Why are so many women with ADHD or Austism being misdiagnosed?
Much of what we have known about autism and ADHD is based on males, but as neuropsychologist Dr Hannah Korrel explains these disorders can manifest in different ways depending on your gender.
Ever felt like you were from a different planet? An off-worlder among aliens who all seemed to ‘get it’? Feel like you were scraping by successfully ‘acting’ like these other aliens and/or exerting huge mental exertion to organise life while others seemed to do it so effortlessly?
Welcome to a glimpse into the lives of adults with undiagnosed ADHD and autism. Or more statistically likely, ‘the lost women’ of our society, as Noelle Faulkner so beautifully described for The Guardian Australia.
The spectrum of neurodiversity
Attention-deficit/hyperactivity disorder (ADHD), and Autism spectrum disorder (ASD) are what the Diagnostic and Statistical Manual of Mental Disorders call “neurodiverse”.
This means the brains of those with ADHD and ASD aren’t necessarily ‘disabled’, as has been misconstrued in the past. Rather, their brains are wired differently, and this is not always a bad thing! In fact, many find their neurodiversity brings amazing gifts like amazing attention to detail or creativity.
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Understanding the ADHD/ASD brain
There can be costs to this neurodiversity.
Imagine all the functions of the brain are like building, each doing their own job – a speed-of-thinking building, an attention building, a memory building, etc. Those buildings work together by sending messages to one another via roads (neural interconnectedness). But sometimes the buildings aren’t working so well. Or maybe the roads are a little too narrow, and bumpy, with lots of dead ends and roundabouts to slow things down.
AND maybe some days it’s also hailing (stress), or there’s a flood (bad sleep) which further blocks the messages driving between buildings!
Someone could have an amazing creativity building but they can’t get their idea out or organise themselves because their attention building and their speed building are on holidays.
Or they are an amazing accountant because their arithmetic building is super high-tech and shiny buuut their ‘social interaction building’ looks run-down, is short-staffed and the fuse box just blows out. This is what it can be like with ADHD and ASD.
The trouble with women in particular…
Each decade, clinicians have gotten better at detecting and diagnosing ADHD and ASD. Researchers have now realised that a lot of what we know about ADHD and ASD was based on, almost exclusively, males. And ADHD and ASD is now known to sometimes present differently in males and females.
Males are more likely to have the hyperactive-impulsive type of ADHD, or the more overt symptoms of ASD that make others notice ‘something is up’ sooner in life.
Females, on the other hand, are much more likely to have the inattentive ADHD profile or a type of ASD where they are very good at ‘social masking’ – this means hiding their social difficulties by ‘acting’ out good social skills they’ve observed in others.
So while the hyperactive, socially awkward boy alerts the teacher’s concerns with his loudness – the distracted, socially ok little girl goes unnoticed and left to stare out the window.
Good for the new generations – but what about adults now?
The good news is that young girls are much more likely to be picked up on earlier nowadays so they can get the help and validation that helps their precious self-esteem as they grow into womanhood.
However, what about the older generations of 20-30+ year old who may have missed the detection boat in their youths? The brain gets more interconnected as we age – so those buildings and roads get a little (or a lot) better at coping just by the virtue of time.
Some kids with ADHD ‘grow out’ of their more dramatic symptoms in adulthood, and some can continue to feel disorganisation and inattention is the bane of their existence. They skim by, but it costs them a huge mental effort to do the same load as others. And many undiagnosed adults with ASD may be feeling alien and disconnected from others. Or worse, like there is something ‘defective’ about them.
You aren’t ‘defective’ for feeling different
We are all on a spectrum of something. You may simply be wired to see the world in a different way to others, which can be beautiful and a gift!
If that gift is interfering in your life, however, causing sleepless nights, interfering with family and jobs, or making you feel downright unhappy, it might be finally time to see your GP, who is the gatekeeper to a referral for assessment.
Neuropsychologist Hannah Korrel is the author of How to Break Up With Friends (Impact Press $24.99) and has spent over a decade becoming an expert in why the brain makes us do the things we do. Hear more from Dr Han at and Instagram @nobullpsych.