How ADHD Typically Presents in Women? Attention-Deficit/Hyperactivity Disorder (ADHD) in women often looks significantly different from the more widely recognised (and historically male-centered) presentation. While ADHD is commonly associated with hyperactivity and disruptive behaviour—particularly in children—women and girls often experience symptoms that are less visible, more internalised, and frequently overlooked. Common presentations of ADHD in women include: - Inattentiveness rather than hyperactivity: Women are more likely to present with the inattentive subtype of ADHD. This includes difficulty concentrating, forgetfulness, disorganisation, and frequent daydreaming. - High levels of internal restlessness: While boys may express hyperactivity physically, women often experience it as racing thoughts, anxiety, or emotional turbulence. - Perfectionism and overcompensation: Many women with ADHD develop high-functioning coping mechanisms, like becoming perfectionists or overly self-critical, in an attempt to mask their struggles. - Mood instability and emotional sensitivity: Emotional dysregulation can manifest as frequent mood swings, low self-esteem, and difficulty managing stress. - Exhaustion and burnout: Managing undiagnosed ADHD can lead to chronic fatigue and mental health issues, especially when combined with responsibilities related to work, relationships, and caregiving roles.

Why is ADHD often missed or diagnosed late, especially in women? There are several key reasons why ADHD in women is frequently underdiagnosed or diagnosed later in life for many —often only after years of struggling without an explanation: - Historical Male Bias in Research. Most early ADHD research was conducted on hyperactive boys, shaping diagnostic criteria and clinical understanding around their symptoms. As a result, the DSM's criteria have traditionally emphasised externalising behaviours (e.g., hyperactivity, impulsivity), which are less common in women. Men can often present with a non-stereotypical presentation too, also leading to late diagnosis. - Social and Cultural Expectations Girls are often socialised to be quiet, compliant, and well-behaved. This can lead to the masking of ADHD symptoms and internalisation of struggles, such as anxiety and depression, which are often treated without exploring underlying neurodiversity. - Camouflaging and Masking Many women with ADHD develop strong masking strategies—mimicking neurotypical behaviours or over-preparing for tasks to hide their difficulties. This can delay recognition by both professionals and the individuals themselves. -Misdiagnosis or Comorbidity ADHD symptoms are frequently misdiagnosed as mood disorders, anxiety, or personality disorders. While comorbidities are common, ADHD may go unrecognised as the root issue. - Life Transitions as Triggers Major life events—such as starting university, entering the workforce, becoming a parent, or reaching perimenopause—can overwhelm coping strategies, revealing ADHD symptoms that were previously masked. Many people are only diagnosed in adulthood, often after a child receives their own diagnosis. - Impact of Hormonal Changes and Menopause Emerging research shows that hormonal fluctuations—particularly around perimenopause and menopause—can significantly worsen ADHD symptoms in women. Declining estrogen levels affect neurotransmitter activity in the brain, intensifying issues with memory, focus, and emotional regulation. For many women, these changes bring longstanding but unrecognised ADHD traits to the surface, often leading to a diagnosis for the first time in midlife or later. Understanding how ADHD presents differently for some is crucial for providing equitable, effective support. At The Cognitive Collective, we recognise that neurodivergent experiences are diverse, nuanced, and shaped by a complex interplay of biological, psychological, and social factors. Our neurodiversity specialist services are designed to meet individuals where they are—supporting accurate identification, strengths-based strategies, and compassionate care.