Until a few decades ago, there was very little research about girls and women with ADHD.  At that time, the National Center for Gender Issues and ADHD (NCGIADD)  started researching the similarities and differences in the symptoms of ADHD in girls when compared to boys.  Not surprisingly, the differences outnumber the similarities.  Not surprisingly, these differences can have an impact on treatment decisions for girls. 

The parent of a girl with ADHD, Dr. Davenport, outlines the symptoms and needs of girls in this article. 

Embracing Differences

Like men and boys, women and girls with ADHD are easily distracted by others around them.  They are also often internally distracted, and may be called “daydreamers”, “spacey” or “scattered.” They show inconsistent alertness and effort, and they easily lose track of time.  As a result, they have trouble finishing work, and they may complete tasks at the last minute.  Adding to this struggle, their room, locker, book-bag, and purse are often messy, and they have trouble finding things.

Unlike boys, ADHD girls will often expend extreme effort and mental energy to succeed at academic tasks: as a result, their challenges are typically identified later in life than boys. Despite (and because of) her unnoticed struggle to do well, a girl with ADHD may feel she is not effective at anything even though she has lots of talents and abilities. As a result, an ADHD girl may appear unsure, anxious, and “shy” in new situations and around new people, but at home or in familiar surroundings, she may talk non-stop about “everything” and “nothing” at the same time.

Most girls with ADHD are seldom considered “hyperactive.”  They are usually considered “well-behaved” but they can be “hypersensitive,” often getting upset more easily, more quickly, and more intensely than others. This emotional reactivity tends to increase in ADHD girls during adolescence.  As a result, they are more quickly hurt and their hurt feelings can rapidly escalate into impulsive overreactions that include yelling, screaming, and cursing at the ones who love and care about them the most.  Often, after these short-lived outbursts, girls with ADHD are extremely remorseful and saddened by their momentary lack of self-control.

Unfortunately, many of those who suffer the wrath of this impulsivity become unforgiving of these outbursts due to their misunderstandings of this aspect of ADHD in girls.  As a result, private schools may privately ask them to leave and parents may openly hold them responsible for all the ills and dysfunctions of the family.  This only serves to snuff out the ADHD girl’s hidden strengths and increase her sadness and worry.

Studies completed by the NCGIADD show that a staggering number of girls and women have been diagnosed with anxiety and mood disorders before their underlying ADHD was finally recognized. Recently, I have seen an unsettling trend in these girls being diagnosed with or being prescribed medications for bipolar disorder even though their emotional reactivity does not even come close to the multi-hours long “rages” seen in teens with this mood disorder.

As they get older, it is very important to monitor their symptoms as girls with ADD/ADHD may take unwarranted risks to try to fit in with their peers.  As a result, they are at high risk for teenage pregnancy and substance abuse.

How do we Help Girls and Women with these Multiple Risks?

It takes a multifaceted. direct, and team approach just like that recommended for boys and men plus these additional recommendations:

• Seek early identification, diagnosis, and research-based treatment

• Find someone who can provide parent training to help you not only understand your ADHD daughter’s temperament differences but also teach you how to develop strong problem-solving strategies before things get out of hand.

• Provide your daughter early and age-appropriate education about the risks she faces as a girl with ADHD and how to best respond to those risks.

• Seek family counseling focused on effective communication, problem-solving, and forgiveness.

• Understand that her emotional reactivity is a part of her ADHD, and recognize when her emotions become more intense:  for example, she may be more likely to become emotional when she is stressed, tired, or hungry.

• Understand that the hormonal fluctuations of the menstrual cycle can intensify and complicate her emotional reactions, irritability, and low frustration tolerance.  If necessary, make plans to provide extra support during this time.

• Understand that her emotions can tip quickly when environmental stresses suddenly overwhelm the teenage girl’s already distressed system.

• Help her start to recognize and manage the stresses that worsen her reactions.

• Understand that psychotherapy needs to be designed to directly address peer problems, self-esteem issues, and the stresses that increase her emotional vulnerability.

• Understand that she may need medications to address symptoms of depression and anxiety in addition to ADHD.

• Help her develop time management, planning, prioritizing, and organization skills needed to be successful during her tween or teen years.  Because your teenage daughter is trying to become more independent, someone other than her parents may need to help her acquire these skills:  a cognitive-behavioral therapist, coach, or school guidance counselor may be able to help.

• Actively help her recognize her strengths. The more aware she is with her areas of competence the less vulnerable she will be to the frustrations that often accompany ADHD.

• Help her stay involved in structured self-esteem building activities that emphasize her strengths: sports, artistic pursuits, performing arts, part-time work and volunteer work can help her build and maintain self-worth.

• It is especially important for fathers to actively spend positive time with their ADHD pre-teen and teenage daughters so that they are less likely to seek male sexual attention.

• Maintain an open, supportive relationship with her so that she has somewhere to turn for advice if she does become sexually active – either to help her make a wise choice of birth control or to help her make the best decision if she accidentally becomes pregnant.

• Girls (and boys) with ADHD may need more driving practice until their skills become more automatic and they require less concerted effort. It is important to discuss and plan for possible distractions or situations that could lead to impulsive reactions in advance.

• Validate her right to express her opinion, and help her learn to express what she thinks in a constructive, effective manner.  Teach her how to argue from the other person’s perspective so she doesn’t get labeled “bossy” or “stubborn.”

• Help her develop self-advocacy skills for a more independent life beyond high school.  Teach her how to assertively and convincingly express her needs to teachers or employers who may not understand the true impact of ADHD.

Do You Need Additional Help and Guidance for Yourself or Your Daughter?

Contact us to make an appointment. As the parent of a daughter with ADHD, Dr. Davenport understands the unique symptoms and needs of girls and women with attention challenges.

 (c) 2010-2019, Monte W. Davenport, Ph.D.