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Emily Bates was diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) at the age of 34. In a recent Nature Outlook programme, Ms Bates reflects on how her symptoms were easy to miss earlier in life - from appearing like a "model student" at school to coping by leaving work until the very last minute, and how receiving a diagnosis helped her make sense of her long-standing struggles.

To understand why this is such a common story for women, Bates spoke with Dr Jessica Agnew-Blais, a Senior Lecturer in the Department of Psychology at Queen Mary University of London, whose research examines ADHD across the lifespan, with a particular focus on girls and women.

Dr Agnew-Blais explains that historically, ADHD has often been thought of as a condition affecting "the hyperactive boy" – stereotypically, the child who can't sit still and disrupts the classroom. Girls, on the other hand, are more likely to show a presentation that is predominantly inattentive, and may seem "daydreamy" or quietly distracted rather than outwardly disruptive. In practice, this means their difficulties can draw less attention from teachers and parents, allowing symptoms to go unnoticed for longer.

Dr Agnew-Blais highlights evidence that when ADHD is missed earlier on, women are more likely to receive a diagnosis of depression or anxiety, and to have received treatments such as antidepressants, before ADHD is recognised. She also notes that women are more likely than men to discontinue antidepressants after receiving an ADHD diagnosis suggesting "perhaps there's some kind of misdiagnosis, [or] diagnostic overshadowing going on - especially for women, prior to receiving their ADHD diagnosis".

Alongside improving understanding of the "missed" presentation of ADHD in girls and women, Dr Agnew-Blais's research addresses a major gap in the evidence base: how ADHD relates to women's health across hormonal transitions such as puberty, the menstrual cycle, and menopause. This has informed new work including the Measuring Adult ADHD and Menstruation (MAAM) study (www.adhdlifelab.com/maam-study), which investigates whether ADHD symptoms, medication effectiveness, and day-to-day functioning among women with ADHD change across the menstrual cycle.

By building evidence in an area that has historically been under-researched, Dr Agnew-Blais's work aims to support earlier recognition and better-tailored support for women with ADHD, and to help ensure their experiences are reflected in research and clinical care.

Watch the full interview: https://fb.watch/EYw3fbpU6F/