5 Reasons Why ADHD is Often Misdiagnosed in Women

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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects people of all genders, ages, and backgrounds.?

However, studies suggest that ADHD is often underdiagnosed or misdiagnosed in women, with many females living with the condition without realising it.?

This gender bias in diagnosis has significant implications for women's mental health, self-perception, and overall well-being.?

In this article, I’ll explore the various factors contributing to the misdiagnosis of ADHD in women and shed light on this complex issue.

To watch the extended video version of this article, click here .

Misdiagnosis/Under Diagnosis

I’ve been driven to write this article because I’m coaching an ever-increasing number of women who have or are in the process of getting a formal ADHD diagnosis.

Previously they have been diagnosed with anxiety, depression, early menopause or other mental health issues. All have commented that their doctors never even considered the possibility of ADHD, and as they knew so little about it themselves, it didn’t occur to them either.

However, once they fully understood how ADHD manifests in women – which is often markedly different from men – I have been able to support them in getting a formal diagnosis and helping put interventions in place to manage their symptoms.

Therefore, my aim in this and all my recent articles and social media posts about ADHD is to raise awareness. Too many people are struggling unnecessarily, and whilst ADHD is incurable, there are many benefits if the symptoms are managed correctly.

How ADHD Symptoms Differ in Women

1. Stereotypical Symptoms & Diagnostic Criteria

ADHD is commonly associated with hyperactivity, impulsivity, and disruptive behaviour, which are more prevalent in males. This stereotype has shaped the diagnostic criteria, making it less sensitive to the manifestations of ADHD in females.?

Women with ADHD tend to exhibit symptoms that differ from the classical presentation, such as internalised struggles, daydreaming, disorganisation, and emotional dysregulation.?

These atypical symptoms are often overlooked or attributed to other conditions like anxiety or depression, leading to misdiagnosis or missed diagnosis.

2. Masking & Camouflaging Behaviours

Women with ADHD are more likely to develop coping mechanisms that mask their symptoms, often due to societal expectations or pressure to conform.?

Growing up, girls are often told to ‘be a good girl’ and to ‘act ladylike’. They are taught that overenthusiastic or unruly behaviour is unattractive, so they learn to bury their hyperactivity, impulsivity and potential disruptiveness.

This camouflaging behaviour, or "masking," allows them to blend in and compensate for their attention difficulties.?

However, it also makes it harder for clinicians to recognise the underlying ADHD symptoms, as these women may appear competent, organised, and successful on the surface.?

The effort required to maintain this facade can be mentally exhausting and may contribute to feelings of inadequacy or anxiety.

3. Hormonal Influences & Life Transitions

Hormonal fluctuations during puberty, menstruation, pregnancy, and menopause can exacerbate ADHD symptoms in women. These hormonal shifts can lead to changes in attention, mood, and overall cognitive function.?

As a result, women may seek professional help during these periods, revealing symptoms that have been present but less noticeable in other phases of their lives.?

Unfortunately, these symptoms can be misinterpreted as hormonal imbalances or unrelated mood disorders, further delaying an accurate ADHD diagnosis.

4. Social & Cultural Factors

Societal expectations and gender norms can influence how ADHD is perceived and diagnosed. Girls are often expected to be more compliant, organised, and quiet compared to boys, making it easier for their symptoms to go unnoticed.?

In addition, the prevailing stereotype of ADHD as a disorder primarily affecting young boys can lead to biases in assessment and diagnosis.?

Consequently, girls and women with ADHD may face scepticism or disbelief from healthcare professionals, friends, family, or even themselves, which hampers their access to appropriate support and treatment.

5. Lack of Awareness & Education

Limited awareness and knowledge about the unique presentation of ADHD in women contribute to the misdiagnosis problem.?

Healthcare professionals, educators, and the general public may be less familiar with the specific challenges faced by women with ADHD, leading to missed opportunities for early identification and intervention.?

Raising awareness about the diverse symptoms and experiences of ADHD in women is crucial for reducing misdiagnosis and ensuring proper support.

Conclusion

The misdiagnosis of ADHD in women is a complex issue with multiple contributing factors. Stereotypical symptoms, masking behaviours, hormonal influences, social expectations, and lack of awareness all play a role in this gender bias.?

Recognising and addressing these challenges through improved diagnostic criteria, education, and awareness is essential for ensuring that women with ADHD receive timely and appropriate support.?

By empowering women to understand their unique experiences and advocating for gender-inclusive approaches to diagnosis and treatment, we can help close the gap in ADHD identification and provide much-needed support for those affected.

If you think you or an adult close to you (regardless of gender) may have ADHD, I recommend visiting the ‘Right to Choose’ page on the Psychiatry UK website:?https://psychiatry-uk.com/right-to-choose/ ?for more information on diagnoses.

What Next?

For more general information on ADHD, I have listed resources in a previous article, ‘7 Surprising ADHD Traits', which you can read?here .

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