How is ADHD Different in Women?
We have all seen the stereotypes of people with ADHD portrayed in TV and movies. Whether it is the disruptive boy acting out in class or the party animal adult male that is the life of the party. Both in the media and in real life, most references to ADHD are in boys and men. Women, who can experience ADHD symptoms in a much different way, typically fly below the radar which can lead to a misdiagnosis or just be missed altogether.
I always suspected I may have ADHD. When I was a young girl, I was the “Chatty Cathy” in class and had a very hard time sitting for long periods of time. Staying focused on boring school work was very difficult for me. When I got to high school, it seemed easier to stay focused with shorter periods and the freedom to move around for my classes. However, it always seemed like I was missing something. I would read a few pages and have no memory of what I just read, or would get easily distracted by just about anything other than what I was supposed to be focusing on.
When I got to college, I felt very overwhelmed with having to create my own schedule and make time for both school and my personal life. Going from the very structured high school world to the very unstructured college life was a very difficult transition. I was fortunate that I was bright and resourceful enough to find a way to get it all done, even if it meant late night cramming sessions as the result of painstaking procrastination. Somehow, I figured it out.
After having my first child, the adjustment from being an independent professional woman with an ideal work/ life balance to an overwhelmed frazzled new mom was also very difficult. I experienced postpartum depression and anxiety and felt like I was a bad mom because I couldn’t manage ALL OF THE THINGS. Keeping up with taking care of the kids, the house, laundry, work, it was just too much, but somehow I figured it out.
Finally, after having my second child and working full-time and still trying to juggle ALL OF THE THINGS, I realized I couldn’t figure it out anymore. I was burnt out, overwhelmed and had run out of ways to cope and compensate with the symptoms I knew was ADHD.
Like so many women, I felt embarrassed and ashamed that I struggled with certain things that seem to come easy to others. Once I was able to be honest with myself and start to identify that I wasn’t stupid or lazy, but accept that my brain just works differently than others, it changed my life.
Finding the right professional help and support from friends and family, allowed me to focus on my strengths and superpowers I have because of my ADHD. Learning to create routines and systems were essential to be able to manage the chaos of everyday life. Identifying the areas where I really was getting stuck and brainstorming ways to find solutions, made life SO MUCH easier. Simple things like creating a weekly meal plan for my family or budgeting in money to get help with cleaning the house made a huge difference for me and allowed more time to enjoy my family.
Although there are many challenges to living with ADHD, I see it as one of my biggest strengths as well. Many women with ADHD are very outgoing and have an easy time talking to others. It makes sense for me that I went from being a “Chatty Cathy” in school, to being a therapist. My love and interest in others and ability to connect have served me well in my profession.
My hope in sharing this article and my story is to help educate others about ADHD, particularly in women, and to break the stigma often associated with ADHD. Although there are many challenges to having ADHD, there can be many benefits as well.
What is ADHD?
ADHD is a neurological condition that is characterized by a persistent pattern of inattention, with or without hyperactivity and impulsivity, that interferes with daily life.
For some time, many believed ADHD was only something that children struggled with, but we now understand the increasing prevalence among the adult population as well. It is estimated that 15 million individuals in the US have ADHD, roughly 4% of all adults.
Common Symptoms of ADHD:
Easily distracted
Lack of organization
Difficulty with time management
Lack of follow through with tasks
Procrastination
Impulsivity
ADHD in Childhood
ADHD is often associated with boys during childhood due to the more common hyperactive presentation, resulting in more behavioral issues at school and at home. Girls are diagnosed at just under half the rate of boys during childhood, and they tend to present with the more inattentive presentation of ADHD. This can lead to girls more often being overlooked or misdiagnosed. Girls with ADHD are more likely to be labeled as “spacy” and often fall through the cracks without the more overt behavioral issues.
ADHD in Women
Similar to my story, it is common for women to not realize they have ADHD until later in life. Women face unique challenges throughout their lifespan from adolescence to later adulthood. Sometimes, it is through getting help for their child with ADHD that women come to realize they can relate to many of the symptoms they see their children struggling with. ADHD happens to have a strong hereditary component as well. By early adulthood, women with ADHD are at a significantly increased risk for anxiety, depression, eating disorders, self harm and suicide.
The Challenge of Diagnosis in Women
ADHD is often misdiagnosed for anxiety or depression, as the symptoms can be so similar. Many women struggling with ADHD can experience anxiety and/ or depression as a result of frustration and overwhelm, making an accurate diagnosis difficult. Women tend to internalize feelings as well as ADHD symptoms, which can also lead to a missed or late diagnosis. Even today, many healthcare providers still view ADHD as a condition more common in males, and there have been concerns that some of the screening tools used to identify ADHD are gender biased. The majority of research has also focused primarily on boys and men, limiting the data we have from studies on ADHD in women. The Duke Center for Girls & Women with ADHD
The Role of Hormones and ADHD
Although there has been limited research on the connection between ADHD and hormone related mood problems, a 2021 Study focused on how women with ADHD may be more vulnerable during times of increased hormonal changes. Premenstrual Dysphoric Disorder (PMDD), is when women experience extreme symptoms of anxiety and/ or depression during the premenstrual week. They may also have increased feelings of overwhelm, difficulty concentrating, changes in mood and irritability and sleep disturbance. This study reported more than 45% of the women with ADHD also reported symptoms consistent with PMDD.
57% of women in the study reported symptoms consistent with postpartum depression and rated perimenopausal symptoms as more severe compared to other women without ADHD.
It makes sense that women with ADHD may have a more difficult time not only adjusting to the hormonal changes during these transitional periods but also the major psychological and social changes that we experience as well. The Duke Center for Girls & Women with ADHD
The Superpowers of Women with ADHD
Although ADHD can bring many challenges for women with ADHD, many often see their ADHD as a gift and describe many benefits. Many successful women have talked openly about having ADHD and how it has been both part of their struggles and accomplishments throughout life. These women include actress Zooey Deschanel, Olympic gold medalist Simon Biles, award winning journalist Lisa Ling, and activist Erin Brockovich. Some common benefits of having ADHD include:
Determination
Women that have struggled with challenges in school, work and home life related to ADHD often have had to work harder at everyday things than others. Over time, this can lead to a greater sense of determination and persistence. Having to think outside the box and problem solve ways to make things work, despite the challenges that come along with ADHD. Finding ways to compensate and adapt new ways of doing things can lead to new and innovative ways of thinking.
Hyper-Focus
This is definitely a fan favorite benefit of ADHD for most people! Hyper-focus is the ability to zero in intensely on an interesting project or activity for hours at a time. This can be a confusing element of ADHD, as it is the opposite of the more common symptoms of ADHD.
Creativity
People with ADHD are often highly intelligent and creative. Often, this can lead to successful careers in the arts or music. Justin Timberlake and comedian Howie Mandel have both been open about their struggles with ADHD and also how it has HELPED their careers.
Extrovert
Many women with ADHD are outgoing and have an easier time talking to others. They tend to be the conversation starters and never have a lull in conversations. These personality traits often make them enjoyable to be around and easy to talk to.
Spontaneity
Although the impulsive part of ADHD can sometimes get us in trouble, it also can also lead to an adventurous and exciting life! This trait can lead to taking more risks and pushing past limits that may prevent others from taking chances.
Getting Help & Support
The good news is, ADHD is totally treatable! Most women will agree that once they realize they have ADHD, they actually experience a sense of relief and validation. The diagnosis of ADHD can provide a framework to understand the symptoms they have been dealing with, in most cases since childhood. Knowing you have a treatable condition, often lessens the shame or guilt that women feel in so many areas of their life.
If you are want to learn more about ADHD or are interested in taking steps to get help, here are some ways to get started:
Educate Yourself
The first step to understanding ADHD is to start reading about symptoms and what ADHD actually looks like for adult women. There are some great resources including books, websites and even TikTok videos, to get you started. It is also important to help educate the people in your life including partners, kids, parents, friends and co-workers. Here are a few of my favorite resources to start with:
Children and Adults with Attention Deficit/ Hyperactivity Disorder (CHADD)
Duke Center for Girls and Women with ADHD
“Understanding ADHD in Girls & Women” by Joanne Steer
“Straight Talk About ADHD in Girls: How to Help Your Daughter Thrive” by Stephen Hinshaw
Seek Professional Help
Once you have a basic understanding of ADHD and think you or a loved one might need more support, it is essential to talk to a professional to try and determine if the symptoms you are experiencing might be ADHD. There are a number of ways to get started:
Talk to your primary care doctor or pediatrician
Although most primary care doctors do not specialize in ADHD, they can be a great place to start the conversation and get help with a referral to a professional that does.
Find a mental health professional that specializes in ADHD
For most people, starting with a psychotherapist that has experience working with clients with ADHD is a good place to start. Typically, during your first meeting, the therapist will ask you a lot of questions about your history and current challenges.This is a great starting point to assess if therapy alone might be a good fit or if you may benefit from further formal testing with a psychologist or possible consider a medication evaluation with a psychiatrist or psychiatric nurse practitioner. Often, therapy alone can be enough support to help manage your symptoms and help establish new patterns of behavior, coping skills and emotional regulation. If symptoms continue to get in the way of your day to day functioning, medication is another option to help further manage the challenges related to ADHD.
Get an ADHD Coach
In addition to psychotherapy, coaching for ADHD has shown to be extremely helpful to help women learn specific tools and skills to help manage their symptoms in daily life. Often, the symptoms of ADHD can create everyday challenges like time management, keeping up with household tasks and paying bills on time. Coaches typically are not mental health professionals and cannot diagnose or provide therapy, but focus on creating new routines, systems and habits to help improve quality of life for people with ADHD. If you think you may benefit from working with an ADHD coach, check out the ADHD Coaches Organization.
Find Your People
One of the most important things to remember about ADHD is YOU ARE NOT ALONE! It is essential to connect to other people that can relate and validate the unique struggles that can come with ADHD. There are many resources available today to make connections, including both in-person and online. Children & Adults With Attention Deficit/ Hyperactivity Disorder (CHADD) is a great place to find support and other resources.
Self-Care and Lifestyle Changes
In addition to getting professional help, there are many things you can do in everyday life to help better manage ADHD symptoms and reduce stress.
Nutrition
Although there is no magic diet for ADHD, we do know some basics about how our diet can impact symptoms. Ideally, a more balanced diet and healthy lifestyle have been shown to reduce ADHD symptoms. Eating foods with a low glycemic index (GI) is important to help maintain balanced blood sugar levels. Foods rich in protein can help build neurotransmitters and actually help improve ADHD symptoms. Look for foods containing zinc, iron and magnesium, all shown to help improve attention and concentration and have a more calming effect on the brain.
Some foods to avoid, which can activate or make symptoms worse, include anything high in sugar or containing artificial dyes. Foods with a high glycemic index (GI) release glucose rapidly and can increase hyperactivity, impulsivity and inattentiveness. Caffeine should also be limited as it can reduce the effectiveness of some medications used to treat ADHD and can make some ADHD symptoms worse. Watch out for hidden sources of caffeine like soda, energy drinks and chocolate!
Movement
Moving our bodies is a great way to help manage stress. This can be in the form of formal exercise, taking a walk, yoga, riding a bike, dancing or chasing after a soccer ball with your kids. WOmen with ADHD often report higher levels of stress related to feelings of overwhelm. The more we move, the less chance stress has to build up in our bodies. Instead of thinking you need to go to a gym 7 days a week, try to focus on a smaller goal instead. Simply committing to any form of movement 30 minutes a day is a great way to start a new routine and help keep stress levels at a minimum.
Meditation
Meditation can be a great way to help calm your mind and improve focus. Some women with ADHD struggle to “quiet their mind”. Although the idea of meditation might be daunting at first, most find with some practice, it can be an essential tool to help slow down racing thoughts. There are many apps that you can use right from your phone to make meditation easy and accessible. Some of my favorites are Calm, Insight Timer and Headspace.
Help with Household Tasks
Most women have a hard time asking for help. This often creates a dilemma for women struggling with ADHD, feeling caught up in the chaos of managing laundry, dishes and cleaning etc…. Part of managing ADHD symptoms is creating routines and systems to help with organization and staying on top of tasks. It is important to realize, no one can DO IT ALL! Whether you live alone or with others, it may be helpful to consider who else can share in some of the household chores and tasks we all need to get done. Which of these things do you love to do and find easy for you to cross off your list and which do you hate and avoid like the plague?
Things that can help:
If you live alone, consider hiring someone to help with cleaning or drop your laundry at a local laundromat
If you live with others, have an honest conversation about things you enjoy doing around the house and things you hate, try to negotiate a good balance that works for you
Try meal planning! Having a weekly plan ahead of time takes the guesswork and overwhelm out the daily task of having to prepare meals
Instead of paying bills on different days of the month, call your credit card companies and ask to move your billing due date. This way, you limit the days you need to remember to pay your bills!
Try setting a timer for tasks that feel overwhelming. Instead of thinking, “I have to clean the whole house,” try saying I will spend the next 30 minutes on cleaning and give yourself permission to stop if it feels like too much.
If you have kids, you would be surprised at how capable they are at helping out around the house, even at a young age. Vacuuming, dusting, mopping and even laundry are things that can help with and lighten your load.
Some many women suffer for years, not knowing they have ADHD, stuck in a cycle of shame, guilt and feeling less than. My hope is that this article helped to explain some of the important differences of ADHD in women and girls and highlighted the often missed or ignored symptoms women experience everyday.
Most importantly, be kind to yourself! Whether you have ADHD or can relate to some of the challenges discussed above, no one can do ALL OF THE THINGS. We all have our own strengths and weaknesses. Remind yourself of your own superpower, and use that gift to help make up for whatever challenges that are unique to you!
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