An increasing number of adults are being diagnosed for the first time with attention-deficit/hyperactivity disorder (ADHD), reports from many countries show.
While symptoms of this highly-heritable, neurobiological metabolic disorder typically start in early childhood, they may not be recognised until later.
Receiving an ADHD diagnosis in adulthood can be a huge relief, particularly for women, says Germany’s Bad Saulgau Acute Care Hospital medical director Dr Petra Beschoner, who is a specialist in psychiatry, psychotherapy and psychosomatic medicine.
It’s often a first step towards 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, internalising their symptoms and blaming themselves for their struggles.
Dr 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, Dr Beschoner says, which can lead to exhaustion, self-doubt or burnout.
Because ADHD in females often manifests itself in behaviours 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 recognised more readily in boys.
In adulthood, females with ADHD tend to be quietly overwhelmed, compensating with self-control, perfectionism or extreme conformism, Dr 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 behavioural abnormalities.
Standardised questionnaires, behavioural 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, Dr Beschoner says an individually-tailored combination of psychoeducation, cognitive behavioural therapy (CBT), 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,” she adds, e.g. by recognising their limits and taking more breaks.
Digital tools, self-help groups and ADHD coaching services can help as well. – By Amelie Breitenhuber/dpa
