Women Are Often Misdiagnosed with Depression and Anxiety: What might be the real culprit?

Do you frequently experience -

  • A feeling of constantly needing to catch up with life, but never being able to actually do it?  
  • Forgetting important deadlines and general brain fog.
  • Getting easily overwhelmed.  
  • Irritability and anxiousness.
  • Your long-term memory is fine, but your short term is lacking.
  • Exhaustion from trying to juggle it all.
  • Sadness because those around you do not understand your overwhelm.
  • Anxiety because you know you are likely to be criticized for your shortcomings.

If you answered “yes” to the majority of items on this list — or believe this sounds like someone you know — keep reading…

What is the real culprit and why is it being misdiagnosed?

It is becoming more and more known that women are repeatedly diagnosed with depression and anxiety, when Attention-deficit hyperactivity disorder (ADHD/ADD) is the real culprit.  Why does this misdiagnosis so commonly occur in women?

  • This is mostly related to our cultural conditioning and behavioral expectancies. Up until recently, most research on ADHD/ADD was done with only males.
  • Physicians are used to the cultural perception that males usually have ADHD, whereas they believe women typically experience depression and anxiety.  
  • Furthermore, women have a difficult time seeking help for ADHD/ADD as their symptoms tend to be more internalised.  They have been conditioned to mask their symptoms in order to fit the female stereotype and gain approval.
  • Professionals are more likely to misdiagnose women with other conditions that have overlapping characteristics to ADHD.  However, it is quite possible that the woman is depressed and anxious because of an ADHD/ADD condition.
You do not have to fit the over-the-top, energetic, stereotype of someone with ADHD, to actually have the condition.

More and more women are being properly assessed and after years (sometimes decades) of being on antidepressants for depression and anxiety, they find out they have ADHD/ADD. Psychologists and psychiatrists tend to recognize ADHD if the individual had problems concentrating in school.  However, we now know that this is not an accurate criterion as many females do well in school despite their condition. They have learned how to develop techniques to accomplish tasks in a neurotypical school system. It isn’t until they get to the university level that the issue of being totally overwhelmed is realized.

Many adult women state that the switch to the proper diagnosis and treatment is life altering.  Their brain fog disappears, they have more energy and ability to concentrate, they are not anxious about not being able to multi-task and carry out their responsibilities, they sleep better, and they have the motivation to exercise which raises and stabilizes their mood. Their symptoms are not just personality traits, they are potential signs of a neurodivergent brain, which is still as perfect as any other brain.

Overlapping symptoms

Many of the symptoms of each of these conditions overlap. To complicate things further, some individuals may have comorbid conditions; that is, they have both ADHD and depression/anxiety.  “80% of adults and 44% of children with ADHD have at least one comorbid psychiatric disorder” (CADDAC, n.d).

Table of Overlapping Symptoms

These are common shared traits between an attention deficit, anxiety, and depression.

As you can see, it's easy to get the conditions confused as they share a variety of symptoms. However, there are major differences between them as well.  

Some distinguishing factors

  • Those experiencing anxiety feel tenseness, nervousness, restlessness, panic, and dread, while having an expectancy of impending doom.  They are hypervigilant and always on guard for the next threat.  Their nervous energy can cause them to talk excessively and interrupt in conversations.  Individuals with ADHD feel nervousness, restlessness, and a sense of overwhelm also, however they are typically not on guard for the next threat.  They often have become anxious over time because they know they have to cope in order to function in work and life, and they worry that they will be criticized for not being able to follow through and meet the expectations of others.  
  • Those with ADHD typically do NOT experience feelings of dread or impending doom.
  • Both those experiencing anxiety and those experiencing ADHD often talk excessively or interrupt in conversations.  However, for individuals with ADHD, it is not due to nervous energy, but rather a feature of their neurodivergent brain.
  • Those who are experiencing depression feel a loss of motivation, restlessness, low moods, and often present as being dishevelled. Those with ADHD can feel low moods also, however it is often because of low self-esteem due to repeated criticisms for undiagnosed inattentiveness or impulsivity.
  • If someone with ADHD appears dishevelled, it is not due to depression, but rather an inability to easily organise their day and develop routine practices.
  • A sudden loss of interest in activities can resemble a characteristic of those suffering with depression, however this can also be a sign of ADHD as the interest may no longer produce enough dopamine (the pleasure and motivation neurotransmitter) that the ADHD brain consistently craves.  

To distinguish between the two conditions, it is best to look at the reason why they are experiencing a low mood, lack of motivation, or appear dishevelled.

Lastly, tips for managing ADHD/ADD symptoms

Some tips for success in manually managing symptoms:

  • Request accommodations especially in academic settings
  • Recognize your excessive energy patterns
  • Work with a coach
  • Ask for feedback from friends, family, or colleagues
  • Work with a partner, or in a team
  • Listen to white noise sounds or music
  • Gamify your To-Do list
  • Practice meditation
  • Get regular exercise
  • Avoid multitasking

References

Centers for Disease Control and Prevention. (2021, September 23). Symptoms and diagnosis of ADHD. Centers for Disease Control and Prevention. Retrieved July 11, 2022, from https://www.cdc.gov/ncbddd/adhd/diagnosis.html

Centre for ADHD Awareness, Canada. (n.d.). ADHD: A Significant Health Risk [web log]. Retrieved July 11, 2022, from https://caddac.ca/wp-content/uploads/policy-paper_seriousness-of-ADHD-final-english.pdf.

Health Canada, H. (2009, February 9). Government of Canada. Canada.ca. Retrieved July 11, 2022, from https://www.canada.ca/en/health-canada/services/healthy-living/your-health/diseases/mental-health-depression.html

Health Canada. (2009, July 22). Government of Canada. Canada.ca. Retrieved July 11, 2022, from https://www.canada.ca/en/health-canada/services/healthy-living/your-health/diseases/mental-health-anxiety-disorders.html

Substance Abuse and Mental Health Services Administration. (2016). DSM-5 CHANGES: IMPLICATIONS FOR CHILD SERIOUS EMOTIONAL DISTURBANCE. Rockville, Maryland; Center for Behavioral Health Statistics and Quality (2020). Adult ADHD at work: TIPS for organization and Control. WebMD. Retrieved July 11, 2022, from https://www.webmd.com/add-adhd/adhd-in-the-workplace

Guest Contributor: Kylie Lenartowicz

Kylie is a fourth-year student of the Bachelor of Design - User Experience program at Humber College in Toronto. She began her journey into the design/content creation industry through her graphic design background. She works as a graphic designer, UX/UI designer, and content creator. Kylie intends to be an advocate for women with ADHD, as well as a mental health and well-being promoter.

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Blog Post written by:

Dr. Nickerson's professional experience as a psychologist and personal passion for developing the mind-body-spirit connection have fueled her success and devotion to training individuals and organizations to foster whole wellness.

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