Understanding ADHD in Women
ADHD affects both men and women, but research shows that women face unique challenges that often go unnoticed (Guo, 2024). While traditional studies suggest that men and women experience ADHD similarly, recent research (Holthe & Langvik, 2017) and lived experiences tell a very different story—one in which societal expectations, hormonal fluctuations, and self-doubt shape how ADHD manifests in women.
Women with ADHD exhibit many of the same core symptoms as men but often struggle with additional burdens. They are more likely to experience inattentiveness and internalising symptoms, such as anxiety and self-esteem issues, rather than the external hyperactive-impulsive behaviours commonly observed in men (Hinshaw, O’Grady & Rosenthal, 2022).
These differences have increased awareness among psychologists and psychiatrists, prompting changes in diagnosis and treatment approaches in the past decade. However, progress remains slow, and many women continue to be overlooked.
Why ADHD in Women Is Misdiagnosed
Historically, ADHD research focused on hyperactive boys. Until 2013, ADHD was classified primarily as a childhood disorder in the DSM-4 (the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), reinforcing the misconception that symptoms must be externally disruptive to warrant diagnosis.
Although the DSM-5 (2013) updated the criteria to recognise ADHD in adults, diagnostic standards still emphasise outward behaviours like impulsivity and hyperactivity, failing to account for the internal struggles many women experience.
As a result, many women unknowingly develop coping mechanisms. Some keep excessively busy, while others strive for perfection to mask their difficulties. Women with ADHD often internalise their struggles, believing they are not “trying hard enough”—until a diagnosis finally makes sense of their experiences.
Celebrities like Solange Knowles, Nelly Furtado and Simone Biles have openly discussed how receiving an ADHD diagnosis has freed them from self-blame.
Diagnosis is not just about labels—it is about liberation, education, awareness, self-compassion, and finally, seeing the full picture.
The Pressure of Gender Roles & Self-Doubt
Societal expectations place additional strain on women with ADHD. Women are expected to be organised, good at planning, and emotionally grounded—qualities that ADHD directly impacts. Many feel they must be the support system for others while receiving little support themselves. This constant pressure can leave them feeling exhausted, overwhelmed, burnt out and isolated.
Additionally, women with ADHD frequently set unattainable standards for themselves. Many were high achievers in school, compensating for their struggles through excessive effort. However, as life responsibilities increase, maintaining this level of overperformance becomes unsustainable. When they fall short, they feel like failures, reinforcing feelings of inadequacy. Instead of recognising ADHD as the underlying cause, they internalise blame, believing they are not “good enough.”
How Hormones Affect ADHD in Women
Hormonal changes significantly impact ADHD symptoms, influencing focus, mood, and emotional regulation throughout a woman’s life.
- Puberty: Fluctuations in estrogen and progesterone affect neurotransmitter activity, often exacerbating ADHD symptoms.
- Menstrual Cycle: In the days leading up to menstruation, estrogen levels drop, intensifying mood swings, irritability, and difficulty concentrating. Many women are misdiagnosed with PMS or PMDD instead of recognising the role ADHD plays.
- Menopause: As estrogen levels decline, ADHD symptoms often worsen, affecting memory, concentration, and sleep, leading to increased frustration and decreased quality of life.
Understanding the hormonal influence on ADHD can help women seek appropriate treatment and adjust strategies to manage symptoms more effectively.
The Importance of Getting an ADHD Diagnosis
Without diagnosis, women with ADHD often struggle in silence. Compared to their neurotypical peers, they are at greater risk for depression, anxiety, and low self-esteem (Rucklidge & Kaplan, 1997). These challenges extend into education and the workplace, where they may struggle with performance issues (Cherkasova, Roy, Molina, Scott, Weiss, Barkley, Biederman, Uchid, Hinshaw, Owens, & Hechtman, 2022).
Additionally, women with undiagnosed ADHD face a higher risk of substance abuse and reckless driving behaviours (Cherkasova et al., 2022). The impact on personal relationships, finances, and overall well-being can be significant (Goodman, 2007).
Receiving a diagnosis is a crucial first step toward better self-understanding and effective treatment. An ADHD diagnosis allows women to access the right strategies, support systems, and medical interventions to improve their daily lives.
Treatment and Management Strategies
Managing ADHD and improving your quality of life can happen with the right approach. Women with ADHD benefit from a combination of strategies, including:
- Therapy: Psychotherapy can help with emotional regulation, organisation, and self-esteem.
- Medication: Stimulant and non-stimulant medications can improve focus and impulse control.
- Lifestyle Adjustments: Regular exercise, yoga, mindfulness, and a structured routine can help manage symptoms.
- Dietary Considerations: Research has found that diet changes, such as reducing sugar and processed foods or increasing protein and omega-3s, improve focus and energy levels.
- Support Networks: Joining ADHD support groups or online communities can help reduce feelings of isolation.
How Women with ADHD Can Take Back Control
ADHD has a profound impact on women’s lives, but it does not define them. Many struggles stem from feeling as though they are failing when, in reality, they are navigating a condition that has been historically misunderstood. ADHD is a neurological condition, not a character flaw.
To move forward, women with ADHD need tailored approaches that recognise their unique experiences. While we cannot change how ADHD affects the brain, we can change how we view and support those who have it.
Here are some steps women can take to regain control:
✅ Seek an evaluation – If you suspect you have ADHD, pursuing a professional diagnosis can be life-changing.
✅ Educate yourself – Understanding how ADHD affects you personally can help you develop effective coping strategies.
✅ Find the appropriate treatment – Whether through therapy, medication, or lifestyle adjustments, managing ADHD is possible with tailored support.
✅ Build a support network – Connecting with others who share similar experiences can be empowering.
✅ Exercise boundaries – Whether in the workplace, at home, or in medical settings, standing up for your needs is essential.
By fostering awareness and promoting research focused on ADHD in women, we can create a more supportive environment where women no longer feel the need to suffer in silence.
With awareness and the right support, women with ADHD can redefine their success on their own terms.
References:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Cherkasova, Roy, Molina, Scott, Weiss, Barkley, Biederman, Uchid, Hinshaw, Owens, & Hechtman (2022). Review: Adult Outcome as Seen Through Controlled Prospective Follow-up Studies of Children With Attention-Deficit/Hyperactivity Disorder Followed Into Adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 61(3), 378–391.
Goodman, D. W. (2007). The consequences of attention-deficit/hyperactivity disorder in adults. Journal of Psychiatric Practice®, 13(5), 318–327.
Guo (2024). Specific Impairments and Challenges in Women with ADHD. Journal of Education, Humanities and Social Sciences, 29, 34-39.
Hinshaw, O. & Rosenthal (2022). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 63(4), 484–496.
Holthe & Langvik (2017). The Strives, Struggles, and Successes of Women Diagnosed With ADHD as Adults. Sage Open, 7(1).
Rucklidge & Kaplan (2000). Attributions and perceptions of childhood in women with ADHD symptomatology. Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Psychology, 56(6), 711–722.
