Understanding ADHD in Women

Understanding ADHD in Women

By Keath Low, MA

Ask a random person on the street to explain ADHD and they will more often than not describe the stereotypical hyperactive boy running around the classroom.  ADHD, however, is much more complex than that.  Many girls and women with ADHD often fall through the cracks.  Symptoms of ADHD go unrecognized or if problems are recognized, they are attributed to other factors or conditions.

It may also be that through childhood and the teenage years, the female is able to compensate for her attentional weaknesses and other impairments, but the effort she must put into completing her work and managing daily activities in her life is enormous.  Her behaviors may also be less disruptive, less noticeable to those on the outside, and so she goes on dealing with the extraordinary pressure until her 20s or 30s or 40s or 50s or 60s and on, feeling as though she may burst from the lack of control and chaos she feels.

A Complicated Picture

Finally, when she meets with her doctor to sort out what has been causing the overwhelm and feelings of depression that have been overtaking her life, to understand why she always feels one….or rather five steps behind, ADHD may not even be considered.  Part of this misunderstanding may be related to her history which doesn’t “look” like what one typically considers ADHD.  Additionally, the normal hormonal changes and fluctuations a female experiences throughout her lifespan – puberty, the monthly premenstrual time, pregnancy, perimenopause, and menopause – can all affect the presentation of ADHD symptoms.

To complicate the picture further, features that are often associated with ADHD in women, such as depression and anxiety are often misdiagnosed as primary symptoms.  It is these secondary conditions that are more likely to be diagnosed and treated in women, so that the ADHD is overlooked completely. And the woman may even feel an initial sense of hope that things will get better with that treatment, yet hope is soon lost when the issues of inattention, planning, organizing, and managing time and emotions continue to harm relationships and day-to-day responsibilities because the root of the problem – ADHD – has been missed.

So she continues on with her life feeling frustrated and depleted, wondering why things that seem so simple for others are so difficult for her, often internalizing negative thoughts about herself, feeling shame, inadequacy, unworthiness, hopelessness.

Know That There is Hope…

ADHD is a common, highly treatable condition.  Life can get better with proper treatment and proper treatment begins with an accurate diagnosis.  Increasing our understanding about the different ways ADHD can present in women can help.  To learn more go to Common ADHD Symptoms in Women.

NOTE: How do you find a doctor who is experienced in assessing and treating ADHD?
That is the question we get asked the most!So, Rick Green has written a blog all about it called How Do I Find Out If I Have ADHD?
and, our Comprehensive Guide to ADHD videos will help you navigate the process.

19 Replies to “Understanding ADHD in Women”

  1. Wow!!!! That is pretty much my life story…. My brother was diagnosed in the 70’s, but I fell through the cracks. Luckily I was able to compensate and had motivation/determination to succeed in life…. Today I am a Speech Pathologist that works in the public schools. . When a teacher ask me to screen a child due to educational issues, I always do an observation to make sure the teacher has not missed any important behaviors that needs to be documented. I hear lazy, blonde, and spacey used often when describing the ADD female…. During therapy, I try to teach my ADHD children “executive functioning” skills/strategies before transferring to the
    middle school. I am passionate about ADHD children and try to educate teachers and parents as much as possible. Loved the blog !

  2. Bianca, you are a professional after my own heart. Oh to have had someone like you on a school support team when I was a teacher. You are well positioned to make a huge difference. Thank you for choosing to do so.

  3. That is my life story, as well. After failing to complete grad school the first time around many years ago–a counseling psych program, no less–I’m back in grad school, this time with my diagnosis in hand. No surprise, I’m in a panic to finish my thesis, which I must, before the end of this quarter.

    Anyway, my thesis is on graduate students with AD/HD. While it is only a phenomenological study, I’m finding that women diagnosed late in life present a much more complicated, and sadder, picture than those “lucky” women diagnosed as children. Still, both groups seem prone to channeling their compulsive fidgeting to compulsive eating or over-eating. I know that if I can’t get engaged by what I’m reading (and it’s my own chosen material!), I risk eating my way through the afternoon…By the way, I do find that mindful meditation helps.

    1. Good on you for going back to do your thesis. The idea of doing one freaks me out. But then I have only just been diagnosed after graduating from a Bachelor of Social Work and wonder how the uni years may have been if I had been correctly diagnosed then, instead of being diagnosed incorrectly with major depression and GAD. Vyvanse has helped me with the compulsive snacking and has even helped me reduce my smoking.
      I would be interested in having a read of the thesis when you have completed it. Do you have a researchgate.com or acadamia.com account that you will be uploading to? Or even a Linkedin account, basically somewhere that is free to access it as I no longer have as much access to articles etc.

  4. I can sure relate. I had taken a class 4 times until the professor took me aside and told me to get checked then come and talk to her after the diagnosis. After total frustration through the mountains of tests, i was dignosted with ADD. I talked to the professor afterwards and she told me how to rethink the equations in my head and draw them on paper. It all made sense. I wish there was a way to help the rest of my life…

  5. Even as a child, I always felt I was different from others. I worked so hard to keep up and did well. I would seek help in college, but was just given meds for depression and told not to be so hard on myself. I was the “go to girl” for every origination I was part of, always going above and beyond. Hit a wall when I unknowingly started going through early menopause and life fell a part. I kept trying but my “coping skills” that had always worked were gone. I honestly thoughtit was my thyroid but it was fine and my doctor was less than supportive. At one point, I thought I had gone crazy or had a brain tumor! New doctor, new diagnosis but until this site I had doubts. Reading the forums is like looking into a mirror! Looking forward to learning more and taking back over my brain! Thanks for giving hope through knowledge and humor!

    1. Most of your post looks like it could have been written by me. I was what was referred to as an over-achiever, a dynamo. I was considered very intelligent and I relied heavily on my mind — while at the same time taking it for granted. My life imploded when I hit menopause.

      I first went to a therapist in my mid 20s. I’m now in my mid 50s and was just diagnosed with ADHD last year — frankly, by accident. The therapist, who is listed as a specialist in ADHD was lamenting that if only I’d had ADHD she’d know how to help me. I asked how she could tell that I didn’t. She gave me a couple of tests, looked at the results, and said, “oh my God.” It turns out she didn’t know how to help me anyway, so I’m still trying to find someone who can.

  6. Ladyg I can totally relate about the childhood thing. My mother has, throughout my whole life, told me that I was different. She once told me that she knew the day i was born that I was different. My earliest memory is of her yelling at me, asking an 6-8 months old “Why can’t you be more like your brother and sister”. She even gave me a little decorative saying one birthday that read I march to the beat of a different drummer. All this would have been ok if she could have explained to me what she meant and been able to help me over it. But this is all in the past. Right now, at 58 and newly diagnosed, I am just trying to get organized and motivated (by something other then fear and panic) to get my life out of intensive care and back on its feet.

  7. One more thing, how much of a roll do hormones play in ADD symptoms? The only time I have had a clean living place was the first 6 months after moving and after my daughter was born and until i weaned her. The time in my life that was the happiest and most organized was while I was breast feeding. Now, post-menapausal, with everyone that used to give me some structure gone, I am a basket case. And this is from someone who has always wanted to live alone.

  8. I don’t want to be dismissive of the point of this article but if you changed the perspective from feminine to masculine you would describe my experience pretty well. Years of therapy targeted at depression, anxiety, difficulties in getting along with my partner, poor organisation ….. missed the cause completely. My new approach based upon my diagnosis has brought far more success in less than a year than all of the sessions in the last two decades did.

  9. Ugh, I completely understand where you’re coming from about ADD and hormones. It’s like my menstruation is 10x worse than it should be (hormones wise) simply because I have absolutely no ability to control myself with that many sensors being triggered or something. It’s insane. My dad never liked when I used the excuse “but I’m on my period” because he thought I was able to exert some sort of control over myself and just simply wasn’t. It’s ironic because I’m pretty sure if ADD is for sure genetic then I get it from him and not my mother who understood my lack of control even thought she”s never actually had that lack before in her life… Oh well..

  10. I am convinced a friend has ADD as this person is a compulsive talker often going non stop with bearly a chance for anyone else to interject. It is exhausting to be in the company of this person for more than a few hours. In certain aspects of their lives they can be very attentive and responsible . When it comes to emotional matters, impulsivity and reactivity seem to be an issue. Do these behaviours sound like ADD?

  11. [[“What are some of the gender specific symptoms of ADHD in women?

    A female with ADHD may be less hyperactive and less impulsive than her male counterpart. Instead she may present with more subtle symptoms such as being disorganized, scattered, forgetful, introverted, withdrawn and socially isolated. She may have great difficulty keeping her focus on tasks, becoming side-tracked and easily distracted by things around her or even by her own thoughts. It may take her a little longer to process information, so that she appears “slow” or “spacey” or “flighty”, when in fact she may be highly intelligent. “]]

    This is me to a tee and always has been. I was diagnosed with ADD a year ago and I am 33. This is the inattentive subtype. It is so frustrating to see it as a male or female thing. If I was like most males with this disorder I would have likely been diagnosed in school because I would have been disruptive. But I’m not a girl…. I’m pretty sure.

    1. I think it is depending on the person’s age that is was the inattentive version that went under the radar. I was at primary school in the 70s and then the ‘label’ was hyperkinetic impulse disorder and I believe it wasn’t that widely known about amongst mainstream teachers of the time as kids whose behaviour was extreme would have been shunted into special schools. So in some ways, it was fortunate to fly under the radar and stay in mainstream schooling.
      I was the chronic daydreamer and spent a lot of time standing outside the classroom for talking.

  12. Ohhhhh…wait until perimenopause/menopause starts! Things get really crazy. I had a very bead 2 years, but then I found a pharmacy that compounds hormones that are not synthetic and it has made a huge difference. I always had horrible problems with periods entire life as well. I love not having to bother with that anymore.

    1. I wish I’d had such a positive response to the bio-equivalent hormones I was prescribed. The progesterone helped me sleep better for a few months, but then stopped working. The estrogen was a complete disaster from the get go. I don’t know if it’s just that they never got the dosage right or that hormones just don’t help some people.

  13. OMG! everything I’m reading on this website I can relate to especially the above article. I don’t know whether I want to cry or scream! Now what do I do? Money is so tight, I’ve even had to lower my meds (depression) because we can’t afford them. (no benefits, husband was laid off after 26 yrs with the same company last Sept.) These days with all the chaos around us, driving into a tree seems more appealing than driving to work, which I totally loath & regret accepting in March. My whole life I’ve felt different, always felt like I can’t keep up. Now I know I can’t keep up but don’t know what to do. No more energy.

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