We have all been in situations where we get into disagreements with people and get a dismissive feeling when told “calm down” or that we’re “overreacting”. The same can be said for misdiagnosis, which is a norm in women’s healthcare spaces. Women are often expected to bite the bullet and accept the diagnosis, not realising that it can be detrimental to them in the long run. Early diagnoses can save many years of frustration, and internalised struggles with identity and fitting into society.
This article will shed some light on the common misconception of healthcare professionals in overlooking symptoms of neurodevelopmental disorders (ASD, ADHD) for other mental health disorders (BPD, Bipolar disorder) in women.
Main cause
We live in a technologically advanced age, where society considers mental health disorders as a medical condition. Most research data are based on experiences of men, which makes the diagnostics indicators more in common with them.
While also compensating for the fact that Post-World War 2 had such a horrible impact on society’s (specifically men) psychological state, making them dysfunctional. This led to greater funding for research and the development of new treatments, most of which have been tested on men which made a direct correlation to finding more diagnostics indicators in men.
Effect of ‘masking’
A review done in 2019 shows that the delay in diagnosing or misdiagnosing autism (ASD) in women or female adolescents is due to contributing nosological, and cultural factors and the many levels of ‘camouflaging’ their symptoms (Green et al., 2019, as cited in Ferguson, 2022).
It's harder to detect signs of autism in women as they ‘mask’ most of their autistic traits to blend into society. Even so, women tend to display more socially acceptable behaviour than men like holding eye contact or even flashing a smile, as it would be considered rude to not comply with these ‘normal’ behaviours. Thus, people or even healthcare professionals get the impression that they’re ‘normal’ though the interaction is awkward (Nash, 2024 as cited in Arky, 2024).
Stimming in women doesn't necessarily display itself in the flapping hands, spinning in circles, rocking, chanting repetition of words; some with skin picking, biting of nails, feet rubbing, pacing, and hair twirling. This may be superficial as it’s perceived as socially normal behaviour when people are under immense stress or just do it out of boredom. But it is a prominent indicator that one is autistic if they do it so often to regulate their emotions.
Problem
Shortage of specialists and lack of research further exacerbate the underdiagnosing and misdiagnosing of Autism or ADHD in women as there’s no lab test or brain scan to determine and diagnose these conditions. The only way to diagnose is by observation of certain symptoms, which could not be quite accurate since Autism or ADHD may display different traits in each individual (Langford, 2024).
Healthcare professionals might misdiagnose these women as many of the symptoms overlap with other mental health conditions like BPD and Bipolar disorder (Langford, 2024). The Venn diagram below (figure 1.1) illustrates a clearer understanding of the overlapping symptoms of neurodevelopment and mental health disorders.
Outcomes of misdiagnosing
Research has found that depression may be misdiagnosed in 30-50% of female patients; these medical misdiagnosis of physical conditions can induce depressive reactions in female patients (Floyd as cited in Langford, 2024).
Unfortunately, our society has an ingrained portrayal of Autism or ADHD in men but rejects the idea that women may have it unless they display the qualities of men with a neurodevelopmental disorder. When healthcare professionals can’t detect/consciously ignore the root cause of the problem and instead focus on the fruit of the problem like misdiagnosing symptoms with depression, obsessive-compulsive disorder or social anxiety disorder.
