Women with ADHD and the risk of suicide attempts

Women with ADHD are often ‘under the radar,’ experts say, and tend to be underdiagnosed and undertreated

Emma Jones 4 minute read January 5, 2021
ADHD in women

ADHD in women is often characterized by inattentiveness, rather than hyperactivity. Getty

If you are struggling with mental health or thoughts about suicide, the Canada Suicide Prevention Service is available at 1-833-456-4566 or 45645 by text.

A University of Toronto study suggests that individuals with attention deficit hyperactivity disorder (ADHD) are more likely to have attempted suicide, with women significantly impacted.

ADHD, also formerly called attention-deficit disorder, is a behaviour disorder characterized by inattention and impulsivity, according to Johns Hopkins Medicine. One of the key symptoms of ADHD is difficulties with executive functioning, the mental process people use to prioritize, plan out and complete tasks. The physical base of ADHD is complicated, but a growing body of research points to altered structures in the brain that should absorb dopamine.

The study looked at a mental health survey of 21,744 Canadians — 529 of whom had an ADHD diagnosis. The researchers found that one in seven adults with ADHD had attempted suicide, compared to one in 37 adults without ADHD. Women seemed to be most affected by this correlation, with one in four having attempted suicide.

“This prevalence of suicide attempts was seven times higher among women with ADHD when compared to women without ADHD, and almost three times higher when compared to men with ADHD,” Esme Fuller-Thomson, PhD, Director of the Institute for Life Course & Aging at the University of Toronto and lead author on the study communicated over email.

“Women with ADHD are often ‘under the radar’ and they tend to be underdiagnosed and undertreated. Health care professionals need to be aware of this very vulnerable group.”

Underdiagnosed and undertreated

For Michelle Allan, a Master of Journalism candidate researching women’s experiences with ADHD, this finding is not surprising.

“As someone who [has] ADHD, as someone who spoke to a lot of women who have had a really hard time finding treatment or managing symptoms of ADHD, I’m honestly not surprised that this is a problem,” says Allan. “A lot of people who struggle with ADHD develop comorbid psychological problems like depression and anxiety. So, I don’t really feel surprised, but I am sad. This problem is so pervasive.”

A previous review of ADHD research in women and girls suggested that symptoms of ADHD in females trend towards inattentiveness versus hyperactivity, which may be missed. The review also found that ADHD in woman correlates with rates of anxiety and depression. Often, the anxiety and depression are caught, but the contributing ADHD is not diagnosed.

“The hyperactive kind of ADHD, that’s easy to spot. It’s the kid who bounces off the wall, won’t sit still, can’t focus on their homework,” says Allan. “But people don’t understand that ADHD does have the inattentive subtype, where it can just be someone who daydreams, someone who has a hard time focusing.”

“There’s so many different ways it presents other than an inability to pay attention. It can also be extreme mood swings, having a hard time keeping your emotions in check. It can be having a hard time prioritizing tasks, keeping track of time.”

The negative consequences of missing an ADHD diagnosis can be serious. Individuals with ADHD may also be diagnosed with additional psychiatric disorders, known as co-morbidity. Frequently ADHD will also occur with mood and anxiety disorders, substance use disorders and personality disorders, which may impact suicidal behaviours.

Women with ADHD are three times more likely to develop generalized anxiety disorder and chronic pain compared to women without ADHD, Fuller-Thomson says. They are also twice as likely to experience depressive disorders, severe poverty, substance abuse, and childhood physical abuse.

“When your ADHD symptoms are making it so hard for you to … succeed at school, the workplace or your personal relationships, of course you’re going to get depressed, of course you’re going to get anxious,” says Allan.

A previous study looking at the entire population of Denmark over the course of two decades found that individuals with ADHD as well as additional psychiatric diagnoses were far more likely to attempt suicide than their peers who did not have any psychiatric diagnoses. Individuals who had ADHD only also had a higher rate of suicide attempts than those without, but this rate wasn’t as high as those who had multiple diagnoses.

If you are struggling with mental health or thoughts about suicide, there is help. Here is a list of resources.

Other resources include:
Kids Help Phone: 1-800-668-6868. Text CONNECT to 686868 or visit www.kidshelpphone.ca
Trans Lifeline: 1-877-330-6366
Hope for Wellness Help Line: 1-855-242-3310. Online chat: www.hopeforwellness.ca
Indian Residential Schools Crisis Line: 1-866-925-4419
Canada Suicide Prevention Service: 1-833-456-4566 
For Quebec residents: 1-866-APPELLE


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