How Women Experience ADHD and Its Symptoms

Attention deficit hyperactivity disorder (ADHD) is a well-known mental health condition. It can affect a person's executive functioning, social skills, and ability to stay still or control their impulses.^¹ ADHD is more common in kids than adults and is diagnosed more often in boys than girls. Because of that, many people aren't familiar with the signs and symptoms of ADHD in women.

Although it may manifest in different ways in adult females, a woman can develop ADHD.

The Gender Bias in ADHD

For years, clinicians diagnosed ADHD much more frequently in males than it was in females. More recently, the gender bias in ADHD diagnoses has decreased. Once, there were 25 males diagnosed with ADHD for each female. Today, males are about three times as likely to be diagnosed with ADHD than females.²

However, this doesn’t necessarily mean that ADHD is less common in females than it is in males. Males with ADHD generally have symptoms like hyperactivity and impulsiveness that are easy to recognize and are closely associated with ADHD. Females are more likely to have internalized or subtle ADHD. Because of that, school counselors or doctors are less likely to refer them for evaluation, and therefore they are less likely to be diagnosed.³

Researchers believe that ADHD is about only about twice as common in men as it is in women. By adulthood, the actual prevalence of ADHD is thought to be about equal between men and women.⁴ That means that the same number of adult men and women are living with ADHD. However, many women with ADHD have never been diagnosed. About 2.5% of adults have ADHD.¹

Signs and Symptoms of ADHD in Women

Rather than experiencing hyperactivity, women with ADHD are more likely to have inattention or internalized symptoms.⁴ These are often harder to notice. They might be brushed off as being personality quirks, or attributed to being a bubbly or social person. In addition, many women develop regimented coping mechanisms that help them hide the symptoms of ADHD.

Some women and girls experience classical symptoms of ADHD, like being hyperactive or impulsive. These females are more likely to get an ADHD diagnosis. Researchers have noted that among all people with ADHD diagnoses, girls with the diagnosis tend to have the most severe symptoms.⁴ That's likely because milder cases of ADHD in women and girls often go undiagnosed.

Here's what ADHD symptoms in a woman might look like:⁵

Inattention symptoms

• Makes careless mistakes or doesn't pay attention to details. She might burn dinner or send an email to the wrong recipient.
• Seems not to listen or has trouble maintaining attention. She might ask you to repeat yourself frequently.
• Struggles with organization and may have a messy home, office, or car.
• Has trouble following directions, causing difficulty at work.
• Is easily distracted or loses things frequently. She may be constantly searching for her keys or phone.
• Avoids tasks that require concentration, like filling out paperwork or filing taxes.

Internalized symptoms

• Daydreaming
• Having a racing mind and trouble staying on topic
• Depression
• Anxiety
• Fear of rejection, which can lead to unhealthy relationships
• Adopting self-coping strategies that require extremely hard work and discipline to mask the symptoms of ADHD

Hyperactive and impulsive symptoms

• Talks excessively or quickly
• Fidgets or moves constantly
• Acts impulsively, including early or reckless sexual behavior
• Makes friends easily but can’t sustain friendships or romantic relationships

When to See a Healthcare Provider

If you suspect that you have ADHD, you should see a healthcare provider who is experienced in diagnosing ADHD in adult women. This is especially important if symptoms like disorganization or difficulty maintaining relationships are affecting your career, family, or personal life.

Reach out to your doctor even if you've already talked to a healthcare provider about ADHD. Many women with ADHD have been evaluated before, but the diagnosis was missed. This might be because they have effective coping mechanisms. Or the psychiatrist attributed their symptoms to depression or anxiety, which are common among women with ADHD.⁶

Treatment

For anyone diagnosed with ADHD, a treatment plan can include therapies, lifestyle changes, and medication. You and your doctor should decide what’s right for you.

There are special considerations in treating ADHD in women. A decrease in the hormone estrogen can make ADHD symptoms worse in women. A woman’s menstrual cycle, birth control, pregnancy, and menopause can cause these hormonal fluctuations. In addition, many women with ADHD need a provider who can treat co-occurring conditions like depression, anxiety, substance use disorder, or low self-esteem, which are common in women with ADHD.⁷

Creating a treatment plan that works for you may take some trial and error, so it's helpful to understand the pillars of treatment plans for women with ADHD.

Medications

Medications are an important tool for many people with ADHD. Stimulant and non-stimulant medications can help ease the symptoms of ADHD. That way, they're easier to control with lifestyle changes and behavioral interventions. Some women with ADHD also use hormone replacement therapy to help control their symptoms during menopause, when estrogen levels dip.⁷

Medications won't help everyone, but research shows they're more effective than a placebo at reducing ADHD symptoms. For adults, the most effective ADHD medication is amphetamines. However, you should talk to your doctor about what's best for you.⁸

Can't Focus? How To Tell When It's Time To Try ADHD Medication

Cognitive behavioral therapy (CBT)

ADHD can have a huge impact on social life and mental health for many women. Because of that, lots of women benefit from counseling. Working with an experienced counselor can help you manage your ADHD symptoms and address consequences of ADHD, like depression, anxiety, and low self-esteem.⁷

Research has shown that CBT on its own is effective for reducing some symptoms of ADHD in adults. It's even more effective when it's used in combination with ADHD medications.⁹

Lifestyle changes

Many women with ADHD have already found lifestyle changes that help them manage their symptoms. Experimenting with new lifestyle changes can help you control your ADHD symptoms when they seem to be getting the better of you.

The best lifestyle interventions will depend on your ADHD symptoms. Some women focus on diet and exercise to help control their symptoms. Others utilize the skills of professional organizers or career mentors to help them overcome their deficits. There are even ADHD coaches who will help you work on your specific challenges and goals in order to reduce the impact that ADHD has on your life.¹⁰

Recap

ADHD is underdiagnosed in females, since doctors often don't recognize the signs and symptoms of ADHD in women. Although some women with the condition have hyperactivity, most women experience inattentiveness and internalized symptoms like depression or anxiety. Still, ADHD can have a huge impact, interfering with your career or personal success.

If you feel that symptoms of ADHD are keeping you from reaching your full potential, reach out to a doctor who is familiar with diagnosing ADHD in adult women. They can help you get a proper diagnosis and find a treatment plan that works for you.

Sources:

1. American Psychiatric Association. What is ADHD? June 2022.
2. Littmann, Ellen. Gender myths & ADHD. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
3. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020. Doi: 10.1186/s12888-020-02707-9
4. Hinshaw SP, Nguyen PT, O’Grady SM, Rosenthal EA. Annual research review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry. 2022. Doi: 10.1111/jcpp.13480
5. Symptoms of ADHD in women and girls. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
6. Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord. 2014. Doi: 10.4088/PCC.13r01596
7. Treatment for ADHD in women and girls. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).