ADHD is a disorder that for years has been associated mainly with children, especially boys. However, increasing attention is being paid to ADHD in women, which often remains undiagnosed or misdiagnosed. In a psychological context, ADHD in women has its own unique characteristics and requires special attention in both diagnosis and treatment. Learn more about the symptoms of ADHD, diagnosis, and treatment options.
Characteristics of ADHD in women
ADHD (attention deficit hyperactivity disorder) in women is often referred to as a “silent” or “hidden” disorder. This is because women with ADHD are more likely to intuitively mask their symptoms or cope with them by developing various compensatory strategies. These may take the form of internal anxiety rather than external manifestations of acting out. Statistically, ADHD is more common in boys than in girls, with a ratio of 3:1, which makes the disorder more difficult to diagnose in women.
ADHD – characteristics
Hyperactivity syndrome is a set of characteristics that affect mental and motor functions. They form a consistent pattern of behavior, varying in severity. ADHD is a neurodevelopmental disorder. It manifests itself in the form of:
- increased motor agitation;
- excessive emotional reactivity;
- and specific cognitive impairments.
Neurodevelopmental disorder – ADHD
Neurodevelopmental disorders are a group of conditions that affect the normal development of the brain and nervous system. They are characterized by disturbances in the development of the structures or functions of the nervous system.Neurodevelopmental disorders are disabilities affecting childrenthat are associated with significant difficulties in acquiring and performing specific intellectual, motor, or social functions.
They arise as a result of abnormal development of the central nervous system during the fetal period and early childhood.
According to the DSM-5 classification, neurodevelopmental disorders include:
- Intellectual disability
- Communication disorders
- Autism spectrum disorders
- Attention deficit hyperactivity disorder (ADHD)
- Specific learning disorders
- Motor disorders
ADHD – specific terminology
Several terms are currently in use:
- The American Psychiatric Association’s classification (DSM-IV) refers to “attention deficit hyperactivity disorder.”
- The International Classification of Diseases (ICD-10) proposed by the World Health Organization uses the terms “hyperkinetic syndrome” or “hyperkinetic disorders.”
- In the latest ICD-11 classification, this diagnosis has been placed in the chapter on neurodevelopmental disorders. The name known from the DSM has been adopted: attention deficit hyperactivity disorder. A significant change is the identification of three subtypes of the disorder: a subtype with a predominance of attention disorders, a subtype with a predominance of hyperactivity and impulsivity, and a mixed subtype.
Symptoms of ADHD
ADHD in women often takes a less obvious form than in men or children, which can lead to a later diagnosis or no diagnosis at all. These symptoms can affect all areas of life, from relationships to career. Although they are similar to those observed in girls, their impact and how they are dealt with often differs in adult women. Here is a detailed list of ADHD symptoms in women:
- Excessive impulsivity – may manifest itself in making rash decisions, from impulsive purchases to spontaneous life changes, without thoroughly analyzing the potential consequences.
- Difficulties with organization and planning – difficulties in managing daily tasks such as meal planning, time management, or keeping the house tidy.
- Fatigue and lack of energy – a feeling of chronic fatigue that is not related to physical activity may result from the constant effort put into trying to focus attention and manage impulsivity.
- Short-term memory problems – forgetting appointments, phone calls, or where everyday items have been left.
- Difficulty maintaining relationships – communication problems, inability to listen without interrupting, which can lead to conflicts in personal and professional relationships.
- Avoiding tasks that require high concentration – a tendency to postpone or avoid tasks that require prolonged concentration or are perceived as boring.
- Low self-esteem – resulting from a lack of understanding of one’s own difficulties and feelings of frustration associated with not meeting social and personal expectations.
- Seeking stimulation – striving for new, exciting experiences that can lead to risky behaviors in search of an “adrenaline rush” to compensate for a lack of internal stimulation.
ADHD in adult women – consequences in adult life
ADHD in adult women affects many aspects of life. The disorder can be a source of significant difficulties, especially in managing professional and domestic responsibilities. Symptoms such as forgetfulness and difficulty planning can lead to missing important deadlines and commitments, which in turn can affect work performance, domestic stability, and ultimately reduce quality of life.
Excessive impulsivity in adult women with ADHD can result in rash financial, professional, or personal decisions that can have long-term consequences. Emotional lability, or rapid and intense mood swings, can in turn affect interpersonal relationships, leading to misunderstandings and conflicts with partners, family, and coworkers.
For many women, diagnosis comes late, which can lead to years of misunderstanding their own difficulties and attributing them to other causes, such as laziness or lack of motivation.
ADHD symptoms in adults and the professional sphere
ADHD in adult women can have a significant impact on their professional lives and career development opportunities. Here are some negative characteristics of ADHD that can affect women’s careers:
- Difficulties with concentration and organization. ADHD can exacerbate difficulties with maintaining attention and concentration on work tasks, which can lead to delays at work, forgetting important deadlines, and a lack of focus on long-term career goals.
- Shifting interests and impulsivity. Individuals may tend to get bored quickly and seek new professional challenges. This can lead to frequent job changes and difficulty staying with one task or project for an extended period of time.
- Difficulties with time management. Time management can be challenging for adults with ADHD, which can result in missed deadlines, late arrivals to meetings, and poor work performance. They often organize their work in a chaotic manner.
- Problems with emotional self-regulation. Attention deficit hyperactivity disorder can affect the ability to control emotions in the workplace, which can lead to interpersonal conflicts and problems in professional relationships.
- Difficulties in organizing teamwork. Individuals may have difficulty working in a team due to a tendency to forget responsibilities, difficulty focusing during meetings, and difficulty making key decisions.
Psychomotor hyperactivity and its positive aspects
It is worth noting that proper use of the positive aspects of ADHD can contribute to professional success. The key is to be aware of your strengths and skillfully adapt them to the requirements of your job.
The most important aspects are:
- Creativity. People with ADHD often have a rich inner life and the ability to generate unusual and creative ideas. This can be an asset at work, especially in areas that require an innovative approach and problem solving.
- Enthusiasm. They can be passionate and engage in their projects with great commitment. Their enthusiasm can be contagious to other team members and help build a positive atmosphere in the workplace.
- Quick thinking and mental flexibility. People with ADHD often have a quick mind and are able to adapt quickly to changing situations. This can be useful in a dynamic work environment where quick decisions and adaptation to new conditions are required.
- Leadership in crisis situations. Thanks to their ability to think quickly and make decisions under pressure, people with ADHD can provide effective leadership in crisis situations or situations that require immediate response.
- Seeking new challenges. People may be open to new experiences and professional challenges, which can lead to seeking new career opportunities and acquiring new skills.
History of past symptoms – ADHD symptoms in girls
Diagnosing ADHD in girls can be difficult because the symptoms are often more subtle than in boys and may be overlooked or misinterpreted. Girls with ADHD may exhibit a variety of symptoms that affect their daily functioning both at school and at home. The most important symptoms of ADHD in girls are:
- Difficulty concentrating – girls with ADHD may have trouble maintaining attention on tasks that require focus, especially if the task is monotonous or uninteresting. This can lead to frequent switching between activities without completing them.
- Daydreaming – unlike the hyperactivity often seen in boys, girls may spend a lot of time daydreaming, which is interpreted as a lack of attention or interest.
- Talkativeness – Excessive talkativeness can be a way of coping with difficulties in concentration and can lead to problems in social interactions, especially when a girl interrupts others or has difficulty waiting for her turn to speak.
- Forgetting daily responsibilities – Girls with ADHD may have difficulty remembering daily tasks such as doing homework, packing their school bag, or performing simple household chores.
- Emotional instability – High emotionality and a tendency to swing between extreme moods may be more common in girls with ADHD. They may quickly go from anger to sadness or from joy to frustration.
- Organizational problems – Difficulties with organization and planning can lead to problems at school, such as unfinished projects, forgotten homework, or messy notes and educational materials.
- Avoiding tasks that require sustained mental effort – girls with ADHD may avoid tasks that require sustained focus, choosing activities that are less mentally demanding.
ADHD in teenagers
Attention deficit hyperactivity disorder can last for years:
- in 70% of children, symptoms persist into adolescence;
- 30%–50% of adults continue to have symptoms of ADHD
ADHD in teenagers manifests itself in ways that can significantly affect their development, education, and social relationships. Mood swings are common and can be confused with the hormonal turmoil typical of adolescence. However, in teens with ADHD, these fluctuations are often more intense and can lead to emotional problems and difficulties in maintaining stable relationships with peers and adults. Academic difficulties resulting from concentration problems, teens can be easily distracted, have difficulty organizing and meeting deadlines, which leads to frustration and low self-esteem.
Teens with ADHD often struggle with academic failure that does not reflect their true intellectual potential. Impulsivity can result in risky behaviors such as early experimentation with psychoactive substances, risky sexual behavior, and making decisions without considering the potential consequences.
What are the causes of ADHD?
There is no single specific cause for hyperkinetic disorder. However, scientists emphasize the importance of genetics, as the risk of passing on the disorder from a parent diagnosed with ADHD is estimated at more than 50 percent.
The most important causes:
- genetics,
- young age of the mother,
- premature birth,
- low birth weight,
- exposure to lead poisoning,
- alcohol consumption and smoking during pregnancy.
ADHD – risky behaviors and the constant search for dopamine
ADHD is often associated with a range of risky behaviors. Why? Because they trigger dopamine. This neurotransmitter is responsible, among other things, for our well-being, motivation to act, and the integration of stimuli reaching the brain. In hyperkinetic disorder, there is not enough dopamine. In order to increase its level and feel better, we start to engage in various activities that can be harmful to us, such as
- speeding, breaking traffic rules,
- practicing sports, often extreme ones,
- using psychoactive substances,
- risky sexual behavior,
- nicotine addiction, marijuana addiction,
- compulsive shopping.
Diagnosing ADHD in adult women
Difficulties in diagnosis often stem from the fact that symptoms may be more subtle than in men or manifest themselves in less obvious ways, such as internal anxiety rather than hyperactivity. The diagnostic process must therefore be particularly thorough and based on a wide range of information.
Diagnosing ADHD in women may require collaboration between various specialists, including psychologists, psychiatrists, and therapists specializing in mood and behavioral disorders. An interdisciplinary approach ensures a comprehensive assessment and treatment plan.
Consultation and medical history
The first step in diagnosing ADHD in women is a detailed consultation during which a doctor or mental health professional collects a comprehensive medical and life history. At this stage, it is important to discuss not only current symptoms, but also a history of behaviors and difficulties in childhood that may indicate ADHD. Detailed questionnaires and rating scales are often used to identify key problem areas.
Observation of symptoms
Specialists may also rely on observations of symptoms reported by women and their loved ones. Because ADHD can affect different areas of life in different ways, it is important to gather information from a variety of sources, including partners, family, friends, and possibly coworkers.
Multidimensional assessment
Diagnosing ADHD in women often requires a multidimensional approach, which may include psychological tests assessing attention, executive functions, memory, and other cognitive functions. These tests help differentiate ADHD from other disorders, such as depression, anxiety, and sleep disorders, which may have similar symptoms.
Diagnosis – DIVA diagnostic interview
When diagnosing ADHD in adults, specialists often use various questionnaires and assessment scales to obtain a more complete picture of the patient’s symptoms and functioning.
The Diagnostic Interview for ADHD in Adults (DIVA) is based on the DSM-IV diagnostic criteria and is the first Dutch structured interview for ADHD in adults. DIVA was developed by J.J.S. Kooij and M.H. Francken.
DIVA is a structured interview conducted by a qualified specialist, usually a psychotherapist or psychiatrist. During the interview, various aspects of the patient’s functioning and the presence of ADHD symptoms in different areas of life are assessed.
In order to facilitate the assessment of whether all 18 ADHD criteria were present in both childhood and adulthood, specific examples of real-life behaviors are cited during the interview. ADHD symptoms are checked in the most important aspects of life: at work and school, in relationships with loved ones and family, in social interactions, during leisure time, and while pursuing hobbies. The patient’s self-assessment and beliefs about their own abilities are also taken into account.
Diagnosis of coexisting disorders
Women with ADHD may experience co-occurring disorders such as mood disorders, anxiety disorders, addictions, eating disorders, or personality disorders. Identifying and treating these co-occurring disorders is crucial for the effective treatment of ADHD. Many of these disorders may have similar symptoms or overlap, which can make diagnosis and treatment difficult. Effective management of ADHD in adults may require a comprehensive approach that addresses both ADHD itself and other co-occurring disorders.
Treatment of ADHD in adult women
Effective treatment methods may include pharmacotherapy, psychotherapy, and coping techniques for everyday life. Below you will find a detailed discussion of these strategies.
Pharmacotherapy
Medication is a fundamental part of ADHD treatment. Stimulants such as methylphenidate or amphetamines are most commonly used to improve concentration and reduce impulsivity. For some people, non-stimulant medications such as atomoxetine or certain antidepressants may also be effective. It is important that medication be closely monitored by a specialist.
Psychotherapy
Cognitive behavioral therapy (CBT) is particularly effective in treating ADHD in adults. It helps to understand and change negative patterns of thinking and behavior, and teaches strategies for coping with difficulties in concentration and organization. Therapy may also include social skills training and coping with emotions.
Psychoeducation
Working with ADHD focuses on developing organizational and time management skills. It helps in setting realistic goals, prioritizing tasks, and implementing systems that support productivity. Counseling may also include support in building healthy habits, such as regular physical activity and a balanced diet, which have a positive effect on ADHD symptoms.
Social support
Building a support network, both among loved ones and in support groups for people with ADHD, can be invaluable. Sharing experiences and coping strategies can help you better understand the disorder and feel more accepted.
ADHD in adults. How to cope?
Understanding the disorder is the foundation on which further coping methods can be built, such as organizing your workspace, setting priorities, and planning. In addition to these methods, stress reduction techniques are also important to help minimize the negative impact of ADHD on your life. Stress reduction techniques can include regular physical exercise, which not only improves overall health but also has a positive effect on concentration and well-being.
Meditation and mindfulness are other useful techniques that teach awareness and help manage impulsivity and emotions. It is also important to find time for relaxation and rest, which can mean both recreational activities and quiet moments spent reading a book or listening to music.
Maintaining a healthy diet also plays a key role in managing ADHD. Meals rich in protein, healthy fats (such as omega-3 fatty acids), and complex carbohydrates can support brain function and improve concentration. Limiting your intake of sugar, caffeine, and processed foods can help stabilize your mood, improve your overall well-being, and enhance your quality of life.
Finally, building and maintaining relationships with people who understand the challenges of ADHD can be very helpful. Support groups offer a space to share experiences and coping strategies, which can greatly impact your sense of acceptance and understanding.
Summary
ADHD in women is a complex disorder that affects various areas of life, from professional and educational to personal and family. Diagnosing ADHD in women is often difficult due to the subtlety of symptoms or their misattribution to personality traits.
If you suspect you are struggling with ADHD, remember that you are not alone. There is a growing awareness of how ADHD manifests itself in a variety of ways in adults, especially women. Professional diagnosis, understanding, and support are available. Finding the right treatment path can significantly improve your daily functioning. Every step forward, no matter how small, is an achievement on the road to better understanding yourself and managing ADHD more effectively.
Bibliotherapy:
Kupnicka, Z., Poraj, G., Kaźmierski, J. (2017). ADHD in adults – recognition, causes, and effects, Psychiatry and Clinical Psychology, 17(3), pp. 195-202.
PsychiatraPlus, (2023, June 2). ADHD in women – characteristics, accompanying disorders.
“Developmental Age Psychiatry” – edited by A. Popielarska; PZWL 2000