Dubai clinics report surge in ADHD cases among women as 'silent struggle' continues

Doctors say more women than men are seeking support, dispelling age and gender stereotypes about the condition

Adult women with ADHD may struggle to concentrate, have anxiety, low motivation and a lack of self confidence. Getty Images

The majority of adult patients seeking assessment for attention deficit hyperactivity disorder in Dubai are women, clinics have reported.

Experts said the challenges of the Covid-19 pandemic and greater awareness have contributed to more women reaching out for support after enduring a "silent struggle" with the condition.

Dr Ioannis Delipalas, medical director at Thrive Wellbeing Centre, told The National there had been a noticeable change over the past two years, as previously his ADHD patients were predominantly male.

“About 60 per cent of [new intakes] are women seeking out an assessment compared to before. This is huge,” he said.

He said about 75 per cent of those women will receive an ADHD diagnosis.

At Sage Clinics, a mental health facility that opened in Downtown Dubai in 2022, resident psychiatrist Dr Zeeshan Ahmad said about 65 per cent of those seeking ADHD assessments are women, 87 per cent of whom were diagnosed with the condition.

ADHD is a neurodevelopment condition categorised by three types: hyperactive and impulsive; inattentive; and a combination of the two.

Key symptoms of the hyperactive subset include being unable to sit still, poor concentration and excessive talking and movement.

Signs of the inattentive form of the condition include short attention spans, appearing forgetful and struggling to stick to time-consuming tasks and follow instructions.

Dispelling ADHD stereotypes

While there is no known cause, scientists have discovered there are differences in the brains, nerve networks and neurotransmitters of people with ADHD, according to Cleveland Clinic, which describes it as “a long-term, chronic brain condition that causes executive dysfunction”, leading to a decreased ability to manage emotions, thoughts and actions.

Historically, it has been more commonly associated with young boys, who typically present with clear symptoms of ADHD.

“We all know the stereotype of ADHD as a typical seven, eight or nine year old boy yelling, screaming, throwing things at mum, throwing a tantrum,” said Dr Delipalas. “That was the reason why young boys or male teens were able to be diagnosed earlier compared to women.

“With time, we discovered that there can be a more diversified clinical picture of ADHD. For example, in females, we know for sure that the inattentive type dominates the clinical picture.

"We typically have a silent girl who cannot focus in the classroom, she may daydream and she goes unnoticed. This going unnoticed follows her for many years to come, until, at some point, in her late twenties or early thirties, it needs to be addressed.”

Dr Saliha Afridi, founder and chairwoman of local mental health clinic The LightHouse Arabia, said the number of adults self-referring for an ADHD assessment at the centre increased elevenfold between 2021 and 2023.

Although Ms Afridi was unable to share gender-specific statistics, the surge in cases reflect a global trend of rising diagnoses among adults, particularly women.

More women being diagnosed than ever

A significant increase in diagnoses among adult women between was recorded in a major US study of more than 3 million patients.

The number of those aged 23 to 49 receiving a diagnosis from 2020 to 2022 nearly doubled, according to the 2023 report by Epic Research.

Experts largely agree the reasons for the increase include the Covid-19 pandemic, as women were less able to manage their symptoms, as well as the proliferation of telehealth services and rising awareness, prompted by social media.

Research on women with ADHD is also still catching up, as the majority of past studies have been conducted on boys and men.

Global statistics show boys are more likely to receive a diagnosis in their younger years, while the average age for women getting diagnosed is in their mid-thirties.

The ratio of boys to girls with ADHD in childhood is about three to one, but in adults there is a 50:50 split between the genders, according to a 2023 study in the Journal of Attention Disorders, suggesting the prevalence is equal across genders, but that women are just more likely to be diagnosed later.

Facing ’silent struggle’ alone

Dr Romena Toki, a clinical psychologist at Sage Clinics in Dubai, says for many women and girls the diagnosis will come after years of “silent struggle”.

“Despite being immensely hardworking, bright, creative and so on, they may often be branded as the ‘day dreamers’, ‘disorganised’, ‘careless’ or ‘unreliable’. The responsibility is entirely always on them to perform the same as those around them, without any adjustments. And in many ways, they often do seem to manage well, but beneath the water’s surface, they’re fiercely swimming on overdrive.”

Women are also more prone to what experts call “masking”, how people compensate for, or cover up their symptoms due to societal expectations.

How ADHD is diagnosed and treated in the UAE

Receiving a diagnosis from a trained professional is key, said Dr Delipalas.

Comprehensive diagnosis includes an initial psychiatric consultation to rule out other conditions that may need to be addressed before a screening, which typically includes answering a professionally devised questionnaire.

Dr Delipalas warns that this is not like those freely available on the internet.

If this is positive, then the third stage is a referral to a psychologist who is trained in measuring psychometrics in neurodevelopment conditions.

Dr Delipalas said medication is available to manage the condition, with the use of such stimulants closely monitored and tailored for each patient.

He said cognitive behavioural therapy can be applied for people with ADHD to improve memory and executive functioning.

Dr Delipalas said comprehensive medical support is available in the Emirates.

"Everything shown on social media is not actually reflecting the truth. There is a tendency to look for a quick fix, so when a social media persona talks in less scientific terms about extremely important matters, it can get stuck in someone’s mind," he said.

“It’s very important when someone seeks out assessment to rule in or rule out ADHD to also have access to reliable and scientific resources.”