Living with ADHD as a woman

Historically, attention-deficit hyperactivity disorder (ADHD) was mistakenly viewed as something that mainly affected hyperactive young boys. This was in part because most ADHD research didn't include girls or women. Also, the diagnostic tools clinicians used to identify ADHD didn’t reflect gender differences. This has resulted in the ongoing problem of many women with ADHD being misdiagnosed or never diagnosed at all. 

Fortunately, we now have a deeper understanding of how gender impacts ADHD. Learning more about how ADHD presents in women can help you know when to ask for help. While ADHD is often identified in childhood, many people don’t receive a diagnosis until later in life. So if you’re an adult woman and think that you might have ADHD, it’s never too late to ask for help.

A note on language: At Rula, we believe that all people, regardless of gender, deserve research-backed information to support their mental health. One of the challenges in discussing ADHD and women is that the vast majority of research focuses on those assigned female at birth (AFAB). It’s clear that gender and socialization play a role in ADHD identification, diagnosis, and treatment. But we don’t yet have reliable data to demonstrate how this experience might diverge for gender diverse individuals. This is because, unfortunately, the scientific community has largely focused on ADHD as it presents in cisgender boys and men. As new, more inclusive research is published, we’re committed to updating our content to reflect these changes.

What signs of ADHD look like in women 

There are three different types of ADHD. These include predominantly hyperactive, predominantly inattentive, and combined. Research shows that women are more likely to have inattentive ADHD. So, their symptoms typically center on difficulties with executive function (like memory, focus, goal setting, and planning).

Here are a few examples of what that can look like:

• Rushing through tasks and making careless mistakes

• Being easily distracted or forgetful in daily activities

• Having trouble with focus and concentration

• Ongoing challenges with organization and prioritizing tasks

• Experiencing difficulty setting and achieving goals

• Avoiding tasks that require mental effort

• Losing or misplacing personal items

Women with ADHD might be more likely to have challenges with inattentiveness. But that doesn’t mean they never experience hyperactivity. The difference is that while “traditional” ADHD hyperactivity is externally visible (like fidgeting or running around), for women it’s often internalized.

Here’s what that might look like:

• Being overly social or “chatty”

• Interrupting or blurting when someone else is talking

• Looking like you’re daydreaming when you’re actually having racing thoughts

• Making friends easily but having trouble maintaining those relationships

• Fixating on activities that require intense physical and/or mental discipline

• Engaging in self-harm* to cope with emotional pain

• Worrying about rejection or failure (and often working extra hard to compensate) 

*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org

If experiencing a life-threatening emergency or you need immediate help, please call 911.

Why ADHD can go undiagnosed in women

We know that ADHD can affect people of all genders. Yet research shows that the ADHD diagnosis rate among men is 69% higher than in women. Some reasons this might be the case include:

• Stereotypes: Many people still think of ADHD as something that only occurs in rambunctious young boys. This prevailing myth means that ADHD in women — especially high-achieving women — is often dismissed or overlooked. 

• Bias: Unfortunately, bias exists in mental healthcare. Clinicians may attribute inattention symptoms to other factors, and many ADHD rating scales are still skewed toward the male presentation.

• Hormonal fluctuations: Naturally occurring hormonal changes can affect the intensity of ADHD symptoms. For example, a woman’s symptoms may change during puberty, pregnancy, perimenopause, or menopause. Sometimes, this can lead to a delayed diagnosis or a misdiagnosis.     

• Masking: Often the result of internalized shame, masking is when a person with ADHD goes to great lengths to conceal their symptoms. For example, let’s say a woman has difficulty with organization. So, she might create a detailed, color-coded filing system to keep track of tasks. But, eventually, this becomes exhausting.

• Co-occurring conditions: Co-occurring mental health conditions like anxiety disorders and depression are more common among women than men with ADHD. This overlap may complicate the diagnostic process or lead to misdiagnosis. 

Untreated ADHD can also create difficulties throughout a woman’s life. From childhood onward, she may experience difficulty with self-esteem, anxiety, and other emotional challenges. 

Without an accurate diagnosis, she might misunderstand where her symptoms are coming from. In response, she may blame herself or think there’s something wrong with her. This is why it’s so important to raise awareness about the distinct ways that ADHD presents in women. Increasing understanding can help more women get the support they deserve.

Getting diagnosed with ADHD as a woman

Sometimes, ADHD symptoms get confused with symptoms of other mental health concerns. For example, a woman experiencing depression may seek treatment for a mood disorder. In the process, her provider may discover that she’s also living with ADHD. While not the most efficient path to ADHD care, this is a common experience.

Alternatively, if you suspect you might have ADHD, you can advocate for yourself by requesting an evaluation. This is typically done by a mental health professional like a psychiatrist or psychologist. But you can also ask your primary care doctor for an evaluation. 

There isn’t a single test that can determine if you have ADHD. So, your feedback will be an important part of the process. You can prepare for your assessment by taking some notes ahead of time. Think about when your symptoms started, what makes them better or worse, and how they impact your life. This information can help ensure that you receive an accurate diagnosis and personalized treatment plan.

Remember, ADHD is a treatable condition, and you deserve to feel seen and heard when you ask for help. If you feel that your provider isn’t taking your concerns seriously, consider getting a second opinion. Look for a provider who has previous experience treating ADHD in adult women.

Clinician's take

Hormonal shifts — like during the menstrual cycle, pregnancy, or menopause — can change how the brain processes focus and mood. For many women, this can make ADHD symptoms feel stronger or harder to manage at certain times.

Brandy Chalmers, LPC

Clinical reviewer

Find care with Rula

ADHD was once thought of as a condition that only affected boys and men. Today, we know it can affect anyone. But it can present differently in women. Adult women with ADHD are more likely to display inattentive symptoms as opposed to physical hyperactivity. 

Women may have challenges with organization, focus, and memory. They may also go to great lengths to mask their symptoms, which can make them harder to detect. This has resulted in many women with ADHD being misdiagnosed or not getting the care they need. So if you suspect that you might have ADHD, don’t hesitate to reach out to a doctor, psychiatrist, or psychologist for an evaluation.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.