What Are The Signs Of ADHD in Women & Girls?

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ADHD, or Attention Deficit Hyperactivity Disorder, is a neurodevelopmental disorder that affects both children and adults. It is characterized by signs such as difficulty with focus, hyperactivity, and impulsivity.

ADHD can make it challenging to complete tasks, follow through on responsibilities, and interact with others.

Despite being seen as a disorder stereotypical of boys who are disruption and cannot sit still, ADHD can manifest in girls and women, challenging the misconception that it primarily affects boys.

woman with many thoughts coming out of her head — ADHD can significantly impact the daily lives of girls and women, influencing their attention, organization, impulsivity, and emotional well-being.

This article will discuss ADHD in girls and women. To ensure clarity, it is important to note that in this article, the terms ‘girls,’ ‘women,’ and ‘females’ will specifically refer to individuals who identify as cisgender.

This is due to limitations in the research on ADHD, which often do not specify whether gender non-conforming individuals or transgender women are included.

Signs of ADHD in Girls and Women

Below are some of the common signs of ADHD that are thought to be present in women and girls. It is worth noting that not every sign will apply to each person with ADHD. This is also not an exhaustive list of signs. Each person can have a different presentation of this disorder, with differing levels of difficulties:

Forgetfulness – e.g., forgetting important dates and work assignments
Difficulty maintaining focus – e.g., mind-wandering during class and finding it hard to listen to the teacher
Hyper-talkative – e.g., your friends and family often describe you as a ‘chatterbox’
Being disorganized and messy – e.g., your home and workspace are cluttered
Appears to be unmotivated – e.g., because of difficulties sustaining attention it can appear as though you are disinterested
Verbally impulsive – e.g., interrupting others during conversations or finishing other’s sentences
Emotionally sensitive – e.g., you may cry easily or become angry at small inconveniences
Poor time management – e.g., finding it hard to stick to deadlines or working all night before a deadline
Problems completing tasks from start to finish – e.g., trying to complete a homework assignment but getting distracted by other more interesting tasks
Shifting focus from one activity to another – e.g., having many different thoughts or ideas at once and finding it hard to focus on one at a time
Taking time to process information – e.g., if someone gives you instructions, then you may need to hear them several times to fully understand

These signs of ADHD are common in all genders, but for girls and women, they may present slightly differently based on other factors, such as social pressures and expectations placed on females.

Below is a deeper discussion of how ADHD can present in girls and women, specifically:

Different presentation of ADHD Signs

Women and girls with ADHD are believed to have more inattentive signs rather than hyperactive signs. This does not mean that they never experience hyperactivity but that it may look different.

“Compared to boys and men, girls and women with ADHD may have symptoms that are less noticeable to others. This is because they often have an inattentive presentation of ADHD, with symptoms such as difficulties with organization, focus and attention to detail.”

Rosenthal (2021).

Girls and women may present their hyperactivity internally, in the form of racing thoughts, or outwardly, as being very talkative and interrupting conversations.

“Girls are more likely to have problems with distractibility, but not always distractibility with things going on around them. Instead, they can easily be distracted by what’s going on internally, like their thoughts. And this can be hard to notice.”
Dr. Jacque Bogdanov, Licensed Child Psychologist.

‘You have so many thoughts in your head that, in the end, it just becomes stressful.’

From Öster et al. (2019)

Girls and women with ADHD are more likely to have internalizing problems compared to boys (Young et al., 2020). Internalizing means directing feelings and behaviors inward instead of outward.

For example, girls with ADHD tend to be more withdrawn, anxious, and depressive and have lower self-esteem, whereas boys tend to show more externalizing behaviors like aggression, hyperactivity, and defiance.

This is partly due to social expectations for girls to be well-behaved and controlled.

Overwhelmed by societal expectations

Girls and women with ADHD often struggle with managing multiple tasks simultaneously due to the social expectations placed on them to excel in various domains.

They are often expected to be organized and on top of household chores, childcare duties, work/school responsibilities, and social obligations.

However, ADHD symptoms like inattention, distractibility, and poor time management make it very difficult to stay on top of everything.

“As soon as responsibilities increase with increasing… demands on their personal lives, maybe they’ve entered into a relationship or parenthood. So think of it as the more balls you have to juggle in the air at some point in the life, things start falling apart.”
Dr Muffazal Rawala, Consultant Adult Psychiatrist and ADHD expert.

Trying to meet these high standards can lead to constant frustration, feelings of inadequacy, and burnout in women with ADHD.

‘When I become so stressed that I can’t do anything, then I lie down and stop caring and I feel like I’m a failure.’
Öster et al. (2019)

‘I would get so overwhelmed by the amount of work that I had to do, that I’d freeze up, not knowing what to do, or end up not doing it. That was hard. I felt very out of control with myself’
Christine, from Holthe & Langvik (2017).

Difficulties regulating emotions

Girls and women with ADHD frequently exhibit problems with emotion regulation, including mood lability, irritability, and difficulties controlling emotional outbursts (Young et al., 2020).

They may have emotional outbursts, react strongly in situations, or have trouble calming down once upset. Their emotions can change rapidly and seem disproportionate to the situation.

They may have trouble thinking before acting when experiencing strong emotions. Impulsivity and poor self-control can make it challenging to manage emotional reactions.

“Girls with ADHD may show more emotional reactivity and have more exaggerated emotions than boys and their peers. They may have trouble regulating their emotions, which can lead to more meltdowns or outbursts.”
Dr. Jacque Bogdanov, Licensed Child Psychologist.

Teenage girls with ADHD are prone to engage in self-harm behaviors, such as cutting, as a means of regulating difficult emotions like sadness, anger, emptiness, anxiety, and loneliness (Young et al., 2020).

“One study we looked at suggests that ADHD in females – especially when it involves hyperactive/ impulsive symptoms – can increase the risk of self-harm when there is also emotion dysregulation.”
Rosenthal (2021).

Emily describes how she has difficulties regulating her emotions, a common sign of ADHD:

‘I remember having temper tantrums that would scare me, because I realized that I couldn’t control them, and I didn’t even know why I was so upset’
Emily, from Holthe & Langvik (2017).

Compensating for ADHD Challenges

One major difference in ADHD presentation for girls and women is their use of compensation strategies to offset struggles. Unlike boys, who often exhibit externalizing behaviors, girls work incredibly hard to adapt to expectations, even in unhealthy ways.

For instance, a girl may become a perfectionist and obsessively over-prepare for tests to produce good grades despite concentration issues. Or she may strictly adhere to rigid daily routines to reduce lateness and disorganization.

Women with undiagnosed ADHD compensate by overworking themselves, only sleeping a few hours a night to complete responsibilities. They may abuse stimulants, unhealthy eating patterns, or social isolation to force focus and cope with overwhelm.

“…were they actually coming in earlier, staying up late to manage their workload when the distractions of an office environment were not there? So what were the compensatory mechanisms which this individual has put in their lives in order to perhaps mask some of these symptoms of having attention dysregulation or time management poor organizational abilities.”
Dr Muffazal Rawala, Consultant Adult Psychiatrist and ADHD expert.

Compensation allows girls and women with ADHD to mask symptoms. But it leads to anxiety, burnout, eroded self-esteem, and physical health issues.

Hyperfocus

People with ADHD, especially girls and women, may use hyperfocus as a coping strategy.

For example, a girl with undiagnosed ADHD might spend hours perfecting a school project not because she is a perfectionist but because she gets absorbed in the details.

She may devote excessive time and energy far beyond what is required to avoid feeling restless or distracted.

This hyperfocus on schoolwork can lead teachers to think she is an exceptionally diligent student, failing to recognize the ADHD symptoms driving her over-the-top focus.

While hyperfocusing, she loses track of time and neglects other tasks. In this way, girls with ADHD may use hyperfocus on academics or other interests as an outlet when they feel unfocused or fidgety, unintentionally masking their struggles with inattention.

Imposter syndrome

Imposter syndrome is common in girls and women with ADHD who are high achievers.

Even when they accomplish great things, they often feel like a fraud who does not deserve their success.

This stems from the fact that their achievements require much more effort for them compared to neurotypical peers due to ADHD-related struggles.

However, others only see the end result, not the immense work and overcompensating behaviors done behind the scenes.

Jess, who has ADHD, earns straight As in school through tremendous extra studying, coping strategies, and help from tutors. Her classmates simply see a smart student who gets top grades. Because they don't witness her struggles, Jess feels like an imposter who sneaked into the "top student" role rather than deserving it. She doubts her abilities and wonders if she could keep up the performance without all the compensation techniques. This erosion of self-confidence worsens the imposter syndrome.

Jasmine describes her experience of not feeling capable enough when everyone else around her appears to manage easily:

‘You really internalize that criticism of not meeting the mark, of not being capable enough where other people seem to manage effortlessly.’
Jasmine

Social difficulties

Girls and women with ADHD are more likely to have difficulties with peer relationships, including having fewer friends, less stable friendships, and more conflicts (Becker et al., 2017; Quinn & Madhoo, 2014).

The social world for girls with ADHD may be more complicated than that of boys and men.

Girls may feel more pressure to pay close attention to their friend’s feelings, or they may have to pick up on subtle social cues, which can prove hard for someone with ADHD.

If they find difficulty in paying attention to their friends and can be impulsive in conversations (e.g., interrupting), this can cause a rift and fallout.

Verity is a 10-year old girl with ADHD. She struggles to maintain friendships and often feels left out at school. Verity tries to join groups at recess but has a hard time listening to her friends talk about their interests. She frequently interrupts them or changes the subject to talk about something she finds more exciting. This frustrates her peers and leads to arguments.

Verity's ADHD symptoms like poor listening skills, impulsivity, and trouble staying focused impact her ability to maintain positive social connections.

Low self-esteem

Girls with ADHD tend to have lower self-esteem than boys with ADHD. This low self-esteem can persist into adulthood for women with undiagnosed ADHD (Becker et al., 2017; Quinn & Madhoo, 2014).

Girls and women with ADHD are often more likely to have an internal locus of control than males. For instance, they may be more likely to blame themselves when things go wrong, whereas males may be more likely to blame external factors.

They may attribute their struggles and challenges to personal flaws or shortcomings rather than anything out of their control.

This tendency to blame themselves can stem from societal expectations and pressures, as well as internalized feelings of inadequacy, which can impact their self-esteem and overall well-being.

“I think because of the self-esteem issues, it has affected me socially because I’ve become a people pleaser. And so, a lot of the time, rather than just being myself and sticking to my values, a lot of the time I’m trying to meet the values of others around me. And so, I find myself people pleasing a lot to make other people happy, sometimes at the expense of my own happiness.”

Female student with ADHD, from Morey & Tyrrell (2023).

Managing ADHD in Girls and Women

While ADHD presents challenges, evidence-based strategies can help girls and women effectively manage symptoms.

Academic accommodations like additional time for assignments allow girls to excel despite focus issues (Young et al., 2020).
Cognitive-behavioral therapy helps build coping skills for organization, emotional control, and social skills (Anastopoulos et al., 2020).
Coaching provides personalized strategies for managing distractions, transitions, and overwhelm.
Medication can alleviate ADHD symptoms but should be carefully evaluated by doctors, as girls may be more sensitive to side effects.
Support groups connect women with ADHD to share ups and downs without judgment.
Mentoring programs can help to build self-esteem and guidance.
Daily movement (e.g., cardio exercises) and mindfulness help channel excess energy and emotions.
Most importantly, compassion and patience from others, as well as themselves, allow girls and women with ADHD to navigate challenges while valuing their unique skills and talents.
Self-help strategies that you can implement yourself, e.g., creating an ADHD-friendly environment, identifying your strengths, and letting go of perfectionism.

FAQs

Can girls and women with ADHD experience difficulties in relationships?

Yes, girls and women with ADHD can experience difficulties in relationships.

ADHD symptoms, such as impulsivity, forgetfulness, and inattentiveness, can impact their ability to effectively communicate, listen, and maintain focus within relationships.

This may lead to misunderstandings, conflict, and challenges in meeting relationship expectations.

However, with awareness and support, individuals with ADHD can develop strategies to manage their symptoms and enhance their relationship skills, fostering healthier and more fulfilling connections with others.

Can ADHD symptoms change during different life stages for females?

Yes, ADHD symptoms can change during different life stages for females.

Hormonal fluctuations during puberty, menstruation, pregnancy, and menopause may exacerbate ADHD symptoms in women. This can lead to changing symptom presentation over the lifespan (Antoniou et al. 2021).

‘We’re recognizing that… often their symptoms get worse before their periods and also after menopause when estrogen drops.’
Professor Amanda Kirby

What are some common misconceptions about ADHD in girls and women?

Before realizing they have ADHD, girls and women may be attributed negative labels such as:

“Lazy” or “unmotivated” due to difficulties with focus and productivity.

“Airheaded” or “scatterbrained” because of forgetfulness and disorganization.

“Spacey” or “daydreamer” as a result of inattentiveness and zoning out.

“Emotional” or “moody” due to challenges in regulating emotions and impulsivity.

“Underachiever” because of inconsistencies in academic or professional performance.

“Unreliable” or “flaky” because of difficulty with time management and meeting commitments.

These labels often overlook the underlying neurobiological factors of ADHD, leading to misunderstanding and frustration for the individuals involved.

References

Advokat, C. D., & Scheithauer, M. (2013). Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Frontiers in neuroscience, 7, 82.

Anastopoulos, A. D., King, K. A., Besecker, L. H., O’Rourke, S. R., Bray, A. C., & Supple, A. J. (2020). Cognitive-behavioral therapy for college students with ADHD: Temporal stability of improvements in functioning following active treatment. Journal of Attention Disorders, 24(6), 863-874.

Antoniou, E., Rigas, N., Orovou, E., Papatrechas, A., & Sarella, A. (2021). ADHD symptoms in females of childhood, adolescent, reproductive and menopause period. Materia Socio-Medica, 33(2), 114.

Becker, S. P., Mehari, K. R., Langberg, J. M., & Evans, S. W. (2017). Rates of peer victimization in young adolescents with ADHD and associations with internalizing symptoms and self-esteem. European child & adolescent psychiatry, 26, 201-214.

Children and Adults with Attention-Deficit/Hyperactivity Disorder. (n.d.). Women and Girls. Retrieved 2022, January 25, from: https://chadd.org/for-adults/women-and-girls/

Chronis‐Tuscano, A. (2022). ADHD in girls and women: a call to action–reflections on Hinshaw et al.(2021). Journal of Child Psychology and Psychiatry.

Finlay, M. (2022, May 12). Why aren’t women getting diagnosed with ADHD? [Audio podcast episode]. In Science Weekly.

Gershon, J., & Gershon, J. (2002). A meta-analytic review of gender differences in ADHD. Journal of attention disorders, 5 (3), 143-154.

Gurian, A. (2014). Girls with ADHD: overlooked, underdiagnosed, and underserved. NYU Child Study Center About Our Kids .

Hinshaw, S. P. (2002). Preadolescent girls with attention-deficit/hyperactivity disorder: I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices. Journal of consulting and clinical psychology, 70 (5), 1086.

Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2021). Annual Research Review: Attention‐deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry.

Hinshaw, S. P., Owens, E. B., Zalecki, C., Huggins, S. P., Montenegro-Nevado, A. J., Schrodek, E., & Swanson, E. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of consulting and clinical psychology, 80 (6), 1041.

Meza, J. I., Owens, E. B., & Hinshaw, S. P. (2021). Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder. Development and psychopathology, 33 (4), 1351-1367.

Morley, E., & Tyrrell, A. (2023). Exploring Female Students’ Experiences of ADHD and its Impact on Social, Academic, and Psychological Functioning. Journal of Attention Disorders, 10870547231168432.

Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The primary care companion for CNS disorders, 16 (3).

Steer, J. (Host). (2022, December 21). ADHD in women, Prof Lucy Easthope, Debbie [Audio podcast episode]. In Women’s Hour.

Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., … & Woodhouse, E. (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), 1-27.