More And More, Young Women Are Being Diagnosed With ADHD

Patti Neighmond June 9, 2014

The stress of adult life can make living with undiagnosed ADHD very difficult, doctors say. (Jing Wei for NPR)

As a child, Diany Levy was called lazy and unfocused. She remembers that teachers called home on a daily basis to tell her parents she was not paying attention in class. Now, at the age of 23, Diany has finally been diagnosed with the cause of her problems – ADHD.

Levy is not alone. The number of Americans taking medication to treat attention deficit hyperactivity disorder is steadily rising. But the biggest spike in ADHD medication is among young women between the ages of 19 and 34, according to a recent report. It found that the number of young women aged 19 to 25 on these medications is 27 percent higher than girls aged 4 to 18.

This is surprising, because ADHD begins in childhood and psychiatrists say the disorder occurs equally among boys and girls. But girls like the young Levy are being overlooked. Boys are diagnosed with ADHD at more than twice the rate of girls.

One reason is that the condition is easier to spot in boys. Boys are more likely to be fidgety and restless, says Dr. Lenard Adler, director of the adult ADHD program at NYU Langone Medical Center. "They're easily bored and do things they are not supposed to be doing," he says. Adler, who is a professor of child and adolescent psychiatry, says these behavioral disruptions in boys are hard to miss, but in girls the symptoms can be quieter and harder to spot.

Levy's problems got worse when she went to college. She couldn't sit through a two-hour lecture without getting up and moving around. A 20-page assignment that took her classmates 45 minutes to read took her three to four hours. Levy is now in graduate school, and she just recently got diagnosed with ADHD.

The NYU health center suggested she see Adler, and within days she was diagnosed and prescribed medication. The change, she says, was nearly immediate. "I can get things done on time without excuses," she says, "I'm actually reading a book for fun for the first time in five years."

What happened to Levy is typical, according to Adler. If people aren't diagnosed and treated in childhood, the symptoms become harder to cope with when they become adults because life gets more complicated. Add the responsibilities of a family – taking care of the kids, getting dinner on the table, paying bills, supervising homework, holding down a job – and life can become overwhelming for many women.

Adler says the good news is that women are more likely to seek out help, to see a doctor or get into therapy, than men. And this is one of the reasons why more young women are being diagnosed with ADHD.

Levy just wishes she had been diagnosed earlier. Maybe she could have been an A student, and maybe her SAT scores would have been better, she says, if she had got on medication earlier. Medication works for adults like Levy because it increases levels of chemicals in the brain that strengthen communication networks between different brain regions, according to Tony Wilson, a neuroscientist at the University of Nebraska Medical Center. "When patients have stronger networks," he says "they are better able to focus on the task at hand."

It's a sort of 'calming' effect that can set the stage for learning more effective coping skills, typically learned through cognitive behavioral therapy. There are some risks for adults taking ADHD medications. The drugs can increase blood pressure and heart rate. So it's essential for patients to be monitored through routine visits with their doctor.

Transcript

DAVID GREENE, HOST:

This is MORNING EDITION from NPR News. Good morning, I'm David Greene. In Your Health today, why emergency rooms are hiring their own pharmacists. But first, ADHD, according to a recent survey, the use of medication to treat attention disorder is rising - most rapidly, not among children, but among young women between the ages of 19 and 34. Girls are often not diagnosed until they're adults. NPR's Patti Neighmond looks at why that is.

PATTI NEIGHMOND, BYLINE: Attention deficit hyperactivity disorder overwhelmingly has its roots in childhood. Dr. Lenard Adler, a psychiatrist with the NYU Langone Medical Center, says it's easier to spot in boys.

LENARD ADLER: Boys are more likely to be fidgety, restless, talking to their friends, getting bored easily, you know, doing some things that they're not supposed to be doing.

NEIGHMOND: Behavioral disruptions that are hard to miss. ADHD can compromise learning and development and teachers often tell parents what they already know, their child has trouble focusing and paying attention. Girls can have the same problems but Adler says the symptoms are often more quiet, like with this former patient.

ADLER: She had difficulty paying attention in class, was seen as daydreaming. Comments on the report cards were underperforming, not meeting potential...

NEIGHMOND: 23-year-old Diany Levy had similar problems focusing and she got labeled as lazy.

DIANY LEVY: Most of my teachers used to call my mom, almost on a daily basis - hey, she's not finishing her work - that I was, like, not paying attention and, like, looking around and listening to everything but them.

NEIGHMOND: By the time she got to college, Levy's difficulties got worse. She couldn't sit through a two-hour lecture. She had to get up and move around. When it took her classmates 45 minutes to read a 20 page assignment, it took her three to four hours.

LEVY: I couldn't focus to get it all done at once. I needed to do something in between and just read a bit now and then reread a little bit and keep reading so it was very hard to get my reading assignments done.

NEIGHMOND: What happened to Levy is typical, says psychiatrist, Adler. If people aren't diagnosed and treated in childhood, when they become adults and go to college or get a job, symptoms become harder to cope with because life is more complicated. Add responsibilities of a family and life can become overwhelming for many women.

SPEAKER: They've got to take care of their kids, be sure they get out the door and go to work, manage all of the things in the workplace and maybe managing others at work, if they've been lucky enough to be in a managerial position. Then come home, get dinner on the table, make sure the kids do their homework, pay the bills, deal with their spouse - this is a very different life than an elementary-age school girl, where you're sitting in a classroom and your homework's handed to you.

NEIGHMOND: The good news, says Adler, women are more likely to seek out help, see a doctor, get into therapy, than men and this is one of the reasons why more young women may be being diagnosed with ADHD. Diany Levy is now in grad school. The college health center suggested she see Dr. Adler and within days she was on treatment, taking medication. The change, she says, was nearly immediate.

LEVY: I can get things done. I can get them done on time, without excuses. I used to be the queen of excuses. I'm actually reading a book for fun for the first time in a good five years and I'm almost done with my book.

NEIGHMOND: Levy wishes she'd been diagnosed earlier. Maybe she could have been an A student, she says. And her SAT scores might have been better. Tony Wilson is a neuroscientist at the University of Nebraska Medical Center. He says medication works for adults like Levy because it increases levels of chemicals in the brain that strengthen communication networks between different regions.

TONY WILSON: When patients have stronger networks, they are better able to do a variety of things from, you know, holding their attention on goal-directed activity to solving, you know, mental problems to better able to focus on, you know, the task at hand, whatever it is.

NEIGHMOND: A sort of calming effect that can set the stage for more effective coping skills, often learned through behavior therapy. Now, there are some risks. ADHD drugs can increase blood pressure and heart rate, so patients need to be monitored on a regular basis. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.