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ADHD Awareness: Is it Really as Overdiagnosed as People Think?

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: August 12, 2021

Attention-Deficit Hyperactivity Disorder, or ADHD, is a condition that is characterized by continual patterns of inattention with or without hyperactivity/impulsivity. It often interferes with development and day-to-day functioning. It is often said that this condition is overdiagnosed and that children are overmedicated. But is that really the case?

According to many prominent social media creators, that statement could not be further from the truth. In fact, they assert that if anything, ADHD is underdiagnosed; specifically among women and people of color. Thanks to the information that has been made available on social media, there are many people who are only now finding out that the suffering they have experienced can be attributed to ADHD.

Historically, ADHD was a diagnosis that was mostly given to boys who exhibited symptoms. Girls were rarely considered, and the same was true for people of color. But ADHD Awareness demands that we take a closer look at these groups of individuals and their individual circumstances. It is possible that there are many people who have suffered for years – or even decades – when they should not have.

 

What Makes ADHD a Common Diagnosis for Caucasian Boys?

In 2013, a pediatric study was done to determine racial and ethnic disparities in ADHD diagnoses starting from kindergarten and going through eighth grade. They found that there were several factors that affected the outcome, including:

  • Being a boy
  • Being raised by an older mother
  • Being raised in a household that spoke English
  • Exhibiting external problematic behaviors

Likewise, there were several factors that decreased a child’s risk of being diagnosed with ADHD. They included getting better grades in school and not having health insurance. Additionally, it was found that children who were members of ethnic minorities were less likely than white children to be prescribed medications for their conditions.

There is no denying that people of color are being left behind when it comes to getting diagnosed with ADHD. The “face” of ADHD is white, and it has become exclusive to other ethnicities. Research has shown that people in black and Latino communities are much less likely to receive ADHD diagnoses. This is the case even though they show symptoms at the same rate as white people. Even if they are diagnosed, they are much less likely to receive the treatment they need to manage their symptoms.

Dr. Paul Morgan is the professor of education and director of the Center for Educational Disparities Research at Penn State. He says, “We don’t want a situation where ADHD is a condition for wealthy white families. We want to be helping children who have disabilities, regardless of their race or ethnicity. But what we’re finding is consistent evidence that white and English-speaking children are more likely to be identified – and that’s an inequality.”

 

ADHD has Been Shown to be Dramatically Underdiagnosed in Girls

A diagnosis of ADHD is typically wrought with stereotypical behavior. It is branded by the inability to pay attention as well as crazy, hyperactive behavior. As a result, many girls are overlooked simply because they do not demonstrate the impulsive, hyperactive characteristics that most people think of when they think of ADHD.

According to an article on the ADDitude website, most girls exhibit the signs and symptoms of the inattentive type of ADHD. This was formerly called ADD. They include:

  • Feeling sad or anxious
  • Inattentiveness or shyness
  • Picking at the skin or cuticles
  • Perfectionistic behavior
  • Daydreaming during school
  • Silliness
  • Problems keeping friends

Hyperactive behavior in girls is very different than it is in boys. A boy might run around the classroom, fidget in his seat or blurt out the answers to questions. But for girls, excessive talking is how they often demonstrate hyperactivity. But instead of being seen as a key indicator of possible ADHD, that type of behavior is seen as simply being chatty.

Dr. Patricia Quinn (National Center for Gender Issues and ADHD in Washington D.C.) and Dr. Sharon Wigal (the University of California at Irvine) surveyed more than 1,797 members of the general public to determine their thoughts on ADHD diagnoses. Their findings showed that 85% of teachers and more than half of parents and members of the general public believed that girls with ADHD are more likely to go undiagnosed than boys. This is because girls tend to suffer in silence or have fewer symptoms. Boys typically demonstrate significant behavioral problems whereas girls are more likely to simply be inattentive or have mood disorders.

 

Social Media Gives Girls and People of Color with Undiagnosed ADHD a Voice

Social media sites like TikTok have given a voice to those who most likely should have been diagnosed with ADHD in their younger years. Not only has it provided them with an outlet for everything they have gone through, but it also allows them to reach out and inform others.

The hashtag #ADHD has gained more than 2.7 billion views on TikTok. Though people should refrain from self-diagnosing based on what they have seen on a social media platform, the content has been a way to get conversations started and people thinking differently.

There are several places where people can find ADHD information on social media. They include:

There are also a lot of memes circulating that tend to make light of the subject, but that uncover very real truths about this condition.

 

What are the Consequences of Undiagnosed ADHD?

It is important to recognize that undiagnosed ADHD has consequences; some of which can last a lifetime. It can affect the person who has the condition as well as those who are in regular contact with them. These consequences include:

  • Experiencing depression, anxiety and low self-esteem. Low self-esteem is very likely in women, particularly, who have undiagnosed ADHD. They may eventually develop severe psychological distress, including anxiety and depressive disorders. Dealing with chronic stress can eventually lead to health issues such as fibromyalgia.
  • Problems in relationships. Studies have shown that the spouses of people with ADHD can feel more neglected than those who are married to people without it. They report less intimacy and less satisfaction in their marriages.  
  • Instability in their jobs. People who have ADHD and are not being treated for it may struggle to graduate from high school or college. As such, they may struggle to be productive at work too, which can cause them to have a hard time keeping a job.
  • Substance abuse. It is common for people with ADHD to reach for drugs or alcohol as a way to cope with how they are feeling. These substances may appear to help them feel better in the short term, but in the long-term, they can lead to addictions.

It is past time that we took a fresh look at ADHD and how it affects all people; not just boys. Women and minorities need to be considered too, and in doing so, more people will be able to get the help they so desperately need.

 

External Sources: 

  1. National Institute of Mental Health: Attention-Deficit/Hyperactivity Disorder. September 2019. Available at https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/
  2. The New York Times: “No One’s Ever Talked to Me About This Before.” May 2021. Available at https://www.nytimes.com/2021/05/24/style/adhd-online-creators-diagnosis.html
  3. US National Library of Medicine: Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade. July 2013. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691530/
  4. ADDitude: Children Left Behind. July 2021. Available at https://www.additudemag.com/race-and-adhd-how-people-of-color-get-left-behind/
  5. ADDitude: ADHD in Girls: Why it’s Ignored, Why That’s Dangerous. October 2019. Available at https://www.additudemag.com/adhd-in-girls-women/
  6. US National Library of Medicine: Perceptions of Girls with ADHD: Results from a National Survey. May 2004. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1395774/
  7. TikTok: #adhd. Available at https://www.tiktok.com/tag/adhd?lang=en
  8. Twitter: Pina ADHD Alien Comic. Available at https://twitter.com/adhd_alien
  9. TikTok: danidonovan. Available at https://www.tiktok.com/@danidonovan
  10. The New York Times: Hello Brains! A Life Spent Helping Others Understand A.D.H.D. Online. May 2021. Available at https://www.nytimes.com/2021/02/22/style/self-care/adhd-youtube.html
  11. Adulting with ADHD. Available at https://adultingadhd.substack.com/
  12. Black Girl Lost Keys: ADHD Time Management Troubles: 5 Areas to Attack! July 2021. Available at https://blackgirllostkeys.com/
  13. Medical News Today: What to know about untreated ADHD in adults. Available at https://www.medicalnewstoday.com/articles/untreated-adhd-in-adults.
  14. Life With a Partner With ADHD: The Moderating Role of Intimacy. Available at https://psychology.uiowa.edu/sites/psychology.uiowa.edu/files/groups/nikolas/files/Ben-Naim%20et%20al%202017.pdf.
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