View Full Version : Gendered diagnostic issues and ADHD: can anyone relate to misdiagnosis first?


GirlieSoGroovy
04-25-14, 03:37 AM
Hello. I am new and recently diagnosed with ADHD combined type as well as an anxiety disorder (limited symptom attacks). I had previously been diagnosed with bipolar ii when I was 15 (I'm now 23). I was upset over a recent move from city to exurbs and private school to public and also experienced some severe bullying. I experienced some situational depression and saw a psychiatrist who assessed me via a short question and answer format.

Surprise surprise, I could relate to most if the manic /hypo manic symptoms associated with a bipolar episode. There were several significant differences like the fact that my ADHD symptoms shared with mania are chronic rather than episodic and I have not experienced depressive episodes outside of that situational one when I was an angsty teenager.. I not know anything about ADHD and so I did not know how to communicate these differences or that they were significant.

From 15-17 I went to counseling and was on depakote, Seroquil for sleep, lamictal, and Zoloft. I did not respond well to these interventions and stopped going to the psychiatrist.

I don't want to argue with a doctor's opinion, but I felt that there was a miscommunication issue once I became more educated on various diagnoses as a psychology student. I came across several trend pieces about how ADHD manifests in adult women and felt like I was reading about me in a way I never did with the bipolar case studies. Prior to this I didn't understand ADHD went beyond the stereotype of kids bouncing off the walls. I thought you had to have bad grades...I have great compensation skills in the structured environment of school unless the subject is boring or the teacher is strict about attendance and late work. don't do so well in my personal life or at work. So I went to seek a second opinion and was given these new diagnoses through several assessment measures in place off the old diagnosis.

The prevalence of bipolar disorder is much higher in women than in men and vv for men. I wonder how much of this is due to gender bias in the diagnostic process and how many other women have had to suffer through interventions that don't get to the real root of the problem in ADHD. Had doctors who seemed dismissive or not very thorough or How many women suffer from depression and anxiety BECAUSE of ADHD related issues that go undetected. Sorry this is so long, but I don't like talking about mental health issues with people I know because I feel that most people stigmatize people with these issues. I was haunted for years by a diagnosis arguably even more stigmatizing and misunderstood than ADHD...a diagnosis I could not relate to and wasted tons of time and money on intervention that did nothing for the root problem. I am so relieved even though I am not thrilled that I have a disorder at all. I would like to hear some other experiences from women who had trouble getting a diagnosis that fit, particularly bipolar whether it is co morbid with ADHD and missed for a long time or is considered a misdiagnosis when ADHD was actually the problem.

sarahsweets
04-25-14, 05:14 AM
Well I am BPII and ADHD but I can relate to the gender bias thing. It seems like at least for me, with the BPII doctors and others who dont understand bpII are more prone to viewing women as hysterical or over emotional, which can be very invalidating. I am not sure if BP really is more common in women or if the bias prevents men from being screened properly. There is definitely a bias when it comes to diagnosing girls with adhd. Most people think of hyper little boys when they think of adhd and totally miss the mark with diagnosing girls.

Lunacie
04-25-14, 09:01 AM
I think that's a very valid perspective.
Looking back, I'm surprised my oldest granddaughter wasn't diagnosed with Bipolar rather than ADHD.
After all, that's what two different therapists said my youngest granddaughter and I both had.

She was eventually properly diagnosed with Atypical Autism,
and a therapist let me fill out a Connor's eval that showed I definitely have ADHD-C
(and GAD and depression and PTSD with a possibility of autism spectrum disorder).
Of course, a therapist can't make an official diagnosis so I'm still undiagnosed.

mrs. dobbs
04-25-14, 03:17 PM
Yes. For almost 20 years.

GirlieSoGroovy
04-27-14, 03:28 AM
For my undergraduate research capstone I actually did some research on gender bias with personality disorders. Borderline and histrionic PD (both are more often diagnosed in women) both share a lot of symptoms with antisocial personality disorder (usually diagnosed in men) and there are some psychologists who theorize that borderline or histrionic PD and antisocial PD are actually gendered manifestations of the same pathology (psychopathy). The difference of course is that histrionic and borderline people tend to be more outwardly emotional (but these emotions are shallow and often for show or just a reaction to loss of control) and less criminally violent than those with antisocial PD. But they all tend to be manipulative, shallow, and have little regard for the feelings of others.

They actually did one study where they gave a vignette of a hypothetical, ambiguous case that fit antisocial personality criteria but not really enough for the other PDs, and gave them to two randomly sampled groups of clinicians. The only difference was that one group got a vignette with female pronouns and the other got a vignette with male pronouns. And the clinicians came back with tons of different diagnoses, and it was often BPD or HPD if the vignette was a woman and APD if it was a man. The difference was statistically significant. I didn't really think of how this applied to bipolar, depression, ADHD, etc. or my life though until I got my diagnosis changed. I wonder if there is a study done with this same methodology that would lend solid support to the idea this bias with ADHD and bipolar/depression...like, if they designed a vignette that fits ADHD criteria, but not enough to fit bipolar according to the DSM-V, or vice versa and see how clinicians diagnose differently between these two genders.

Pingu*
04-27-14, 06:28 PM
They actually did one study where they gave a vignette of a hypothetical, ambiguous case that fit antisocial personality criteria but not really enough for the other PDs, and gave them to two randomly sampled groups of clinicians.
Do you remember the name of the study?

I have posted in other threads about my diagnostic history, but don't have time to make a link right now.

GirlieSoGroovy
04-28-14, 01:16 AM
Do you remember the name of the study?

I have posted in other threads about my diagnostic history, but don't have time to make a link right now.

Yep! If you have access to PsycInfo, it's linked full text PDF on there.

References
Crosby, J., & Sprock, J. (2004). Effect of patient sex, clinician sex, and sex role on the diagnosis of Antisocial Personality Disorder: Models of underpathologizing and overpathologizing biases. Journal Of Clinical Psychology, 60(6), 583-604.