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22 December 2023 | Story Michelle Nöthling | Photo Anja Aucamp
Dr Munita Dunn-Coetzee
According to Dr Munita Dunn-Coetzee, it is increasingly recognised that females with ADHD portray a different ‘picture’ in terms of behaviour, symptoms, and comorbidities when compared to males with ADHD.

I’m a failure as an adult. I’m a disappointment as a colleague. I’m a lousy friend. I’m a burden as a wife. I’m a bad mom and I’m constantly scrambling to try and hide it.

This is the secret interior reality of a group of neurodivergent adults who have been long overlooked by scientists and doctors alike. The Lost Generation. It is now recognised that there is an entire generation of women out there who have battled with ADHD (attention-deficit hyperactivity disorder) their entire lives – and don’t know it.

Women and girls living with ADHD

For decades, ADHD has been predominantly associated with hyperactive young boys bouncing off the walls. The reason for this widely-held misconception is due to the fact that studies originally focused on young European American boys – their symptoms becoming the benchmark for all. Women were not even included in ADHD studies until the late 1990s, and the first long-term study on girls was only conducted in 2002. The results? Girls’ ADHD symptoms bear little resemblance to those of boys. Dr Munita Dunn-Coetzee, Director of Student Counselling and Development at the UFS, agrees. “It is increasingly recognised that females with ADHD portray a different ‘picture’ in terms of behaviour, symptoms, and comorbidities when compared to males with ADHD. Females are less likely to be identified and referred for assessment, and their needs are less likely to be met.” Therefore, the majority of girls and women with ADHD remain un- or misdiagnosed.

But what does ADHD in women look like? First, let’s take a step back. There are three types of ADHD: the hyperactive type, the inattentive type, and the combined type – which includes both hyperactivity and inattention. Hyperactivity in females is much more likely to present internally, in the mind, and inattentiveness as daydreaming and disorganisation. This is much more than sitting still in class or having trouble with homework. Faced with behavioural and social pressures to perform, girls often learn to mask and overcompensate for their problems – making diagnosis even more difficult.

Carry the struggle to adulthood

When left untreated, girls with ADHD will most likely carry their struggle into adulthood. ADHD in adult women often results in chronic low self-esteem, self-loathing, feelings of inadequacy, sleeplessness, anxiety, depression, substance abuse, and eating disorders. Women with ADHD also typically present with tremendous time management challenges, chronic overwhelm, and exhaustion – exacerbated by societal pressures. The risk of self-harm and suicide attempts is also startlingly higher compared to their male counterparts.

There is tremendous hope, though. Drs Edward Hallowell and John Ratey – experts in the field who both have ADHD – describe ADHD as an array of traits specific to a unique kind of mind that can become a distinct advantage with appropriate treatment and support. ADHD is not a condemnation of character. Instead, it unveils a kaleidoscope of strengths and a unique constellation of traits deserving of celebration.

News Archive

UFS cardiologists and surgeons give children a beating heart
2015-04-23

Photo: René-Jean van der Berg

A team from the University of the Free State School for Medicine work daily unremittingly to save the lives of young children who have been born with heart defects by carrying out highly specialised interventions and operations on them. These operations, which are nowadays performed more and more frequently by cardiologists from the UFS School of Medicine, place the UFS on a similar footing to world-class cardiology and cardio-thoracic units.

One of the children is seven-month-old Montsheng Ketso who recently underwent a major heart operation to keep the left ventricle of her heart going artificially.

Montsheng was born with a rare, serious defect of the coronary artery, preventing the left ventricle from receiving enough blood to pump to the rest of the body.

This means that the heart muscle can suffer damage because these children essentially experience a heart attack at a very young age.

In a healthy heart, the left ventricle receives oxygenated blood from the left atrium. Then the left ventricle pumps this oxygen-rich blood to the aorta whence it flows to the rest of the body. The heart muscle normally receives blood supply from the oxygenated aorta blood, which in this case cannot happen.

Photo: René-Jean van der Berg

“She was very ill. I thought my baby was going to die,” says Mrs Bonizele Ketso, Montsheng’s mother.

She says that Montsheng became sick early in February, and she thought initially it was a tight chest or a cold. After a doctor examined and treated her baby, Montsheng still remained constantly ill, so the doctor referred her to Prof Stephen Brown, paediatric cardiologist at the UFS and attached to Universitas Hospital.

Here, Prof Brown immediately got his skilled team together as quickly as possible to diagnose the condition in order to operate on Montsheng.

During the operation, the blood flow was restored, but since Montsheng’s heart muscle was seriously damaged, the heart was unable to contract at the end of the operation. Then she was coupled to a heart-lung machine to allow the heart to rest and give the heart muscle chance to recover. The entire team of technologists and the dedicated anaesthetist, Dr Edwin Turton, kept a vigil day and night for several days.

Prof Francis Smit, chief specialist at the UFS Department of Cardiothoracic Surgery, explains that without this operation Montsheng would not have been able to celebrate her first birthday.

“After the surgery, these children can reach adulthood without further operations. Within two to three months after the operation, she will have a normal active life, although for about six months she will still use medication. Thereafter, she will be tiptop and shortly learn to crawl and walk.”

Mrs Ketso is looking forward enormously to seeing her daughter stand up and take her first steps. A dream which she thought would never come true.    

“Write there that I really love these doctors.”

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