The 411 On Adult ADHD

March 22, 2024

For Canadian women mental health and emotional well-being is an ongoing topic of concern. If you’re a neurodiverse woman, it only adds to the pressure. A recent CADDAC survey of Canadian women with ADHD found that 46 per cent were misdiagnosed with another disorder prior to being diagnosed with ADHD. Although the number of adult women newly diagnosed with ADHD has nearly doubled from 2020 to 2022, many women remain undiagnosed or in limbo over their care. Their concerns are being written off by the healthcare system as depression or hormones and many family doctors are unwilling or unable to prescribe the needed medications. They’re getting no help, struggling, frustrated and don’t know what to do about it. We chatted with Natasha Meadus, healthcare practitioner and expert in adult ADHD, to learn more. —Vita Daily

Please tell us a bit about yourself to start.

I am a Senior Program Manager, Frida, Canada’s leading healthcare platform for accessible clinically-proven diagnosis and treatment for adults with ADHD in Canada. With a background as a Nurse Practitioner, my career has been centered around mental health advocacy and enhancing healthcare access for marginalized communities. As a Nurse Practitioner, I’ve had the opportunity to work closely with individuals affected by ADHD, providing compassionate care, evidence-based treatments, and ongoing support. My commitment extends beyond clinical practice; I am deeply passionate about destigmatizing ADHD, raising awareness, and fostering an environment where individuals can embrace their unique strengths with pride.

Why are ADHD diagnoses missed in women and young girls?

ADHD diagnoses in girls and women are frequently overlooked due to their distinct symptom profile, characterized by subtle signs like inattention and low self-esteem, contrasting with the more overt impulsivity and hyperactivity seen in boys. For example, rather than displaying hyperactivity through physical activities such as running and climbing, girls might exhibit it through nuanced actions like playing with their hair, biting their nails, or excessive talking. This distinction highlights the diverse ways in which hyperactivity presents in girls. As girls mature into women with adult ADHD, these symptoms can intensify, particularly during periods of hormonal fluctuations such as menstruation, and menopause. These hormonal changes may exacerbate existing ADHD symptoms, making it even more crucial to recognize and address ADHD in women throughout their lifespan.

How does ADHD affect women’s self-esteem,  intimate relationships, parenting and work?

Women frequently internalize their ADHD symptoms, which can contribute to feelings of depression and anxiety, significantly impacting their self-esteem. Many of our patients share that they’ve spent years believing they aren’t smart or capable enough, feeling inadequate and flawed, when in reality, their brains simply operate differently, and it’s not their fault. Women tend to experience their adult ADHD diagnosis as a profound lightbulb moment, illuminating the root cause of their lifelong struggles. It allows them to reframe their self-perception, recognizing that their challenges stem from neurobiological differences rather than personal shortcomings, fostering a greater sense of self-acceptance. In relationships, parenting, and work, untreated symptoms of ADHD present significant challenges. Traits like distractibility, disorganization, and impulsivity can strain interpersonal dynamics and hinder success in various aspects of adult life. People with untreated ADHD often struggle with rejection-sensitive dysphoria (RSD) meaning they are more sensitive than others to rejection, teasing, or criticism.  As a result, partners with ADHD may feel perpetually unsatisfied with their efforts or undervalued in their relationships, exacerbating feelings of inadequacy and strain within intimate connections. Navigating these challenges requires understanding, support, and effective coping strategies. By addressing ADHD symptoms proactively, fostering open communication, and seeking professional guidance, individuals with ADHD can cultivate healthier relationships, navigate parenthood with greater ease, and thrive in their professional endeavors, ultimately reclaiming agency over their lives and well-being.

How can you tell whether you’re overwhelmed or actually have ADHD?

 A better question to ask is: is stress significantly impacting your daily functioning? Stress can certainly exacerbate ADHD symptoms,  it’s important to recognize that stress alone isn’t the root cause of ADHD-related challenges. This is where the expertise of a healthcare professional specializing in ADHD becomes invaluable, as they are trained to distinguish between stress-related symptoms and those indicative of ADHD. While the symptoms of stress and adult ADHD can overlap,  normal levels of stress are often situational and transient, fluctuating in response to external factors versus remaining a constant. Additionally, stress-related symptoms usually dissipate once the stressor resolves, whereas ADHD symptoms tend to persist despite changes in circumstances.

Are ADHD levels actually increasing in women?

A recent CADDAC survey of Canadian women with ADHD found that 46% were misdiagnosed with another disorder prior to being diagnosed with ADHD. This underscores the challenges many individuals face in obtaining a clinical diagnosis for adult ADHD. Across Canada, there is a growing awareness of adult ADHD, leading more people to consider whether they may have the condition. However, the process of obtaining a clinical diagnosis can be arduous, particularly in regions like British Columbia, where psychiatrist waitlists have been closed, and finding a doctor to diagnose ADHD is rare. That’s why access to clinical diagnosis is so important. It can rule out or confirm ADHD to set someone on the path to getting the appropriate support and interventions. Recognizing the need to address these gaps in the healthcare system, we founded Frida with the mission to empower patients and provide Canada’s most accessible, clinically proven treatment program for ADHD.For example, access to healthcare professionals within 1-2 weeks compared to over 6 months in the public healthcare system and a fraction of other private clinics.

Why are depression or hormones often blamed, leading to rampant ADHD misdiagnosis?

Depression and hormonal fluctuations are commonly implicated in symptoms that can overlap with those of ADHD, leading to the misdiagnosis of ADHD. Symptoms such as difficulty concentrating, irritability, mood swings, and fatigue can be shared among these conditions. Moreover, hormonal changes during menstruation, pregnancy, or menopause can further muddy the diagnostic waters by causing mood disturbances, cognitive fluctuations, and attention difficulties. ADHD in females is often under recognized and misdiagnosed due to differences in symptom presentation and societal stereotypes. Girls and women with ADHD may exhibit more internalized symptoms such as inattention and disorganization, which can be overlooked or attributed to other factors like hormonal fluctuations or mood disorders. Addressing these challenges necessitates heightened awareness, enhanced training for healthcare professionals, and a comprehensive approach to evaluation and treatment. By considering the unique needs and experiences of individuals, we can strive for more accurate diagnoses and better support for those affected by ADHD. There is growing evidence about the link between ADHD in women and hormonal factors, especially during pregnancy, and perimenopause/menopause. However, these factors have also diminished a woman’s concerns that she may have ADHD. These cycles are not the cause of ADHD but need to be taken into consideration by an ADHD-clinical professional during treatment. 

How does gender influence identification and treatment of ADHD?

Missed ADHD diagnosis in girls and women can be due partly to a special profile of more subtle symptoms (inattention – low self-esteem) compared to the more overt impulsiveness/hyperactivity of boys. For instance, instead of engaging in physical activities like running and climbing, girls might manifest their hyperactivity through subtler behaviors such as twirling their hair, chewing their cuticles, or being overly talkative. This distinction sheds light on the varied manifestations of hyperactivity in girls. When girls become women with adult ADHD, these symptoms can intensify due to hormonal fluctuations during the menstrual cycle, , and menopause. Hormonal changes can exacerbate existing ADHD symptoms, making it crucial for healthcare professionals to consider these factors when evaluating and managing ADHD in women. By recognizing the subtleties of ADHD symptomatology in girls and women and understanding how hormonal fluctuations can influence symptom severity, healthcare professionals can improve diagnostic accuracy and provide more tailored interventions to address the unique needs of females with ADHD.

What’s the importance of an ADHD clinical diagnosis vs. a gut feeling?

Those who think they might have ADHD need to be aware that ADHD is a complex disorder that shares symptom overlap with conditions such as depression, anxiety, and PTSD. The treatment for each condition is quite different. The thing is, about half of adults with ADHD aren’t diagnosed. They might not even know they have it but suspect it. Coming into the diagnosis as an adult means there’s a lot of learnings to absorb and adjust to – and that’s why our process involves clinically proven diagnosis and evidence based support – every step of the way. By providing comprehensive assessment and personalized interventions based on the latest research and clinical guidelines, we aim to empower individuals to navigate the complexities of ADHD with confidence and clarity. Our goal is to ensure that each person receives the support they need to thrive, regardless of the challenges they face along the way.

Should we be concerned with increasing prescriptions of stimulant medication?

Canadians need to be concerned about getting a clinical diagnosis from a healthcare professional that specializes in ADHD who can monitor their medication, how it’s working and overall treatment progress. This is why Canadians also need to beware where they are getting their diagnosis from. At Frida, we only offer clinical diagnosis and treatment. Our team of healthcare practitioners are experienced in mental health and adult ADHD. We undergo continuous training to stay updated. Frida also has a dedicated clinical leadership team committed to quality assurance. While stimulant medications play a valuable role in ADHD treatment, it’s essential to balance their benefits with potential risks and ensure that they are prescribed judiciously and monitored carefully. Healthcare professionals should conduct thorough evaluations, provide comprehensive education, and consider a multimodal approach to treatment that incorporates both pharmacological and non-pharmacological interventions. Additionally, efforts to address disparities in access to ADHD diagnosis and treatment are crucial for promoting equitable and appropriate use of stimulant medications.

How does one find accessible help for diagnosis and treatment of adult ADHD in Canada?

We developed Frida to fill the gaps in the healthcare system and empower patients to thrive with Canada’s most accessible clinically proven treatment program. For example, at a time when most doctors in the public healthcare system don’t feel comfortable or have the bandwidth to diagnose, wait lists for psychiatrists are long or even closed and other private options are out of reach, Frida provides access to healthcare professionals within 1-2 weeks. Patients see results within 4-6 weeks and it’s inspiring to see how, with the right support, it can be life-changing. For example, data from over 10,000 patients shows 80 percent reported clinically significant improvements in feelings of hopefulness and self-worth within six weeks and patients. We also saw a 34 percent improvement in ADHD symptoms by month four in this group.


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