ADHD In Women and Girls

5 Reasons ADHD Is So Often Missed

You’re smart, capable, and hardworking.

But your brain feels like it’s juggling chaos on fast-forward.

You can’t seem to follow through on plans—even ones you’re excited about.

And somehow, you’re always just one step behind, no matter how hard you try.

If this hits a little too close to home, you’re not alone. ADHD in girls and women is often misunderstood, misdiagnosed—or missed entirely.

But it’s not just you.

There are real, research-backed reasons why ADHD presents differently in females and why so many don’t find out until adulthood.

And in this blog, I’ll walk you through the top five.

Why It Matters

Girls with ADHD aren’t just “spacey” or “sensitive.”

Women with ADHD aren’t just “bad at adulting.”

These labels are symptoms of a larger problem: undiagnosed and unsupported neurodivergence.

And the cost? Years of anxiety, burnout, and self-doubt.

In this post, you’ll learn why ADHD gets missed in women and girls—and what to do if you see yourself in these patterns.

1. ADHD in Girls Looks Different Than in Boys

Let’s start with the most basic misunderstanding: ADHD doesn’t look the same across genders.

Boys are more likely to show externalized symptoms, like hyperactivity, impulsivity, and disruptive behavior (Hinshaw et al., 2021). Girls, on the other hand, tend to internalize their symptoms—they may daydream, fidget quietly, or struggle silently with disorganization (Quinn & Madhoo, 2014).

This means girls are:

More likely to be labeled “spacey,” “unmotivated,” or “emotional”
Less likely to be referred for ADHD evaluations by teachers or parents
Often diagnosed much later—if at all

In fact, research shows that girls are diagnosed with ADHD an average of five years later than boys (Hinshaw et al., 2021). And many aren’t diagnosed until adulthood—after decades of invisible struggle.

2. Girls and Women Learn to Mask ADHD Symptoms

From a young age, girls are taught to please others, be polite, and meet expectations. So when ADHD makes that difficult, many compensate by masking.

Masking can look like:

Over-preparing for every meeting or test
Relying heavily on planners, to-do lists, or others to stay organized
Mimicking peers’ behavior to blend in socially
Hiding emotional outbursts or overwhelm until they’re alone

It’s exhausting.

Over time, this effort to “act normal” becomes a full-time job. Many women say they’ve spent years overcompensating—only to collapse into burnout by their 30s or 40s.

As Russell and Rostain (2023) explain, masking often delays diagnosis because the person appears high-functioning on the outside—even when they’re crumbling on the inside.

3. Diagnostic Criteria Are Based on Boys

Here’s a frustrating truth: The original ADHD diagnostic criteria were based almost entirely on young white boys in clinical settings (Young et al., 2020).

That means:

Diagnostic tools often miss inattentive symptoms more common in girls
Hyperactivity is over-emphasized, while emotional dysregulation is overlooked
Girls who seem quiet, shy, or anxious get misdiagnosed—or dismissed

Today, girls are underrepresented in ADHD research (Gershon, 2002). As a result, many providers still rely on outdated models of what ADHD “should” look like—and females often don’t fit the mold.

Newer research, however, confirms that inattentive ADHD (which includes distractibility, forgetfulness, and executive dysfunction) is more prevalent in girls and women (Antoniou et al., 2021).

4. Hormones Add Complexity

ADHD symptoms don’t exist in a vacuum—they’re influenced by hormonal changes across a woman’s life.

Estrogen plays a key role in dopamine regulation, the same neurotransmitter affected by ADHD (Quinn & Madhoo, 2014). When estrogen drops, symptoms often worsen.

Common hormonal “hotspots” that affect ADHD in women:

Before periods (premenstrual worsening of ADHD symptoms)
During postpartum (executive dysfunction, emotional volatility)
In perimenopause (memory lapses, fogginess, increased distractibility)

Many women report that these transitions feel like “losing control” of their minds, only to be told it’s just stress or hormones.

In reality, it may be ADHD in women emerging more clearly at times when estrogen fluctuates.

5. ADHD Is Often Misdiagnosed as Anxiety or Depression

Because women with ADHD internalize their struggles, they’re often first diagnosed with:

Generalized Anxiety Disorder
Major Depressive Disorder
Bipolar Disorder
Borderline Personality Disorder
Or treated for “burnout” without a clear root cause

And while ADHD does often co-occur with anxiety and depression (Arnold et al., 2020), treating those without addressing the underlying executive dysfunction leaves women feeling frustrated and stuck.

They may think, “I’ve done the therapy. I’m on the meds. Why am I still overwhelmed and underperforming?”

The answer is often: untreated ADHD.

One large-scale survey of over 1,200 women with ADHD found that more than 90% had at least one additional diagnosis, but many weren’t diagnosed with ADHD until much later (ADDitude, 2023).

"It’s not that women with ADHD are failing to cope—it’s that they’ve been coping without a diagnosis for years."

What to Do If You Recognize These Patterns

If you read this and felt a pang of recognition, here's how to take the next step.

1. Educate Yourself

Start learning about ADHD in women and girls—through books, podcasts, or blogs. Look for resources that reflect your lived experience, not just the textbook definition.

2. Document Your Symptoms

Start tracking:

When symptoms show up
How they affect daily life
What makes them worse or better

This will help you advocate for yourself during an evaluation.

3. Find an ADHD-Savvy Provider

Not every clinician understands how ADHD presents in women. Look for someone who has experience with neurodivergent women or who specializes in adult ADHD.

Bring your notes, your questions, and your suspicions. You’re allowed to ask for a second opinion.

4. Explore Treatment Options

Once diagnosed, effective treatment might include:

Stimulant or non-stimulant medication
Cognitive-behavioral therapy (CBT) or ADHD-specific coaching
Lifestyle strategies (structured routines, sleep, movement, mindfulness)
Peer support through online communities or in-person groups

The right support can help you feel less overwhelmed, more focused, and more like yourself.

Final Thoughts: It's Time to Change the Narrative

ADHD in girls and women doesn’t have to go unseen.

When we shift the lens—when we recognize that perfectionism, disorganization, and burnout can all be ADHD in disguise—we give women the chance to stop blaming themselves and start healing.

Because the sooner we recognize these patterns, the sooner we can offer real support.

How I Can Help

If this post hit home, you're not alone—and you're not imagining it. I specialize in helping high-achieving women make sense of their anxiety, burnout, and overlooked symptoms that often stem from ADHD and other root causes.

Whether you’re newly diagnosed, self-suspecting, or just plain exhausted, I’ll help you untangle what’s going on and finally feel like yourself again.

Curious about how I can help? Check out these resources:

Or, when you're ready, schedule a consult to chat more.

There’s more to life than coping. Let’s figure this out together—with a plan that works for your brain.

Have people ever described you as “high-functioning,” even when you were struggling inside?

Yes, constantly
Once or twice
No, I show my struggles
Not sure

What’s Your Experience?

Have you ever suspected ADHD in yourself or someone you love?
What has been your biggest challenge or breakthrough?

Drop a comment below and let’s keep the conversation going.
Your story might be exactly what another woman needs to read today.

References

ADDitude. (2023). ADHD in women: Survey results from over 1,200 diagnosed adults. ADDitude Magazine. https://www.additudemag.com/
Antoniou, E., Kalyva, E., & Tsinakos, G. (2021). ADHD symptoms in females of childhood, adolescent, reproductive and menopause period. Mater Sociomed, 33(2), 114–118. https://doi.org/10.5455/msm.2021.33.114-118
Arnold, L. E., Hodgkins, P., Caci, H., Kahle, J., Young, S., & Liddle, E. (2020). Attention-deficit/hyperactivity disorder: A lifespan perspective on the assessment and treatment of ADHD in women. Primary Care Companion for CNS Disorders, 22(1). https://doi.org/10.4088/PCC.19com02600
Gershon, J. (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders, 5(3), 143–154. https://doi.org/10.1177/108705470100500303
Hinshaw, S. P., Owens, E. B., & Zalecki, C. (2021). Developmental trajectories of girls with ADHD: From childhood through emerging adulthood. Journal of Clinical Child & Adolescent Psychology, 50(3), 385–398. https://doi.org/10.1080/15374416.2020.1765134
Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis. Primary Care Companion for CNS Disorders, 16(3). https://doi.org/10.4088/PCC.13r01596
Russell, A. E., & Rostain, A. L. (2023). Adult ADHD and self-regulation: Emotional, cognitive, and behavioral strategies for clinicians. APA Publishing.
Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., & Gudjonsson, G. H. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20(1), 404.