The Overlooked Reality of ADHD in Teenage Girls
We still aren’t identifying all the teenage girls who struggle with ADHD. As a result, the transition into adulthood could be more difficult than necessary.
I’ve been seeing it ever since I started practicing child and adolescent psychiatry full time in 2013.
Take Emily, for example.
Emily is a 15-year old girl who lives at home with both biological parents and her 10-year old brother.
She didn’t report any mental health problems until the 9th grade when she started feeling anxious and depressed. She was an ‘A’ student through the 8th grade, but her school performance began to suffer once she started high school.
When I met with her for the first time, she told me that she was cutting herself superficially, but not deep enough to require a visit to the doctor for stitches. She showed me her arm.
Her primary care doc diagnosed her with anxiety and depression about a year ago. In addition to weekly therapy, she’s tried Zoloft and Wellbutrin without much benefit.
She and her family were starting to lose hope because nothing seemed to be working and no one knew exactly what was going on.
This is a pretty typical case for an adolescent girl with undiagnosed ADHD. Many of us think of a bouncy 6-year old boy when picturing a child with ADHD. That unconscious bias gets in the way of properly diagnosing female teens with the disorder.
Among youth, the M:F ratio of individuals with ADHD is 3:1. In adulthood, it’s 1:1. The statistics demonstrate that we are missing way too many cases of ADHD among young women.
When we don’t catch ADHD early enough, it can lead to increased social-emotional distress:
- Low self esteem
- Feeling out of control
- Unhealthy coping strategies
- Regret about missed opportunities
- Problems in romantic and family relationships
It’s easy to see how experiencing some of these feelings for years can lead to anxiety and depression in someone like Emily. In turn, the anxiety and depression can worsen impulsivity and inattention, exacerbating her ADHD. It’s a nasty cycle.
I hope this can be a reminder to clinicians and families to consider an ADHD diagnosis among teen girls when they appear to be struggling with anxiety and mood swings. It’s not always going to be ADHD, but we owe it to them to look for it.
[Photo Credit: Jack Bell Photography, Montana]
