Health
ADHD in males versus females: What you must know about the differences in symptoms and treatments
Attention-deficit/hyperactivity disorder (ADHD) may be common, but it’s also sometimes hard to spot.
ADHD is usually first diagnosed in childhood and is one of the most common neurodevelopmental disorders in children, according to the Centers for Disease Control and Prevention (CDC).
Symptoms of ADHD in kids can include trouble paying attention, difficulty controlling impulsive behaviors and displaying periods of hyperactivity.
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But how these symptoms show up in boys versus girls, and eventually in men versus women, can make a big difference in diagnosis.
Sabrina Nasta, a licensed mental health counselor in Orange Park, Florida, told Fox News Digital that ADHD can show up in three different ways: through inattention, hyperactivity and a combination of the two.
ADHD in males compared to females can means significantly different symptoms, experts say. (iStock)
In women, ADHD most commonly manifests as inattention, which includes an inability to pay attention, distractibility and lack of compliance, according to Nasta.
In men, ADHD occurs in a hyperactive way, causing issues with sitting still or wanting to be constantly “doing something,” said the expert.
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McCall Letterle, head of U.S. commercial operations for ADHD assessment company Qbtech, also commented on these differences in a conversation with Fox News Digital.
Athough many of the symptoms, including hyperactivity, inattention and impulsivity, are the same, it’s how the symptoms “manifest themselves” that causes a variation between males and females, the Atlanta-based expert noted.
Young girls with ADHD may sit still in the classroom, but they’re “not paying attention,” an expert said. (iStock)
A struggle with discipline seems to be a commonality of ADHD in men and women based on their lifestyle and age, Nasta added.
In young boys, for example, ADHD shows up as “unnecessary” hyperactive energy; they “don’t have the capacity to not do anything,” the expert said.
In girls, the same inattentiveness may arise, but it’s most likely internalized.
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“They may be sitting in the classroom, they may be sitting still, but they’re not paying attention,” Nasta said.
“It’s tough because for a girl, it looks like they’re rebelling or being disobedient, [but] for a boy, [it seems that] they’re just being ridiculous and hyper.”
Underdiagnosis in women
The differences in ADHD presentation have led to a “massive amount of underdiagnosed women,” according to Letterle.
“This [disorder] was first researched in males, and the criteria developed around symptoms most commonly seen in boys,” she told Fox News Digital.
Initial research on ADHD in boys and men could have led to the misdiagnosis in women, one mental health expert suggested. (iStock)
“These are also the most overtly obvious symptoms — like hyperactivity, inability to sit still, disruption and difficulty focusing, often in the classroom — that lead to associated behavioral issues,” Letterle added.
While some women do experience these hyperactive symptoms, they are not the most prevalent symptoms and they look different when they do occur, according to Letterle.
“Women tend to exhibit symptoms that are more internalized,” she said.
“For instance, their inattention is much harder to recognize than boys, as it can be displayed as daydreaming or inward distraction.”
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Letterle pointed out the “external fallout” of these ADHD symptoms in girls — which results in “high rates of anxiety” due to missed information at school.
In many cases, girls have to work twice as hard to retain information and meet academic standards as their peers, and they experience low levels of confidence stemming from these difficulties, she added.
Girls with ADHD can experience “high levels of anxiety,” said a mental health expert. (iStock)
“That is subjectively a lot harder to identify than distracted boys, who are poking the individual next to them as they struggle to maintain focus.”
These variants lead to a “massive difference in diagnostic rates” between young girls and boys, Letterle said.
Boys are often diagnosed and treated faster than girls because their symptoms are easier to identify, she added.
Personalized coping
One of the best ways to cope with ADHD is to educate yourself, or your child, on the best way to function in different environments, said Nasta.
Some of the strategies she recommended include practicing mindfulness and self-awareness, and coming up with the best game plan in any given situation.
Stress management is another great coping tool, especially for boys, added Nasta.
Allowing kids with ADHD the time to release stress is an important coping technique, experts say. (iStock)
For kids, stress management can mean participating in leisure activities or hobbies like playing video games or hanging out with friends.
“It’s about allowing them to let that energy go in a more supportive way,” Nasta said.
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ADHD in boys and girls can be difficult for caretakers — parents, guardians and even teachers — to identify when they lack the “appropriate tools” to make “more accurate referrals,” Letterle noted.
To overcome that challenge, Nasta encouraged caretakers to “listen more.”
“If you’re really paying attention and your kid’s trying, this could be a neurological or neurodevelopmental concern versus them just struggling with emotions,” she said.
In young boys, ADHD shows up as “unnecessary” hyperactive energy; they “don’t have the capacity to not do anything,” according to experts. (iStock)
It might be helpful for parents to “be more curious” and ask their children questions about their feelings when they are overwhelmed, Nasta suggested.
“What do you experience when you’re overwhelmed? Are you able to focus or pay attention to your teacher? Do you notice what your thoughts are doing?” she listed as example questions.
“If it sounds really concerning and intrusive, I would say that’s the point of … seeing a professional.”
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Early ADHD intervention is “critical for reducing suicide rates, job instability and substance abuse in those left untreated,” Letterle said.
“The diagnostic process has been left largely to subjective rating scales, creating a desperate need for clinicians to start adopting a more data-driven approach to symptom measurement,” she added.
Impairments in managing basic hygiene, finances, academic or communication skills could signal the need for ADHD evaluation, according to experts. (iStock)
“Objective data compares performance in the three core symptom areas against age- and sex-matched controls without ADHD — meaning women are compared to other women to improve the ability to accurately identify their diagnosis,” the expert said.
When to seek help
While the term “ADHD” is often tossed around to describe when someone is feeling unfocused, Nasta listed a few warning signs that could point to an actual diagnosis.
The expert said to monitor daily responsibilities such as hygiene, finances, academics and even basic social skills such as listening and communication.
“If you notice impairments and deficits in any of those, I would say that would be the time to talk to somebody,” she advised.
For people who are unsure of their symptoms, Letterle recommended seeking out a provider who uses objective data in a comprehensive evaluation.
“[This] would help to better ensure not only a more accurate diagnosis, but also one that helps eliminate the bias that often leads to high rates of underdiagnosis or misdiagnosis in women,” she said.
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Feeling lonely may take a toll on older adults’ memory — but it may not speed up cognitive decline, according to a new study.
Researchers from Colombia, Spain and Sweden analyzed data from more than 10,000 adults ages 65 to 94 across 12 European countries and found those who reported higher levels of loneliness did worse on memory tests at the start of the study, according to research published this month in the journal Aging & Mental Health.
Over a seven-year period, however, memory decline occurred at a similar rate regardless of how lonely participants felt.
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“The finding that loneliness significantly impacted memory, but not the speed of decline in memory over time was a surprising outcome,” lead author Dr. Luis Carlos Venegas-Sanabria of the School of Medicine and Health Sciences at the Universidad del Rosario said in a statement.
Loneliness may be linked to memory performance in older adults, a new study suggests. (iStock)
“It suggests that loneliness may play a more prominent role in the initial state of memory than in its progressive decline,” Venegas-Sanabria said, adding that the findings highlight the importance of addressing loneliness as a factor in cognitive performance.
The findings add to debate about whether loneliness contributes to dementia risk. While loneliness and social isolation are often considered risk factors for cognitive decline, research results have been mixed.
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The study looked at data from the long-running Survey of Health, Ageing and Retirement in Europe (SHARE), which tracked 10,217 older adults between 2012 and 2019. Participants were asked to recall words immediately and after a delay to measure memory performance.
Social isolation and loneliness could play a surprising role in cognitive health among seniors. (iStock)
Loneliness was assessed using three questions about how often participants felt isolated, left out or lacking companionship.
About 8% of participants reported high levels of loneliness at the outset. That group tended to be older, more likely to be female and more likely to have conditions such as depression.
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Researchers found that those with higher loneliness had lower scores on both immediate and delayed memory tests at baseline. Still, all groups — regardless of loneliness level — experienced similar declines in memory over time.
The results suggest loneliness may not directly accelerate the progression of memory loss, though it remains linked to poorer cognitive performance overall.
Researchers look at a brain scan at the National Institutes of Health in Bethesda, Maryland. (Saul Loeb/AFP/Getty Images)
Experts warn, however, that the findings should not be interpreted to mean loneliness is harmless.
“The finding that lonely older adults start with worse memory but don’t decline faster is actually the most interesting part of the paper, and I think it’s easy to misread,” said Jordan Weiss, Ph.D., a scientific advisor and aging expert at Assisted Living Magazine and a professor at NYU Grossman School of Medicine.
“It likely means loneliness does its damage earlier in life, well before people show up in a study like this at 65-plus,” Weiss told Fox News Digital.
By older age, long-term social patterns may already be established, making it harder to detect when the effects of loneliness first took hold, an aging expert says. (iStock)
He suggested that by older age, long-term social patterns may already be established, making it harder to detect when the effects of loneliness first took hold.
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“By the time you’re measuring someone in their late 60s, decades of social connection patterns are already baked in,” he said.
Weiss, who was not involved in the research, added that loneliness may coincide with other health conditions, and noted that participants who felt more isolated also had higher rates of depression, high-blood pressure and diabetes. The link, he said, may reflect a cluster of health risks rather than a direct cause.
“While they can go hand-in-hand, it’s not clear that loneliness contributes to dementia,” a psychotherapist says. (iStock)
Amy Morin, a Florida-based psychotherapist and author, said the findings reflect a broader pattern in research on loneliness and brain health, and that the relationship may be more complex than it appears.
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“The evidence shows there’s a link between loneliness and cognitive decline but there’s no direct evidence of a cause and effect relationship,” she said. “So while they can go hand-in-hand, it’s not clear that loneliness contributes to dementia.”
Morin added that loneliness, which can fluctuate, may not be the root of the problem, but rather a symptom of other underlying mental or physical health issues.
Researchers suggested screening for loneliness be incorporated into routine cognitive assessments as one way to support healthy aging. (iStock)
She said staying socially and mentally engaged is crucial for overall brain health.
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“It’s important to be proactive about social activities,” Morin said. “Joining a book club, having coffee with a friend, or attending faith-based services can be a powerful way to maintain connections in older age.”
The researchers also suggested screening for loneliness be incorporated into routine cognitive assessments as one way to support healthy aging.
Fox News Digital reached out to the researchers for comment.
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Research continues to uncover new details on how fasting may help extend life.
A new study published in the journal Nature Communications investigated how intermittent fasting can boost longevity in small worms often used in aging research.
Researchers from the University of Texas Southwestern Medical Center in Dallas compared worms that were fed normally to those that underwent a 24-hour fast in early adulthood and were then fed again, according to a press release.
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The scientists measured a variety of factors, including stored fat, gene activity related to fat metabolism and lifespan.
The results showed that the life-boosting benefit did not depend on the fasting itself but on the body’s behavior after eating again.
Experts say sustainability is key when choosing a long-term weight-loss strategy. (iStock)
Study lead Peter Douglas, associate professor of molecular biology and a member of the Hamon Center for Regenerative Science and Medicine at UT Southwestern, suggested that these discoveries “shift the focus toward a neglected side of the metabolic coin – the re-feeding phase.”
“Our data suggest that the health-promoting effects of intermittent fasting are not merely a product of the fast itself, but are dependent on how the metabolic machinery recalibrates during the subsequent transition back to a fed state,” he said.
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“Our findings bridge a gap between lipid metabolism and aging research,” he added. “By targeting aging, the single greatest risk factor for human disease, we move beyond treating isolated conditions toward a preventive model of medicine that enhances quality of life for all individuals.”
Lauri Wright, director of nutrition programs at the University of South Florida’s College of Public Health, called this a “high-quality” study that adds an “important nuance to how we think about fasting and longevity.”
Intermittent fasting typically involves limiting meals to an eight-hour daily window or fasting every other day. (iStock)
The benefits of the refeeding phase after fasting were “especially interesting,” Wright, who was not involved in the study, told Fox News Digital.
“The researchers showed that longevity was linked to the body’s ability to turn off fat breakdown after fasting, allowing cells to restore energy balance,” she reiterated.
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“From a scientific standpoint, that’s a meaningful shift because it suggests fasting is not just about burning fat, but about metabolic flexibility.”
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Fasting may support longevity through triggering metabolic switching, enhancing cellular repair and stress resistance and improving markers like insulin sensitivity, research shows.
Limitations and cautions
Although this study provides “important insight” on the power of refeeding, Wright noted that the findings should be approached with caution, as the study was done on worms and cannot always be translated to humans.
“Additionally, it explains how a process might work in a controlled lab condition rather than real-world eating behaviors,” she added as a limitation. “Finally, the study is short-term and doesn’t give us the long-term translation on lifespan outcomes.”
The review found intermittent fasting was barely more effective than doing nothing, according to the study authors. (iStock)
Wright cautioned that fasting is “not a magic solution for longevity, and how you eat overall matters more than when you eat.”
“I advise, first and foremost, to focus on diet quality, including a variety of fruits and vegetables, healthy fats and minimally processed foods,” she said.
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For those who are considering fasting, it’s better to stick with a moderate plan — like a 12- to 14-hour overnight fast — rather than going to extremes, Wright said. After fasting, she recommends focusing on well-balanced meals.
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Several groups of people should be cautioned against fasting, according to Wright, including those with diabetes who are on insulin or hypoglycemic medications, those who are pregnant or breastfeeding, anyone with a history of eating disorders and older adults at risk of malnutrition.
Anyone considering intermittent fasting should consult with a doctor before starting.
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