At midlife, many women enter the sandwich generation, juggling the often-conflicting needs of their children, parents, and partners. Society’s gender role expectations pressure them to conform to a traditional feminine ideal and prioritize others’ needs before their own.
Some of these women feel overwhelmed with overcommitment and dread moral judgment of their efforts. They feel ill-equipped to manage life’s complexities. These are the women with hidden ADHD: undiagnosed, untreated, and underserved.
Evading ADHD detection for so long suggests these women were able to present a seamless façade; that they passed for neurotypical, which may have felt like a win. But perfectionistic masking almost always comes at a high emotional cost. The self-monitoring is relentless; the hypervigilance, fueled by anxiety, exhausting.
While hiding their true selves may have seemed necessary to escape anticipated judgment and rejection, women who receive an ADHD diagnosis later in life report a new appreciation for the courage and determination that served them for so long.
Getting an ADHD Diagnosis Can Be Revelatory
Diagnosis at midlife unleashes a kaleidoscope of sensations—shock, anger, relief, regret, shame, fear, guilt, resentment, and sadness. On the life-changing journey toward understanding and acceptance, your first step is to learn everything you can about ADHD in women. Make use of audiobooks, articles, podcasts, webinars, support groups, and therapy.
[Read: Women with ADHD – No More Suffering in Silence]
Gradually, the explanation for your years of distress and confusion will emerge with increasing clarity. Share it with the people most important to you. Honor the regret you feel about the opportunities lost, then embark on building a more rewarding future.
The Impact of Hormones
For women with ADHD, declining estrogen levels in perimenopause and menopause trigger a perfect storm: functionality suffers as the severity of ADHD symptoms and coexisting anxiety and depression spike. Fluctuating hormones also disrupt mood, memory, sleep, concentration, and motivation. Shame and self-doubt, amplified during the premenstrual phase, become more intrusive and destabilizing.
Ambushed by tsunamis of emotion and memory lapses, many women attribute their worsening struggles to character flaws and judge themselves harshly. Since women now spend about a third of their lives in menopause, it’s a game-changer to discover that your unpredictable functioning is hormonally mediated.
Reinvent Yourself
We cannot change our age, history, or brain wiring, but we can change the lens through which we view our world. Changing our perspective and redefining our identity is best achieved through an alliance with a therapist who has expertise in working with women with ADHD.
[Read: Relief, Grief, and More Raw Reactions to an Adult ADHD Diagnosis]
In the meantime, begin the process of creating a new version of yourself by doing the following:
- Embrace your strengths. Understanding the far-reaching impact of ADHD in midlife enables a more realistic assessment of your strengths and weaknesses. After years of ruminating about your limitations, you’ll learn that there is strength in knowing when you need help and asking for it.
- Trust your unique vision. Non-linear thinkers are differently abled. Your passion and creativity enhance the neurotypical status quo with novel solutions.
- Create boundaries. To many women, social acceptance is an indicator of self-worth. Social dynamics are confusing, and you may consider others’ agendas more important than your own. Boundaries can help you find a balance between feeling trapped by overcommitment and withdrawing from interactions to avoid confrontation.
- Prioritize self-care. It takes a serious investment in your wellbeing to change the way you interact with your body. Women with ADHD tend to skimp on attention to their health. Creating a bedtime routine to improve sleep requires small changes over time. Eating healthier foods, drinking more water, and maintaining an exercise routine demand healthy vigilance. Balance conflicting needs—protection vs. connection, self-care vs. accommodating others, and passivity vs. assertiveness. Each small step will improve your quality of life.
- Develop systems that work for you. When chaos and clutter threaten to consume your environment, you may feel more frantic and unable to envision solutions. Creating organization and routine will help you manage your time and space more effectively.
- Seek pleasure. Take a designated amount of time each day, even just 15 minutes, to do something you find pleasurable. This transition will allow your brain to revel in unstructured downtime, whether that means chilling out with music, meditating, or having a cappuccino while playing Wordle.
After decades of shame, apologizing, and fearing criticism, a diagnosis gives you explicit permission to forgive yourself for being your own harshest critic. Whether you’ve punished yourself in the past with isolation, substance abuse, binge eating, or other kinds of self-harm, a midlife diagnosis can help you accept that you are worthy of being nurtured—by yourself and by others.
Diagnosis at midlife is the beginning of an ongoing journey toward enlightenment and transformation. Seize this unexpected second chance to believe in yourself. As you get the hang of reinvention, you will rejoice.
Reinvent Yourself Post-Diagnosis: Next Steps
- Watch: The Science Behind Diagnosing and Treating ADHD in Older Adults
- Download: Free Guide to ADHD in Older Adults
- Read: ADHD in Older Adults – Distinct Diagnostic and Treatment Considerations
Ellen Littman, Ph.D., a clinical psychologist in New York, is co-author of The Hidden Side of Adult ADHD, Understanding Women with ADHD, and Gender Differences in ADHD.
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Updated on April 16, 2025