ADHD in Girls: Signs, Symptoms, & Treatments

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurological condition in which individuals experience chronic issues with inattention, hyperactivity, and/or impulsivity.¹ ADHD symptoms affect executive functioning, contributing to disrupted cognitive development in attention, response, anticipation, processing, and memory.² Onset of ADHD typically starts in childhood, and symptoms persist throughout adulthood.

The types of ADHD include:

• Inattentive ADHD: Inattentive ADHD often results in struggles with paying attention, staying organized, and avoiding careless mistakes.
• Hyperactive-impulsive ADHD: Those with hyperactive-impulsive ADHD display excessive activity, fidgeting, and impulsivity without significant inattentiveness.
• Combined ADHD: Combined ADHD refers to a combination of both inattentive and hyperactive/impulsive symptoms. Individuals may struggle with paying attention, controlling impulses, and managing hyperactive behaviors.

ADHD Symptoms In Girls

Girls with ADHD tend to display more inattentive symptoms than hyperactive symptoms.^3,4 Some may struggle with staying on task at school, often falling behind on homework assignments or scoring lower on tests. Others may face difficulties with forgetfulness or determining how much time they should spend on a particular task.

However, parents and teachers should understand these challenges are not due to unintelligence. Instead, many academic environments are not inclusive to girls with ADHD, often overlooking the unique needs of those on the neurodiversity spectrum.

Symptoms of ADHD in girls may include:³

• Difficulty staying on task
• Poor time management
• Difficulty relaxing at home or school or taking a needed break
• Trouble staying organized
• Forgetfulness
• Impulsive behaviors
• Chronic procrastination
• Emotional dysregulation
• Distractibility
• Frequent daydreaming
• Perfectionism

Signs of ADHD in Girls

Some common signs of ADHD in girls include difficulties with attention and concentration and emotional sensitivity. Many may also display symptoms such as daydreaming, disorganization, forgetfulness, and poor task management. Awareness of these behaviors can help trusted adults provide appropriate support for girls with ADHD.

Impulse Control Issues

Poor impulse control in girls with ADHD can manifest as speaking over others, interrupting conversations, or blurting comments without considering their meaning. People often see this behavior as rudeness or lack of social awareness. However, young girls do not purposefully “highjack” conversations. Instead, they simply share their immediate thoughts and feelings.

Overcompensating for Attention Deficits

Another sign of ADHD in girls is overcompensating for attention deficits. They may go to great lengths to appear focused and attentive, putting extra effort into completing tasks or appearing organized. However, this behavior can lead to anxiety and ADHD burnout, as they constantly try to mask their difficulties.

Being on the “Go”

Girls with ADHD may also exhibit restlessness and a need to be on the “go.” They may have difficulty sitting still or staying quiet, often fidgeting or engaging in excessive physical activity. This behavior may be more subtle compared to boys with ADHD, meaning adults can easily overlook or attribute hyperactivity to normal child behavior.

Rejection Sensitive Dysphoria (RSD)

RSD in ADHD is a common experience among girls with ADHD. They may have intense emotional reactions to perceived criticism or rejection, leading to feelings of sadness, anxiety, or anger. Their responses can impact social interactions, as others may feel they must walk on eggshells when interacting with them.

Executive Dysfunction

Executive dysfunction negatively impacts the ability to plan, organize, and prioritize tasks. Because of these difficulties, girls with ADHD may struggle with time management, forgetfulness, and completing assignments on time. Such dysfunction can affect academic performance and daily functioning, with some requiring support and interventions to improve related skills.

ADHD in Girls Across Different Ages

ADHD can manifest differently as girls mature. Younger girls may fall behind developmentally, struggle with impulse control, or appear too talkative or disruptive at school. ADHD in teen girls may affect emotional regulation, sometimes leading to mood swings and irritability.

ADHD in Young Girls

In young girls, early signs of ADHD may include falling behind at school. They may struggle to keep up with their peers in language, motor skills, or social development. These behaviors can impact their academic performance and relationships, highlighting the importance of early intervention and support.

ADHD in Teen Girls

As girls transition into adolescence, they face additional unique challenges. ADHD symptoms in teen girls can include difficulty with social rejection and relationships, as many may struggle with emotional regulation and impulsivity that impacts their ability to relate with their peers. Teenage girls with ADHD may also exhibit shyness or social awkwardness, causing them to withdraw from interactions.

ADHD In Girls Vs. Boys

Biological males and females have historically demonstrated different presentations of ADHD. Many boys externalize behavioral problems related to hyperactivity. Conversely, girls with ADHD often experienced internalized symptoms like inattention and emotional dysregulation.

Another significant difference is the female connection to perfectionism. In many cases, societal pressures can lead girls with ADHD to set unrealistic expectations for themselves, frequently leading to low self-esteem and self-judgment.

Why Does ADHD In Girls Go Unnoticed?

Many factors contribute to low female ADHD diagnosis rates. As mentioned, signs of ADHD in young girls are often less apparent than in boys with ADHD. Moreover, girls may develop coping strategies to mask their ADHD, learning to accept this camouflaging behavior as “normal.” Unfortunately, becoming adept at hiding their symptoms means many girls miss opportunities to receive support or diagnosis.⁵

The “female protective effect” theory suggests girls and women have to reach a higher threshold for others to deem their symptoms “legitimate.” This concept transcends into the medical community, thus influencing who is eligible for diagnostic testing and treatment.⁶

Challenges for Girls With ADHD

Girls with ADHD may face several challenges that can impact their daily lives and overall well-being. Some of these complications include low self-esteem, as difficulty with attention and organization can impact academic success. Additionally, girls with ADHD have a higher risk of experiencing anxiety related to social relationships. Early intervention and support can help mitigate these impacts and improve outcomes.

Below are possible complications for girls with ADHD:

• Low self-esteem: Girls with ADHD may feel different or isolated from peers, sometimes contributing to low self-esteem.
• Higher risk of self-harm: Girls with ADHD have a higher risk of engaging in self-harming behaviors, possibly due to the challenges they face in social relationships, school performance, or emotional dysregulation.
• Depression and anxiety: Managing symptoms of ADHD in a neurotypical-designed world can impact self-esteem and confidence, sometimes leading to depression or anxiety.
• Social difficulties: Girls with ADHD may face challenges with interpersonal relationships and feel rejected or isolated by their peers.
• Academic struggles: Difficulty with attention and organization can impact academic success, leading to lower grades and frustration with school.
• Risk-taking behaviors: Impulsivity may lead to risky behaviors such as substance abuse, dangerous driving, or unsafe sexual practices.

Causes & Risk Factors of ADHD in Girls

The exact causes of ADHD in girls are not fully understood. However, experts suggest a combination of genetic, neurological, and environmental factors affect development. Girls with a family history of ADHD are more likely to develop the condition. Additionally, exposure to toxins during pregnancy, premature birth, low birth weight, and maternal smoking or substance abuse may also increase the risk.

Possible causes of ADHD in girls include:

• Genetic factors: Girls with immediate family members who have ADHD are at a higher risk of developing the condition.
• Neurotransmitter imbalances: Those with ADHD often exhibit dopamine and norepinephrine imbalances, possibly contributing to inattention, impulsivity, and hyperactivity.
• Brain anatomy and function: Differences in brain structure responsible for attention, impulse control, and executive functioning may contribute to ADHD.
• Environmental factors: Exposure to certain environmental factors during prenatal or early childhood stages, such as toxins, maternal smoking, or substance abuse, may increase the risk of developing ADHD.
• Brain injuries: Traumatic brain injuries or damage to certain parts of the brain can lead to ADHD-like symptoms like impaired attention and impulse control.

How Is ADHD in Girls Diagnosed?

Diagnosing ADHD in girls typically includes a comprehensive evaluation process. Professionals gather information from multiple sources, including parents, teachers, and other relevant individuals.

A diagnostic process for ADHD in girls may include:

• Clinical interviews: Healthcare professionals conduct interviews with the child and their parents or guardians to gather information about behavior, symptoms, and developmental history.
• ADHD rating scales: Standardized scales help assess and quantify the severity of ADHD symptoms, including inattention, hyperactivity, and impulsivity.
• Behavior and symptom observations: Observing behavior and symptoms in various settings (i.e., school or home) can provide valuable insights into functioning and help confirm the presence of ADHD.
• Medical Examination: A medical examination can rule out potential underlying medical conditions or factors that could contribute to ADHD-like symptoms.

Treatment for ADHD in Girls

Without treatment, ADHD can impact social or academic engagements for girls. Over time, they may experience severe consequences in adulthood as they struggle to maintain employment or stable housing. However, early intervention can help mitigate these potential challenges. Treatment outcomes may differ for girls with ADHD, but medication and therapy can provide the support they need to develop and grow.

Medication

Several medications for ADHD, including stimulants or non-stimulants, can help girls with ADHD manage their symptoms. However, parents should consider various biological and individual factors before consulting a pediatrician about medication. Some research suggests that hormones play a role in pharmaceutical treatment response during the different phases of the menstrual cycle.^{7, 8}

Many parents are apprehensive about ADHD medications for kids because of potential side effects. However, consider a cost-benefit analysis–the severity of ADHD may outweigh the risk of adverse effects.

Try to view medication as a way to explore what works for your child. A pediatrician or prescriber can always provide a tapering dose if you and your child determine that medications are not a good fit. Other ADHD treatments for children may prove more helpful, and you will likely face trial and error before finding the best approach.

Below are common medications for ADHD in girls:

Stimulants

• Adderall (amphetamine/dextroamphetamine)
• Ritalin (methylphenidate)
• Concerta (methylphenidate extended-release)
• Vyvanse (lisdexamfetamine dimesylate)

Non-Stimulants

• Strattera (atomoxetine)
• Intuniv (guanfacine extended-release)
• Kapvay (clonidine extended-release)

Therapy

Medication can aid in symptom management for girls with ADHD, but cognitive and behavioral therapies also play a role in treatment. Finding a neurodiversity-affirming therapist can help ensure your daughter or loved one receives informed care, as these professionals understand the unique way neurodivergent brains work. Like with any mental health disorder, acceptance and validation play an essential role in the quality of treatment.

Other times, girls may enter therapy without knowing they may have ADHD. A skilled therapist will openly discuss ADHD symptoms, make recommendations for testing or medicinal treatment, and work with the patient to develop skills and a better understanding of their strengths.

Therapies for ADHD in girls may include:

• Cognitive behavioral therapy (CBT): CBT for ADHD is an effective way to recognize, confront, and replace unhelpful thoughts. This approach can help girls examine their self-esteem and embrace neurodiversity instead of focusing on perceived deficits.
• Family therapy: Family therapy involves the entire family in the treatment process to improve communication, understanding, and support by creating an environment that promotes positive behavior and reduces conflicts related to ADHD symptoms.
• Occupational therapy: Occupational therapy focuses on improving functioning and independence in daily activities. For girls with ADHD, occupational therapy can help with time management, developing organizational skills, and improving focus.
• Social skills training: This therapy helps girls with ADHD learn and practice social skills, such as listening, making eye contact, and understanding social cues. Social skills training can improve their ability to interact with peers and establish healthy relationships.
• Support groups: Support groups can give girls a sense of community and understanding. They can share experiences, receive support, and learn strategies for managing ADHD symptoms from peers and facilitators.

How to Support a Girl With ADHD

Supporting a girl with ADHD means providing understanding, structure, and encouragement. Consider creating a consistent routine, breaking tasks into manageable steps, setting clear expectations, and offering positive reinforcement for their efforts and achievements. Additionally, offering a safe and supportive environment and promoting self-advocacy can contribute to her well-being and success. Seeking guidance from healthcare professionals and staying educated about ADHD can also aid in providing effective support.

Below are tips for supporting a girl with ADHD:

• Seek out helpful accommodations: Work with teachers and other professionals to explore accommodations to support her learning styles, such as preferential seating, flexible assignments, or assistive technology.
• Praise their strengths: Recognize and celebrate her strengths and accomplishments to boost her self-esteem and confidence.
• Provide clear and consistent expectations: Set clear expectations for behavior and communicate them in a consistent and structured manner to help her understand.
• Break tasks into manageable steps: Help her break down tasks into smaller, more manageable steps to avoid feeling overwhelmed and improve focus and completion.
• Create a structured routine: Establish and maintain a consistent daily routine to provide predictability and help her manage her time and responsibilities better.
• Encourage regular physical activity: Engage in regular physical activities, such as sports or exercise, to reduce hyperactivity, improve focus, and manage stress.
• Teach and practice organization skills: Provide guidance and practice for organizing belongings, keeping track of assignments, and managing time effectively.
• Foster self-advocacy skills: Encourage your child to understand her strengths and challenges. Teach her to communicate her needs, ask for help when necessary, and advocate for herself in various settings.
• Cultivate a supportive environment: Create a safe and supportive environment at home and school where she feels understood, accepted, and encouraged to express herself.
• Educate yourself and others about ADHD: Stay informed about ADHD symptoms, treatment options, and strategies to better understand and support your child. Educating family members, teachers, and other close individuals about ADHD can also help improve support and communication.