I’ll never forget the moment I read an article that changed my life. It chronicled a word-for-word description of my lived experience—a general feeling of always playing catch up and trying to outrun my brain, wrestling with a million thoughts and paralysing indecision until I would collapse with exhaustion, and lay on the couch for hours, numb and staring blankly into space. It was my exact daily battle, down to the minute... but it was written by a person who had adult ADHD.
That’s when the lightbulb went off… did I have ADHD? Would that explain my general feeling of feeling simultaneously too much, yet never ‘enough’, or that nagging sense I hadn’t met the potential I knew I had, and couldn’t explain why?
As a former teacher, my only experience of ADHD related to young kids (mostly boys) who wouldn’t sit still, and needed IEPs and medication. I had no idea ADHD could remain present in adulthood, and furthermore, that the typical hyperactivity shows up differently in women, presenting as internalised racing thoughts rather than outward physical motion.
Late diagnosis of ADHD in women
Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition characterised by symptoms such as impulsivity, restlessness, distractibility, and difficulty focusing. Women who live with ADHD often struggle with anxiety, depression, low self-esteem, and relationship problems.
Late diagnosis among women (aged between 20 and 60) is on a steep incline. Women tend to be diagnosed with attention deficit hyperactivity disorder at an older age than men. Researchers believe this may be due to differences between boys' and girls' brains. Boys typically show symptoms of ADHD before puberty, while girls often experience these symptoms after they reach their teenage years.
In a society already medically and socially behind on actually addressing the needs of women, it’s not a huge surprise that girls with ADHD are diagnosed less than half as often. The disorder itself has no gender preference, but the squeaky wheel gets the grease, and girls with ADHD are more likely to present the quieter of the two subtypes: Inattentive. Until recently, “almost all research on ADHD has focused on boys and men, with female presentations having been largely overlooked in both clinical and research settings,” according to this 2021 scientific review.
ADHD traits tend to run in families
One of the most common stories of women getting diagnosed is that they seek a diagnosis for their young child, which in turn prompts them to consider whether they themselves have undiagnosed ADHD. While studies have shown ADHD tends to run in families, science hasn’t reached a consensus on exactly how the traits are inherited; nature or nurture, or a combination of both.
Research has found if a parent has ADHD, a child is 50% likely to develop the traits in childhood, or conversely if a child is diagnosed with ADHD, there’s a 50% chance one of their parents has ADHD (often undiagnosed.) But science hasn’t conclusively been able to establish how exactly it’s passed from parent to child, and to what extent it’s a combination of genetic neurobiology (brain wiring) ) and environmental factors (based on behaviours exhibited by one or more parents/caregivers, and unconsciously adopted by the child).
Many women report that finding an online community of females with ADHD is transformative
The experience of discovering there’s a name, body of research and entire community living with the same invisible struggles you do is simultaneously relieving, sobering and surprisingly hilarious. Many women describe that finally they found a group where they weren’t too loud, too talkative, too quirky or interrupting too much.
In Facebook threads, recently diagnosed women talk with wry cynicism about their ‘ghosts of hyperfixations past’, (a long list of hobbies they’d impulsively started, and become obsessed with, only to abandon days or weeks later).
They lament their constantly messy cars or desks, and question why the weekly grocery shop and meal prep is such a doom spiral, ad infinitum. These are not complex tasks, but women share their embarrassment and closeted shame of ‘why can’t I be like other women? Why is it so hard for me to remember school events, or that I’m rostered on canteen duty this week? Why am I always driving to Coles at 11pm to get milk for breakfast tomorrow?”
Women also report being easily overstimulated in shopping malls or other crowded spaces, walking into a room and regularly forgetting why they walked in, difficulty staying on top of household chores like washing and cleaning, and constantly underestimating how long things take, and thus running late often.
Videos on TikTok demonstrate the lesser-known ways that time blindness shows up: a feeling like you can’t get anything done the entire day if you have an important afternoon appointment looming. And then there’s the difficulty relaxing or ‘switching off’, nightly insomnia, rejection sensitivity, forgetting instructions as soon as they’re given, and trouble staying attentive on phone calls.
For women, ADHD is intertwined with complex and outdated gender roles
Not only is the female experience of ADHD uniquely different, but women are also further impacted by the “added burden of restrictive gender roles, fluctuating hormones, and a greater tendency towards self-doubt and self-harm,” reports ADDitude Magazine.
Across a lifespan, undiagnosed ADHD traits mean that girls struggle in school with daydreaming, friendship breakdowns, homework and remembering assignment due dates. In higher education, this disorganisation and inability to focus during lectures can impact their academic output. Many women, including myself, report that they almost quit university or college because they felt overwhelmed by something they couldn’t put their finger on, and this made sense when they got a diagnosis of ADHD later in life.
ADHD can run invisibly for most of a girl’s life, put down largely to quirky or rebellious personality traits until a woman reaches motherhood. At that point, the functional demands on her to care sometimes 24/7 for small, unpredictable humans far outweighs her executive functioning capacity, as Dr. Edward Hallowell notes in his book ADHD 2.0.
In the case of motherhood, “the organisational demands of daily life skyrocket and the mother shows the symptoms of ADHD that she had been able to compensate for in the past,” writes Dr. Hallowell.
The ADHD and PMS link
Women’s ADHD symptoms are also influenced by their menstrual cycle in ways that science is only just beginning to understand, with much more yet to be discovered.
“During the week before menstruation begins, increasing progesterone and declining dopamine can provoke and exasperate ADHD symptoms such as irritability, forgetfulness, and impulsivity (often at the same time) and heighten emotional dysregulation,” writes ADDitude Mag.
At the same time, many ADHD women also report that during the ovulation phase of their cycle, they have increased energy, increased productivity and can work for 14+ hours a day hyperfocusing if they’re interested in something.
Is it me or is it my brain condition?
The final piece is the effect symptoms of forgetfulness, distractibility, impulsivity and emotional regulation have on your sense of self. A friend who doesn’t understand why you’d miss their birthday might call you selfish. A teacher who tried to explain something while you were inattentive might call you unintelligent. A new romantic partner who caught an outburst might call you ditzy or crazy. A boss may fire you for forgetting to turn up for that important presentation with a major client (you had the wrong date in your calendar).
A child or family member who relied too heavily on you during a moment where overwhelm got the best of you might consider you to be a bad caretaker or not nurturing.
If you don’t take these on board, you risk losing touch with reality and losing jobs, relationships and opportunities. If you do take them on board, how do you manage to see yourself in a positive light?
Women with ADHD can often stack up accompanying disorders. The most common seem to be:
- Generalised Anxiety Disorder
- Disordered Eating and diagnosed Eating Disorders
- Alcohol and Substance Abuse
- Sleep Difficulties
- Mood Disorders
- Tic disorders
- Chronic Fatigue Syndrome
- Body Dysmorphia
And in terms of other risk factors, “compared to women without ADHD, women diagnosed with ADHD have – on average – more problems with employment and higher rates of unplanned pregnancy, teen motherhood and intimate partner violence,” as reported in the 2021 Review by Hinshaw et al.
With all of these elements stacked against us, it’s no surprise that women with ADHD tend to report lower self esteem than women without it.
A proper ADHD diagnosis is often a turning point; a point at which you can start separating out which of your traits are your identity and which bits are ADHD-related. This work of developing acceptance and self-awareness can be painful and often takes years, but can also set you up for a much healthier relationship with yourself and the world around you.
Beyond that, you can start being deliberate about making the most of the superpower aspect of ADHD - the parts that neurotypical folk don’t have access to.
Other resources specifically for women
ADHD for Smart Ass Women is a helpful, relatable podcast
A Radical Guide for Women with ADHD is a workbook by Sari Solden, MS and Michelle Frank, PsyD that helps regain a sense of self post-diagnosis
This digestible wrap up of 42 years of research on ADHD in girls and females