Does ADHD Affect Women Differently?

3 Women stand together

Before we get going on the topic of Attention Deficit Hyperactivity Disorder in women, there’s something important to note. This article pertains both to people who were assigned female at birth (AFAB), and people whose gender expression is female, since the complexities of ADHD as they relate to gender and sex are both neurobiological and societal.

There are also generalisations, as this article will explore. You might be AFAB, read this article and wonder why it doesn’t really resonate with you, and that’s fine. Your experience of ADHD is as unique as the next person’s, and it’s no less valid because of it.

Dad plays with 2 kids

ADHD In Children

The differences between boys and girls with ADHD has been a topic of much discussion over the years, and has evolved continually.  Just as our understanding of ADHD itself has evolved. It used to be thought that only boys could have the condition. It also used to be thought that boys always grew out of it. We now know that neither of those is true.

More recently, the perception has been that girls with ADHD tend to have inattention issues, whereas boys tend to have problems with hyperactivity and impulsivity. This has led to an oft-repeated oversimplification: girls tend to be the “inattentive” subtype. The truth is a bit more complex.

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The Female ADHD Brain — Is it Different?

study published in BMC Psychiatry in 2013 showed very little difference between the level of inattentive versus hyperactive symptoms in boys and girls (with some of the differences actually being the opposite of the stereotype).

Their conclusion, which is shared by many in the ADHD community, is not that the symptoms themselves are different. The difference is in the ways in which boys and girls express those symptoms.  This is likely in no small part due to the societal expectations of appropriate behaviour in boys and girls.

If a boy is running all over the place, unable to sit still, and barging his way into things rather than waiting his turn, it’s far more easily excused as typical “boy” behaviour.  Particularly at a younger age.

Girls, however, are told very early on that this is “unladylike”.  They are more likely than boys to be expected to follow the rules, be obedient, and be passive. This leads many girls to internalise their hyperactive symptoms such as running around, and climbing things.

Internal and External Hyperactivity

We all know what external hyperactivity looks like. It’s the stereotype of ADHD; the child running around and screaming, climbing things they shouldn’t, and being generally disruptive. What isn’t as easy is explaining what internal hyperactivity looks like, which is likely why girls are often considered inattentive.  Their hyperactivity is still there, but it isn’t obvious to anyone else.

Internal hyperactivity includes:

  • Racing thoughts
  • Feeling agitated or restless
  • Easily bored, craving excitement or stimulation
  • Trying to do too many things all at once
  • Fidgeting, twirling hair, biting nails, tapping feet
  • Talking excessively, interrupting conversations

For most people with ADHD, male and female, hyperactive and impulsive symptoms tend to become more internalised with age.

However, recent research has suggested that girls tend to start internalising that hyperactivity much earlier than boys.

Girl plays on swing

Are Girls Not Hyperactive?

This is not to say that girls are never hyperactive, nor that they are only hyperactive internally. There are plenty of examples of girls and women, myself included, who exhibit visible, external hyperactive and impulsive symptoms of ADHD.

That said, the visible hyperactive traits that tend to remain in girls and women are either internalised, or are more likely to be those that are societally expected or acceptable.  Being a “chatterbox”, or hyper-social, for example, and are not typically seen as characteristic of ADHD.

The “Double-Whammy” of ADHD in Girls

Because of the tendency for girls and women to internalise their hyperactive and impulsive symptoms, and for the symptoms that remain to be stereotypically feminine traits, females tend to be seen as inattentive. This means that either:

• Girls who have internalised their hyperactivity “fly under the radar”.  Never getting an ADHD diagnosis, because it’s the hyperactive (i.e. disruptive) symptoms more typically presented by boys that get the most attention from teachers, parents and peers.
Or
• The girls that are exhibiting hyperactive symptoms are either doing so in societally acceptable ways, such as chattiness.  Or are not considered to have ADHD because “girls with ADHD aren’t hyperactive”.

Family sits together on sofa

ADHD In Adult Women

ADHD can put a strain on our work, love, and family relationships. The symptoms of ADHD (and their effects) that girls and women experience are in fact common to both sexes, but are compounded by societal expectations. It’s important to note that this is also true for boys and men, although the set of societal expectations is obviously different.

Physical and Mental Health

Living with ADHD, whether diagnosed or not, can contribute to both mental and physical health problems. With the added pressure of societal expectations and stereotypes, women more often than men experience issues with eating disorders, anxiety, low self-esteem, and chronic stress. ADHD can cause issues with remembering to keep appointments, such as with a doctor or specialist, or with taking medications on schedule.

Employment and Finance

Many adults with ADHD report feeling a chronic sense of underachievement, particularly in the world of work.

ADHD adults often have trouble with:

  • finding and retaining work
  • meeting deadlines
  • staying on task
  • following company rules
  • punctuality
  • obeying authority figures
  • prioritisingsticking to a 9-to-5 routine

This is often exacerbated in women, who, despite the fact that we’re in the twenty-first century, still experience a significant pay gap.  Are less likely to be considered for promotion or pay rises.  Are more likely to be offered lower starting salaries.  And receive less career mentorship than their similarly qualified male peers.

Women are often seen as the “bookkeepers” of the family, expected to be able to balance a budget, and pay bills on time. However, ADHD makes these tasks particularly challenging, and may cause other issues such as impulsive spending or gambling.

A couple leans on a fence

Home and Relationships

For adult females, expectations of being a successful wife and mother can cause feelings of inadequacy and shame.  ADHD makes it difficult to keep up with the household chores, organise, plan and prioritise.

Non-ADHD partners can feel as though they are expected to shoulder the burden of household chores.  Or, they may see their ADHD partner as irresponsible or insensitive. The partner with ADHD may feel as though they are being constantly nagged to tidy up, or pay attention. All of these scenarios can cause resentment, tension, and arguments.

There are particular problems in this area that disproportionately affect women. In a world that puts so much pressure on wives and mothers to be able to “do it all,” it can feel hugely shameful to be the mother who can’t seem to get the children ready for school on time.  Or, the wife whose house is always messy.  Failing to meet the societal expectations of women as caretakers can make females with ADHD feel as though they have failed fundamentally as people.

Receiving a Diagnosis

Even when females do reach out for help, their symptoms are often explained as character traits, or a disorder other than ADHD. A girl might be thought of as a “space cadet”, a day-dreamer, absent-minded, or a chatterbox. Later in life, a woman may well seek help and be diagnosed with depression or anxiety rather than ADHD.

What Can We Do?

Thankfully, there are things we can do to help make life with ADHD a little easier.

A female doctor

Get a Diagnosis

If you don’t yet have a diagnosis, obtaining one can be extremely helpful in mitigating some of the unwelcome symptoms of ADHD. A diagnosis will allow you to access medication and therapy options to better manage your symptoms, and their effects on your daily life.

ADHD-Friendly Tools and Strategies

Either prior to a diagnosis or after one, ADHD-friendly tools and strategies specific to the issues you are having can bring marked benefits. For organisation, try a Bullet Journal. If time management is an issue, the Pomodoro technique can be helpful. There are many options, so give as many of them a try as you can until you find some that work for you.

Understanding Yourself

For many of us with ADHD, simply having a better understanding of why we are the way we are brings a huge sense of relief. You can better understand that you are not to blame for the way your brain is wired.  And that your struggles are not because of a character flaw or personal weakness.

If you are a woman with ADHD, know that you haven’t failed as a person. There are valid, biological reasons for the struggles you are facing. You haven’t failed as a woman, a wife, a mother, or a daughter. And you are not alone.

About The Author:

Headshot for Elizabeth Storm

Diagnosed with ADHD as an adult after a near-breakdown, Elizabeth decided to make it her mission that nobody with ADHD should ever have to go through life without the ability to understand and harness their powerful mind.

Through her website, social media channels (FacebookInstagramPinterestTwitter), coaching, and an upcoming book, she helps individuals with ADHD to find success at school and work, see improvements in their relationships with friends, families, and romantic partners, and raise their self-esteem, enabling them to see that their ADHD isn’t a problem to be fixed, but a difference to be embraced.

More Information about ADHD & Women:

Common ADHD Symptoms in Women

Understanding ADHD in Women

4 ADHD Tips for Women

ADHD & Women with Patricia O. Quinn M.D. – Webinar

ADHD and the Individual. Does ADHD Impact Women Differently?

THE THREE PILLARS OF CHANGE FOR WOMEN WITH ADHD

Do Women With ADHD Have Extra Challenges?

How Women Can Win with ADHD

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