Female ADHD: the signs and impact of ADHD in women
ADHD impacts millions worldwide, yet the experience of living with it can vary significantly between genders. While ADHD symptoms in men and boys have been widely recognised and studied, ADHD in women often remains underdiagnosed or misdiagnosed. This gap has led many women to discover their diagnosis later in life. Understanding the unique symptoms of ADHD in women is essential for early diagnosis, compassionate support, and effective treatment.
Why ADHD Symptoms Differ in Women
Historically, ADHD has been associated with hyperactive, impulsive behaviour commonly seen in young boys. In women, however, ADHD often presents differently. While men and women may share core symptoms such as inattention, hyperactivity, and impulsivity, women frequently exhibit subtler, more internalised symptoms. This distinction can result in underdiagnosis, as symptoms are sometimes mistaken for anxiety, depression, or hormonal imbalances.
Inattention and Daydreaming
Women with ADHD often experience inattentiveness rather than hyperactivity. They may be easily distracted, “zoning out” or daydreaming, which can affect their ability to manage daily tasks. This tendency can be mistaken for a lack of motivation, when it is actually part of the ADHD experience.
Emotional Sensitivity and Mood Swings
Emotional sensitivity is common in women with ADHD, manifesting as rapid mood shifts, low frustration tolerance, and irritability. A minor comment may feel like a criticism, or a small mistake can seem like a significant failure. This emotional sensitivity can lead to, or exacerbate, feelings of guilt, shame, or anxiety.
Overwhelm and Difficulty Prioritising
Women with ADHD may find it difficult to organise tasks and manage priorities, leaving them overwhelmed by their workload, responsibilities, and social obligations. This difficulty prioritising tasks can result in procrastination, a backlog of incomplete tasks, and missed deadlines.
Forgetfulness and “Brain Fog”
Forgetfulness is a common experience for women with ADHD, ranging from forgetting names or misplacing items to missing important appointments, birthdays, or deadlines. The mental cloudiness, often described as “brain fog,” can affect self-esteem and lead to feelings of inadequacy.
Struggles with Self-Image and Self-Esteem
Low self-esteem is often a challenge for women with ADHD. Many internalise their struggles, feeling that they should be able to “do better” or that they aren’t trying hard enough. ADHD symptoms can make it difficult to meet societal expectations of organisation, efficiency, and emotional regulation, leading to feelings of failure or self-blame.
Perfectionism and People-Pleasing
To compensate for ADHD symptoms, many women strive to appear “put-together” or even perfect, often adopting perfectionistic or people-pleasing tendencies. While such efforts can go some way to compensate for ADHD difficulties, it can be exhausting and unsustainable.
Physical Restlessness or Hyperactivity
Although physical hyperactivity may not be as prominent in women, they may experience restlessness, fidgeting, or an inner sense of being unable to relax. Women may doodle, bite their nails, or struggle to sit through long meetings without feeling anxious or uncomfortable.
Challenges in Personal Relationships
Due to symptoms such as distraction, forgetfulness, or emotional sensitivity, women with ADHD may experience challenges in relationships. They might miss important dates or struggle with consistent communication, leading to feelings of “letting people down” and consequent social withdrawal.
Hormonal Influence on ADHD Symptoms
Hormonal changes—such as those related to menstrual cycles, pregnancy, or menopause—can impact ADHD symptoms in women, with fluctuations that exacerbate symptoms like mood swings, irritability, and inattention. Recognising the role of oestrogen in relation to attention is helping many women better understand significant shifts in their ADHD symptoms at these times.
ADHD in Women: The Weight of a Second Burden
ADHD is a complex and challenging condition, but for women, it often carries an additional layer of difficulty—a second burden stemming from societal expectations, gender roles, and mental health stigma. This pressure can be exhausting as women feel they must meet standards that seem unattainable. Understanding this “second burden” is essential to fostering a more compassionate perspective on ADHD in women.
The Double Standard of Gender Expectations
Women are often expected to be organised, nurturing, detail-oriented, and emotionally stable—traits seen as “natural” for women but challenging for anyone. ADHD symptoms such as disorganisation, forgetfulness, and emotional sensitivity clash with these expectations. This disconnect may leave women with ADHD feeling they’re falling short, which can lead to shame and guilt. Women with ADHD may feel a constant pressure to appear competent and calm, using their energy to maintain a facade rather than addressing their symptoms effectively. This need to “mask” symptoms can result in burnout and added emotional stress, deepening the second burden of ADHD.
The Cost of Late Diagnosis and Misdiagnosis
Many women with ADHD remain undiagnosed until adulthood, as their symptoms are often subtler and more internalised than the noticeable hyperactivity seen in boys. Without a diagnosis, women may struggle for years, attributing their challenges to personal failings. Misdiagnosis extends confusion and frustration, leaving women without access to the resources that could improve their quality of life. When a diagnosis is finally reached, the mental and emotional toll may already be significant, adding to the second burden.
The “Emotional Rollercoaster” and Self-Esteem
Emotional dysregulation—difficulty managing emotions—is a common part of ADHD. Women may experience heightened sensitivity, mood swings, and anxiety, which are often dismissed as “overreacting” or “too emotional.” This ongoing struggle can erode self-esteem over time, especially when women are criticised for their feelings. As a result, many women feel misunderstood or judged, which intensifies feelings of isolation and compounds the challenges of ADHD.
Steps Towards Lightening the Second Burden
There is hope in the increasing awareness and understanding of ADHD in women, and resources are now becoming more accessible. Here are some steps that can help lighten this burden:
Education and Self-Compassion: Learning about ADHD and understanding it as a neurodevelopmental condition, not a personal failing, can foster self-compassion and reduce self-criticism.
Connecting with a Supportive Community: ADHD support groups, especially those for women, can provide emotional relief and reduce isolation.
Therapy and Treatment: Working with an ADHD specialist can help women develop coping strategies, and options such as therapy, medication, mindfulness techniques, and organisational tools can aid symptom management.
Challenging Societal Expectations: Consciously challenging unrealistic societal standards can help women feel empowered to prioritise their well-being.
Conclusion: Embracing ADHD as Part of a Full Life
Women with ADHD often feel as though they’re carrying a hidden burden. However, assessment and resulting formulation of difficulties can offer a framework for greater self-understanding, acceptance, and improved relationships. For those who suspect ADHD, seeking support from a mental health professional can be transformative. ADHD is not a limitation but rather a unique perspective and way of thinking that, with the right support, can lead to a fulfilling life.