ADHD in Women

“ADHD Is Too Often Overlooked in Women. This Needs to Change.”

“Undiagnosed ADHD in women has far-reaching consequences that can impact every area of life. While an early diagnosis is best, a diagnosis at any age can start a woman on a new path that will change her life for the better.”

Woman walking out of rectangular opening of coloured wall

An ADHD diagnosis, in childhood or beyond, is the first and most crucial step toward effectively managing symptoms. Simply put, a diagnosis can change a life.

But the clarifying experience of an accurate diagnosis doesn’t come easy for many women, whose ADHD is routinely missed or misdiagnosed. In large part, this is because the disorder often presents differently in females and in males — manifestations influenced by biology or by societal standards, among other factors. Current clinical criteria are not set up to account for these differences.

What Clinical Criteria Misses for Females with ADHD

It’s easy to assign the ADHD label if we’re talking about a young boy with a whole lot of energy. In the classroom, he bounces off his seat, interrupts his teacher, and distracts his classmates – the “perfect” ADHD representative. And the DSM-5 would clearly align these signs and symptoms with an ADHD diagnosis for him.

Yet this stereotypical boy does not represent every person with ADHD, or the variety of ways its symptoms present and affect individuals. This archetype is certainly not the way ADHD is often seen in girls.

While the research on girls and women with ADHD is still lacking, we do know that girls are not often hyperactive or impulsive – two of the three symptom categories for ADHD included in the DSM-5. Instead, girls are more likely to exhibit symptoms in the third category: inattention.

[Take This Self-Test: ADHD Symptoms in Women]

ADHD Symptoms as Experienced by Girls – and Misinterpreted by Most

We know there’s so much more to ADHD than these broad categories, especially when we’re considering how it presents in girls. Something as simple as picking cuticles can be a subtle sign of ADHD!

Then there’s the little girl who will talk your ear off and somehow always has her head in the clouds, dreaming the day away. And the girl who never seems to pay attention in class, but who always goes above and beyond on every assignment and gets incredible grades.

The signs are also there in the young woman who seems like she had everything figured out — until she reaches college. In over her head, she’s persistently anxious, held back by her fear of failure and scrambling to put all the pieces of her life back together.

These signs of ADHD are often missed in females. At worst, these signs may be misinterpreted as laziness, irresponsibility, rudeness, or another negative quality. Parents, for example, may scold their daughter for forgetting to do homework or having a messy bedroom, viewing both as clear signs of irresponsibility — instead of symptoms of ADHD.

[Self-Test: ADHD Symptoms in Girls]

How Undiagnosed ADHD Affects the Lives of Women

Many girls who unknowingly struggle with this disorder internalize these misinterpretations. As the criticisms accumulate, their self-esteem plummets. They begin to feel shame and confusion, and they question their ability to handle seemingly simple aspects of life.

A Barrier to Independent Success in Education and Career

Girls and women with ADHD often find it difficult to concentrate in school and in the workplace. While they aren’t disrupting others, their own difficulties with focus can keep them from getting things done. They’ll often struggle silently with these issues, even as they fall behind.

Undiagnosed, some may overcompensate for their difficulties, going above and beyond with lists upon lists, noise-cancelling headphones, and other carefully planned strategies. But it’s not always enough.

A Detriment to Relationships

ADHD can also make navigating social situations difficult. Individuals may not know why they often lose track of what’s being said or frequently interrupt during conversations, inadvertently annoying and upsetting so many along the way. Then there’s ADHD’s real impact on romantic relationships.

The woman with ADHD wants to be a better friend, sister, daughter, mom, and wife, but she just can’t help how an undiagnosed disorder affects her socially.

A Common Cause of Additional Mental Health Issues

Low self-esteem and chronic shame often lead to other mental health issues and disruptions in the lives of undiagnosed women with ADHD. This helps to explain why anxiety, mood disorders, and even self-harming behaviors are so common in this group. By the time a diagnosis is made, the patient has likely had noticeable symptoms of one of these comorbid conditions for years.

The Right Tools Can Change a Woman’s Life

Undiagnosed ADHD in women has far-reaching consequences that can impact every area of life. While an early diagnosis is best, a diagnosis at any age can start a woman on a new path, unlocking the tools, supports, and treatments that can help her manage ADHD and change her life for the better.

What Needs to Be Done for Women with ADHD

We need to start recognizing ADHD in women. This is not a male-specific disorder.

Women, take your concerns seriously. Your struggles may be pointing to ADHD, even if the notion seems far-fetched to you. Talk to a professional and get tested — it is so essential.

Clinicians play a role, too. I’ve diagnosed so many women who have been clearly struggling with undiagnosed ADHD for years, but didn’t meet the clinical criteria for the disorder as outlined by the DSM-5. It’s on us, as practitioners, to think outside these incomplete guidelines so that we can help more girls and women get the diagnosis they need.

Let’s push for more research. Let’s push to expand the symptoms of the DSM-5 to better fit females. Let’s push to get girls and women the tools they need to manage ADHD and improve their lives.

ADHD in Women: Next Steps

Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

5 Comments & Reviews

  1. Thank you for this article. It should be spread far and wide, but sadly I don’t know how much difference it will make. I currently have Kaiser insurance, and they cling very tight to the DSM-5 symptoms. I am currently being evaluated and the clinician with whom I am dealing, told me point blank that I will need to have demonstrated (per the DSM-5) symptoms present by age 12 or I don’t have it. The guy I am seeing is the head psychiatrist of Kaiser’s Assessment Clinic in Roseville, CA. So, for all the millions of people Kaiser serves, no woman in that system will get an unbiased examination. I had to fight hard for almost 3 months, calling Kaiser multiple times on a daily basis. At one time, I even filed a Sexism and Ageism grievance against them, considering I am 52 and in 1982 when I turned 12, there has only been one study asking whether or not females could even have ADD (as it was called then). The likelihood I would have been diagnosed as almost nonexistent. I finally got a call a couple of weeks ago, they were going to assess me. But still, I have to “fudge” my symptoms as a kid. I was a “weird” girl and played hard with the boys any chance I got. I did OK in school, but my report cards always had comments like: “If Dee would apply herself more, she could do better.” “If Dee would follow directions fully and pay attention to details, she could improve her grades.” Yadda yadda. But I don’t have my elementary school report cards, and I am not even sure these details would be enough. They want to see disruption from me. Causing problems in classrooms and the like. I can demonstrate I have ADHD, including Hyperactivity/Impulsivity currently, and that is has become worse since I hit perimenopause and all my coping skills I developed no longer work. I tick off 7 symptoms for the Inattentiveness, and 5 for the Hyperactivity/Impulsivity, with many examples from 30 years of my life and how they have evolved, even how starkly different my attempt at college in my late teens/early 20’s went (GPA 1.69) to my college experience at age 38 with 18 years of improving my coping skills (GPA 3.89). But Kaiser is not interested in any of that. They only care about the DSM-5 age of diagnosis, 12 years old. It’s like deciding my mental health future comes down to ONE SINGLE YES/NO QUESTION: Were you diagnosed by age 12? <<Anyone who thinks that is good psychological care is a joke. We need to change the DSM-5. Who's working in it now? Who's on the working group for ADHD? Hopefully more than one expert on Women with ADHD. How do those people get picked? I want Stephen P. Hinshaw, Kathleen Nadeau and Ellen Littman. we should get to vote on who is on that committee. After all, it's the people who have to live with the results.

  2. For so many of us there was NO DIAGNOSIS available. And drs now are acting as though somehow WE are the problem. That there is something wrong with us when we get overwhelmed by our partners diagnosis, managing two special needs kids, and a full time job. I just get so mad!

    I see so many kids today, the boys? They get the dx and the meds. The girls get told they are defiant and need counseling. Or that they will end up pregnant because they aren’t listening or are “low and slow.” UGH.

    I don’t hear Hallowell and Ratey getting on the bandwagon, as the big names. But maybe instead of pushing for a different name, they can help out with getting actual studies going for women!

  3. I know this is unrelated, but I can’t seem to find anyone talking anywhere about how trying to conceive affects women with ADHD. What was anyone else’s experience like? I’m currently trying to conceive, I’m 8 months in and I am so stressed, worried, obsessive at times. I’m worried that all my worrying is actually hindering me. I decided not to start my medication again as I was concerned that it could have an affect on the baby or my eggs. I know I’d be handling things a lot better if I was on meds right now. Things are really pilling on top of me and I’m trying my best not to drown right now. I’m 37 and I really worry about my age too…. I’ve been checked at the doctors and he said there’s no reason why I shouldn’t be able to get pregnant naturally. Every month now feels like a roller-coaster… analysing every symptom and getting my hopes up… its awful. I’m over emotional anyway and this is sending me over the edge! I can’t focus on much else atm, I’m completely consumed by it.
    Does anyone have any advice on how to chill the [email protected]%k out?

    I’m going to post this comment on a few of the articles in the hope that someone will reply and can help…. or that Additude may have advice on this and do an article to help. As there is little advice of what a female with ADHD should do about meds when TTC or how to manage the stress etc.

Leave a Reply