An increasing number of adults are being diagnosed for the first time with attention-deficit/hyperactivity disorder, or ADHD, reports from many countries show. Although symptoms of the highly heritable, neurobiological metabolic disorder typically start in early childhood, they may not be recognized until later. Receiving an ADHD diagnosis in adulthood can be a huge relief, particularly for women, says Dr. Petra Beschoner, a specialist in psychiatry, psychotherapy, and psychosomatic medicine who is medical director of the Bad Saulgau Acute Care Hospital in Germany.
It’s often a first step toward more self-understanding, emotional stability, and better quality of life, she explains, because many of them have lived for years and even decades under psychological strain, internalizing their symptoms and blaming themselves for their struggles.
Beschoner points to ‘typical warning signs’ of ADHD in women.
They include difficulty concentrating, restlessness, chaotic daily routines, impulsiveness, emotional instability, a strong feeling of being different, and a sense of being constantly driven.
Further signs can be recurrent conflicts in relationships or at the workplace, mood swings, or self-harm. Many women with ADHD believe they habitually fail or don’t measure up, although they accomplish a lot. It’s often difficult for them to set priorities, structure tasks, or finish them.
“The discrepancy between appearance and reality” is especially stressful for them, Beschoner says, which can lead to exhaustion, self-doubt, or burnout.
Because ADHD in females often manifests itself in behaviors not usually associated with the disorder — the women tend to be inattentive and unobtrusive rather than hyperactive, and often mask their symptoms too — a diagnosis can take a long time. This is a big reason why, experts say, ADHD is recognized more readily in boys.
In adulthood, females with ADHD tend to be quietly overwhelmed, compensating with self-control, perfectionism, or extreme conformism, Beschoner says.
“Before they receive a diagnosis [of ADHD], many have gone through a long period of suffering and misdiagnoses — of depression or an anxiety disorder, for example.”
If everyday stresses chronically impair life quality, a medical assessment by a specialist is strongly advisable. Underlying a diagnosis is a detailed medical history and guideline-based evaluation by a psychiatrist, psychotherapist, medical psychotherapist, or psychological psychotherapist.
An examination interview is conducted in which the examiner asks the person about their current problems, sources of stress, individual symptoms, and life history, including development of their problems from childhood to the present.
In some cases the person’s spouse or partner, parents, or longtime acquaintances are called on to report when they noticed any behavioral abnormalities.
Standardized questionnaires, behavioral observations, or physical examinations are also brought into play. An ADHD assessment typically requires multiple sessions.
Not everyone diagnosed with ADHD needs therapy. When their level of suffering is high, though, Beschoner says an individually tailored combination of psychoeducation, cognitive behavioral therapy, and sometimes medications can be effective. Medication help many women with ADHD improve their concentration and impulse control.
“It’s equally important that these women learn to go easier on themselves,” Beschoner adds. One example is recognizing their limits and taking more breaks. Digital tools, self-help groups, and ADHD coaching services can help as well.
-by Amelie Breitenhuber
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