusion is the same. Go get checked out. Get the support you need. Okay. So let's jump into the research. ADHD is the same disorder no matter what gender you are. The same brain regions and neurotransmitter systems are affected and the same core deficits are present. But the resulting symptoms, what people actually see, can show up differently due to the biological difference between males and females as well as the social differences in the experiences of men and women.

As a result of gender and sex differences, ADHD leads to different presentations and outcomes. For example, women are often expected to be good at organizing, planning, and other executive functions, and society is generally less forgiving to women when they mess up. We tend to work harder to fit in and be good due to social pressures. Females with ADHD tend to show more inattentiveness than hyperactivity or impulsiveness and are more likely than males to develop anxiety, self esteem issues, and other internalizing problems, while males with ADHD tend to develop more externalizing problems, like rule breaking or aggression, than females do. That's not to say that girls and women with ADHD don't also experience hyperactivity and impulsivity symptoms. We do. The those symptoms are just a little less obvious. They might take the form of racing thoughts, speaking before thinking, talking quickly, risky sexual behavior and relationship problems.

Also, for those of us who menstruate, our ADHD symptoms may change or worsen during certain parts of our menstrual cycle and during certain stages of life, like puberty, pregnancy, post pregnancy, menopause, when we have these big hormonal changes. So our ADHD presentation and treatment needs may change as well. Cool. Okay. But my doctor knows all that. Right? Probably not. Most research on ADHD has been done in males and the DSM criteria for ADHD doesn't fit the way females tend to present as well as it does for males. As a result, a lot of women with ADHD get misdiagnosed with depression or bipolar disorder and end up getting the wrong medication or a less effective one.

Those of us who internalize our symptoms are far less likely to be referred for diagnosis, less likely to receive a diagnosis if we are referred, and less likely to be treated with stimulant medication even if we do get a correct diagnosis, despite the fact that stimulant medication is the first line medication used to treat ADHD and it works just as well for females as it does for males. Even if we are diagnosed and treated with stimulant medication, it's really unlikely that our hormones will be taken into consideration. Personally, no one suspected I had ADHD as a kid because I was a good kid and because I was smart. But the truth is, I went to some pretty extreme lengths to hide the fact that I was struggling, and I hated myself every time I couldn't. Every time I came home without my jacket, or lost the really pretty earrings someone bought me for my birthday, or didn't get invited to parties, or couldn't remember the question the teacher just asked, Despite my best efforts, I still picked up a lot of not fun labels. Spacey, messy, clumsy, weird, forgetful, flaky, lazy, irresponsible. But I didn't talk to anyone about it. I was ashamed of it.

I tried my best to hide it. It wasn't until my symptoms became more obviously problematic to others, more externalized, when I was going through puberty, hormonal changes, and started rage quitting conversations, when my coping mechanisms weren't working anymore because the demands on my executive function had changed and I started doing badly in school, that my family even noticed there was a problem. Even then, the first doctor my mom took me to told her I couldn't have ADHD because I had done well in elementary school. Thankfully, my mom told that doctor, thanks for your opinion. I'd like to see a specialist. And I was diagnosed with ADHD. And thankfully, she was willing to try a stimulant medication to see if it helped, which it did, a lot. But even after that, it felt like no one really took my ADHD seriously, so I didn't take it seriously.