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Miss Diagnosis: Anxiety, ADHD, & Women

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In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small 😎

❝Why is ADHD so often misdiagnosed as anxiety in women?❞

A great question! A short and slightly flippant answer could be “it’s the medical misogyny”:

Women and Minorities Bear the Brunt of Medical Misdiagnosis

…and if you’d like to learn more in-depth about this, we recommend this excellent book:

Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghornyou can read our review here

However, in this case there is more going on too!

Part of this is because ADHD is, like many psychiatric issues, a collection of symptoms that may or may not all always be present. Since clinical definitions are decided by clinicians, rather than some special natural law of the universe, sometimes this results in “several small conditions in a trenchcoat”, and if one symptom is or isn’t present, it can make things look quite different:

What’s The Difference Between ADD and ADHD?

There are two things at hand here: as in the above example, there’s the presence or absence of hyperactivity, but also, that “attention deficit”?

It’s often not really a deficit of attention, so much as the attention is going somewhere else—an example of naming psychiatric disorders for how they affect other people, rather than the person in question.

Sidenote: personality disorders really get the worst of this!

“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”

“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”


In the case of ADHD and anxiety and women, a lot of this comes down to how the redirection of focus is perceived:

❝For some time, it has been held that women with ADHD are more likely to internalize symptoms and become anxious and depressed and to suffer emotional dysregulation❞

~ Dr. Patricia Quinn

Source: Attention-deficit/hyperactivity disorder and its comorbidities in women and girls: An evolving picture

This internalization of symptoms, vs the externalization more generally perceived in boys and men, is more likely to be seen as anxiety.

Double standards also abound for social reasons, e.g:

  • He is someone who thinks ten steps ahead and covers all bases
  • She is anxious and indecisive and unable to settle on one outcome

Here’s a very good overview of how this double-standard makes its way into diagnostic processes, along with other built-in biases:

Miss. Diagnosis: A Systematic Review of ADHD in Adult Women

Want to learn more?

We’ve reviewed quite a few books about ADHD, but if we had to pick one to spotlight, we’d recommend this one:

The Silent Struggle: Taking Charge of ADHD in Adults – by L. William Ross-Child, MLC

Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!

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