Catri Barrett and Samantha Pena live an ocean apart, but they have one big thing in common. Both had debilitating symptoms of attention deficit hyperactivity disorder for years, but were repeatedly misdiagnosed. It was only in adulthood they were finally assessed for ADHD.
Common symptoms of the developmental disorder include feeling restless and having trouble concentrating. It can present as inattentiveness, hyperactivity/impulsiveness or a combination of the two. Research suggests it affects about 6 million children and 11 million adults in the U.S.
Stereotypes about ADHD such as the idea that it’s only found in “naughty schoolboys” —and a lack of awareness about how it affects females—have led to late diagnoses for many women.
Newsweek spoke to Barrett, Pena and ADHD experts to find out how misdiagnosis and late detection can shape a life.
‘I Developed Eating Disorders, Which Was 100% Linked to My Undetected ADHD’
“From the age of 15, my mental health started to spiral. Only now am I beginning to understand that was about my then undiagnosed ADHD,” Catri Barrett told Newsweek.
The London-based life coach received her diagnosis last year, at the age of 33. Since that moment, which she describes as “extremely validating,” she has been trying to unpack the impact undetected ADHD had on her mental and emotional wellbeing.
“As a teenager my self-esteem started to take a nosedive because I was suddenly realizing that I’m not reaching my potential. I began feeling like I’m not doing well enough, I compared myself to others and just felt, ‘I’m not good enough.’ I developed eating disorders in my teenage years, which was 100 percent linked to my undetected ADHD. Only now do I see how the emotional dysregulation I experienced was related to my neurodivergence,” she said.
Since her disorder hadn’t been identified, she was left unsupported at school. She felt overwhelmed in class, a common ADHD symptom, and “underperformed” academically, leading to a drop in her sense of self-worth.
The teenage Barrett couldn’t understand why she was finding life so hard. She believed her feelings of incompetence weren’t justified and didn’t extend any compassion towards herself.
Eventually, she began self-medicating with drugs. “Self-medicating is really common in neurodiverse people, particularly those with ADHD. When I had my assessment the psychologist said, ‘Well, of course you use drugs.’”
People with ADHD react differently to stimulants, she added. For some, “caffeine can have a calming effect.” By the time Barrett got to college, she had “developed quite a drug problem.”
“I was self-medicating, but I understand why my tutors may have thought that I just didn’t care about my degree by not showing up properly,” she said. “This then becomes a self-fulfilling prophecy. It just spirals.”
Women with ADHD are more likely to experience low self-esteem than their male counterparts, research has found. For Barrett, the impact was catastrophic. Throughout her teens and twenties, she struggled, largely in silence, to keep up with academic demands.
“I would hit deadlines at university, but at such a cost. I’d crash and burn. I had a mental breakdown in my final year. It’s all tied together and it all influences one another; my undiagnosed ADHD, my self-medicating and the issues I had with disordered eating.”
‘They Put Me on Anti-Anxiety Medication’
Samantha Pena can relate. The 23-year-old Floridian told Newsweek that she struggled with her mental health until she was diagnosed with ADHD at the age of 21. While her feelings were undoubtedly real, Pena believes they were a knock-on effect of the undetected disorder.
“I went to a doctor because I was so overwhelmed and I got diagnosed with depression and anxiety. They put me on anti-anxiety medication, which I hated. During college, I started going to counseling and my counselor was the first person who told me that I should get assessed for ADHD,” Pena said.
“Having it and not knowing that you do lowers your confidence. It’s like you’re almost seeing yourself as the clumsy, unreliable person all the time. It’s like that’s your whole personality. It makes people think you’re dumb, but you’re not dumb. You just can’t focus in the same way they do,” she said.
A common symptom of ADHD is speaking too much or over other people, which became a major worry for Pena. “I put up a facade and sometimes would stop myself talking because I knew I would talk too much or I’d cut people off.
“I became hyper-aware of these things and it was because of my ADHD, but I didn’t know it was ADHD. I’d always feel like everything was my fault or that I’d not been good enough.”
Pena now accepts that her brain is simply “wired differently” and her confidence has sky-rocketed.
Why Does ADHD Go Unrecognized in So Many Women?
Pena is now looking back at why her ADHD went undetected for so long. “I definitely think that being a woman was part of my misdiagnosis,” she said.
For her part, Barrett believes her ADHD was not picked up because women are socialized to camouflage their symptoms more than men.
Rosemarie Manfredi, a neuropsychologist based in Bensalem, Pennsylvania, explained how ADHD symptoms can present more subtly in girls and women.
“They are more likely to have symptoms of the inattentive type of ADHD, rather than the hyperactive/impulsive type. As a result, their symptoms are more internal than externally observable to others. They may be able to appear attentive to others but be internally distracted by thoughts or daydreams,” Manfredi told Newsweek.
“They may be exerting a high level of effort in order to appear attentive, which can be exhausting over time and result in emotional costs.”
She added: “Their symptoms may not become evident until the environmental demands begin to exceed their ability to cope with and compensate for their areas of difficulty.”
Women are more likely to experience mood and anxiety symptoms in addition to ADHD because of their hormonal patterns, Manfredi said, and ADHD symptoms are often attributed to these conditions instead.
In some cases, mothers only begin to suspect they might have the disorder after their children have been diagnosed with it. “Recognizing the same experiences and symptoms in herself as in her child, she will specifically request an evaluation for adult ADHD, rather than a health professional suggesting it be done,” according to the charity Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
This is what happened to Hester Grainger, a former TV and radio presenter who was diagnosed at 43. Like Barrett and Pena, she found the experience “life changing.”
“Looking back, it does make me sad that I found some things very difficult and that I struggled at school. Now I understand why and I feel OK about that. I’m much kinder to myself,” she told Newsweek.
Grainger now works as an ADHD coach and has seen many cases of misdiagnosis. “Women are often misdiagnosed with conditions ranging from borderline personality disorder to bipolar and anxiety, as clinicians and specialists are missing the ADHD symptoms,” she said.
“Women are known to mask more and can often ‘get through life,’ which is where ADHD is missed.”
Across the United States, about 6 million children aged 3 to 17 have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. The National Survey of Children’s Health and the National Health Interview Survey have found that boys are twice as likely as girls to have a formal diagnosis, the CDC said.
The advocacy group CHADD states: “This difference in diagnosis rate is made up for in adulthood, where women and men are diagnosed with ADHD at roughly the same rate. The current ADHD prevalence for all adults is 4.4 percent.” This suggests there are roughly 11 million adults in the U.S. with ADHD.
Although it took Barrett 33 years to get a diagnosis, she refuses to dwell on the downsides. “I’m hugely proud that I’ve navigated my life with this disability, and it does come with some positives and has led to me being more creative,” she said.
Her advice for anyone with ADHD is to extend compassion to themselves, embrace dopamine-releasing exercises and surround themselves with understanding people.
“If you don’t know anyone who takes your ADHD seriously, find a community online that will. There’s always someone.”
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