Is your daughter secretly struggling with ADHD? Here's how to know

For as long as I can remember, I was constantly getting called out in class for staring out of windows, fidgeting excessively or forgetting to do homework tasks I did not realise were ever assigned.

Meanwhile, my energetic and excitable nature was considered immature and attention-seeking by most.

When this started to affect my learning, my parents tried everything from cutting out sugar from my diet to supplying me with endless amounts of Omega 3 supplements and multivitamins.

All the while, I had been displaying obvious symptoms of Attention Deficit Hyperactivity Disorder (ADHD), but because I'm a girl, I went years undiagnosed, and struggled severely because of it.

The real issue began when I left boarding school, went off to university and was no longer forced to study during designated study times or handed monthly pre-scheduled test and deadline reminders.

After four long years of university, a handful of therapists, four hours of psychological assessments and a river of tears, I was diagnosed with ADHD at the age of 22.

ADHD explained

ADHD is a mental health disorder that can be categorised by high levels of hyperactivity and impulsive behaviours. The common symptoms include:

• distractibility, or trouble concentrating

• forgetfulness

• inattentiveness

• fidgeting

• interrupting people while they are talking

This often leads to poor organisation, poor prioritisation, lack of attention to detail and poor time-management skills.

ADHD has fallen prey to many misconceptions, including the idea that it only affects young boys.

Why girls get diagnosed late

The truth is, in earlier years when ADHD and ADD were being studied, they only studied young boys.

ADHD has been found to have the same prevalence in boys as in girls, but girls often go undiagnosed due to the ways in which girls mask their symptoms – meaning that they can adapt their personalities better to conform to social pressures.

Research indicates that 75% of girls with difficulties paying attention go undiagnosed, while those who are diagnosed receive their diagnosis an average of five years later than boys.

Lorian Phillips, a clinical psychologist with a special interest in ADHD, told Parent24, "Boys' symptoms are very often very obvious because they're more hyper – whereas girls often are just very chatty, and because girls have got a reputation of being chatty at the best of times, it often goes undiagnosed."

How girls mask their symptoms

While ADHD is usually categorised as the disorder that makes little boys disruptive, in girls it often presents itself as inattentiveness.

"In class, girls often are the inattentive type – that's a child who is day-dreaming, staring out the window, playing with their hair – and a teacher is not going to think 'well, that's ADD' because they're looking at the wild boy jumping around," said Phillips.

Not only do girls display their ADHD symptoms differently, but they develop compensatory strategies for coping with their neurodivergent abilities.

For example, girls with ADHD develop perfectionistic characteristics as well as obsessive and compulsive behaviours, such as repeatedly checking for mistakes or missing items when packing, to avoid mishaps that their forgetfulness has led to in the past.

This makes it easier for adults to discount ADHD as a possibility as children with ADHD have often been portrayed as "messy" or "sloppy".

Additionally, girls often have more emotional, mood-related symptoms, such as feeling anxious, sad, and overwhelmed, which can lead to meltdowns.

"Because girls are socialised to be more compliant, more respectful of authority, they might, just like boys, leave their work to the last minute, but because they're more anxious about what might happen at school, they might do it the night before and do it beautifully and perfectly because they're under so much pressure," Phillips told Parent24.

Lesser-known side-effects of undiagnosed ADHD

The issue with this late diagnosis goes far beyond the idea of a handful of schoolgirls who struggle to concentrate in class. Years of masking ADHD symptoms without the correct diagnoses or medication can have dire risks and implications.

Girls with ADHD are often talkative and loud, to the extent that they often talk over their peers.

This, however, allows them to appear confident or even self-centered when they may actually suffer from low self-esteem.

Phillips explained to Parent24, "Their self-esteem gets very poorly affected – if you're being shouted at all the time and feeling like everybody can manage except for you [and] everybody has got it right except for you – that is very destructive for their self-development."

This makes so much sense to me, as I often lost hours of sleep overthinking and worrying about things I had said, and planning conversations before I had them so that I could control my ADHD before it controlled me.

This brings us to the more serious, lesser-known side-effects of undiagnosed ADHD: anxiety and depression.

Individuals with ADHD tend to become overwhelmed more easily. That coupled with the constant fear of missing deadlines, forgetting to complete tasks and, for those like me, the worry that they might impulsively say or do something embarrassing, anxiety is more likely to be present in someone with ADHD.

Depression is estimated to be nearly three times more likely to occur in adults with ADHD and 30% of adults with ADHD are expected to experience a depressive episode or develop a mood disorder.

Not only do these mental health disorders make it more difficult to identify ADHD as they mask the ADHD symptoms, but individuals with impulsive symptoms are at a higher risk of suicide.

Individuals with ADHD have lower levels of dopamine, which limits their ability to recognize reward and results in a lack of motivation.

"It is so difficult for them to put in effort for anything that feels challenging or feels boring, and that lack of motivation seeps into all areas of their lives," Phillips said, explaining that ADHD can make it difficult to perform simple tasks such as getting out of bed or taking a shower.

For this reason, children with ADHD can often be stigmatised as lazy, when in fact people with ADHD have to put in five times as much effort as a neurotypical individual.

If undiagnosed, this leads to burnout and builds on feelings of inadequacy that may already exist.

People with ADHD are also at a higher risk of drug addiction with more than 25% of adolescents with substance abuse issues fitting the criteria for ADHD.

This is especially true for those with higher levels of hyperactive and impulsive behaviours.

Overall, untreated or undiagnosed ADHD can go on to have a negative impact on academics, relationships, sleeping patterns and employment opportunities.

Need help? Contact theADHD helpline at 0800 55 44 33.

First published on Parent24.