ADHD in Boys vs. Girls

ADHD (Attention deficit hyperactivity disorder) is one of the most common mental health disorders diagnosed in children. This is a neurodevelopmental disorder that’s symptoms often consist of difficulty concentrating, difficulty staying still, and difficulty staying organized. This disorder is often noticed in children by about age 7 and much more noticeable by teachers at school where there are numerous expectations to sit in your seat, speak when you’re called on, and focus on lessons and assignments. However, there are circumstances in which people are not formally diagnosed until they are adults.

There are significant gender differences in the presentation of ADHD. However, it’s important to be aware of, that just as with any other mental disorder, two people can have the same issue and it can look differently and be treated in the same or different way.

According to the CDC, boys are 3 times as likely to be diagnosed with ADHD than girls. This doesn’t mean that boys are necessarily more afflicted by ADHD, but that the symptoms present in much different ways. With girls, the symptoms are often more subtle and harder to identify.

Boys tend to show more of the externalized symptoms such as running, physical aggression, blurting out or nonstop talking, and greater impulsivity. Girls however, tend to show more internalized symptoms such as inattentiveness, verbal aggression, and low self esteem. Due to girls showing fewer physical behavioral problems, they are often overlooked and not referred for an evaluation or treatment. This can lead to difficulties later on in life such as problems in school, difficulty in social settings and difficulty with other peer relationships. Because girls internalize their feelings of frustration, pain, and anger more, they are at a greater risk for other mental health disorders such as anxiety, depression, and eating disorders. Boys typically externalize their emotions and receive feedback for behavioral issues.

Girls more often display the inattentiveness side of the disorder, while boys display the hyperactive part of the disorder. It is easier to identify the hyperactive behaviors at home and school because a child won’t be able to sit still, continuously interrupts or doesn’t stop talking, and generally acts impulsively which at times can be dangerous. Inattentive behaviors are more subtle. The child is not as likely to be disruptive in class, but will often forget assignments and seem “spacey.” Unfortunately, this can be mistaken for laziness or a learning disability.

ADHD can also be misdiagnosed in boys. Because we traditionally see boys are more energetic, if they’re running around and acting out, we may attribute it to just a headstrong/hyper boy. Not all boys are hyperactive though. It is even less likely to properly diagnose a boy with ADHD if he has more of the inattentive symptoms and is not disruptive.

Regardless of gender, it is critical to treat ADHD as soon as possible. As children mature and become older, symptoms do become less intense and severe, but can still lead to numerous issues and affect multiple areas of a person’s life such as school, work, and relationships. They are also more likely to develop other issues such as anxiety and depression. They may not be diagnosed with a learning disability, but it is typical to fall behind in subjects due to disorganization and distraction. Getting a prompt diagnosis is helpful in order to begin treatment. Medication management is very successful for many children and adults, as well as behavioral therapy to work on organization and maintaining focus when conducting work.

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