Honestly, I have struggled with personal bias regarding ADHD (Attention-Deficit/Hyperactivity Disorder) diagnosis as I feel it has been chronically misdiagnosed, overhyped and misinterpreted all over social media and throughout society. Additionally, ADHD can be a difficult diagnosis to understand especially if we take into account ‘doom-scrolling’ (aka short-term dopamine hits) which has plagued society and has chronically shortened our attention span and activity levels. This bias has led me to often overlook or ignore ADHD symptoms in those I work with as I frequently attribute it to serial phone-use. While phone-use and doom scrolling can definitely play a part in an ADHD diagnosis (which I will probably end up writing a post about at some point), I understand that this bias may be promoting misunderstanding and preventing effective care.

That being said, let’s dive into better understanding how ADHD symptoms display in women, and how that can often be misunderstood or misdiagnosed (by myself included).

ADHD in women vs. men

Why, do you ask, is this post directed towards better understanding ADHD in women rather than the whole population? ADHD is often underdiagnosed in women and girls due to differences in symptom presentation and societal perceptions. While boys typically exhibit more obvious hyperactivity, girls often display inattentive behaviors, which are less disruptive and more easily overlooked. Additionally, many women experience more subtle or internalized symptoms that can be mistaken for anxiety, depression, or even personality traits rather than a neurodevelopmental condition. In the United States, approximately 15% of boys and 8% of girls aged 3–17 have been diagnosed with ADHD. This indicates that boys are nearly twice as likely to receive an ADHD diagnosis compared to girls. The following are common symptoms of ADHD in women/girls:

Inattention and Distractibility

Women with ADHD may struggle with staying focused, especially on tasks that require sustained mental effort. They may:

Lose track of conversations or forget details.
Frequently misplace items like keys, wallets, or phones.
Have difficulty following through on long-term projects.
Experience "brain fog" or zoning out in meetings or social situations.

Executive Dysfunction

Organizing, planning, and managing time effectively can be major challenges. This can manifest as:

Chronic procrastination or difficulty initiating tasks.
Forgetting appointments, deadlines, or important obligations.
Feeling overwhelmed by daily responsibilities.
Struggling with prioritization and decision-making.

Emotional Sensitivity and Rejection Sensitivity

Many women with ADHD experience heightened emotional responses and sensitivity to criticism, often leading to:

Intense mood swings.
Feeling easily overwhelmed or overstimulated.
A strong fear of failure or disappointing others (often linked to rejection-sensitive dysphoria).

Hyperactivity and Restlessness

Unlike the stereotypical hyperactivity seen in young boys, women’s hyperactivity may be more internalized. It may appear as:

Racing thoughts or an inability to "turn off" the mind.
Constant fidgeting, nail-biting, or leg-bouncing.
Feeling the need to stay constantly busy to avoid boredom.

Masking and Coping Mechanisms

Many women develop strategies to compensate for their ADHD symptoms, often at the cost of their mental and emotional well-being. This can include:

Overworking to maintain a sense of control.
People-pleasing to avoid conflict or criticism.
Internalizing struggles and blaming themselves for their difficulties.

Because ADHD in women often goes unrecognized, many grow up feeling as though they are "not trying hard enough" or that they are fundamentally flawed. Recognizing these symptoms is the first step toward understanding and finding supportive strategies.

Why are females chronically underdiagnosed with ADHD compared to men?

ADHD has long been viewed as a condition that primarily affects hyperactive young boys, leading to a significant gap in diagnosis for females. This discrepancy is due to a combination of social expectations, gender biases in research, and the way ADHD symptoms present differently in women and girls.

Differences in Symptom Presentation

Many diagnostic criteria for ADHD were developed based on studies of young boys, who often display more outwardly disruptive symptoms such as hyperactivity, impulsivity, and difficulty sitting still. Girls, on the other hand, are more likely to experience:

Predominantly inattentive symptoms (daydreaming, forgetfulness, difficulty focusing).
Internalized struggles like anxiety and low self-esteem rather than external behavioral issues.
Hyperactivity that manifests as excessive talking or fidgeting rather than physical restlessness.

Because these symptoms are less disruptive in a classroom or work setting, they often go unnoticed or are misattributed to personality traits (e.g., "she’s just spacey" or "she worries too much").

Social Conditioning and Masking

From a young age, girls are often encouraged to be organized, quiet, and people-pleasing. Many learn to mask their ADHD symptoms by developing coping mechanisms that allow them to "blend in," such as:

Over-preparing or working extra hard to compensate for forgetfulness.
Mimicking others' organizational habits to appear put-together.
Suppressing hyperactivity or impulsivity to avoid standing out.

While these strategies may help them navigate childhood, they often lead to burnout, anxiety, and self-doubt in adulthood when demands increase.

Misdiagnosis and Overlapping Conditions

Because ADHD in females frequently coexists with other mental health conditions, it is often misdiagnosed as:

Anxiety or depression – Since many women with ADHD experience emotional dysregulation and chronic overwhelm, they are more likely to be treated for anxiety or mood disorders while the root cause (ADHD) remains undetected.
Personality traits – Traits like forgetfulness, disorganization, or impulsivity are sometimes dismissed as character flaws rather than signs of a neurodevelopmental condition.
Perfectionism or OCD tendencies – Some women develop rigid routines or obsessive planning as a way to compensate for executive dysfunction, leading to an incorrect OCD diagnosis.

Later-in-Life Realization

Many women don’t realize they have ADHD until adulthood, often after:

A child or sibling is diagnosed, prompting them to recognize similar traits in themselves.
Life transitions (college, motherhood, career shifts) expose the limits of their coping mechanisms.
They experience burnout or struggle to manage daily responsibilities despite their best efforts.

This delayed diagnosis can come with a sense of relief, but also grief over years of unnecessary self-blame and struggles.

ADHD in Women