ADHD in Girls and Women: Unveiling the Hidden Struggles

ADHD in Girls and Women: Unveiling the Hidden Struggles

Attention Deficit Hyperactivity Disorder (ADHD) is often stereotyped as a condition affecting hyperactive young boys. However, the reality for girls and women is far more nuanced and frequently overlooked. As our understanding of ADHD evolves, it's becoming clear that females experience ADHD differently, presenting unique challenges that demand tailored support and recognition.

The Distinct Presentation of ADHD in Females

Research by Quinn and Madhoo (2014) highlights several key differences in how ADHD manifests in girls compared to their male counterparts. Women with ADHD are more likely to grapple with low self-esteem and face greater difficulties in peer relationships. Unlike the more overt hyperactive behaviours often seen in boys, girls tend to display the inattentive type of ADHD. This can include being easily distracted, disorganised, and feeling overwhelmed or lacking motivation. Despite exhibiting fewer symptoms, the level of impairment remains comparable to that seen in males.

Young et al. (2020) further elaborate that females often present a combination of inattentive and hyperactive-impulsive symptoms, though the severity of hyperactive-impulsive symptoms may be less pronounced than in males. Additionally, hormonal changes can exacerbate these symptoms, making ADHD particularly challenging during different phases of a woman's life, such as puberty, menstruation, and menopause.

The Role of Hormones in ADHD

Hormonal fluctuations play a significant role in the experience of ADHD for women. Moseley et al. (2020) found that menopause can intensify autistic characteristics and executive functioning difficulties, a finding that parallels challenges faced by women with ADHD. Increased premenstrual symptoms, including premenstrual dysphoric disorder (PMDD), are also more common among those with ADHD and Autism, adding another layer of complexity to their daily lives.

The Hidden Struggles of ADHD in Girls and Women

Girls and women with ADHD often find themselves lagging behind their peers, not because they cause trouble, but due to internal struggles. They tend to blame themselves for their difficulties, facing a higher incidence of anxiety, depression, and obsessive-compulsive disorder (OCD). These internalising disorders are compounded by compensatory strategies like perfectionism, which can be both a coping mechanism and a source of additional stress.

Social relationships pose another significant challenge. Women with ADHD frequently have fewer friendships and more volatile interactions, leading to conflicts and a desperate wish to behave differently. The tendency to mask their symptoms—putting on a façade to hide their struggles—can result in feelings of shame and isolation. Many are bullied more often than their non-ADHD peers, and accessing positive social networks becomes increasingly difficult.

The Impact of ADHD Across the Lifespan

ADHD in girls and women doesn't simply fade away with age. Instead, it evolves, often becoming more pronounced during adulthood. The daily battle to conceal inner turmoil can lead to risky behaviours, such as early experimentation with sex and substances, as a means to cope with feelings of restlessness and emptiness. This can sometimes be confused with characteristics of Borderline Personality Disorder, complicating diagnoses and treatment.

Procrastination and difficulties with sustained motivation are common, leading to incomplete assignments at school and unfinished tasks at home. These ongoing challenges can perpetuate a cycle of low self-esteem and heightened emotional distress.

Overlooked and Underdiagnosed

One of the most pressing issues is that ADHD in girls and women is frequently overlooked by teachers and healthcare services. Recognising ADHD in females requires an understanding of their unique presentation—often quieter and less disruptive than in males. By the age of five, many girls are already aware that they are different, yet their struggles remain hidden behind a veneer of normalcy.

Moving Forward: Support and Awareness

Addressing ADHD in girls and women necessitates a shift in both perception and practice. Educators, healthcare providers, and society at large must acknowledge the distinct ways ADHD presents in females. Providing appropriate support—ranging from behavioural therapies and educational accommodations in childhood to cognitive-behavioural therapy and workplace adjustments in adulthood—is crucial for helping women manage their ADHD effectively.

Conclusion

As we continue to deepen our understanding of ADHD, it’s imperative to shed light on the unique experiences of girls and women. By recognising and addressing the specific challenges they face, we can foster a more inclusive and supportive environment that empowers them to thrive. The work of researchers and organisations, such as Attwood and Garnett Events (2025), highlights the importance of this ongoing dialogue, paving the way for better outcomes and a brighter future for all women with ADHD.