The group insurance industry saw a rapid rise in claims related to attention-deficit/hyperactivity disorder during the coronavirus pandemic, particularly among women over age 40, said Catherine Biermann (pictured left), manager of digital products, solutions and partnerships at Medavie Blue Cross, moderating a Q&A session with two medical experts at Benefits Canada’s 2025 Mental Health Summit.
“I see women who have internalized the struggle for decades,” said Kristina Rodenhurst (pictured centre), primary care nurse practitioner with Beyond ADHD. “Sometimes they’re high achieving, they’re perfectionists and they’re always holding it together, but underneath there’s anxiety, there’s blame for themselves and they’re just exhausted. [However,] no one ever thought to screen them for ADHD because, from the outside, they look like they’re managing fine.”
Diagnostic tools for ADHD are built on data from hyperactive boys, said Dr. Hanif Chatur (pictured right), founder and chief executive officer of Beyond ADHD, so they don’t take into account emotional regulation challenges, masking behaviour or the hormonal interplay that can worsen symptoms. As a result, diagnosis may be delayed until someone reaches a breaking point — for example, burnout, motherhood or a major life disruption such as the coronavirus pandemic.
“We need to redesign our approach to ADHD assessments to capture what traditional models miss,” he said. “It’s also important to emphasize that high-functioning doesn’t mean symptom-free. It just means the person is carrying that load privately.”
With the rise in claims, questions have been raised about the over-diagnosis and over-treatment of ADHD. From Dr. Chatur’s perspective, the key is to get diagnosis right and that may involve including assessment for other mental and physical conditions that affect executive function. When ADHD is identified, he said the approach to treatment needs to be a multimodal, considering medication, but also counselling and coaching.
Read: How employers can help employees with ADHD be engaged, productive
Appropriate treatment and small adjustments by a person with ADHD can result in big performance improvements and better retention in the workplace, said Rodenhurst, noting neurodiversity education for leadership can amplify the effects. Dr. Chatur added accommodations that help people focus at work can be extended across organizations to benefit anyone who struggles with distraction and focus.
“Undiagnosed ADHD leads to about 22 days of lost productivity a year, which is massive,” he said. “There’s also a hidden kind of productivity cost as ADHD is often mistaken for poor performance. If you can provide early access to quality care, you can have a high impact not only for that individual but there’s a clear ROI for the employer.”
Read more coverage of the 2025 Mental Health Summit.