Women and ADHD

Many girls and women are undiagnosed with ADHD, meaning they are also lacking support and treatment for a mental health condition that can have rippling effects in their lives. Women are more likely to be diagnosed in adulthood than as a child, even though ADHD typically onsets by adolescence. This means many women spend years feeling the impacts of ADHD, which often leads to lower self-esteem and other negative emotional effects. On the other hand, men are much more likely to get an ADHD diagnosis as a child. This isn’t because ADHD affects boys more.

Rather, it’s because the diagnostic criteria is based on research from how it appears in boys. It was conceptualized as a disorder affecting only boys and is based on observations of only boys. Modern understanding of ADHD is changing, but it’s important to keep in mind that this is built on a foundation that failed to consider women and girls from the start.

Gender Norms and Social Expectations

Because of this gap in understanding of the diagnosis, clinicians and teachers (who often recommend children get an evaluation) are more familiar with how ADHD looks in boys. ADHD presents differently in girls and boys, though, in large part due to socialization and gender expectations. Social constructs establish different “rules” for boys and girls that become internalized and perpetuated into adulthood. Women and girls are often encouraged to be demure, empathetic, organized, and obedient. Boys are often encouraged to be tough, strong, active, and energetic.

So, something like inattentiveness (an internalizing symptom) is more prominent in women than impulsivity and hyperactivity (externalizing symptoms). Girls also tend to be taught more about emotional intelligence and may develop better coping and masking strategies (e.g. talking less and sitting still) than boys. Even knowledgeable clinicians and teachers may overlook internalizing symptoms because they are not as obvious—nor as disruptive to others—as externalized symptoms. Boys tend to display more visible hyperactivity or disruptive behaviors than girls and are therefore more likely to trigger a teacher’s referral for a diagnosis. Also, women’s underdiagnoses of ADHD may be due to attributing ADHD symptoms, like trouble focusing on tasks, to another mental health condition that is more often diagnosed in women, such as anxiety or depression.

Late Diagnosis

So, why is there an increasing number of adult women getting ADHD diagnoses? Well, social media plays a role in this. With so much content about people with lived experiences with ADHD, people are learning more about it and some may be approaching mental health professionals about a diagnosis. Also, lots of people with ADHD can “mask,” or hide their ADHD, for a time. To be clear, masking does not mean someone is not experiencing the challenges of ADHD. It simply means that other people are not perceiving their struggles. Women tend to be better at this because of social expectations, as mentioned above. It’s easier to mask ADHD throughout one’s school years because other life demands are limited.

A teenager living with her parents is able to put the majority of her energy into academics. That’s not to say teenagers with ADHD have it easy; they simply have more time and fewer responsibilities than an adult who is also navigating a job, paying bills, maintaining a home, taking care of children, dealing with unexpected life changes, and generally managing being an adult. As demands increase, it gets harder to mask. This is when others might start to see the symptoms that are causing distress—one reason women may not be diagnosed until adulthood. Now add to that the unique pressures placed on young women to be quiet, well-behaved, and responsible; the fact that working women in heterosexual relationships still do more of the invisible labor of housework and childcare than their male partners; and a history of underdiagnosis of ADHD and other conditions in women. Whether implicitly or explicitly, the message to women is clear: if we can’t see your pain, it isn’t as bad as you think it is.

Implications for Women with ADHD

The core symptoms of ADHD fall into three categories: impulsivity, inattention (or difficulty regulating attention), and hyperactivity. This can lead to risk-taking, which for women might mean a greater chance of unexpected pregnancy, among other things. It can also include a lower tolerance for frustration and more impatience in work and social settings. Being frequently distracted and poor time management skills can make it difficult to hold down jobs. And, for undiagnosed women, this leads to a lot of self-blame. Compared to men, women with ADHD have “decreased self-esteem, more difficulty in peer relationships, [and] increased likelihood of anxiety and other affective disorders” (Attoe & Climie, 2023, p. 647).

In some cases, women may be diagnosed with anxiety instead of ADHD. Because women tend to have more internalizing symptoms, hyperactivity might manifest as racing thoughts, similar to anxiety. Depression, anxiety, and substance abuse commonly co-occur with ADHD. These might be a result of ADHD, such as depression brought on by low self-esteem or substance use due to impulsivity.

But they might be coping strategies, such as using substances to manage ADHD symptoms. Women also tend to experience more of an external locus of control; they minimize their successes by attributing them to outside factors (e.g. “my boss gave me good feedback because they were in a good mood”) and highlight setbacks as personal failures (e.g. “I missed the deadline because I was lazy”). Imagine being a woman who doesn’t know she has ADHD, who has internalized expectations of being a responsive mother, a compliant employee, and an always-empathetic partner and friend. Imagine you just can’t get yourself to do the tasks you need to do, and you are having a hard time being the parent you want to be. But, you see this as your fault. It would be hard for anyone, but it’s exacerbated by the compounding of social pressures and lack of understanding.

A lot of women report feeling more self-acceptance after getting an ADHD diagnosis, even if it was later in life. Often, women with ADHD don’t know that their difficulty focusing, trouble with time management, and impulsivity are unusual. Many times, women with ADHD are high achievers who have “powered through,” which takes a lot of mental and emotional energy. I have a friend who did not receive an ADHD diagnosis until she was in a PhD program. She’d made it through college while working as a restaurant server, a fast-paced job where she could shift attention and be on her feet. But in her PhD program, she had so little wiggle room that the challenges of ADHD were finally visible enough to a mental health professional. She said it was validating, but it also brought to light how much she had been compensating her whole life. When others see accomplishments, they don’t see what it took to get there.

Getting Support If you think you might have ADHD, know that you are not alone. Therapy is a space to process the emotions around this diagnosis, develop skills and tools for emotional regulation, manage possible co-occurring disorders, and build self-esteem. For women with ADHD, therapy might be the first time they feel truly seen. When I work with neurodivergent clients, I validate their experience and support them as they consider how they want to reshape their identity to include their ADHD. We can also work together to explore the ways in which ADHD can be an asset. I like to help clients define ADHD for themselves, and, ultimately, feel more empowered.

References Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Journal of Attention Disorders, 27(7), 645–657. https://doi.org/10.1177/10870547231161533 Levin, F. R., Ostinelli, E. G., Parlatini, V., Ramos‐Quiroga, J. A., Sibley, M. H., Tomlinson, A., Wilens, T. E., Wong, I. C., Hovén, N., Didier, J., Correll, C. U., Rohde, L. A., & Faraone, S. V. (2025). Attention‐deficit/hyperactivity disorder (ADHD) in adults: evidence base, uncertainties and controversies. World Psychiatry, 24(3), 347–371. https://doi.org/10.1002/wps.21374 Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3), PCC.13r01596. https://doi.org/10.4088/PCC.13r01596