ADHD in Women: Why Diagnosis Matters and How It Affects Life

ADHD and Its Gender Differences

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects attention, impulsivity, and self-control. Studies estimate its prevalence at 7.1% among children and adolescents and 2.5–5% in adults (Da Silva et al., 2020).

However, there is a gender gap in ADHD diagnosis. Boys are diagnosed 3 to 16 times more often than girls (Mowlem et al., 2018), leaving many women undiagnosed and without proper support. This can have serious consequences for their mental and social well-being in the long run.

Why Are Women Often Undiagnosed?

Historically, ADHD was considered a "childhood" and "male" disorder because boys more often display hyperactivity, whereas girls tend to have subtler symptoms — such as inattention, forgetfulness, and anxiety (Nussbaum, 2012).

Many women with ADHD learn to mask their difficulties, striving to appear organized and responsible (Waite, 2010). Their symptoms are often misattributed to stress, fatigue, perfectionism, or emotional difficulties. As a result, they may receive misdiagnoses such as depression, anxiety, or bipolar disorder — without realizing that ADHD is the root cause.

Key Reasons Why Women Are Less Likely to Be Diagnosed with ADHD:

• Subtle symptoms – Instead of hyperactivity, women often experience inattention, forgetfulness, and anxiety (Mowlem et al., 2018).

• Social pressure – Girls are conditioned to be organized and responsible, making them more likely to mask their struggles (Holthe, 2013).

• Lack of awareness – Teachers and parents are less informed about ADHD in girls (Quinn & Wigal, 2004; Lynch & Davison, 2022). Even psychologists rarely suspect ADHD in adult women if it wasn't diagnosed in childhood (Faraone et al., 2004).

• Misdiagnoses – Women are often diagnosed first with depression, anxiety, or even bipolar disorder (Quinn, 2005).

• Less disruptive behavior – Girls are less likely to show problematic behaviors in school, reducing the likelihood of early diagnosis compared to boys with visible hyperactivity (Waite, 2010; Mowlem et al., 2018).

ADHD, Hormonal Changes, and Their Impact on Women

New research suggests that hormonal fluctuations significantly affect ADHD symptoms in women. Experts, including Professor Russell Barkley, note that ADHD symptoms may worsen during the menstrual cycle, puberty, pregnancy, and menopause (Ashley G. Eng et al., 2024). Higher estrogen levels can improve cognitive function, whereas estrogen declines can lead to increased inattention and impulsivity. Critical periods for women with ADHD include: pregnancy – hormonal shifts may intensify ADHD symptoms, menopause – estrogen decline can worsen cognitive functioning.

This explains why many women receive an ADHD diagnosis in adulthood, when hormonal changes start significantly affecting their lives.

How ADHD Affects Social Relationships

Women with ADHD often struggle to build and maintain relationships due to differences in thinking, emotional regulation, and behavior. This impacts friendships, romantic relationships, and workplace interactions.

Women with ADHD May:

• Feel "different" and struggle with social norms.

They may find it difficult to follow conversations, avoid distractions, and navigate social expectations. Others might label them as "too emotional" or "disorganized", leading to feelings of isolation.

• Experience emotional instability in relationships. 

ADHD is linked to heightened emotional reactivity, making it harder to or set boundaries.

• Face misunderstandings at work and home. 

Many women hear criticism for forgetfulness or disorganization from family members and colleagues.At work, they may work harder than others yet struggle with focus and consistency, leading to negative evaluations.

• Enter unhealthy relationships due to low self-esteem.

Undiagnosed ADHD can make women feel "not good enough," leading them to tolerate toxic or abusive relationships.

The Impact of ADHD on Mental Health

Without timely diagnosis and treatment, women with ADHD may struggle for years with invisible challenges, leading to hopelessness and self-blame. Women with ADHD have a higher risk of developing comorbid conditions, including:

• Depression & Anxiety – Women with ADHD are 2-3 times more likely to experience mood disorders (Lynch & Davison, 2022).

  
  

• Eating Disorders – They are 3-4 times more likely to suffer from bulimia or binge-eating disorder (Mowlem et al., 2018).

  
  

• Sleep Disorders – Many struggle with insomnia and poor sleep routines due to racing thoughts and lack of structure.

  
  

• Addiction – Women with ADHD are more prone to substance abuse (alcohol, drugs) and impulsive spending.

Why Diagnosis Matters

Many women with undiagnosed ADHD have been labeled as: "Lazy." , "Too emotional.", "Disorganized." , "A daydreamer." But the real issue is not personality —it’s neurobiology. Women who receive an accurate ADHD diagnosis often feel a huge sense of relief, as it helps them understand themselves better and find effective symptom management strategies.

Getting a Diagnosis Can Help Women:

✔ Improve self-esteem

✔ Develop effective organization strategies

✔ Reduce anxiety

✔ Build healthier relationships

✔ Enhance productivity at work and in studies

How to Improve Life with ADHD

✔ Diagnosis – The first step toward understanding yourself and getting the right support.

✔ Medication (if prescribed by a doctor) – Can help enhance focus and emotional regulation.

✔ Therapy (CBT, ADHD coaching, or support groups) – Helps develop coping strategies and reframe negative thought patterns.

✔ Self-acceptance – Learning to embrace one’s unique strengths and challenges.

✔ Supportive environment – Connecting with understanding people who recognize the reality of ADHD.

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Посилання на використані джерела:

1. Da Silva A. G., Malloy-Diniz L. F., Garcia M. S., Rocha R. (2020). Attention- deficit/hyperactivity disorder and women. https://doi.org/10.1007/978-3-030-29081-8

2. Mowlem F. D., Rosenqvist M. A., Martin J., Lichtenstein P., Asherson P., Larsson H. (2018). Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. https://doi.org/10.1007/s00787-018-1211-3

3. Nicole Crawford. (2003). ADHD: a women's issue. https://www.apa.org/monitor/feb03/adhd

4. Darby E. Attoe and Emma A. Climie. (2023). Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. Miss. Diagnosis: A Systematic Review of ADHD in Adult Women - Darby E. Attoe, Emma A. Climie, 2023

5. Ashley G. Eng. (2024). Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence - ScienceDirect