ADHD in Adult Women

Please note - I am not a therapist or ADHD expert. I am an adult woman interested in the topic :) The information in this blog post should be taken as psychoeducation. If you suspect that you have ADHD, talk to your PCP or us for a referral for testing.

October is ADHD awareness month. For decades, Attention-Deficit/Hyperactivity Disorder (ADHD) was seen primarily as a childhood condition affecting boys who were impulsive or hyperactive. But in recent years, researchers and clinicians have begun to recognize the subculture of adult women with ADHD who went undiagnosed in childhood.

Why have so many women gone undiagnosed?

Historically, ADHD diagnostic criteria were based on studies of boys, not girls. Because girls and women are less likely to show the “classic” symptom of hyperactivity, their struggles often fly under the radar. In fact, over half (55%) of adults with an ADHD diagnosis were diagnosed in adulthood.

Many women experience what’s called predominantly inattentive ADHD, which may look like:

• Chronic disorganization or forgetfulness

• Difficulty starting or finishing tasks

• Feeling mentally scattered or overwhelmed

• Emotional sensitivity and self-criticism

• Daydreaming or “zoning out” instead of acting impulsively

In childhood, girls with ADHD often learn to mask — working harder to appear organized, polite, and put-together. But as the demands of adulthood grow (career, relationships, parenting), those coping strategies often fall apart. What looks like anxiety, depression, or burnout may actually be untreated ADHD.

So at this point you might be wondering, do I actually have depression? Anxiety? ADHD? Is it trauma? All the above? That's an excellent question, and the truth of it is, it's a question that experts struggle with as well. These challenges overlap and interact with each other. Think of it this way:

• ADHD can cause distraction, impulsivity, and mental chaos.

• Anxiety can cause racing thoughts and restlessness.

• Depression can cause brain fog and lack of motivation.

• Trauma can cause hypervigilance, forgetfulness, and emotional reactivity.

You can see how these interact!

If you're a 20s or 30s-something woman thinking "my brain just doesn't stop" or "I can't keep up with it all!" the answer isn't straightforward. Therapy can help you sort through what is going on underneath, and provide some helpful insight.  However, studies show that women are diagnosed with ADHD years later than men, often after first being treated for depression or anxiety (Quinn & Madhoo, 2014). Additionally, depression, anxiety, and ADHD often coexist. A woman with ADHD may have developed anxiety after years of missing deadlines; a trauma survivor may appear to be distracted because her brain is in survival mode.

What can healing look like?

In a therapeutic setting, healing can look like building emotional awareness and regulation, healing shame and perfectionism, reconnecting with your strengths, and creating practical systems that work for your brain, among others.

In addition to therapy, medication is often utilized to help treat ADHD. Medication does not "cure" ADHD, but it does help make it easier to implement other skills.

Lifestyle changes can help too. Sleep, physical activity, time management skills, routine/structure, nutrition, and more can all help, too.

For women who have gone undiagnosed for years, this information can be lifechanging. If this resonates with you, Caring Conversations can help. Give us a call today (724.201.9815).

Sources:

McTeague, L. M., & Lang, P. J. (2012). The anxiety spectrum and the amygdala: A dimensional approach. Journal of Anxiety Disorders, 26(4).

Quinn, P. O., & Madhoo, M. (2014). A review of ADHD in women and girls: Uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3).

van der Kolk, B. A. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

Young, S. et al. (2020). Females with ADHD: An expert consensus statement. BMC Psychiatry, 20(404).