Content reviewed and updated: 02/26/21
ADHD in Women
Both men and women can have ADHD, but men are more likely than women to be diagnosed with this condition. In fact, when it comes to adults with ADHD, for every 2 men diagnosed, only 1 woman is diagnosed. Why the disparity? For starters, ADHD research has generally focused on men, and ADHD in women often presents with symptoms different from those in men. What’s more, ADHD symptoms in women are sometimes attributed to causes other than ADHD.
Given the available ADHD research to date, the present article refers to gender in the binary sense, but ADHD can affect anyone who falls anywhere on the gender spectrum. Read on to learn more about ADHD in women.
ADHD in women vs. men
Historically, ADHD research primarily revolved around men, but research on ADHD in women is currently expanding. Even so, the criteria used today to diagnose ADHD are still generally based on observations in young boys, and studies performed to test these criteria have typically included more boys and men than girls and women. Plus, girls and women are less likely than boys and men to be referred for ADHD diagnosis and treatment. This all means that the picture of how ADHD looks in different populations, particularly in women, is still developing.
A common misperception is that ADHD is only found in young boys. Young girls with ADHD, who show different symptoms and behaviors than boys do, are less likely to be suspected of having the disorder. ADHD is 9 times more common in boys than in girls. It makes sense, then, that the classic picture of ADHD involves a young boy, and most likely one who is bouncing off the walls, speaking out of turn in class, and unable to sit still.
A girl or woman with ADHD is less likely to fit the stereotype of the disorder. Instead, ADHD in a young girl might manifest as her staring at the clouds outside her classroom window, too distracted to finish her work. ADHD symptoms in a girl might also be misconstrued as certain character traits, such as being a chatterbox, though in girls with ADHD this presentation is less common than being inattentive or distracted. It is common for parents and teachers to overlook such variations in ADHD symptoms in girls. Girls are therefore less likely to be referred to a specialist for treatment, leading to missed diagnoses.
There are 3 types of ADHD: hyperactive-impulsive, inattentive, and combined type. While young boys with ADHD are typically diagnosed with the hyperactive-impulsive type, young girls with ADHD are twice as likely to be diagnosed with the inattentive type.
Although some boys and girls with ADHD outgrow it by the time they are adults, almost 65% of children with ADHD experience symptoms well into adulthood. For adult men and women alike, these symptoms can be debilitating, affecting things like work schedules and social interactions to varying degrees.
Symptoms of ADHD in women
Young girls and boys tend to exhibit different signs and symptoms of ADHD, and similarly, the symptoms of ADHD in women are usually more subtle than those in men. Women can show symptoms of hyperactive-impulsive, inattentive, or combined type ADHD. The symptoms associated with each type of ADHD are defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which providers use to help diagnose mental health conditions. The signs and symptoms of ADHD in women generally include:
- Being easily distracted while doing school or work tasks
- Being quiet or withdrawn in social situations
- Being extremely talkative or interruptive during conversations
- Having difficulty remembering important information or peoples’ names
- Having trouble paying attention during conversations with friends, family, or coworkers
- Having trouble relaxing
- Having a cluttered home and/or personal workspace
- Missing work deadlines
- Having difficulty organizing materials for school or work
- Having trouble working in an office environment because of noise or other distractions
- Staying late at work to finish projects that piled up throughout the day
- Having sudden urges to spend money or go on shopping sprees in order to cope with stress
- Feeling frustrated with not being able to make important decisions or reach certain goals
The symptoms of ADHD can make things hard to accomplish, and deeply ingrained societal expectations based on gender may be related to women’s experiences with ADHD. Many women take on the bulk of household duties and parental responsibilities. Since those with ADHD often have trouble with executive functioning (managing their thoughts, time, productivity, etc.), piling on such demands, for themselves and also for others, can lead to heightened feelings of anxiety.
For someone with ADHD, it can be exceedingly difficult to manage work, family, and other aspects of life. The overwhelming feelings associated with various responsibilities can circle back and worsen the symptoms of ADHD, leading to other issues, such as feelings of inadequacy and low self-esteem. Consistent feelings of inadequacy and low self-esteem can then lead to depression or anxiety.
Diagnosing ADHD in women
Many women with ADHD are diagnosed later in life. Women might not seek help until their symptoms become more apparent to them or others, or until their lives feel out of control. For example, women starting college or a new career may experience more stress than normal, which could lead to more pronounced symptoms.
ADHD symptoms may also be more noticeable or intense during menstruation or pregnancy due to hormonal changes. Fluctuations in estrogen and progesterone levels can affect attention, memory, and executive functioning. Studies have shown that very high or very low hormone levels may reduce cognitive performance, which can influence the development or worsening of ADHD symptoms.
ADHD can also be genetic, so it is possible that some women might only consider the idea that they themselves have ADHD after their child is diagnosed.
A mental health provider, such as a psychiatric-mental health nurse practitioner (PMHNP), can help diagnose someone with ADHD through a clinical assessment. This assessment may consist of a questionnaire. A provider might ask questions about daily habits, social life, and work. They might also try to rule out other mental health conditions (e.g., anxiety) or physical health conditions (e.g., hyperthyroidism) that may present with symptoms similar to those of ADHD.
Questions a provider might ask during an ADHD assessment include:
- How often are you distracted by your external environment or random, disruptive thoughts?
- How often do you have trouble listening or engaging in conversations with coworkers, friends, or loved ones?
- Do you tend to forget appointments, important dates, or bill payments?
- Do you often misplace important items like your keys or purse?
A well-versed provider will be able to discern the root cause(s) of the symptoms being experienced.
Conditions associated with ADHD in women
The following conditions are commonly associated with ADHD in women:
- Anxiety disorders, such as generalized anxiety disorder, panic disorder, social phobia, and obsessive compulsive disorder (OCD)
- Mood disorders, such as major depressive disorder and bipolar disorder
- Sleep disorders, such as insomnia
- Substance use disorders, such as alcohol or drug abuse
- Eating disorders, such as anorexia, bulimia, or compulsive eating
Women with ADHD may be prone to developing these additional mental health conditions. Women with ADHD often feel ashamed, perhaps because they forgot a loved one’s birthday or arrived late to an important meeting. Some women with ADHD might even refrain from seeing their coworkers, family, and friends since societal pressure, and even self-pressure, can make it hard to feel like they are living up to certain roles or expectations in the workplace, at home, and among their social groups. These feelings can lead to problems with sleep and mood, and women with ADHD may also be at an increased risk of attempting suicide.
Some of these associated conditions have symptoms that overlap with those of ADHD. For example, excessive worry associated with an anxiety disorder can lead to difficulty concentrating or planning, which are prominent symptoms of ADHD. Because of this overlap, ADHD in women is sometimes misdiagnosed as an anxiety or mood disorder.
The possibility of comorbid conditions highlights the importance of early treatment of ADHD in women. Effective treatment of ADHD may prevent the development of other mental conditions. An accurate diagnosis by a licensed professional is needed to ensure prompt and appropriate treatment.
Treating ADHD in women
If a woman with ADHD does not have an official diagnosis, then they may not get the help and support they need. After being diagnosed by a certified provider, someone with ADHD can start getting treatment, typically with medication and/or talk therapy. Treatment can give someone with ADHD a greater sense of control and relief. They can regain their focus and learn how to be more confident at work and with their friends and family.
Women can learn about effective behavioral changes, and which ones to make and how, with the help and guidance of a mental health provider. A provider can also help people navigate feelings of shame or low self-esteem, which tend to accompany ADHD in women. In addition, a provider can help people learn organizational habits and show them how to implement daily systems that will alleviate stress, such as focusing only on select tasks on certain days.
Some stimulant medications can be effective for treating ADHD, as well. Adderall (amphetamine) is commonly prescribed to help treat all types of ADHD in both men and women. Alternatively, nonstimulant medications, such as Strattera (atomoxetine), might be recommended for those who do not or are unlikely to respond well to stimulants. Antidepressant medications might also be prescribed for women who are experiencing depression along with ADHD.
By creating awareness about how ADHD manifests in women, more women can get the treatment and support they need. There are many treatment options for women with ADHD. Talk therapy and medication are the main treatments, and support groups, such as the Attention Deficit Disorder Association (ADDA), are widely available for anyone with ADHD. Plus, with the recent growth in telehealth, it is now convenient to get treatment from online mental health providers, who are always available to meet the needs of women with ADHD.