Adult women and men typically undergo the same diagnostic process for ADHD. However, there are many other factors that healthcare professionals may need to consider when diagnosing ADHD in women specifically.
The diagnostic process often consists of multiple steps, and a qualified mental health professional typically uses several tests and assessments to determine whether one has ADHD and to rule out other conditions that may have similar symptoms. It can be critical to note that this process often differs between individuals and healthcare providers.
The first step of the diagnostic process is typically an interview and assessment of your personal history to determine whether you displayed ADHD symptoms during childhood. For example, the healthcare provider may ask questions about your school performance, as well as whether you got in trouble with teachers, had difficulty establishing relationships with peers, or struggled with organization and time management.
The professional may also request to speak with a parent, caregiver, family member, or anyone else who can provide more information about your childhood. Not only can this give them a fuller perspective of your childhood experience, but questions about your family history may also reveal risk factors for ADHD.
An exact cause for ADHD has yet to be identified. However, experts believe there are several potential links:
During this initial assessment, a physician or mental healthcare professional will typically ask about your current challenges and uncover symptoms you may be experiencing. To understand how ADHD symptoms shape individual experience, it can be helpful to understand that there are generally three types of ADHD classified by their most dominant symptoms.
ADHD predominantly inattentive presentation (formerly known as ADD)
People with this type of ADHD often struggle with attention and concentration. They may:
This type of ADHD is largely characterized by hyperactive and impulsive behaviors, such as the following:
People with this type of ADHD often display a combination of both inattentive and hyperactive/impulsive symptoms. For example, they might have challenges with hyperactivity and impulsive behavior while remaining distracted and unfocused.
It may be prudent to mention that executive dysfunction, typically involving difficulty with organization, time management skills, and emotional dysregulation, can present with every type of ADHD.
Women and girls can have any type of ADHD, and the frequency and severity of symptoms may vary between all individuals, regardless of gender.
According to Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), women and girls with combination or hyperactive/impulsive presentation sometimes report experiencing “internalized” hyperactivity, presenting symptoms such as the following:
Your doctor may review your medical history, conduct a physical exam, and order lab work if necessary to identify or rule out underlying medical conditions that may mimic or contribute to ADHD symptoms, such as hormonal changes, a seizure disorder or thyroid condition. They may also ask about your family’s medical history.
During the evaluation process, psychological testing may be recommended by the healthcare provider to assess cognitive function, emotional dysfunction, and other relevant psychological factors. This may also rule out any other mental health conditions, like personality or mood disorders, that may mimic symptoms of ADHD.
Functional assessments can also measure cognitive function within the context of executive dysfunction. This generally refers to the difficulties you might face in everyday life that impact your ability to meet your responsibilities and goals, such as problems with working memory, organization, planning, problem-solving, time management, and emotion regulation.
Functional assessments often have an interpersonal component, measuring one’s ability to sustain relationships, interpret social cues, and maintain awareness of one’s own behavior and its impact on others.
Although there is some debate as to whether it should be reevaluated, the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR) to diagnose ADHD states that children up to age 16 must display six or more symptoms for at least six months to receive a diagnosis. Adults 17 and over must present five or more symptoms. In addition:
Women and minorities tend to be among the most misdiagnosed and underdiagnosed groups in healthcare, which can contribute to a significant disparity in treatment and successful outcomes. When left untreated, ADHD can cause problems affecting both genders:
However, mis- or undiagnosed ADHD in women may carry additional consequences. For example, without a diagnosis, there is often no explanation for perceived “flaws” other than personal shortcomings. When an individual resorts to self-blame for social, emotional, academic, and work struggles, it can lead to low self-esteem and self-efficacy.
These types of troubles can begin in childhood, potentially causing alienation, peer rejection, and bullying. Studies also suggest that women may use self-harming behaviors to cope with these painful experiences, such as misusing substances, alcohol, and sex to self-medicate.
There can be potential physiological consequences to an ADHD misdiagnosis as well. For example, a misdiagnosis of anxiety or depression might cause professionals to overlook a severe physiological condition with symptoms similar to ADHD because they didn’t believe a physical examination was warranted.
Serious conditions, such as inflammatory diseases and immune dysregulation associated with ADHD and comorbid stress, may be overlooked when ADHD isn’t considered as a diagnosis.
Psychoeducation can empower women to take charge of their mental health, speak confidently to healthcare professionals, and advocate for appropriate diagnosis and ADHD treatment. Receiving a diagnosis can be a huge relief for some women who have potentially internalized symptoms throughout their lives as “faults” or “character flaws.” Education can often provide explanations for their experiences, helping them make sense of the past and gain confidence in their abilities to cope with struggles in the future.
While early intervention can be preferable for favorable outcomes, treatment at any time can make a significant difference in one’s quality of life and well-being. With therapy and/or coaching, women with ADHD can improve executive function, learn techniques to enhance cognitive flexibility, manage emotional regulation, and regain self-confidence.
If you’d like to get support in how you manage ADHD symptoms, help is available in a variety of formats. For one, the rise in online therapy through platforms like BetterHelp may provide unique advantages for people with ADHD. For example, because it eliminates geographical barriers, virtual therapy typically offers access to a broader pool of therapists with experience diagnosing and treating women with ADHD. In addition, therapy from home may be better suited for people with organization and time management challenges due to its flexibility in scheduling.
BetterHelp therapy is frequently more affordable than conventional treatment options without insurance, and a growing body of research also suggests that virtual therapy can be just as effective as traditional therapy for treating ADHD and common comorbidities like anxiety and depression.
How can you get diagnosed with ADHD as a woman?
You may receive an ADHD diagnosis from a health care professional or a therapist after a thorough evaluation. Some women living with ADHD may experience trouble staying focused and/or impulsivity.
Can girls with ADHD be quiet?
ADHD can affect people of all genders. Some people living with ADHD may experience difficulty with impulse control. Impulsivity symptoms may include talking excessively at times. However, some people may experience the inattentive type of ADHD—not the impulsive type—which means they may be quiet or reserved. Also, attributing talkativeness or any symptom to ADHD in people assigned female at birth can reveal gender bias, as symptoms can affect anyone living with ADHD. Regardless of gender, the causes of ADHD may be related to differences in brain structure and/or genetics.
How do you treat adult female ADHD?
To treat ADHD, women may take ADHD medication and talk to a psychotherapist. Some people may believe that girls tend to develop specific symptoms, but there are no official gender differences in the diagnostic criteria listed in the DSM-5. The specific treatment plan may depend on the degree of negative feelings and externalizing symptoms. Externalizing disorders are typically those that cause behavioral symptoms. They may include conduct disorder, ADHD, and substance use disorder (formerly referred to as substance abuse). In some cases, a person with an externalizing disorder may engage in risky sexual behaviors and experience difficulty maintaining healthy romantic relationships.
Can a woman have ADHD without hyperactivity?
Young girls and women can have ADHD without hyperactive behaviors. Some people experience mostly inattention type symptoms rather than hyperactivity, while others experience the combined form of ADHD. Help is available for ADHD and related mental health conditions through therapy and/or medication.
How do I know if I'm ADHD female?
The symptoms of ADHD can affect people of all genders. More women than men tend to be undiagnosed with ADHD. Also, more adult women are being diagnosed with ADHD in their 30s, 40s, and 50s. Some people may be confused about whether certain symptoms are related to ADHD or common hormone fluctuations associated with a person’s menstrual cycle. The symptoms of a mental illness like ADHD tend to be pervasive and not just temporary. It may help to speak with a licensed mental health professional to learn how to recognize ADHD symptoms.
Is ADHD a form of autism?
ADHD and autism spectrum disorder are separate disorders in the DSM-5. However, some people may experience both disorders. Many women living with ADHD experience comorbid mental disorders. Common comorbid disorders may include anxiety, depression, and eating disorders.
Do I have ADHD or am I just lazy?
An ADHD diagnosis typically involves a specific set of criteria that can be confused for laziness. A licensed medical or mental health care professional typically has to assess symptoms to provide an accurate diagnosis. Inattention symptoms, which can be common among some people living with ADHD, are different from laziness. Common misperceptions about ADHD symptoms may affect professional and social relationships.
What is ADHD masking in females?
ADHD masking typically involves hiding one’s symptoms. Masking can affect people of all genders in numerous ways. In some cases, people living with ADHD may put in extra time after school or work to make up for time when they lost concentration. Other people may mask symptoms by pretending to be engaged even if they lost track of a conversation.
Can ADHD get worse with age?
ADHD doesn’t typically get worse with age, but this may vary considerably depending on whether a person receives early diagnosis and treatment. Commonly prescribed ADHD medication may include stimulants and non-stimulants. ADHD research suggests that 70% to 80% of children experience fewer ADHD symptoms with stimulants.
Do girls with ADHD struggle to sleep?
Some girls and young women living with ADHD may experience difficulty sleeping. In some cases, ADHD drugs can cause difficulty sleeping, in addition to other physical symptoms like decreased appetite and stomach aches. Women living with ADHD may benefit from support groups with other women who have had ADHD diagnosed or those who believe they may be experiencing ADHD symptoms.