Introduction: Recognising ADHD in Women
ADHD is often misunderstood, especially when it comes to women. While ADHD comes with many wonderful strengths (which you can read about in my article on strengths here), this article focuses on the symptoms that can help women recognise if they might have ADHD.ADHD symptoms in women often present differently than in men, leading to underdiagnosis or misdiagnosis. You may experience primarily inattentive symptoms (Inattentive ADHD), primarily hyperactive/impulsive symptoms (Hyperactive/Impulsive ADHD), or a combination of both (Combined Type ADHD). This article explores the common symptoms, the reasons why they are often overlooked, and how these symptoms can impact daily life. Whether you're suspecting you have ADHD, supporting a loved one, or seeking to understand more, this article will help shed light on the symptoms and their impact.
While exploring these symptoms, it’s important to remember that not all of them may resonate with your experience, and that’s okay—reading about ADHD can sometimes feel overwhelming or even trigger self-doubt, so take your time and be kind to yourself as you navigate this information.
Common ADHD Symptoms in Women
Inattention—More Than Just Daydreaming
Inattention in women with ADHD often presents in ways that can easily be overlooked or mistaken for other issues. Here’s how it might manifest:
Difficulty sustaining attention: Struggling to stay focused on tasks that are uninteresting or repetitive.
Frequent forgetfulness: Forgetting appointments, deadlines, or where you placed important items.
Disorganisation: Often feeling overwhelmed by clutter, whether it’s physical (like a messy desk) or mental (like a cluttered schedule).
Starting tasks but not finishing them: Getting excited about new projects but losing interest before they’re completed.
Losing track of conversations: Zoning out during discussions, missing key points, or having to ask for things to be repeated.
Hyperactivity—It’s Not Always What You Think
Hyperactivity in women with ADHD may not look like typical ‘bouncing off the walls’ behaviour but can be more subtle and internal. Common signs include:
Mental restlessness: A constant stream of thoughts that makes it hard to relax or fall asleep.
Physical fidgeting: Feeling the need to move or fidget, even in situations where it’s not appropriate.
Always being on the go: Taking on too many tasks at once and feeling restless or unproductive if not busy.
Difficulty relaxing: Struggling to unwind, often multitasking even during downtime.
Impulsivity—Decisions in the Blink of an Eye
Impulsivity can lead to quick decisions without full consideration of the consequences. For women with ADHD, this might look like:
Impulsive spending: Buying items on a whim, sometimes leading to financial stress.
Interrupting conversations: Struggling to wait your turn to speak, or jumping in with thoughts before others finish.
Sudden changes in plans: Frequently switching plans or taking on new projects impulsively, which can disrupt routines or commitments.
Understanding the DSM-5 Diagnostic Criteria for ADHD Symptoms in Women
When discussing the symptoms of ADHD, it’s important to understand how these symptoms are evaluated and diagnosed. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides the standard criteria that healthcare professionals use to identify ADHD. However, these criteria were originally developed based on research predominantly involving young boys, which means ADHD symptoms can manifest differently in women.
The DSM-5 outlines two main categories of ADHD symptoms:
Inattention Symptoms:
Difficulty sustaining attention on tasks or activities.
Making frequent careless mistakes in work or other activities.
Struggling with organisation and managing tasks.
Often losing important items like keys, phones, or paperwork.
Being easily distracted by extraneous stimuli.
Forgetfulness in daily activities.
Avoiding or being reluctant to engage in tasks that require sustained mental effort.
Hyperactivity and Impulsivity Symptoms:
Fidgeting or tapping hands or feet, or squirming in the seat.
Difficulty remaining seated in situations where it is expected.
Feeling restless or always being "on the go."
Excessive talking or interrupting others.
Difficulty waiting for one’s turn in conversations or activities.
Interrupting or intruding on others, such as butting into conversations or games.
To meet the DSM-5 criteria for ADHD:
An individual must exhibit at least five symptoms from the Inattention category (Inattentive ADHD), at least five symptoms from the Hyperactivity and Impulsivity category (Hyperactive & Impulsive ADHD), or more than five symptoms from both categories ie 5 inattentive and 5 hyperactivity/impulsive (Combined Type ADHD).
These symptoms must have persisted for at least six months.
Symptoms should be present before the age of 12.
They must occur in multiple settings (e.g., at home, work, or school).
Symptoms should cause significant impairment in social, academic, or occupational functioning.
The Role of Emotional Dysregulation
Emotional dysregulation, although not officially listed in the DSM-5 criteria, is a common experience among women with ADHD. This can involve mood swings, intense emotional reactions, and feeling overwhelmed by daily stressors. When considering if you might have ADHD, it’s important to recognise that emotional dysregulation is increasingly acknowledged by health professionals as a significant aspect of the condition, particularly in women. This recognition underscores the importance of considering emotional symptoms as part of the ADHD assessment process.
Rejection Sensitivity Dysphoria (RSD)
Rejection Sensitivity Dysphoria (RSD) is an extreme emotional response to perceived criticism or rejection, often leading to intense feelings of shame, sadness, or anger. Although not part of the official ADHD diagnostic criteria, RSD is frequently mentioned anecdotally and is increasingly recognised as common among women with ADHD. This hypersensitivity can cause women to avoid social situations, struggle in relationships, and negatively impact self-esteem. RSD can also exacerbate other ADHD symptoms, making it harder to focus, complete tasks, or maintain emotional stability, highlighting its significant impact on quality of life despite not being formally acknowledged in diagnoses.
Confusing Contradictions—Is It ADHD?
One of the most perplexing aspects of ADHD is the way symptoms can seem contradictory, making it harder to recognise. For example, you might struggle with inattention, yet find yourself hyperfocused on certain tasks or interests to the point of losing track of time. Similarly, while you may feel restless and unable to sit still at times, there are also moments when you crash from exhaustion, unable to muster the energy to do anything. These contradictions can leave you feeling confused about whether what you’re experiencing is ADHD, as the symptoms don’t always fit neatly into one category.
If you’re curious about these paradoxes, be sure to check out my article on the Top 10 Contradictions of ADHD—that is, how these conflicting symptoms can manifest and impact daily life.
Masking and Adapting—Why ADHD in Women Is Often Missed
Masking: Women with ADHD frequently learn to mask their symptoms in social or professional situations to meet societal expectations. This involves deliberately covering up or suppressing behaviours that might be seen as inappropriate or distracting. For example:
Staying seated in meetings: Even when you’re restless and would love to move around, you stay seated to avoid drawing attention.
Holding back in conversations: Instead of being chatty or interrupting, you might bite your tongue to avoid seeming rude or overly enthusiastic.
Taking on specific roles: You might assign yourself as the notetaker in meetings, not just to contribute but to keep your focus and manage your restlessness.
Adapting: In addition to masking, many women with ADHD develop adaptive strategies to compensate for their symptoms. These adaptations help them function but can also hide the underlying challenges. For example:
Double and triple-checking emails: To compensate for inattention, you might spend extra time reviewing your work to catch mistakes, which can be exhausting.
Implementing rigid systems: You might create strict routines or systems at home, like always placing keys in the same spot, to prevent losing important items. You may also find that you get agitated or upset if others mess with these systems, as they are crucial for maintaining your focus and organisation.
These efforts can make it difficult to recognise ADHD, as they often result in an outward appearance of control and competence. However, like the swimming duck analogy, while everything may look calm on the surface, underneath there’s a constant, tiring effort to keep up. Recognising how you might be masking or adapting your behaviours is crucial in understanding and addressing the challenges of ADHD. Masking is often a survival strategy women with ADHD use to navigate a world that doesn't always understand their challenges—it's important to see this as a means of coping, not as a failure or shortcoming.
Mistaking ADHD for Other Conditions
Because ADHD symptoms in women often manifest as internal experiences—like emotional sensitivity, anxiety, or overwhelm—they are frequently misattributed to other conditions, such as anxiety, depression, Bipolar Disorder, or Borderline Personality Disorder. This can lead to women receiving treatment for these conditions rather than for ADHD. However, it’s important to understand that while some women with ADHD might not have these co-occurring conditions, ADHD and these mental health challenges are not mutually exclusive. That is, they can coexist, each affecting and amplifying the other. Living in a neurotypical world with an ADHD brain can be exhausting and stressful, which can contribute to the development of anxiety, depression, or other emotional challenges. Recognising this interconnectedness is essential for accurate diagnosis and effective treatment, ensuring that both ADHD and any co-occurring conditions are properly addressed.
Hormonal Fluctuations and ADHD
Hormonal changes during menstruation, puberty, pregnancy, and menopause can significantly impact ADHD symptoms. You might notice that your symptoms worsen or change at different times in your life or during your monthly cycle. Women with ADHD often seek support and diagnosis during these life stages, as the hormonal impact "pushes ADHD symptoms to the surface." The ability to manage these symptoms—often well-adapted but causing underlying stress—can diminish, making the challenges of ADHD more apparent. This fluctuation can add another layer of complexity to your experience, especially if symptoms are attributed solely to hormonal changes rather than recognised as part of ADHD.
ADHD in Women: Three Ways It Can Show Up
ADHD presents uniquely in every woman, so the following examples may or may not resonate with your experiences and don’t represent all, or even most, women with that ADHD type. However, they may offer some insight into how that type of ADHD can present in women. It’s also important to remember that symptom intensity exists on a continuum—some women may experience only mild impacts, while others might find ADHD significantly affecting multiple areas of their lives, such as career advancement, relationships, and finances
Emma, 45 (Inattentive ADHD)
Emma, 45, works as an editor for a small publishing house, where she occasionally zones out during meetings and often forgets tasks like paying bills on time or picking up groceries, leaving her overwhelmed by her growing to-do list. Despite setting reminders, she sometimes misses appointments, which frustrates her. Her disorganisation and forgetfulness have caused tension in her relationships, as friends and family feel overlooked when she forgets important dates or plans. The constant effort to manage her tasks has led to fatigue, affecting her energy levels and confidence in her career, even though her love for books and attention to detail remain her strengths.
Lisa, 36 (Hyperactive & Impulsive ADHD)
Lisa, 36, is a freelance graphic designer with boundless energy and creativity, constantly buzzing with new ideas and projects. Her impulsive decisions, like taking on too many clients or making unplanned purchases, often leave her feeling overwhelmed and financially strained. Lisa's hyperactivity is internalised, with her mind always active, even when she tries to relax, leading to restless behaviours like fidgeting and a constant need to be productive. Despite feeling mentally and physically exhausted, her racing mind makes it difficult for her to fall asleep, further impacting her health. These challenges also strain her relationships, as friends and family struggle to keep up with her changing plans and energy levels. Despite these obstacles, her quick thinking and innovative approach have earned her a loyal client base and kept her business running.
Claire, 52 (Combined Type ADHD)
Claire, 52, is a marketing executive with a knack for creative problem-solving and innovative thinking, often entering hyperfocus to deliver impressive results under pressure. However, her struggles with inattention lead to missed details, disorganised meetings, and a cluttered desk of unfinished tasks. Over the years, ADHD has caused more frequent job changes as Claire seeks novel environments where her creativity can thrive. At home, her busy mind makes it hard to relax and fall asleep, and she finds maintaining a consistent routine challenging, leaving chores like laundry and bills half-done. The ongoing effort to juggle professional and personal responsibilities is exhausting, especially as menopause brings symptoms like brain fog, further exacerbating her concentration issues. Despite these challenges, Claire’s strategic thinking and ability to inspire her team remain key strengths, even as she sometimes battles feelings of inadequacy. Lately, she feels like she could really use a few months off to recharge.
Conclusion: Taking the Next Steps
If what you’ve read in this article feels familiar, it might be time to explore whether ADHD is influencing your life. Understanding the symptoms is the first step toward gaining clarity and finding the support you need. Properly managing and treating ADHD can lead to significant benefits in various areas of your life, including physical health, emotional well-being, financial stability, relationships, and occupational success.
It's crucial to work with professionals who specialise in, or at least have a deep understanding of, ADHD in women. These experts can provide tailored strategies and support that address the unique ways ADHD presents in women, helping you navigate your life with greater ease and self-compassion.
Ready to take the next step? Consider reaching out to a healthcare provider who understands the nuances of ADHD in women. If you’re looking for personalised guidance, I offer strategy sessions (and also offer ADHD assessment & treatment). Together, we can work towards better understanding and managing your symptoms, so you can thrive.
ADHD-Friendly Summary:
ADHD in women often presents differently than in men, leading to underdiagnosis or misdiagnosis.
Inattention can manifest as forgetfulness, disorganisation, and difficulty completing tasks, impacting daily responsibilities and relationships.
Hyperactivity may be internal, with mental restlessness and difficulty relaxing, rather than visible physical activity.
Impulsivity can lead to quick, unconsidered decisions, resulting in financial strain, disrupted plans, and challenges in maintaining stability.
Masking behaviours to meet societal expectations and adapting to cope with daily life can make ADHD symptoms harder to recognise, often resulting in an outward appearance of control.
Emotional dysregulation and Rejection Sensitivity Dysphoria (RSD) are significant aspects of ADHD in women but are often overlooked and not yet officially recognised in diagnostic criteria.
ADHD symptoms can be mistaken for or coexist with other conditions, such as anxiety or depression, complicating diagnosis and treatment.
Hormonal changes during life stages such as menstruation, pregnancy, and menopause can exacerbate ADHD symptoms, adding complexity to the experience.
Diagnosis and treatment of ADHD in women should involve a comprehensive approach, by professionals experienced in working with women with ADHD, and include professional interpretation of symptoms, structured interviews, and input from others.
FAQs
1. What are the common ADHD symptoms in women?
Common ADHD symptoms in women include difficulty focusing, forgetfulness, feeling overwhelmed by tasks, internal restlessness, impulsivity, and chronic disorganisation. These symptoms may manifest differently than in men, often leading to misdiagnosis or underdiagnosis.
2. How can I get an ADHD diagnosis as an adult woman?
The diagnostic process typically involves a structured interview, rating scales, and observation during sessions. Often, data from another source, such as a partner, parent, or teacher, is gathered to provide further information about symptoms in different contexts or before age 12. This additional input supports the person with ADHD, especially in cases where memory issues might affect self-reporting.
3. What ADHD tests are available for women?
ADHD testing exists on a continuum, ranging from informal online quizzes to more structured screening measures and detailed rating scales. Informal quizzes can provide a general sense of whether you might have ADHD, but they are not diagnostic tools. Screening measures like the Adult ADHD Self-Report Scale (ASRS) are more formal; the ASRS is a widely used tool that helps identify symptoms of ADHD through a brief self-assessment. For a more in-depth evaluation, rating scales such as the Conners’ Adult ADHD Rating Scales-2 (CAARS-2) have been developed through extensive research. The CAARS-2 includes both self-report and observer-report forms, allowing others to provide additional insights and confirmatory information.
It's important to note that many of these tests were developed based on research primarily involving males. As our understanding of ADHD evolves, these tools may be refined to better capture the experiences of women. Interpretation of these tests is best left to professionals with the appropriate training, as they can identify patterns and 'read between the lines' to provide a more accurate diagnosis.
4. What treatment options are available for women with ADHD?
The main treatment options for women with ADHD include medication, psychological therapy, lifestyle changes, and coaching. A tailored treatment plan that addresses your specific symptoms and life circumstances can help manage ADHD effectively. Additionally, new and alternative treatments are being explored, offering further options for those seeking different approaches to managing their symptoms.
5. How do ADHD symptoms change throughout a woman's life?
ADHD symptoms in women can change with life stages such as puberty, pregnancy, and menopause, as well as throughout the monthly menstruation cycle. Hormonal fluctuations can intensify symptoms like inattention, mood swings, and impulsivity, making it important to consider the influence of these changes when managing treatment.
About the Author:
Sioban Laffey is a registered psychologist with over 20 years of experience, now specialising in ADHD assessment, treatment, and strategy sessions for women. As someone with ADHD herself, Sioban understands the unique challenges that women face and is passionate about helping them navigate their ADHD journey with clarity and confidence. Through her practice, Sioban offers personalised guidance and support, empowering women to understand their symptoms, explore effective treatment options, and thrive in all areas of life.