ADHD in Women: 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 Typically, the onset of symptoms occurs in childhood but continues into adulthood. Those with adult ADHD can experience impacts on their ability to perform in school or at work, and some may also have difficulty managing social relationships.

Below are the types of ADHD:

• Inattentive ADHD: Inattentive ADHD results in difficulties sustaining attention, distractibility, and poor organization skills.
• Hyperactive/impulsive ADHD: Hyperactive/impulsive ADHD refers to excessive physical activity, difficulty staying seated, and impulsive behavior.
• Combined ADHD: Combined ADHD is the most common type and presents symptoms of both inattentive and hyperactive/impulsive ADHD.

ADHD Symptoms In Women

ADHD in women often presents primarily as inattentive ADHD, leading to difficulties with organization, time management, and similar skills. However, ADHD symptoms in adult women vary significantly depending on the individual, their environment, and other factors.

In many cases, women with ADHD may appear more “high-functioning” than men with ADHD, as many have become experts at ADHD masking. Unfortunately, this camouflaging behavior and a pre-existing clinical bias toward men with ADHD means professionals frequently misdiagnose or overlook symptoms of ADHD in adult women.

Common symptoms of ADHD in women include:

Inattentive symptoms 

• Difficulty sustaining attention on tasks or activities
• Getting easily distracted by external stimuli
• Forgetfulness
• Frequently losing or misplacing belongings
• Avoiding or disliking activities that require sustained mental effort
• Difficulty following instructions or completing tasks
• Poor organization skills
• Difficulty managing time
• Frequently making careless mistakes

Hyperactive/impulsive symptoms

• Difficulty sitting still or constantly fidgeting
• Excessive talking
• Restlessness and feeling “on the go”
• Difficulty in engaging in quiet activities or relaxing
• Impulsive behaviors such as interrupting others or intruding into conversations or activities
• Difficulty in waiting for their turn in situations
• Tendency to blurt out answers or respond impulsively without thinking through the consequences.

Signs of ADHD in Women

Women with ADHD may have more difficulties with inattentive symptoms, such as poor time management or organization skills. They may also be more sensitive to criticism, leading to low self-esteem and shame. Additional signs of ADHD in women include emotional dysregulation, hyperfixation, and risky behavior.

Below are common signs of ADHD in women:

Shame About Symptoms

Many women with ADHD may experience shame when struggling to meet societal standards of productivity and time management. They may feel inferior to their neurotypical peers and attempt to hide their symptoms to avoid rejection. While their symptoms do not reflect personal failure or lack of effort, women may struggle to accept their differences impact their functioning.

Rejection Sensitive Dysphoria

Rejection sensitive dysphoria (RSD) is a common symptom of ADHD, especially in women. Rejection sensitivity in ADHD may look like extreme reactions to being teased or feeling like a disappointment to partners, family, or friends. Women with ADHD may struggle with any perceived criticism, attributing comments to critical flaws in their personality. This hypersensitivity can contribute to low self-esteem and social withdrawal.

Chronic Procrastination

Women with ADHD may struggle to initiate and complete tasks, sometimes leading to procrastination. Poor task initiation can occur for several reasons, such as executive dysfunction or fears of criticism. Regardless, this pattern can impact their ability to perform at work, fulfill responsibilities, or support their relationships.

Poor Time Management

Poor time management is another facet of ADHD in women. They may struggle with estimating the time required for tasks, prioritizing activities, and organizing their schedules effectively. In turn, women may miss appointments, leave projects unfinished, or feel under constant pressure.

Emotional Dysregulation

Emotional dysregulation can manifest as heightened sensitivity, irritability, anger, or overwhelm. For example, women with ADHD may appear overly sensitive to stress, struggling to stay grounded or balanced when encountering difficult situations. Unfortunately, these fluctuations can impact relationships, mental well-being, and overall quality of life.

Poor Organization Skills

Some women with ADHD report difficulties with time management, especially with concrete tasks, such as managing finances. Others may struggle with more subjective experiences, like maintaining a work-life balance.

Difficulty Listening

Difficulty listening and understanding instructions are common signs of ADHD in adult women. They may get easily distracted by external stimuli, leading to miscommunications about tasks, dates, or projects. Some women may appear disengaged or uninterested during conversations, but this behavior is likely due to constant internal dialogues or racing ADHD thoughts.

Hyperfixation or Hyperfocus

Hyperfixation or hyperfocus includes periods of intense concentration on tasks. This behavior can manifest as complete absorption in a specific activity, such as reading, gaming, or working. Unhealthy and unmanaged hyperfocus can interfere with daily responsibilities, including self-care, work, or parental obligations.

Risky Behaviors

Adult ADHD in women may also manifest as an increased risk of risky behavior, such as substance use or unprotected sex. Driving with ADHD can be risky due to impulsivity and risk taking behaviors. These tendencies may stem from difficulties managing emotions or dopamine-seeking behavior.

ADHD In Women Vs. Men

ADHD in women can differ from traditional presentations seen in men. Females may exhibit more internalized symptoms, such as daydreaming, inattentiveness, and emotional dysregulation, than hyperactivity. Because these behaviors are less disruptive, undiagnosed ADHD in women is common. Additionally, societal expectations and gender roles may lead women to compensate for their perceived deficits, meaning they may engage in ADHD masking more so than males.

Why Is ADHD Overlooked in Women?

Biologically-born males are diagnosed with ADHD more often than females, with some research suggesting the ratio is as high as 10 to 1.^1,2 Because women with ADHD more commonly exhibit inattentive symptoms, caregivers and professionals can easily overlook their support needs.

A lot of research supports the idea of a gender bias in the diagnostic criteria for ADHD, with adults recognizing hyperactive ADHD symptoms in boys while assuming girls with ADHD are just emotional or shy.^1,2,3,4,5

When looking at comorbidities, women with ADHD are more likely to be diagnosed with major depression than ADHD.³ In other cases, people may attribute distractibility, disorganization, and poor time management to laziness. However, this assumption comes from incomplete information and psychoeducation about the condition.

Below are reasons why ADHD may be underdiagnosed in women:

• Symptom presentation: Women with ADHD may exhibit more inattentive symptoms. These differences are often less significant indicators.
• Clinical bias: Some healthcare professionals still view ADHD as a predominantly male disorder, meaning they may misattribute symptoms in women to other diagnoses.
• Less research available: Research specifically on ADHD in women is limited, as studies have traditionally focused on presentations and treatment in boys and men. This lack of comprehensive evidence can hinder healthcare professionals from accurately assessing and diagnosing ADHD in women.
• Stereotypes: The perception that ADHD is primarily a childhood disorder or only manifests as hyperactivity can lead healthcare providers to dismiss symptoms in adult women. This misinformation perpetuates a lack of awareness about the full range of ADHD symptoms in women.
• Criteria discrepancies: The symptoms more commonly associated with women, such as inattentiveness and emotional dysregulation, may not be adequately captured in existing diagnostic criteria, potentially leading to misdiagnosis or missed diagnosis.

What Causes ADHD in Women?

The causes of ADHD in women are multifactorial, often including a combination of genetic, neurological, and environmental components. Brain differences, such as structural or functional abnormalities, are also implicated in ADHD. Moreover, prenatal complications may increase the likelihood of developing the condition. However, experiencing these risk factors does not necessarily mean someone will have ADHD.

Causes of ADHD in women may include:

• Genetics: ADHD tends to run in families, suggesting a strong genetic component.
• Brain differences: Research has shown individuals with ADHD have differences in brain structure and functioning, particularly in areas related to attention, impulse control, and executive function.
• Neurotransmitter imbalances: ADHD is associated with dopamine and norepinephrine imbalances. These neurotransmitters play a role in regulating attention, motivation, and impulse control.
• Environmental factors: Prenatal exposure to substances like tobacco smoke, alcohol, drugs, or lead may increase the risk of developing ADHD.
• Maternal factors: Poor nutrition, mental health conditions, or stress during pregnancy may also contribute to the development of ADHD in women.

Complications of ADHD in Women

Complications of undiagnosed ADHD in adult women are numerous and can affect various aspects of life. Women may be at an increased risk of anxiety, depression, and low self-worth. These challenges may further exacerbate pre-existing academic, professional, and relational problems.

Impacts of ADHD symptoms in women may include:

• Financial difficulties: ADHD symptoms can lead to financial challenges due to impulsive spending, poor budgeting skills, and unemployment.
• Poor coping skills: Women with ADHD may struggle with stress management, which can lead to increased levels of anxiety and overwhelm.
• Higher risk of bullying: ADHD symptoms can make women more vulnerable to bullying due to difficulties with social interaction, impulse control, and executive functioning.
• Academic or professional underachievement: Difficulties with attention, organization, and time management can contribute to underachievement in academic settings or the workplace, potentially leading to lower grades, missed career opportunities, or job instability.
• Relationship challenges: Communication difficulties, forgetfulness, and impulsivity can strain friendships, romantic partnerships, and familial bonds.
• Mental health issues: Women with ADHD may have a higher risk of developing mental health conditions like anxiety, depression, and low self-esteem, as managing ADHD symptoms can be emotionally taxing and lead to feelings of frustration and inadequacy.
• Parenting difficulties: Moms with ADHD may face additional challenges while juggling the demands of parenting, which can impact their ability to provide consistent structure and discipline.

ADHD in Women & Co-Occurring Conditions

ADHD in adult females may co-occur with other conditions, including anxiety disorders, substance use disorders, depression, and eating disorders. Comorbidities can exacerbate ADHD symptoms, leading to poorer overall functioning and a reduced quality of life.

Conditions that commonly co-occur with ADHD in women include:

• Depression: Women with ADHD may be at a higher risk of developing depression, possibly due to ongoing struggles with ADHD symptoms, low self-esteem, and relationship or professional challenges.
• Anxiety disorders: ADHD and anxiety commonly co-occur, as executive dysfunction and different social skills can contribute to excessive worry and nervousness.
• Disordered eating: Some women with ADHD may experience disordered eating patterns, such as binge or restrictive eating. Impulsivity and emotional dysregulation may contribute to these behaviors.
• Substance use disorders: Women with ADHD have an increased risk of developing substance use disorders, whether as a coping mechanism or product of impulsivity.
• Learning disabilities: ADHD is not a learning disability but can coexist with conditions like dyslexia or dyscalculia. These challenges can further impact academic performance and success.
• Borderline personality disorder (BPD): Symptoms of impulsivity, emotional dysregulation, and difficulty with self-identity may overlap between ADHD and BPD, requiring specialized treatment approaches.

How to Get Diagnosed With ADHD as a Woman

Getting diagnosed with ADHD as a woman involves a professional evaluation, typically through assessment of symptoms, medical history, and childhood and adult experiences. Finding a clinician with knowledge and expertise in female ADHD is essential, as they understand the nuance of symptom presentation. They can help develop a treatment plan tailored to your needs if they determine ADHD is an appropriate diagnosis.

Treatment for ADHD in Adult Women

One of the most common treatments for adult ADHD in women is stimulants. Other medications may include non-stimulants and antidepressants. These prescriptions can help with symptom management, allowing women to better cope with challenges related to inattention and impulsivity.

Along with medication, therapy can be an invaluable asset. Untreated ADHD in women can contribute to various difficulties across all aspects of life, but therapy can provide them with the tools to address these complications and make positive changes.

Medication for ADHD

Medications for ADHD can effectively reduce symptoms and improve daily functioning. Several types are available, including stimulants and non-stimulants. Stimulants are a first-line option that increases neurotransmitters in the brain to boost attention, focus, and impulse control. Non-stimulants can be an alternative for individuals who cannot tolerate stimulants or have specific concerns about potential risks.

A healthcare professional can evaluate your symptoms and medical history to determine what medication suits your needs. Adverse effects vary from person to person, so consult your provider if you notice any uncomfortable or unmanageable reactions.

Below are common medications for females with ADHD:

• Adderall (amphetamine/dextroamphetamine)
• Ritalin (methylphenidate)
• Vyvanse (lisdexamfetamine)
• Concerta (methylphenidate)
• Strattera (atomoxetine)
• Wellbutrin (bupropion)

Therapy for ADHD

Many therapies are available for women seeking support with symptom management. Finding a neurodiverse-affirming therapist can be beneficial as these providers have experience working with individuals on the ADHD spectrum. They can help you learn coping skills specifically for issues related to inattention or impulsivity so you can practice positive symptom management.

Therapy options for ADHD in women may include:

• Cognitive behavioral therapy (CBT): CBT for ADHD helps clients examine how much their thought patterns impact functioning or ability to complete tasks.
• Dialectical behavior therapy (DBT): DBT combines elements of CBT with mindfulness techniques to help individuals with ADHD develop emotion regulation, distress tolerance, and interpersonal effectiveness skills.
• Acceptance and commitment therapy (ACT): ACT focuses on accepting difficult thoughts and feelings while committing to actions that align with personal values. This approach promotes self-awareness, acceptance, and healthy coping strategies.
• Occupational therapy: Occupational therapy for ADHD aims to improve functional skills and daily routines by helping individuals develop strategies to manage time, organize tasks, and improve independence.
• Family therapy: Family therapy involves the participation of family members in therapy sessions to promote mutual understanding, communication, and support.
• Couples counseling: Couples counseling focuses on improving communication in a relationship. Counseling can help couples understand how ADHD impacts their relationship and develop strategies to manage challenges together.

Can ADHD in Women Be Prevented?

Preventing ADHD in women, or anyone, is impossible. As mentioned, various factors influence the development of ADHD, and attempting to change or alter these components is unrealistic. However, individuals can practice specific strategies to improve functioning and symptom management.

Early identification and diagnosis are essential when seeking appropriate support. Additionally, creating a supportive environment with accommodations at home, school, and work can help women with ADHD thrive.

How to Cope With ADHD as a Woman

Coping with ADHD as a woman involves a combination of strategies, such as seeking professional support, developing routines, practicing self-care, and prioritizing physical health. Moreover, educating yourself about ADHD can empower you to continue pursuing your goals and personal growth.

Here are tips for coping with ADHD as a woman:

• Take medications as prescribed: Continue taking your medication to ensure you feel at your best.
• Seek therapy or counseling: Therapy can provide strategies for managing ADHD symptoms, improving time management, and enhancing coping skills.
• Develop routines and organizational systems: Structured routines can help you stay on task and reduce the likelihood of forgetting important dates, appointments, or projects.
• Utilize assistive technologies: Use calendars, alarms, or organizational apps to boost planning, prioritizing, and organization.
• Practice self-care and stress management: Engage in activities that promote relaxation and reduce stress, such as exercise, mindfulness, meditation, and adequate sleep.
• Seek support from loved ones: Share your experiences and challenges with trusted friends, family members, or support groups who can provide understanding, encouragement, and practical support.
• Prioritize and break tasks down: Breaking tasks into smaller, manageable steps can make them more achievable, and prioritizing can help with time management and reducing overwhelm.
• Communicate openly with employers and educators: Advocating for necessary accommodations, such as flexible schedules or modified workspaces, can support success in the workplace or educational settings.
• Maintain a healthy lifestyle: Eating a balanced diet, staying physically active, and managing stress can contribute to overall well-being and healthy symptom management.
• Educate yourself and others: Learn about ADHD to feel equipped when coping with any challenges. Sharing this information with others can promote understanding and support.