Why are so many women struggling with ADHD?

Why are so many women struggling with ADHD?

I vividly recall the day I first encountered the term ‘neurodiversity’ and wondered what it meant. Having worked in the disability sector for years, I was shocked and more than a little embarrassed by how narrow my understanding of cognitive and neural differences truly was.

Ironically, I grew up with more than half of my immediate family living on the neurodiversity spectrum, with both siblings and one parent diagnosed with autism or ADHD.

Online platforms like TikTok have exploded with resources and personal stories of adults, mainly women, who fell through the cracks of ADHD screening and diagnosis as children. The hashtag #actuallyADHD has more than 117 million views (at the time of writing) and is growing daily.

A quick scroll through these videos clearly shows that, until recently, our understanding of ADHD has been grossly limited and skewed by gender bias. Girls and women have historically been far less likely to be screened for conditions like ADHD and autism, thanks to longstanding and pervasive sexism in the medical industry.

Many people continue to conflate ADHD with a stereotypical image of a young boy who can’t sit still and constantly causes disruptions in class. It wasn’t until my sister and mother were diagnosed in their 30s and 60s that I realised how little most people truly understood about ADHD.

What exactly is ADHD?

ADHD is the acronym for a neurodevelopment disorder called Attention Deficit Hyperactivity Disorder. It has historically been used interchangeably with ADD (Attention Deficit Disorder) however, this term is now inappropriate and has not been used in medical settings since the 1990s.

We now understand that there are three types of ADHD: impulsive/hyperactivity, inattentive/distractible, or the most common: a combination of the two.

The impulsive/hyperactivity type is the ‘stereotypical’ form of ADHD, often characterised by being overly excitable, loud, impulsive, or restless.

People with more inattentive/distractable ADHD traits may be forgetful daydreamers perceived as flaky and easily distracted. They may struggle with routine tasks like staying on top of paperwork, personal care, or household chores.

Growing up, I recall marvelling at my sister’s forgetfulness. I remember feeling hurt when I would earnestly share something personal with my mother, only for her eyes to wander off and for her to start talking about something unrelated.

I grew frustrated by what I perceived as a lack of effort on her part and resented the impact on my life of having a caregiver who struggled to give me consistent attention.

My childhood brain made up all kinds of stories for why these things were happening: my mother cared more about my siblings than me, my sister was naturally messy or lazy, and I alone worked hard to get things right.

Knowing what I do now, I realise my naive mind unfairly judged my family members. I know they were doing their absolute best while living in a world not designed for their unique neurological make-up.

Unfortunately, the conversation taking place now simply didn’t exist back then. Few people understood that women could appear to be succeeding in life, despite invisible challenges that made mundane and routine tasks overwhelming enough to cause severe mental and physical health problems.

Why have so many women had their ADHD missed or misdiagnosed?

Women may tend to display more inattentive traits than hyperactive ones, which is one of the reasons they often go without the recognition or support they need. Because these symptoms of ADHD are often less obvious or ‘loud’, women with ADHD frequently fly under the radar or are misdiagnosed with other issues like anxiety and depression.

Many women with ADHD have faced long journeys with their mental health and may have explored medications for anxiety and depression with mixed or poor results. The issue is that these disorders are usually present in addition to, not instead of, ADHD. Often, depression or anxiety is even a direct result of living in a world that doesn’t understand or accept them for who they are.

The additional social pressures on women to behave nicely, fit in, and not make a fuss also play a role. Girls and women suffering from unexplained challenges with cognition and focus are often more skilled at developing coping strategies than boys and men. They can be excellent at ‘masking’ their symptoms.

Sadly, when women are eventually diagnosed, they face even further challenges. They may grieve for their younger selves, who deserved more understanding and support. They also face frequent stigma, shame, and gaslighting from people around them who insist they couldn’t have ADHD or imply that they are using the diagnosis as an excuse.

People misunderstand that while someone may have been able to act neurotypical or ‘normal’ for many years, this performance came at an excruciating cost and ravaged their self-esteem, ability to form meaningful relationships, and their mental and physical health.

If someone trusts you enough to share their ADHD diagnosis with you, resist the temptation to dismiss the information or reject the idea because it is incongruent with your beliefs of who they are.

You should also avoid giving them the ‘compliment’ of saying, “I would never have known,” or “you don’t look like you have ADHD!”. While well-intended, this response can feel invalidating and imply that the less obvious their ADHD, the better, further ingraining the idea that it is something to feel ashamed of or hide.

Why are so many women struggling with ADHD?

Busting ADHD myths: What people with ADHD want you to know

  1. We aren’t all ‘a little bit ADHD’. Some traits, like forgetfulness, distractibility, or disorganisation, can happen to anyone. The vital difference is the severity, chronic nature, and detrimental effect on one’s life. Avoid using the term casually to describe days you feel a little off or diagnosing people as a ‘joke’ during a conversation.
  2. Medication is necessary and life-changing for many. Avoid stigmatising language around ADHD medication. Don’t encourage people to tough it out on willpower or motivation alone. When you are in agony, you want pain medication; the same applies here. If willpower were enough to overcome the challenges associated with ADHD, the person living with it their whole life would have done so.
  3. People with ADHD aren’t making excuses. Dismissing someone’s real challenges as them just being lazy, unmotivated, or unreliable is triggering, invalidating, and a covert form of ableism. Don’t assume you know what someone is experiencing better than they do. Instead, ask how you can better understand and support their journey.
  4. ADHD also has a lot of positives. While the challenges of a neurodiverse brain in a neurotypical world are genuine, ADHD is not all doom and gloom, nor is it a disease requiring a cure. People with ADHD are often creative, hilarious, spontaneous, artistic and often make excellent entrepreneurs.
  5. Your organisational tips may be unhelpful. Telling someone with ADHD to use to-do lists or alarms for essential tasks is usually well-intentioned. It also misses the point of executive dysfunction – a key aspect of ADHD. Neurodiverse brains process information differently and have barriers to effectively managing their thoughts, emotions, and actions. Your tools for managing your life will likely miss the mark and may even feel triggering or dismissive.
  6. Don’t assume every person with ADHD is the same. Every individual along the neurodiversity spectrum is different. I can only speak to my own understanding, experiences, and relationships with neurodiverse people. I still get things wrong and have a lot to learn. Never presume you understand a person’s life experience is because you met someone with ADHD. Always see the person first, and ask respectful questions to understand them better.
  7. Neurodiverse people get exhausted from constantly educating those around them. Take some initiative to explore educational content about ADHD, and take the burden off your friends or family members from continually having to advocate and teach you about the condition. Some good places to start are listed below:

If you think you or someone close to you may be living with undiagnosed ADHD, this useful guide can help you navigate the diagnosis process.

Always be respectful, and leave your assumptions at the door. We are all unique, which should be celebrated and supported, not shamed or stigmatised.

Emma Lennon

Emma Lennon

Emma Lennon is a passionate writer, editor and community development professional. With over ten years’ experience in the disability, health and advocacy sectors, Emma is dedicated to creating work that highlights important social issues.