A surprising new study finds attention deficit hyperactivity disorder remains a hidden danger for girls, as it takes much longer for them than boys to get diagnosed and treated for the condition.
That delay leaves these girls at a much greater risk for depression and eating disorders than girls without ADHD.
For Chloe Potter, 17, the first sign of a problem appeared while she was in elementary school.
"I couldn't do my homework. I was failing in school," she said.
Her mother, Dominique Potter, said it would take "hours" for her to do homework.
Chloe was often distracted and disorganized, which led to frustration and family feuds. But she was not perpetually "restless," as is expected with ADHD, so it took years to correctly diagnose her condition.
"Girls have ADHD just as often as boys, but it looks very different, so it's harder to diagnose," said child psychologist Ellen Littman. "They are not usually hyperactive … so the … hallmarks of ADHD tend not to be seen at all."
As a result, girls with ADHD are at least twice as likely as boys to go undiagnosed, according to a study from the University of California at Berkeley.
"Clinicians are reluctant to accept and diagnose. Teachers are less willing to believe girls can have ADHD," said Stephen Hinshaw, a UC Berkeley professor.
His pioneering research reveals the cascading effects when girls go undiagnosed.
"A girl with ADHD is going to fall further and further behind academically. It's going to get her into deeper and deeper trouble with her peers," Hinshaw said. "Her self-esteem is going to plummet because the negative feedback from parents and teachers … will take a toll.
"She's going to be tempted to self-medicate or dull some of the pain, to try alcohol and drugs," he said.
The good news is that roughly 80 percent of girls with ADHD can be effectively treated with medication and behavior therapy, meaning parents and teachers can provide the structure and predictability needed to help girls with this condition.
Littman said that means setting specific times for dinner and bedtime each night.
"And it's not really flexible," she said.
The strategy helped Chloe.
"I was more calm and I could concentrate better," she said.
And that means she can focus on her schoolwork, and appreciate the friends and family around her whom she previously struggled to enjoy.