Is there a gender bias in ADHD diagnosis?

Gender bias is leaving many women with attention deficit hyperactivity disorder undiagnosed, leading psychologists are warning.

The prevailing stereotype ADHD affects only "naughty boys" means at least tens of thousands in the UK, it is estimated, are unaware they have the condition and not receiving the help they need.

"I used to tell doctors and therapists all the time, 'You've got to make this constant noise in my head stop. I can't think. I can't sleep. I can't get any peace,' but this was always dismissed as anxiety or women's problems," Hester says. Diagnosed with depression at 16, she spent much of her 20s unsuccessfully battling to be referred to a psychiatrist. And she constantly felt she was not reaching her true potential.

Make mistakes

"I studied history at university and could write an essay on an academic subject - but when I worked as a sales assistant, I couldn't fill out an order form," Hester says.

"My mind would wander off and I would make mistakes. I would get a lot of criticism for that. I was always thinking, 'Why am I not able to manage things that other people can do so easily - like keep their house tidy or remember deadlines?'".

Nervous breakdown

The anti-depressants and anti-anxiety pills Hester was encouraged to take were not helping but she learned to hide her struggle.

"You suppress who you are, so you can look like a normal person - but it's exhausting," she says.

"Then, I had a baby - suddenly, that extra pressure, the sleep deprivation, all the wheels fell off. When he was three-years-old, I had a nervous breakdown.".

Doctor's radar

Hester was finally diagnosed with ADHD in 2015, aged 34, and only, she says, because her husband had discovered he had the condition, a year earlier. His diagnosis took 12 months.

"At no point did anyone say to Chris, 'This sounds like anxiety,' or 'Have some tablets,'" Hester says.

"He was taken seriously. Whereas with me, I was on the doctor's radar from the age of 16. Bluntly, it took so long for me to be diagnosed because I'm a woman.".

Disruptive behaviours

A late diagnosis can have a negative impact on relationships and careers, as well as increase the risk of mental-health problems such as anxiety, depression and eating disorders.

Clinical and forensic psychologist Dr Susan Young says childhood is where the bias starts - with boys three to four times more likely to be diagnosed.

Research suggests boys tend to display more disruptive behaviours, such as rule-breaking or fighting, while girls' symptoms are likely to be more subtle.

"It's the boisterous boys who are causing problems in the classroom who are going to be referred for help, not the quieter girls who are criticised for daydreaming or not paying attention - but those girls are also struggling," Dr Young says.

"Women haven't just woken up with ADHD - there have been signposts all the way along their life."