Shy, listless and depressed? She may have ADHD, explains Fintan O’Regan
ADHD occurs in four times more boys than girls, but increasing numbers of girls are being diagnosed as research reveals how differently it can present in females.
Hyperactive and Combination types of ADHD seem to be more frequent in boys, and as they often disrupt class, it’s a quicker route to referrals to professionals. The majority of girls who have been diagnosed with ADHD do not have this type.
Inattentive type ADHD symptoms present far more frequently in girls. They may seem unusually distracted, untidy, or late with assignments. While these behaviours may cause frustration and tension for the child, they usually don’t disrupt class or prompt parent-teacher conferences.
Social isolation and depression
Girls with ADHD often do not conform to traditional social roles, and they can be tagged with gender-specific terms such as tomboys, flaky, or spacey, terms we simply do not use for boys.
Though girls with ADHD can develop some antagonistic and anger issues and be oppositional, more often they become listless and isolate themselves socially from others.
Doctors tend to zoom in on the diagnosis of depression, which is more common in females and especially female adolescents. They still tend to think of ADHD as a boys' condition.
Case study: Sarah's experience of ADHD
Sarah was in year 7 before her ADHD was diagnosed. She had done very poorly in her first term and she needed a lot of help to complete the things she wanted to accomplish. She was always overwhelmed. Even though she had always been anxious to do well, her family thought Sarah was irresponsible, and she started to believe them. Even good friends teased and called her names such as space cadet or airhead. Sarah learned to laugh along, but secretly she was ashamed and frightened, until she learned what the problem was.
Signs of ADHD in girls include:
- Not feeling liked and accepted by other girls
- Worries that they can't keep up with all that is expected of them
- Fears that their teacher will become angry at them
- Dread that they will be embarrassed in class
- A sense of being pummelled by criticisms and corrections every day
In girls, the disorganisation and distraction results in lack of activity - they are too confused to get things started. As girls with ADHD hit the teen years, the increased organisational demands of secondary school become too much. They may become tired and disheartened by poor school performance.
Social problems in ADHD
Both genders have trouble learning the nuances of social interactions but girls are more likely to become shy and withdrawn. They don't like the negative reactions they get when they don't tune in to the nuances. Boys are more likely to proceed with social behaviour that is considered inappropriate; even if they get negative reactions, they continue.
Girls with hyperactivity may throw themselves into social relationships to compensate. They may be described as boy-crazy or party girls. Girls with ADHD may begin risk taking in sexual behaviours, or they may use drugs or alcohol, both as a result of increasing impulsivity, and in order to self-medicate. Shoplifting, teen pregnancy, and eating disorders are also found more often in females with ADHD.
Girls with ADHD tend to have fewer learning problems in the early years than their male counterparts. Boys often get diagnosed through an evaluation of their learning problems. Girls with ADHD, especially those with high intelligence, may actually be good students and/or well-behaved.
As a result often many girls with ADHD never receive diagnosis and options for support.
Treatment of ADHD
The good news is that ADHD is a highly treatable condition.
How parents can help girls with ADHD:
- Identification is the first step in providing the support that is required; so act on your instincts if you suspect that something is different
- Support, and do not penalise, organisational weaknesses both at school and at home in aspects such as assignment due dates, having PE kit, and planning for tests and exams.
- Be prepared to support homework requirements
- Consider clubs and activities that offer options for socialising across a range of ages
- Monitor electronic communication with peers sensitively
- Often girls with ADHD may be extremely talented in specific areas so develop and support these areas of interest
- Consider counselling if issues of negative moods or anxiety occur, as in some cases they may not want to talk to teachers or parents
- Don’t rule out the option of medication to support attention and concentration skills
- Prepare the child for changes of routine and transitions
- Enjoy and embrace the differences in learning styles of girls with ADHD
Fintan O’Regan is a behaviour and learning specialist, and author of Educating Children with ADHD.