ADHD manifests differently for women. Learn the unique signs and symptoms.
In recent years, more experts have begun recognizing the effects of ADHD in women. While it’s best known as a children’s disorder, it often impacts adults. And that impact can be devastating. Let's take a look.
ADHD, or attention deficit/hyperactivity disorder (also called ADD), is commonly overlooked in girls and women. Many adults don’t realize they have it until well into their 20s, or even decades later.
Often women will piece together their symptoms on their own, a therapist will finally diagnose them, or their child’s diagnosis will prompt them to realize they have it too. Women may be more likely to have the inattentive, or quiet, type of ADHD, which is more often missed.
Looking for more solid support for your ADHD or related symptoms or need help right away? I offer a limited number of coaching spots and would love to help. Learn more!
Everyday Signs
Some of the day-to-day experiences of women may include:
Frequently losing physical items like phones, keys, or paperwork
Often running late
Forgetting or overlooking important items, despite consequences
Becoming frustrated and down on yourself due to messiness or falling behind
Tending to have negative thoughts overall about yourself and your capabilities
Tending to have depression, anxiety, or other mental challenges
Pushing projects off until the last minute, and then marathoning to get it done
These problems can make life very difficult. On the other hand, women with this condition are often very creative, may have above-average intelligence, and are probably able to manage well in a crisis. Many highly successful women have been diagnosed with this disorder.
Here’s a look at the overall picture of adult attention-deficit disorder, the important elements to know about, it’s strengths and weaknesses for women, and next steps you can take.
How Common is it?
It’s difficult to say exactly how many women have ADHD. Very little research has looked at this, and the data available is outdated and narrow in scope. Some data shows that at least 4% of adults have this condition, and that men are more likely to be diagnosed.
I know in my practice, I run across more women who have ADHD than those who don’t. The negative thoughts that often accompany this condition tend to overlap and worsen other mental health struggles.
Because we know so many girls and women go undiagnosed, it’s difficult to confirm national statistics. It’s possible that millions more females qualify for this diagnosis than is currently reported.
Symptoms Specific to Women
One reason women may be diagnosed less is because symptoms can present differently than with men. According to the DSM-V, there are three different ways ADHD may present. Essentially the underlying condition is the same, but the symptoms can appear a bit differently, and are split into three categories.
Here’s a look at the symptoms of each type, including hyperactive, inattentive and combined type. Symptoms may lean towards one category or may be mixed. Women and girls more often have the predominantly inattentive type.
This symptom list is based on the DSM-V, however additional examples have been added for your reference.
Inattentive Type:
Often makes careless mistakes or misses details relating to school, work, or other responsibilities (might overlook a form or miss an assignment)
Has difficulty sustaining attention during tasks (particularly repeated and/or boring tasks)
Often seems to not listen when spoken to (because the mind is wandering, "spacing out," or focused on other things)
Difficulty finishing homework, chores, or duties at work due to being side tracked or losing focus
Has a difficult time organizing tasks
Reluctance to start tedious jobs (ie, returning e-mails, completing forms, cleaning the kitchen)
Frequently misplaces important items such as phones, car keys, books, papers
Often distracted by surroundings, noises, activity, or one’s own wandering thoughts (which may spiral into starting activities that aren’t necessary at that moment)
Frequently forgetting tasks such as paying a bill or upcoming appointments (even when consequences of this may be serious, such as utilities being turned off)
Often feeling behind on or embarrassed about late or missed work, housework, or infrequent responsibilities (ie, updating the car license)
Hyperactive Type:
Often fidgets or taps hands or feet
Often stands or leaves seat when expected to stay seated (at school or work)
Feeling restless or the need to move around often
Difficulty staying quiet during leisure activities
Often talks excessively
Impulsivity:
Blurts out answers before questions are completed
Trouble waiting a turn or waiting in line
May intrude into conversations or activities of others
If the majority of symptoms are inattentive, an expert may diagnose this as ADHD, predominantly inattentive type. If hyperactive symptoms are predominant, then it will be diagnosed as predominantly hyperactive type. If there is a mix of both, this is called combined type.
Other Criteria
Additionally, for adults to be diagnosed with any of the three types, the following criteria must be met:
Symptoms began before age 12
Symptoms must be present in at least two settings, such as at work and home
Symptoms must interfere with everyday life such as at school or with family responsibilities
Other conditions that could cause overlapping symptoms must be ruled out, such as a physical illness, head injury, or other mental health diagnosis
Attention deficit may also be diagnosed as mild, moderate, or severe, depending on how many symptoms are present and how much they are impacting everyday life.
Manifestations
Women are diagnosed in the same way as men, based on the criteria outlined in the DSM-V. However, symptoms may manifest differently, or may impact them differently. For example, women may feel “supermom” pressure, believing everyone else is more “together” or responsible. This, along with low self-esteem formed in childhood, may contribute to depression and/or feelings of hopelessness.
Managing with Kids
Women often take on the bulk of household organizing and coordinating children’s activities at home, at school, or after school. This can be quite a job for anyone, but with the added organizational difficulties, it can feel next to impossible. Children may add to this, comparing your house or lifestyle to that of their friends.
Additionally, many families include more than one household member who carry this diagnosis. You may have one or more children diagnosed, and your spouse may have it too. This adds to the chaotic feeling.
Housework Pressures
Women are disproportionately in charge of duties at home. Tedious jobs such as housework can feel almost physically painful to start or complete. Due to societal pressures or perceptions, others may also expect women to be more organized and prepared than men, especially when it comes to family and childcare tasks.
Challenges at Work
Women at work may feel self-conscious about their workspace appearing disorganized, or may be judged by colleagues who work differently. They may become painfully bored in meetings, or feel distracted during training events.
Those with more hyperactive symptoms may interrupt or talk to others frequently, while those with inattentive symptoms may be thrown off by others interacting at unexpected times.
Biological Differences
It’s possible that female hormones may interact with ADHD symptoms as well. For example, for those assigned female at birth, hormonal changes during the regular reproductive cycle, pregnancy, or menopause may all affect mood and focus, and could make symptoms worse.
The Focus on Others
Women often prioritize everyone else, at the expense of their own needs. Self-care can go out the window when it's exhausting just to keep up with daily tasks. This can add to stress that makes symptoms worse.
Real-Life Example
ADHD in girls can be complicated, because the symptoms are more subtle, but still impactful. Here's a personal testimony about one woman's experience.
When I was in elementary school I was great at reading. We used to have word competitions in class and I wouldn't get to play because I won every time.
Because I seemed smart and capable, the teachers were confused when I lost homework (so many worksheets), couldn’t get a single math problem right, and papers and pencils were falling out of my desk. I must have been lazy, not trying, or obstinate, right?
Looking back, I most certainly was dealing with the inattentive version of attention deficit/hyperactivity disorder. It’s still easy to miss this in girls and women, and back then it was pretty much unheard of.
Since I didn’t understand what was going on, I began to feel frustrated and overwhelmed. I particularly struggled at math, and believe I probably have a related diagnosis called dyscalculia, which 20% of students with ADD also meet criteria for. My conditions made me forget and mix up numbers, similar to readers who suffer with dyslexia.
I wasn’t diagnosed until college, and then it all began to make sense. While a lot of people feel discouraged when they get a diagnosis, it was a comfort to me. I finally had something to point to when explaining to people while I had problems with simple things, like arriving on time or remembering events.
Because girls with ADHD are often also intelligent, creative, and even driven, others may mistake symptoms for laziness or carelessness. When in fact, such girls and women are working harder than many others to keep track of everything. Meanwhile, they may feel alone or confused as others don't seem to have the same challenges.
Self-Reported Experiences
There are formal diagnostic criteria that allow doctors and therapists to make a diagnosis. However, these aren’t all-encompassing of what women may experience. Here are other symptoms my clients often report:
Constantly running late, no matter how hard they try to be on time
Never feeling caught up with housework, and feeling embarrassed or fearful about people stopping by
Feeling mostly successful at work, but occasionally getting reprimanded or living in fear for not completing tedious tasks like paperwork or responding to messages
Feeling overwhelmed trying to keep up with their child’s school expectations, such as sending supplies or snacks, or taking them to extra events
Constantly losing things, and spending good portions of their time looking for important documents, car keys, or phones
Hyperfocus for hours or even days on things they find interesting, even while they can’t get other basic tasks completed
Remembering challenges in school, such as being the kid who lost entire notebooks and had papers spilling out of their desk
Strengths
It’s true that the symptoms of ADHD can add up to a significant life impact, often not for the better. However, there are many strengths of the condition.
The very things that make your mind wander may also make you very creative, with unending ideas. When you’re at your best, you may be very hopeful and optimistic, seeing many possibilities in the future. You’re unlikely to live a tedious, predictable life, and you may not mind that whatsoever.
Others may come to you for advice, despite seeing your messy desk and other flaws. Perhaps you’re the one who can problem-solve and generate an idea they can’t. When you go into hyperfocus mode, you can become an expert on topics others don’t quite comprehend.
These are all great strengths, but don’t fix the day-to-day problems. Here are some ideas to cope.
Coping
Realistically, all of the symptoms of ADHD aren’t likely to go away completely. However, many women do get to a place where they feel like life is more manageable. And some behavioral aspects, such as running late, can be improved. Here are some tips I offer to my clients who struggle with this. (Get more resources here.)
ADHD coaching
Coaching can be a life saver. Just feeling less isolated is a good start. Most ADHD coaches have the condition themselves, so they know what it's about. You can identify your strengths and challenges and begin to tackle them one by one. meanwhile you'll get closer to the fun stuff -- dreams, goals, and inspiration!
Let Go of Perfection
It’s not going to happen. If you’re a messy housekeeper, you’re not going to come close to a magazine spread for Martha Stewart.
However, you can get your home to the point where you don’t fear the health department stopping by. Or, you can spend more time at work you love and pay a friend to help you keep up with things. And maybe you will always be that person who runs late. So what? There are certainly worse traits.
Simplify
If you can’t keep up with all of your volunteer projects and committees, you’re probably overbooked. The same goes for all of the extra work you take on.
Wherever possible, pick activities that are the easiest and most fun, and stick with those. You can also simplify your space, activities at home, and tangible items. Get rid of things that aren't adding to your life in a positive way.
Prioritize Changes
The quickest, most doable changes are those based in forgetfulness and simple habits, such as running late and losing your keys. If it’s these or something else, pick just one thing at a time and focus on changing it. Then move on to the next.
Research Medications
Meds alone won’t cure ADHD, and aren’t always a long-term solution. However if they seem right for you, they may at least get you through more difficult times. It can also be a bridge to working on some everyday skills that are impacting your life. If medication interests you, research specialists in your area for a consultation.
Try CBT
Cognitive behavioral therapy, or CBT, is a way to change the negative thoughts that often accompany ADHD. Those with the condition are known to think more negatively, tending to focus more on problems and beating themselves up. You can look for a CBT therapist in your region, as well as starting to change your thinking habits on your own.
Here are some examples to give you a taste of how this might work:
You lose your keys and think, “Why am I so stupid? I do this all the time.” Instead try, “This is frustrating, but I always find them and no harm is done in the long run.”
Work becomes overwhelming, and you feel like giving up. Coach yourself by saying something like, “It is harder for me than some other people. But I am better than my colleagues at other things. Maybe I should take a quick break and then just get one thing done.”
Your friend stops by and sees your messy house. You tell yourself, “How embarrassing. She’s going to tell everyone.” Instead try, “Well, she didn’t seem to mind the mess. Either she’s a good friend and won’t judge me, or if she uses it against me I know she’s not trustworthy.”
See the pattern? Recognize your tendency to go negative, and acknowledge the thought if it’s there, and then practice saying nice things instead. Treat yourself no worse than you would someone else you care about.
Check out this guide with specific steps to practice CBT.
Find Resources
Do you just need more help, or are you looking for people who understand? Here are a couple of resources that can help.
Get the women's ADD/ADHD resource kit, including a symptom checklist, welcome to ADHD letter, tip sheets, and more. Check it out here.
Consider coaching. We are an affiliate partner of Shimmer, which offers quality, affordable coaching for ADHD. Visit Shimmer and enter code THECOUNSELINGPALETTE for 40% off your first month.
Look for a doctor who specializes in treating ADHD and discuss options that may work for you.
Above all, give yourself a break. The idea of women struggling with ADHD is often joked about or minimized. Indeed, there's plenty that can be funny about it. But it also makes many women's lives very challenging. There's no need to fix it all or be perfect. Just take things one step at a time until life feels a bit easier.
Jennie Lannette, LCSW, is a licensed, practicing therapist in Missouri, specializing in trauma, anxiety, and related mental health issues.
*The Counseling Palette will receive a commission if you sign up for Shimmer using the code provided, THECOUNSELINGPALETTE at checkout. We chose to partner with Shimmer to offer a more hands-on and extensive option for our readers struggling with ADHD.
References
American Psychiatric Association. DSM-V. 2021. https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
Mayo Clinic. 2021. https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878
National Institute of Mental Health. 2021. https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know
Substance Abuse and Mental Health Service Administration. 2021. https://www.samhsa.gov/