Gone are the days that ADHD was considered “a boy thing”.
No longer are the naughty boys causing chaos in the classroom the only ones on the diagnostic radar for clinicians. Now their mums, sisters and aunts are in doctors’ sights, too.
Social media feeds flooded with posts from high-profile female personalities going public with their ADHD diagnoses are symptomatic of this relatively new phenomenon: where women of a certain age are finally being able to put a name to why they behave the way they do.
Radio host Em Rusciano, reality star-turned-radio host Abbie Chatfield and more recently, feminist writer Clementine Ford are among influencers who have bravely opened up about their recent diagnoses.
Each has described how knowing they have ADHD has provided a final puzzle piece in understanding how their brain works.
The neurological condition is often characterised by hyperactivity, impulsiveness, a lack of concentration, but that’s not always the case and it’s why many women have managed to slip through the diagnostic net.
Because their behaviour often doesn’t fit the “naughty boy” stereotype, many women are able to cope well enough, that is until they reach a critical juncture in adulthood — usually motherhood and menopause.
But many argue it’s a gender stereotype that urgently needs to be redressed, particularly given a diagnosis can be transformative.
Rusciano described going through life with ADHD symptoms pre-diagnosis as like living in a prison of her own making, in one interview saying (Stellar magazine): “I’ve put all these rules on myself: you’re messy, you’re disorganised, you’re a bad friend, you’re unreliable. I’ve had to work so hard to try to feel normal, and it was tiring. I’ve always been told that I’m too much, so allowing yourself to be yourself is liberating.”
For Chatfield, getting diagnosed was like confirming that there was something “not wrong but different, that can be fixed”.
As for Ford, she described feeling relieved to finally fully understand herself, sad about all the times she berated herself for feeling “stupid” but also optimistic for a less confused and anxious future.
Their stories are just the tip of the iceberg.
Priory, the UK’s biggest provider of mental health services, recently reported on the female ADHD phenomenon.
It suggests the number of adults coming forward with ADHD symptoms has increased five-fold in 10 years.
Better awareness of the condition — thanks, in part, to TikTok where it has become fertile ground for thousands of women who are posting videos about their experiences — but also the increased pressure brought on by pandemic lockdowns and other COVID-linked struggles “unmasking” those with symptoms.
The traits of ADHD are highly heritable so if someone in your family has it, then the chances are you may, too. So, another driver is parents seeking a diagnosis for their kids suddenly find themselves under the microscope, too.
ADHD affects about 800,000 people in Australia — 5 per cent of children and 2.5 per cent of adults.
In children, boys are more likely to be diagnosed than girls at a ratio of 2.5 to one, but that gap closes in adults with the ratio narrowing to 1.5 to one.
Psychiatrist Roger Paterson says ADHD still gets missed in girls and women because they don’t fit the stereotype.
“The number one reason would be that originally, ADHD was thought to be hyperactive naughty boys. Gradually we’ve realised that you don’t have to be hyperactive. You can be the inattentive type, the quiet dreamy type.”
“Even my adult patients come in and say I didn’t think I had it because I wasn’t hyperactive but I am inattentive and disorganised.”
Dr Paterson says another reason women are less likely to be diagnosed is because they are better at managing their symptoms.
Some women who have only mild to moderate ADHD went through life quite happily until they hit menopause.
“This seems to be a peak that you will probably see a few patients,” he says.
“Menopause comes along around 50 and it just knocks off their cognition a little bit and they start to get a little bit less sharp in their thinking. ADHD magnifies that menopausal hit to their cognition and unearths something that was a subclinical problem to a clinical problem.”
The good news, though, is that it is one of the few medical conditions where almost overnight, you can make a significant difference to someone’s life with the right medication and support.
“If you can run a tidy home and manage a job well, then suddenly the stress levels dramatically drop and all sorts of virtuous cycles can happen as opposed to those negative spirals downhill that were happening previously,” Dr Paterson says.
Martha Barnard-Rae, who was diagnosed with ADHD in 2021, aged 39, says she came by it almost by fluke.
The Denmark–based copywriter and business owner was initially diagnosed with anxiety after suffering ongoing stomach problems following the birth of her two children. But a family friend, who was also a doctor, drilled down to the true source of her issues: ADHD.
When the proper diagnosis came, it was a relief, Barnard-Rae says. It was also a light-bulb moment for her husband of 12 years, David.
“He said: ’That makes so much sense’ and then he gestured to the kitchen counter which still had every vegetable and item that I had used to make my lunch three hours earlier, he’s like ‘things just disappear from your brain when they are no longer immediate’,” Barnard Rae says.
“It has been a really, really life-changing situation.”
Barnard-Rae says that given ADHD often runs in the family, after she was diagnosed she had her sons Henry, 10, and Will, 5, assessed and they both have it. Henry is also on the autism spectrum.
Barnard-Rae admits she doesn’t fit the ADHD stereotype, having excelled at school and gone on to get a master’s degree in education. She was adept at masking her symptoms, right up until she had children.
“What girls and women tend to do is we mask our stress or symptoms or anxiety or feeling overwhelmed . . . when I had kids, the stressors I was facing, I just couldn’t work around them and when that happens it is distressing,” she says.
“I love my kids but doing that same thing every day was, like, very painful and it was just really hard and really distressing.”
Barnard-Roe says it can be difficult explaining her ADHD symptoms because many people just write them off.
“The difficulty is when somebody wants you to explain it, (because when you do) they go, ‘Oh, that happens to everybody, I’m sure we’re all a bit like that’. It is really upsetting because it just feels like the things that you explain don’t feel significant but over the course of a day or a week or a life those little ‘failures’ can feel like death by a 1000 cuts.”
Now that she takes medication, though, she says her brain is “quieter”.
Former teacher Sarah Andrews was shocked when a doctor told her she could have ADHD — because she was there for the paediatrician to assess her daughter for the condition, not her. She was 40 at the time.
Nearly four years later Andrews is an ADHD coach and has realised it is quite common for parents to recognise their ADHD through the process of having their children diagnosed.
“In our case the paediatrician made it very clear that it was my side of things that perhaps would benefit the whole family dynamic, if I was able to get that diagnosis and treatment for myself as well,” she says.
“One day I’d come home . . . and I’d bought shopping in, started to unpack it, half done the washing up , then I was cleaning the couch and I stood up to go peg the washing out and realised I had started all these things.
“It was the first time I saw it for what it is because that was always normal for me.”
Like Barnard-Roe, Andrews has been diagnosed with anxiety in the past and prescribed medication she did not need, which caused its own medical issues.
“Once I was able to get the correct diagnosis and the correct clinical treatment, then my life changed in all ways for the better,” she says.
She’d struggled at school and left at the earliest opportunity, revealing her troubled high school years were the ”stuff of family legend”. When she had kids, the scheduling demands were overwhelming.
“I had to be somewhere on time, I’ve got to pack a school lunch every morning; there’s that element of organisation and timekeeping, remembering things that I was having difficulty with,” Andrews says.
“Now with correct diagnosis and treatment, not only am I able to manage that for two children but I am also able to run my own business.
“I’ve clearly got the intelligence to do these things but it’s the non-cognitive habits of timekeeping, organisation, focus, motivation, impulse control — all of these things are just essential ingredients to wellbeing.”
She says taking her medication is “like putting my glasses on, because my lens changes completely”.
For Rachel Steward, 37, it was returning to work after COVID lockdowns that finally saw her diagnosed with ADHD.
She wasn’t coping with being around people anymore and was feeling like her brain was under attack from too much stimulation because she had been at home for so long.
“I started using alcohol to self-medicate, so I was drinking a lot, I was shopping a lot. I would shop for that dopamine hit. And, honestly I thought I was bi-polar, I thought ‘this is not right, I need to see someone’,” Steward says.
“I had always had anxiety and depression so I had been medicated for that, but it just wasn’t working for me anymore.”
The diagnosis came just in time to save her marriage.
“We were at that point where I don’t know if we would have stayed together much longer if something hadn’t changed,” the mother-of-three admits.
“He is a very stable person, I would describe him as type A, very organised, liked to have lots of money saved up in the bank, and then you have me, I was just like a cyclone sometimes.
“He loved me because I’m fun . . . I’m vibrant and bubbly and he loved it, but there were things about me that were just exhausting to him.”
Steward says the process of diagnosis was enlightening because those closest to you are required to fill out a questionnaire, and that can be very revealing about how other people view you.
“There’s no other process in your life where you do that, where your mother and your husband and everyone tells you what you’re like,” she says.
“Especially the childhood stuff, I was like ‘wow, I was a bit of a pain in the bum!’”
“Even like reading your old school reports . . . they say a lot — ‘Would achieve more if they weren’t talking’, ‘very intelligent, but . . .’, there’s always a ‘but’ with an ADHD kid. So that was interesting, that process.”
Had she been diagnosed in her school years, Steward suspects her life may have gone in a different direction — with fewer impulsive decisions.
She was good at school but hated it and left early. She went to university as a mature age student and now works in communications.
“I love my children and I wouldn’t change it for the world but I was a teen mum. I had (my daughter) at 19 and that was an impulse decision that I probably wouldn’t have made if I had been medicated earlier or was aware of what my brain was,” she says.
Studies have shown a clear association between risky sexual behaviour — including having sex at a younger age and early pregnancy — and ADHD.
Steward says being diagnosed and getting the proper medication for ADHD has transformed her life.
“A few weeks after I was taking the medication I woke up and I messaged my mum and my husband and said, ‘I feel happy’ . . . and I haven’t felt happy since I was 18,” she says.
“So, that was a major thing for me . . . I used to wake up every morning and I would think, ‘what can I do to make sure I stay in this bed?’”
But the biggest benefit, she says, is that now she will able to help her children, who also share some of the ADHD traits and are in the process of being assessed.
“If I hadn’t have got diagnosed, I wouldn’t have seen it in them at all and I would have just thought that they were a bit troubled.”