diagnosing adults: recent publications

What Does ADHD Look Like in Women? Many Doctors Are Still Getting It Wrong

“I’m nearing the end of my rope,” said Michelle, a 38-year-old mother of two, to her internist. “I leave and then return to our apartment three times to retrieve everything I’ve forgotten. I don’t plan meals.

I can’t keep up with meetings at school, doctors’ appointments, or sports practices. I’m not sleeping well and I’m anxious all the time about just getting through my day without a catastrophe.”“Michelle, you’re clearly depressed and anxious,” said her internist. She prescribed a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant.Michelle left the office feeling heard and pleased with what seemed a reasonable diagnosis and treatment plan.

Except for one thing: It was wrong. Michelle’s symptoms of frustration, worry, underachievement, depressive feelings, and chronic anxiety were not signs of depression or anxiety; they were signs of ADHD in women — misinterpreted and misdiagnosed.What happened to Michelle, a fictional character, happens to many women with inattentive symptoms of ADHD. The fact is that most professionals, from medical doctors to psychologists, have little training in ADHD and do not know how to recognize it outside of hyperactive children.

People with inattentive ADHD report symptoms of depression (because they are having trouble achieving their goals) and anxiety (because they fear dropping the many balls they are juggling).Practitioners of all stripes know that SSRIs are good for treating depression and anxiety, so the prescription seems to fit the bill. Except that these women with undiagnosed ADHD are “depressed” largely because they are underachieving, falling behind, and feeling ashamed about it. And they are “anxious” because they never know what bad thing will happen next.

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diagnosing adults: Readers Choice

“I’m nearing the end of my rope,” said Michelle, a 38-year-old mother of two, to her internist. “I leave and then return to our apartment three times to retrieve everything I’ve forgotten. I don’t plan meals.
ADHD diagnoses among adults are growing four times faster than are ADHD diagnoses among children in the U.S. 1 Still, ADHD remains significantly underdiagnosed beyond childhood. Fewer than 20% of adults with ADHD are currently diagnosed and receiving treatment, which means most are navigating symptoms without any support or treatment.

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