Highlights
- Women and girls are much less likely to be diagnosed with ADHD, especially earlier in life. This means that many of them often go without treatment until they reach adulthood.
- This discrepancy does not indicate that women are less likely to live with ADHD, as previously assumed. Instead, it’s a sign of provider bias that can make girls and women less likely to be referred for ADHD treatment.
- If you think you may have ADHD, it’s essential to get the right diagnosis. ADHD can be managed, but it’s important to work with a provider who understands how the disorder presents in women.
If you just look at the officially reported numbers, it appears as though attention deficit hyperactivity disorder (ADHD) affects far more males than females.
However, many experts argue that these statistics don’t reflect the true prevalence of ADHD in women. Instead, they may highlight disparities in diagnosis and treatment across genders.
People who identify as female may be less likely to be properly diagnosed with ADHD because of the different ways it presents in women. Provider bias also plays a role—we tend to think of ADHD as a condition that affects boys, so girls with ADHD fly under the radar until they hit adulthood.
Thankfully, this bias is slowly, but surely, changing. Understanding the unique ways that ADHD can manifest in women is essential to helping them get the diagnosis—and treatment—that they need and deserve.
A note on language: Both MEDvidi and the author understand and celebrate the vast variety of identities and presentations that exist on the gender spectrum. Most research studies on this topic have been conducted on cisgender women assigned female at birth; in this article, we use the terms “women” and “females” to refer to this group. More research is needed on whether ADHD rates and presentations differ among cisgender and transgender women, although some studies have shown that transgender and gender-diverse people in general experience
How ADHD Differs in Females
Research shows that the difference in ADHD diagnosis between sexes isn’t just related to provider bias. ADHD traits in women can actually look differently than they do in males. It’s important to understand how this disorder presents in women to be able to get the right diagnosis and appropriate treatment.
Inattention
For example, research has found that women are more likely to have inattentive symptoms of ADHD than hyperactive-impulsive symptoms, which are more common in men. Symptoms of inattentive ADHD can include:
- Struggling to stay organized and feeling overwhelmed by clutter
- Forgetting things easily or misplacing everyday items
- Finding it hard to focus, especially on boring tasks
- Starting tasks but rarely finishing them
- Feeling mentally exhausted by daily responsibilities
- Zoning out or losing focus throughout the day
- Missing deadlines or running late often
- Avoiding tasks that seem too complicated or tedious
- Getting easily distracted by noises or your environment
Depression and Anxiety
ADHD can come with a lot of shame and frustration. Males are more likely to externalize those feelings, which can lead them to be diagnosed with co-occurring conditions like conduct disorder or oppositional defiant disorder.
Females, on the other hand, are more likely to present with internalizing symptoms. These feelings of shame and frustration can affect their self-esteem. Rather than getting angry at the world for putting high demands on them, they may blame themselves and label themselves as “stupid” or “lazy.” Unfortunately, this means that women with ADHD are much more likely to also live with depression and anxiety.
Often, these co-occurring conditions are what drive women with ADHD to initially seek treatment. Depression and anxiety can also often mask the symptoms of attention deficit hyperactivity disorder and cause misdiagnosis.
Hormone Fluctuations and the Menstrual Cycle
Although we need more research, one recent study also found that females who menstruate may
More specifically, when estrogen levels drop—such as during the premenstrual phase—women may experience heightened emotional sensitivity and worse executive functioning, which then leads to increased inattention and difficulty managing impulses. This can be particularly challenging for women with ADHD, as the disorder can make the limbic system more reactive. As a result, during times of low estrogen, women with ADHD may feel more overwhelmed, impulsive, or emotionally volatile.
Better Coping Skills
Lastly, females with ADHD tend to have stronger coping skills, which can sometimes be a double-edged sword. For example, they may be more likely to rely on strategies like making lists or scheduling their days in a planner.
This is partly because of the societal expectations that are placed on females. Boys and men may “get away with” being messy, rambunctious, and too talkative—but girls are expected to be orderly and demure. Therefore, girls with ADHD may feel immense pressure to hide their symptoms in order to be accepted.
Although these coping skills can sometimes help girls be less debilitated by ADHD, they can also mask ADHD symptoms, which can lead to a late diagnosis.
Why Is ADHD Underdiagnosed in Females?
Research shows that the ratio of child ADHD diagnosis in boys vs. girls is as high as 3:1. However, for adults, the ratio is closer to 1:1. This isn’t a sign that girls are suddenly developing ADHD as they get older—it means that many of them aren’t receiving the right diagnosis until they’re older. This leaves them to struggle in silence as children, without the treatment that could help them succeed.
According to experts, an important reason why females with ADHD are so underdiagnosed, especially in childhood, is because of the bias that may exist in healthcare and other professionals.
Traditionally, ADHD was thought of as a condition that affects young boys. We imagined children with this condition as boys who couldn’t stop “jumping off the walls” and often didn’t do well at school. But while this can be one presentation of ADHD, it’s far from the only one.
As we mentioned before, girls with ADHD tend to internalize their symptoms. They may also have stronger coping strategies to deal with the symptoms. In addition, they’re more likely to have a predominantly inattentive type of ADHD, so they may not be “jumping off the walls” and causing disturbances. Often, they’re the student daydreaming in the back of the classroom.
All of these factors add up to make healthcare providers, teachers, parents, and other adults less likely to refer girls for ADHD diagnosis. Even when they do get referred, they may be more likely to get misdiagnosed with another condition like anxiety or depression.
Impact on Day-to-Day Life
Living with ADHD as a woman is tough. Because females with ADHD are so often misdiagnosed until adulthood, many of them have had to learn how to deal with their symptoms on their own. When left untreated, the condition can get worse and worse over time, and these unaddressed ADHD symptoms often wreak havoc on women’s lives.
If you are a woman with ADHD, it’s likely that your condition affects every area of your life.
Impact on School and Work
Women with ADHD may have a harder time at school and at work, especially if they haven’t received the right diagnosis and treatment. One review found that females with ADHD tended to have worse relationships with teachers. In another qualitative study, women with ADHD reported feeling that their
You might have been told throughout your life that you weren’t meeting your full potential at work or school. You might miss deadlines or overcommit to projects. You might have performed well academically but started to fall behind when success started requiring more organization and focus.
ADHD can also be a superpower at work and allow you to think outside of the box and offer innovative solutions. But you could also feel like it’s held you back.
Impact on relationships
ADHD can significantly affect your social and romantic relationships as a woman. Although you’re not to blame for them, you might have found that some symptoms associated with ADHD have been causing frustration in your friends and romantic partners. For example, you might consistently forget about date appointments or find yourself getting distracted when they’re talking to you.
ADHD can also cause mood swings and emotional dysregulation, which is a difficulty with self-managing strong emotions. You might have emotional outbursts when it becomes too much, which might drive partners and friends away.
The impulsivity that comes with ADHD can also cause risky sexual behaviors, like having multiple partners or having unsafe sex, that can also affect your intimate relationships.
Impact on Mental Health
As we’ve already mentioned, women with ADHD are more likely than their male counterparts to live with co-occurring mental health conditions like depression and anxiety. They’re also more likely to struggle with sleep disorders like insomnia.
More research is needed to know exactly why this is. But if you’re a woman with ADHD who hasn’t received the right diagnosis, you may have blamed yourself for your symptoms. People may have judged you throughout your life. You may have internalized unkind labels like “lazy.”
All of this can have a tremendous impact on your overall mental health. People who receive the right ADHD diagnosis earlier on in life may have had time to build self-acceptance, but if you’re a female who wasn’t diagnosed until adulthood, that journey may still be ahead of you.
Impact on Daily Life
Aside from these important areas, ADHD likely has an impact on the ordinary details of your everyday life. You might feel overwhelmed by household chores like cleaning. You may forget to pay bills, which could sometimes lead to financial consequences. You might sometimes face ADHD paralysis and find it almost impossible to get up off the couch to get to your to-do list.
Symptoms and Signs of ADHD in Women
There are no gender differences when it comes to the formally recognized symptoms of ADHD. However, as noted earlier, women are more likely to live with an inattentive type of this disorder than a hyperactive-impulsive type. That means that its signs and symptoms in women may look very differently than they do in males.
Here are some ADHD symptoms in women to watch out for. If you relate to many of these signs, then it could be worthwhile to schedule a consultation with a healthcare provider for a detailed assessment.
- You often struggle to stay organized. You often feel overwhelmed by clutter or unfinished tasks on your to-do list.
- You have difficulty managing time. You frequently run late or underestimate how long things will take.
- You find it hard to focus on tasks that don’t interest you, which leads to procrastination and sometimes missing deadlines.
- You may start several projects but rarely finish them. You leave many things incomplete. For example, you might become very interested in a hobby only to put it down a few weeks later.
- You sometimes feel restless, but it feels more like internal agitation than physical hyperactivity.
- You misplace things often, whether it’s keys, your phone, or important documents.
- You often forget appointments or commitments. This makes it hard to stay on top of daily responsibilities.
- You feel easily distracted by your environment, whether it’s noises, people talking, or something on your phone.
- You struggle to follow conversations, especially when they go off-topic or involve multiple people.
- You tend to interrupt others during conversations or speak impulsively without thinking it through.
- You feel mentally drained from balancing multiple responsibilities, and you often feel like you just can’t keep up with it all.
- You experience frequent mood swings. You feel easily frustrated or irritable when things don’t go as planned, and you sometimes have emotional outbursts.
- You often feel anxious about deadlines or tasks but find it hard to take action until the last minute.
- You frequently zone out or daydream, especially when you’re supposed to focus on something important.
- You have trouble sitting still during long meetings or events. You often fidget or feel uncomfortable.
- You feel more emotionally sensitive than others and tend to become deeply wounded by criticism or conflict.
- You struggle to prioritize tasks and find it hard to know what to focus on first.
- You often feel overwhelmed by decision-making, even for small choices like what to eat or wear.
- You avoid tasks that feel too complex or tedious, even if they’re important.
- You feel like you’re underachieving, despite putting in effort and trying to stay on top of things.
Diagnosis and Tests
The first step to getting the ADHD treatment that you need and deserve is to get an accurate diagnosis. This can be even more important for women with ADHD, who may not have gotten the right diagnosis when they first started showing symptoms as a child. Even if you’ve been diagnosed with another mental health condition, like depression or anxiety, it’s possible you also have ADHD.
If you recognize ADHD characteristics in yourself, then it’s essential to see a qualified mental health provider to get a diagnosis. Many different types of medical professionals can give you a diagnosis, including psychiatrists, medical doctors, nurse practitioners, and licensed therapists.
Diagnosing ADHD can be tricky, especially among adult women, because this condition continues to be highly misunderstood. It’s always best to connect with a provider who has specific expertise in this disorder. They may be more familiar with what ADHD looks like in women specifically, and help you understand ADHD-related behaviors. Healthcare providers at MEDvidi are experienced in diagnosing and treating ADHD online, and you can consult with them within 24 hours.
Treatment
Fortunately, even if you receive an ADHD diagnosis only as an adult, there are ways to successfully manage your symptoms and live a life that makes you feel happy and fulfilled. There are many effective ADHD treatments, and although they won’t “cure” you, you can build self-acceptance of your condition and limit its negative effects on your life.
The most common and recognized treatment methods for ADHD are medication, therapy, or a combination of both:
- Stimulants like Vyvanse and non-stimulants like Qelbree are helpful for most people with ADHD. Stimulants tend to be more effective, but non-stimulants can help as well if you can’t or don’t want to take stimulants.
- Cognitive-behavioral therapy for ADHD can help you learn new skills to manage the symptoms, like new study strategies or time management skills. It can also help you challenge negative and unhelpful thinking patterns that you may have developed about yourself due to years of living with undiagnosed ADHD.
Get Connected With an ADHD Provider Today
Undiagnosed ADHD in women and men can have severe negative consequences for daily life. Unfortunately, research shows that because of both bias and the different ways that ADHD shows up in females, women with ADHD are much more likely to reach adulthood without the proper diagnosis.
MEDvidi can connect you with qualified medical professionals who can assess your symptoms, provide a diagnosis, and walk you through treatment options. Find an ADHD provider on MEDvidi today!
