dr Angel: The main reason is that there is a so-called symptom change in ADHD. Those affected are typically noticed early on, who are very active and impulsive in the school class, who constantly interrupt or generally attract attention with restless behavior and are then often seen as disrespectful. Classically, these are mainly the boys.
All of these behaviors can change with age. For many, for example, the restlessness continues to decrease or shifts more to the inside. Because as they grow up, many train themselves to withdraw more and more, reacting to the negative feedback they get in kindergarten or school with strong self-control. As with those who are not affected, people with ADHD in adulthood no longer behave the way they did when they were children. As a result, there was a long-standing assumption that ADHD symptoms simply stop at 18. However, the symptoms that are primarily associated with inattention, such as organizational difficulties or a weak working memory, are still very pronounced in many cases. Perhaps, as an adult with ADHD, I often leave things in the middle of work or have trouble completing things, meeting deadlines, or having trouble with time management in general. This has been ignored for a long time.
Symptoms in adult women – and why they are often overlooked
GLAMOROUS: You have already mentioned that there is a dominant stereotype of ADHD symptoms. There are various studies on the subject that not only show that children are diagnosed more frequently than adults, but that there is also a diagnostic gap in terms of gender – i.e. girls and women are diagnosed less often than boys and men. What is the reason for this and what other symptoms do girls and women show who deviate from the prevailing stereotype?
dr Angel: There are different theories. One theory is that boys are more likely to be hyperactive-impulsive ADHD types and women are more likely to be inattentive types. In this way, women or girls fall out of the “typical” behavior pattern associated with ADHD earlier. Another problem is that girls are being encouraged to pull themselves together more. We’re just still victims of old role clichés and often hear “get your act together” or “you don’t do that as a girl” and are more likely to be rejected if we babble on or are very expressive and competitive. Then it says “you always want to be the center of attention” and “don’t interrupt so much”, and you should be “female”, “feminine” – which for many means: “be reserved”. In this way, girls and women learn early on to make an effort to compensate for or hide their symptoms.
GLAMOROUS: Are there also those affected who come to you and report about “Medical Gaslighting”?
dr Angel: “Gaslighting” is the wrong term. The fact that self-diagnoses by those affected are viewed critically or misinterpreted is something that can be found everywhere in medicine, including ADHD, of course. This doesn’t happen on purpose. Especially when those affected bring a range of other diagnoses with them, it is sometimes difficult to differentiate between the symptoms.
Enlightenment in the social media and the accusation of a “fashion diagnosis”
GLAMOROUS: In the meantime, more and more people are talking about ADHD and ADS in adulthood, but unfortunately this means that terms such as “fashion diagnosis” are also coming back into common usage. Do you also see a danger for those affected in this label?