- Loren Bahor, MSW, LCSWA
ADHD in Women: The Hidden Diagnosis
Updated: Jul 9, 2021
Lazy. Stupid. Irresponsible. Unmotivated. Flakey. Ditzy. Undisciplined.
These are the words I hear many of the women I work with labeling themselves- or reporting that this is how they have been labeled by others.
These women often have either been diagnosed with ADHD or are experiencing undiagnosed ADHD.
These same women- extremely high functioning in certain areas of their lives- have entire other facets of their lives where they struggle to function. This struggle manifests as:
* frequently losing keys or other belongings
* losing time or constantly running late
* feeling chronically disorganized
* difficulty managing their time
* difficulty completing tasks on time
* constantly playing catch-up
* chronic feelings of overwhelm
It is because these women are higher functioning in other areas of their lives that so many assume it must be a character flaw that causes them to struggle. Often, I hear them compare themselves to their peers and hear their self-critique on areas where they feel stuck or less than.
Unfortunately, when most people think about Attention-deficit/hyperactivity disorder (ADHD), the first thing that probably comes to their mind is a hyperactive school-aged boy. You know – bouncy, lots of energy, easily distracted, impulsive, fidgety; think Tigger for Winnie-the-Pooh.
This has been the standard conception of ADHD for many years, in part because boys were what was researched– specifically white, hyperactive, young boys. We see this within the rates of diagnosis- according to the Centers of Disease Control and Prevention, boys are three times more likely to get diagnosed with ADHD when compared with girls.
This disparity exists not because ADHD affects fewer girls but because it affects girls differently as symptoms tend to be expressed in more subtle ways making it more difficult to identify. Often, it is not until girls become women that they are diagnosed at all- and even then, it is often difficult to get a diagnosis or effective treatment, and often with extreme skepticism from providers.
Boys with ADHD
· Fidgety or hyperactive
· Poor impulse control
· Easily agitated; gets into physical fights with peers
· Difficulty paying attention
· Poor emotion regulation
· Often seen as “troublemaker”
Girls with ADHD
· Daydreams or mind easily wanders
· Difficulty completing tasks
· Messy or disorganized
· Difficulty with time management
· Emotional outbursts leading to social isolation
· Often labeled a “poor student”
Men with ADHD
· Poor emotion regulation
· Job instability
· Habitual substance use- especially of alcohol or marijuana
· Often seen as an “idea man” or labeled as someone with energy and charisma
· Struggles with follow through
· Difficulty keeping or making appointments
· Messy home, workspace, or car
· Dependence in romantic relationships on their partner to coordinate their lives
Women with ADHD
· Persistent use of “masking”- pretending things are fine, hesitant to ask for help, over-compensates in certain job or home functions
· Difficulty completing school
· Does not achieve as highly in jobs as their intellect would indicate
· Habitual substance use- especially of marijuana and alcohol
· Exercise dependence
· Often labeled as “flighty”, “lazy”, or “ditzy”
· Messy home or car; often one workspace or living space will be very neat
Because women tend to internalize their symptoms more, they often fly under the radar, making it less likely that as children they will be evaluated by a professional or as adults that they will be taken seriously. To be clear, however, both males and females can be diagnosed with ADHD and can be categorized as either inattentive, hyperactive-impulsive, or combined-inattentive and hyperactive.
As a result of these disparities in the way ADHD is manifested, often times, signs and symptoms of ADHD in girls and women are missed or mistakenly identified as depression, anxiety, or other conditions. Many women are not diagnosed until adulthood, after they begin work or college, or when they start recognizing similar symptoms between themselves and their diagnosed children.
Undiagnosed and/or untreated women with ADHD tend to experience significant psychological distress, underachievement, depressive and anxiety symptoms, have a more external locus of control (a tendency to attribute success and difficulties to outside factors such as chance) and have chronic low self-esteem.
While ultimately, you must complete psychological testing to get a formal diagnosis of ADHD, if any of the themes of this article resonate with you, we recommend reaching out for support! At Honeybee Psychotherapy, I specialize in providing treatment for ADHD or executive dysfunction- especially in women and women who have been diagnosed as adults or have not yet been diagnosed but strongly suspect they are struggling with it.
In therapy, we work on both the skills and strategies needed to live with ADHD as well as the anxiety, depression, and dysphoria that having and living with ADHD can cause.
Please don’t hesitate to reach out to get scheduled today!
Adult ADHD resources
Several additional articles that outline what adult ADHD looks like in women and why it goes chronically underdiagnosed:
Information from the CDC outlining what ADHD is, the various types, as well as treatment options available: https://www.cdc.gov/ncbddd/adhd/index.html
An ADHD resource site that is specifically for women with ADHD: https://www.kaleidoscopesociety.com/adhd-in-women-101/
Several organizations that supports ADHD research and provide resources:
TikTok: search #ADHD