ADHD in Women

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Many more women and girls are being diagnosed or starting to identify with ADHD (Attention Deficit Hyperactivity Disorder). As an ADHDer myself and a therapist working with this group I find that we are only just scratching the surface of how our ADHD has shaped our lives. Read on for some insights.

According to the NHS, the main markers for ADHD are difficulty concentrating and focusing (short attention span, easily distracted, forgetful), hyperactivity and impulsiveness. There are 3 different types you can be diagnosed with; inattentive type, hyperactive type and combined.

So how does ADHD actually affect people? Well, firstly, the name (Attention Deficit Hyperactivity Disorder) isn’t the most accurate description. It’s not so much a deficit of attention, more a difficulty controlling the focus and attention. And the word ‘disorder’ doesn’t do it any favours either. Far from being disordered, many ADHDers are vibrant, creative thinkers, with great intuition and empathy.

The stereotype still around for ADHD is the noisy, disruptive, hyperactive boy in the classroom. In the past it had been thought that it was much more common in men, and rare in women. And consequently, many of the ADHD assessment tools have been designed with boys and men in mind, leading many women and girls to be overlooked.

There are many different ways ADHD can show up and, particularly for women, it’s not always obvious when first looking at the ‘symptoms’ of ADHD.

Take the trait of time blindness for example. Time blindness is the inability to estimate the passing of time. This might mean you struggle to know how long a task may take. So it might lead to you often being late for appointments or not finishing tasks. Conversely though it could also lead to you being habitually early as time becomes a real anxiety. It could also lead to procrastination and overwhelm, as a seemingly simple task feels like way too much to deal with.

Image of a diary with a piece of paper saying to do list on it and a silver and gold pen laying on top

Other difficulties often lie within executive functioning. This is the term used for a set of skills like planning, organisation and task initiation.

This could manifest as a difficulty keeping your house tidy, forgetting birthdays or a struggle to carry out some aspects of work or school. But it’s also important to note that many women with ADHD have employed coping strategies to help them over the years. So it could be that you have a particularly ‘messy’ home that you don’t seem to be able to keep on top of. Or maybe you are actually extremely neat and tidy, to the point where you become anxious about it.

Maybe you don’t tend to forget things, but that’s only because you put so much effort into writing lists upon lists, or setting reminders for yourself because you’re so anxious about forgetting. Although you have worked hard at putting in coping strategies, to the rest of the world you are coping fine. Whereas actually you are finding this exhausting and life incredibly overwhelming as a result.

This is possibly another reason why so many women go undiagnosed, as they have worked out ways to help themselves and mask their struggles so everyone assumes they are fine. And, as ADHD traits can exhibit in a multitude of ways, it may lead many women to second guess what they’re identifying in themselves.

Shifting the Blame

For women in later life, coming to a realisation that they may be ADHD can be really powerful.

Before you know it is ADHD, you might assume you’re the only one having these struggles. Everyone else manages to do it. So the natural conclusion therefore is to blame yourself. You think you must be lazy, or stupid, or awkward (maybe others have called you this in the past). This then has a detrimental impact on your self esteem.

But, add the idea of ADHD into the mix and you can reframe some of this. Actually perhaps it’s not that you’re lazy like you’ve always assumed. Maybe your executive functioning skills are impaired making it extremely hard to finish tasks, or to find the motivation to get started in the first place. ADHD can also affect social communication skills, so maybe you aren’t awkward or getting it wrong, it’s just you’re having to try extra hard to fit in, or be liked. Lots of us mask what’s really going on for us underneath and can develop a chameleon-like ability to fit in wherever we go.

ADHD can also affect how you focus. So, possibly the reason that you couldn’t concentrate in school or at work, isn’t actually because you are stupid at all. Perhaps this means you can finally let that label of stupid go and start seeing your strengths instead.

Often there are things you might never have considered were attributed to your neurodivergence. For instance, as a neurodivergent person you may have often grown up feeling misunderstood a lot. Perhaps feeling like people misread your intentions or that you somehow always missed the mark. This leads to feelings of rejection where you blame yourself for always getting it wrong.

These experiences can then emerge as an urge to clarify everything you say. To make sure you’re being heard correctly. Maybe following up your email with another one or two to explain more fully, or speaking more words than may be necessary to get your point across. Perhaps you’re often remembering something you should have said after the conversation. If you’ve had years of misunderstandings, awkwardness and a feeling of not being heard, this can easily translate into the need to clarify.

Another way I see this come out is in interaction with others. You might find that you start feeling angry at someone you’re having a conversation with but not really have a clear idea of why. Then later, as the interaction has ended, you realise they were being unfair, mean or manipulative.

For ADHDers this can come from your assumption that (because you’ve had a catalogue of misunderstandings in the past) it must be you that is getting it wrong here, it must be you who is not reading it right.

So your default is always to assume you are getting it wrong. Which means you park that annoyed feeling because you don’t want to get ahead of yourself and make enemies when it was your misunderstanding. And it’s only afterwards you fully process the interaction and realise that person was being spiteful or manipulative that you feel that anger was actually justified. And by then it’s too late to make the point! By looking at all this through a neurodivergent lens, it can help you to understand that, although your style of communication might be different from some people, that doesn’t mean it is wrong.

Learning you have ADHD can reframe things for you and allow you to shift some of the blame off yourself. And perhaps even be proud of how far you’ve come without even knowing you had ADHD.

Hyperactivity

Image of a woman sitting with her arms wrapped around her knees, looking down

With women and girls with ADHD we tend not to be so much hyperactivity present. Or at least not in an external way that others notice. It can show up as a more internal hyperactivity, multiple, racing thoughts in the brain, overthinking.

And any hyperactivity there was (like fidgeting or being overly talkative) gets conditioned out of girls at an early age. Society has generally taught us that women should sit still and be ‘good girls’.

Be ladylike’ ‘sit still’ ‘stop talking’, all messages girls are often given throughout their life. So any hyperactivity they may exhibit (in the form of fidgeting, stimming or talking a lot) gets seen as not desirable behaviour. And because ADHD girls are very good at masking and copying others, they will suppress their natural urges in order to be the ‘good girl’. So maybe taking to fidgeting with something inside their pockets, picking the skin round their nails, or more ‘acceptable female’ traits like twirling their hair, they hide that hyperactivity so no one notices.

After many years of this, and with no knowledge of being neurodivergent at all, many women will have suppressed things so much that they mistrust what their body is telling them. If your body tells you to move about or fidget, but everyone else (and society) tells you that isn’t the right thing to do, you learn over time that your body can’t be right. Gradually this produces a disconnect between the brain and the body. This can lead to a mistrust of the body’s signals sometimes leading to difficulty around food or alcohol and strong emotions like anxiety coming up out of nowhere.

Self diagnosis

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Many people are criticising the emergence of so-called TikTok diagnoses of ADHD. This is where people are watching TikTok and Instagram videos and identifying with what they see and perhaps leading them to self diagnose. Whilst some social media accounts can be notoriously inaccurate and there can be a tendency to over simplify things, my personal view is that if lots of ADHD accounts resonate with you then it’s worth exploring more. If more girls & women are able to identify as ADHD early, they can start to shift the blame off themselves, improve self esteem, and build a much more positive identity. There’s enormous value in that.

Therapy & Resources

If you are just learning about your ADHD, of course there is far more to explore . Not least the affect of going undiagnosed for so long. Therapy can be so helpful here to start looking at your life through a neurodivergent lens and unpacking some of the difficulties you might be experiencing. See my Therapy and Neurodivergence article for more information on how therapy can help.

There are many other traits of ADHD you might be interested to know about. My article about Rejection Sensitivity might be helpful and women particularly often suffer from this and go to great lengths to avoid rejection. If you go to my Autism/ADHD page, there are links to many of my other related articles there. Please contact me or see my website if you’d like to know more about my therapy services.

You might also be interested in my new self esteem workbook for neurodivergence in my Etsy shop. Also available are my Neuro cards which are designed to explore neurodivergent traits and experiences. Click below to go to my shop.


Amy is a counsellor specialising in neurodivergence and the founder of Newglade Counselling. She has created a team of neurodivergent counsellors who work online and face to face around Canterbury, Kent. Amy also provides parent support sessions, clinical supervision and delivers training in therapy and neurodivergence. For more information about our services use the contact button below.

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