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While there has been a significant increase in the studies on attention deficit hyperactivity disorder (ADHD), some showing that the disorder persists throughout life, while others tracing the origins of the illness- classified as a neurobiological and motor disorder. Generally noticed around early childhood, ADHD is characterized by a child’s inability to internalise norms and lower levels of self-control, and an inability to control or understand limits. Moreover, there are patterns of inattentive, restless, and overly stimulated behaviour.
The speculations on the origins of the disorder have ranged from brain damage to heredity to sociocultural and environmental changes in life and developmental milestones. In fact, it was only when the focus shifted from brain dysfunction as a childhood disorder, that ADHD came to be identified as an attention-deficit and impulse-control disorder. While there are ongoing studies on the origins and diagnosis of hyperactivity, theories of social origin explain gender differences in the diagnosis, percentage, likelihood, and impacts of ADHD.
The existing literature on the diagnosed cases of ADD and ADHD in women have also been limited so far. Moreover, new research suggests that the number of adults suffering from ADHD is roughly equal for men and women. However, during childhood, more boys are diagnosed with the disorder. The literature on how hyperactivity affects other genders is also new. What influences these changes?
While hyperactivity is a common symptom amongst male patients, the symptom of inattention is more commonly diagnosed in women with ADD or ADHD. This might be a reason why it is not spotted early in girls, and also because inattention occurs in a wide range of other behavioural patterns, personalities, and even psychological disorders.
Although about 32 million females have ADHD across the world (Staller and Faraone, 2006), research biases continue to underestimate females, especially younger females with attention-deficit disorders. While girls with ADHD struggle on many levels (psychosocial, academic, physical) as much as their male counterparts, only older females with greater impairments receive clinical attention.
However, this is not to deny that females with ADHD have significantly different struggles and are affected differently by psychosocial parameters. There are biases in the analysis of the female samples that cover these differences even though the expression of attention-deficit behaviour is present in the diagnoses. When these differences are clear, treatments will also be modified accordingly.
The lack of access to substances as compared to males, as well as to other forms of potentially dangerous behaviour is institutionally controlled; as a result, more boys are suspended from school than girls due to deviant behaviour with ADHD. The causation also differs according to gender.
For instance, in all the cases diagnosed, incidents of sexual abuse acted more of a triggering event for female cases. Comorbidities and a history of other disorders such as anxiety, depression, and suicidal ideation (identified more amongst women with ADHD) might also shape the causal factors.
More girls have ‘inattentive’ symptoms (dreamier, introverted, and distracted) and are not noticed by schools and families- while boys with disruptive behaviour tend to get noticed. Their expressions of inattention and hyperactivity are expressed through self-directed or “internalised” behaviour- such as abusing drugs or being liable for involvement with abusive romantic partners. Impulsivity and aggression, generally seen as masculine traits, connect to the larger picture- higher crime rates among men suffering from ADHD- and contribute to the under-diagnosed cases of ADHD in girls.
It is also to be noticed that in a society where mental health is still hard to talk about, a lot of the diagnoses are done institutionally in the case of criminal activities of men- and in rare cases, of women with ADHD.
While it can be agreed that symptoms may differ as per gender, the larger consequence of inattentive rather than impulsive-hyperactive traits being expressed by girls points to external factors like family and school socialisation.
Diagnoses are delayed as these girls are thought to be “naturally” shy and passive than to exhibit a disorder. Sometimes, diagnoses are deceptive and they are likely to be declared depressed or anxious.
The strength of research on ADHD has also to be checked since most of them have historically only included boys and men. While boys exhibit the symptoms at an earlier age, girls’ symptoms have a lot to do with hormones such as oestrogen. The symptoms and diagnoses procedures are liable to fail for them.
Overall, while the cases of ADHD are equally occurring for women, they are less noticed due to self-induced feelings of guilt, or institutional conditioning of behaviour in case any symptoms are noticed- because authority figures like parents and teachers- don’t know what to do in that situation.
In a cultural context where the physical and sexual health of women is not administered seriously, it isn’t surprising that their mental health is also taken into consideration as secondary and exaggerated. These factors can easily become barriers to the effective treatment of women and girls with ADHD.
At a broader level, if some of these institutional problems are resolved, and myths and stigmas related to ADHD in females are busted, it will pave the way for greater and more accurate research and treatment for ADHD and other attention and impulse-related disorders in genders socially considered a series of submissive traits.
