'Covid brought everybody out of the woodwork': Significant rise in recent years of women with ADHD diagnosis

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological disorder that impacts approximately 5% of the population in Ireland.

This is according to ADHD Ireland, the national non-profit organisation dedicated to providing up-to-date information, resources and community building opportunities to individuals with ADHD and their families.

ADHD is a developmental impairment of the brain’s executive functions, which affects an individuals ability to plan, focus on, and execute tasks.

While ADHD is more commonly diagnosed among children, speaking to The Echo, service development manager of ADHD Ireland in Cork Martin Finn said that the service has seen a significant increase over the last two to three years in adult women seeking a diagnosis.

“Covid brought everybody out of the woodwork because people were at home — they couldn’t go to the office and they found that without structure, they couldn’t operate as normal,” Mr Finn said.

“People realised they couldn’t work and they were thinking ‘what’s wrong with me?’.

“At the same time, they were looking at short form media like TikTok and YouTube shorts, that were starting to present conditions like ADHD in a digestible way, and that was another part of that explosion.

“It’s at epidemic proportions at the moment,” he added.

“We see a lot of women coming out now and saying ‘I’ve been diagnosed’ or ‘I think I have it’ and classically what happens is boys are picked up first because boys have an externalised version of ADHD more so than the girls, so people have gone their whole lives not knowing that they had this condition.

“Between the ages of eight and 12, boys in Ireland are four times more likely to be diagnosed with ADHD compared to girls.

“Many women are not diagnosed until they reach their 30s, 40s, or even later in life.

“We have noted an increasing trend of women in their 40s and beyond, and even some in their 70s, receiving a diagnosis,” he added.

“This reflects a broader trend where girls are often underdiagnosed due to differences in symptom presentation, and the ability of many girls to mask their symptoms.”

Administration manager at ADHD Ireland in Cork Sara Falconer said: “Women and girls are so often missed because of the criteria, when they were originally drawn up, they were drawn up for boys, and it manifests quite differently in women and girls — so they call it invisible ADHD.

“With girls they tend to be more dreamy, maybe staring out the window, whereas boys are jumping around the classroom, so girls, because they’re not causing any trouble, they tend to struggle.”

Further confirming this sentiment, clinical psychologist at West Cork Psychology Dr Vicky Matthews said: “I think for a long time, there were two misconceptions about ADHD — one, was that it was only a childhood condition, and two, was that it really only existed in boys.

“There’s been a huge increase in women seeking a diagnosis.

“I would say that my waiting list at the moment is predominantly adult women.”

ADHD often misdiagnosed as a mental health issue especially in women

While ADHD is a disorder that can co-exist to a greater or lesser degree with other neurological conditions, it is often misdiagnosed as a mental health based condition such as depression or anxiety due to the similarities in symptoms.

ADHD Ireland Cork service development manager Martin Finn highlighted that the manifestation of symptoms often differs between the sexes, with many women and girls misdiagnosed with mental health disorders due to the similarities in or shared symptom effects.

“Not only is it a story that we commonly see, it’s the most common story,” he said.

“If we got money for every woman who came and told us this story, we wouldn’t need funding from the HSE.”

Dr Vicky Matthews, clinical psychologist at West Cork Psychology, said: “Because ADHD is very underdiagnosed in women, and misunderstood in terms of how it presents, it is often characterised as something like depression or anxiety.

“If you have a neurodiverse brain and you’re living in a neurotypical world without any accommodation, you are always at a higher risk of feeling uncomfortable or out of place.

“So it’s easy to misinterpret these symptoms as something else,” she added.

Mr Finn said: “If you’ve got a fast brain, you tend to be a warrior.

“If you’re thinking all the time, if you can’t sleep at night because there’s a million things going around in your head – it’s just made for anxiety – they’re all linked.

“For women with ADHD, symptoms can become more pronounced during different phases of their menstrual cycle, which often leads to misdiagnosis or treatment for anxiety and depression rather than ADHD itself.”

Despite increasing awareness of the disorder, which Mr Finn partially attributes to social media, he said that many ADHD patients still feel a sense of shame when receiving their diagnosis due to a historically negative narrative on the subject.

“For every person diagnosed with ADHD, there could be another one to two people who have the disorder but remain undiagnosed,” he said.

“In some populations, particularly among women and older adults, the rate of undiagnosed ADHD is higher due to the subtlety of symptoms and societal misconceptions about the disorder.

“Every day is a perfect storm when you have ADHD, it’s not just losing your keys, or being late — it’s the cumulative nature of ADHD — your life becomes a kind of circus because you can’t focus like other people.

“You can’t sustain mental effort like other people and unfortunately, the world we live in, it isn’t set up for people with ADHD.

“It’s chronic,” he added.

Further combatting ‘everyone wants a label’ narrative, administration manager at ADHD Ireland in Cork Sara Falconer said: “If you have ADHD, there’s nothing fun or glamorous about it. When you look at the proportion of people in prison with ADHD, when you look at the amount of addiction amongst people with ADHD, this isn’t something anyone wants to have.The expectations of how you operate have been set by people whose brain works differently — it’s quite difficult for people with ADHD. It is much bigger than everybody just wanting a label.”

Dr Matthews said: “The classic idea of ADHD still pervades, but thankfully the narrative has been shifting in terms of public awareness and also research. We now understand that ADHD does continue into adulthood and it does continue to create functional impairments for people, so they still have a harder time than a neurotypical peer.

“We also understand more and more about the presentation in women, where it does tend to be more obviously those kind of inattentive symptoms; that might be difficulty with organising themselves, difficulty being late, lack of motivation, procrastination and forgetfulness.”

ADHD: Getting an assessment

ADHD Ireland Cork service development manager Martin Finn has highlighted that while growth in awareness of the condition is a positive thing, there is a substantial backlog in acquiring assessments due to the lack of personnel within the sector.

He said that another barrier for patients is the growing cost, with the average price for an assessment standing between €1,000 to €1,500.

“If somebody suspects they have ADHD, the first port of call is the GP, because the GP will need to refer you to a psychologist or psychiatrist,” Mr Finn said.

“Then you can go public or private, but a lot of the places in Cork that privately assess for ADHD in adults [also] have a very long waiting list.

“I’m hearing one to two years for clinics that we have sent people to,” he added. “That’s a huge problem.

“People tend to end up going to Dublin for their assessment and that’s just the situation, even in the private sector, like in the private clinics, we just need more of them.

“We just need more of everybody; more psychologists and particularly more psychiatrists,” Mr Finn said.

Dr Vicky Matthews further backed this, saying additional supports are “absolutely” needed within the sector, as well as encouragement of other clinical practitioners to learn more about the condition.

“It’s fascinating how much people within these fields don’t feel able to work with ADHD, and until relatively recently, it was never anything I had worked with because I misunderstood it myself,” she said.

“You need to learn, and do continuous professional development, and for that reason, there are a lot of people who will tell you straight that they don’t want to work with it.

“It’s a shame because I think it is such a rewarding area to work in.”

For further information on ADHD supports, or to attend an in-person support group run by ADHD Ireland, visit: https://adhdireland.ie/

To book an ADHD assessment with Dr Matthews, contact West Cork Psychology via: https://www.westcorkpsychology.ie/