Last year, over a quarter of a million British women took an online test for attention deficit hyperactivity disorder (ADHD). The condition is most commonly diagnosed in childhood, but with cases routinely being missed in schoolgirls – just one is referred for every four boys – many women may find themselves wondering later in life. I asked Tony Lloyd, CEO of ADHD Foundation, what they need to know.
What are the symptoms of ADHD?
There are three core characteristics: impulsivity, inattention and hyperactivity. You only have to have two to get a diagnosis.
It’s about the intensity of those characteristics right? Because I imagine most people experience all those things regularly. I sure do.
It can be overwhelming. And impulsivity is not just impulsive actions; it’s impulsivity of emotion and thought. So you go to bed and you’re exhausted, but you can’t sleep because your mind is still racing.
Oof, that last bit sounded way too familiar.
Anybody who is really stressed is going to look a bit like they’ve got ADHD. But whereas anxiety is a direct response to environmental stresses, ADHD is an innate genetic cognitive impairment, which can be exacerbated by stress. If somebody’s got anxiety, once you remove the stresses, the response goes. With ADHD, it’s more constant.
So if someone’s reading this thinking, “This sounds like me”, what next?
There is a free booklet on our website about what ADHD is, and ways to manage it. I’d caution everybody to read that first – because you can’t expect your GP to know how ADHD presents in adults. They’re not trained. Even many general psychiatrists aren’t. If you think you’re still struggling and need medication, ask for an appointment with an ADHD specialist. The problem is, there’s a three- to five-year waiting list for adults. And nearly half of all new adult diagnoses are made by private clinicians.
Blimey. So why has testing increased so suddenly? Is it just greater awareness? I know a number of celebrities – singer Solange Knowles, reality star Olivia Attwood – have opened up about their adult ADHD diagnoses.
I think so, though the pandemic may be a factor. When most people leave education, they gravitate towards careers where they can play to their strengths and have strategies. But during lockdown, routines, structure and support mechanisms were disrupted. So people may have found themselves struggling, having coped for a long time, and begun asking why.
I still don’t really get why schoolgirls in particular have been so underdiagnosed.
ADHD correlates with neurodevelopmental delay. So certain parts of the brain develop more slowly. Girls mature quicker than boys, so that immaturity appears more obvious in boys. Also, girls are more likely to mask anxiety that comes from a difficulty with cognitive functioning.
One more thing, Tony – how many people are estimated to have ADHD?
Roughly one in 20 people. We know that one in 10 have dyslexia, one in 60 have autism – and in fact roughly one-fifth of the human population are neurodiverse. One in five people can’t be seen as errors of genetics. We have to acknowledge there is diversity of human neurocognitive capacity and we’re all the richer for it.