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ADHD Awareness Month: Understanding ADHD in Women
October is ADHD Awareness Month, providing an opportunity to raise awareness of how ADHD can impact women and why it is so often misunderstood or overlooked. ADHD does not always look the way we expect. For many women, difficulties with attention, organisation, emotional regulation and overwhelm can be hidden behind perfectionism, people-pleasing, anxiety or years of developing strategies to cope. Some women may appear highly capable and organised on the outside while feeling exhausted and overwhelmed underneath. In this article, I explore some of the common misconceptions about ADHD in women, the signs and experiences that can be easy to miss, and why understanding ADHD can sometimes help make sense of difficulties that have been present for years.
ADHDWOMENS MENTAL HEALTHMASKINGOVERWHELMPERFECTIONISM
Jessica Reynolds MBACP
10/7/20267 min read
When most people hear the words ADHD, they probably have a picture in their head. Perhaps it is a child who cannot sit still, someone who is constantly distracted or a person who is often losing things. But ADHD does not always look like this, particularly in women. In fact, many women reach adulthood without ever considering that ADHD could explain some of the things they have struggled with throughout their lives.
This is one of the reasons ADHD in women is so important to talk about. Some women spend years believing they are lazy, disorganised, forgetful, too emotional or simply not very good at managing life. Others become extremely good at hiding their difficulties. They may have successful careers, relationships, children and busy social lives, while privately feeling as though they are constantly running to catch up.
This ADHD Awareness Month, it is worth looking beyond the stereotypes and thinking about what ADHD can actually look like in women.
ADHD does not always look like hyperactivity
One of the biggest misconceptions about ADHD is that someone must be visibly hyperactive. If a woman is quiet, calm and able to sit through a meeting, people may assume that ADHD could not possibly be relevant to her.
But hyperactivity does not always mean physically bouncing off the walls. For some people, it can be much more internal. There may be a constantly busy mind, difficulty switching off, racing thoughts or a feeling that there are hundreds of things happening in your head at once. Some women experience more difficulties with attention and organisation than obvious physical hyperactivity.
This can make ADHD much harder to spot, especially when a woman has learned to compensate for her difficulties.
The woman who looks incredibly organised may be working incredibly hard
This is something that is easy to miss. Imagine a woman who has a calendar full of reminders, alarms on her phone, lists everywhere and very specific routines for getting through the day. From the outside, you might think she is wonderfully organised. But what happens if those systems disappear?
Perhaps she becomes completely overwhelmed. Perhaps she is terrified of forgetting something important, so she checks her diary repeatedly. Maybe she arrives everywhere early because being late causes enormous anxiety. Maybe she has developed a very strict morning routine because without it she knows the entire day can quickly become chaotic. The organisation is real, but so is the effort behind it.
Sometimes what looks like excellent organisation is actually compensation. A woman may have spent years creating systems to manage difficulties that other people do not realise she has.
"But you're so capable"
This is another common misconception about ADHD in women. A woman might be excellent at her career while struggling to keep on top of household tasks. She might manage a complicated project at work but forget to return a phone call. She might meet every deadline, but only because she has spent the previous three nights working under enormous pressure. There can be a huge difference between being capable of doing something and being able to consistently manage the process of doing it.
If someone is achieving what is expected of them but is permanently exhausted, overwhelmed or relying on last-minute panic to get things done, that is worth noticing.
ADHD and perfectionism can go hand in hand
It might seem strange to put ADHD and perfectionism in the same sentence. But they can absolutely coexist.
A woman who has spent years feeling that she forgets things, loses things, runs late or struggles to stay on top of life may become extremely perfectionistic as a way of compensating. She may check everything repeatedly because she does not trust herself to remember. She may spend far too long on a simple piece of work because she is frightened of making a mistake. She may avoid starting something altogether because the thought of doing it badly feels unbearable.
Other people might describe her as conscientious, thorough or a perfectionist. She may experience it very differently. She may feel that if she does not work incredibly hard to keep everything under control, everything will fall apart.
Masking can make ADHD difficult to recognise
The word masking is becoming more widely used when talking about ADHD, particularly in women.
Masking can involve hiding difficulties, copying behaviours that seem to come naturally to other people or developing strategies to make your struggles less visible. It is not always something a person consciously chooses to do. Sometimes it develops over many years.
Perhaps you have learned not to interrupt because you know you can become impulsive. Perhaps you pretend you remembered something because you are embarrassed to admit that you forgot. Perhaps you watch how other people behave socially and consciously try to copy them. Maybe you spend enormous amounts of energy appearing calm when internally you feel completely overwhelmed.
The problem is that masking can be exhausting. If you spend much of your life trying to appear as though everything comes naturally, you may eventually have very little energy left for yourself.
Emotional overwhelm can be part of the picture
When people talk about ADHD, they often focus on attention and forgetfulness. But emotional regulation can also be an important part of the experience for some people with ADHD.
A woman with ADHD may find that emotions feel particularly intense or difficult to switch off. Criticism may stay with her for hours. A disagreement may be replayed repeatedly in her mind. Frustration can build quickly when something is not working, particularly when she is already tired or overwhelmed.
This does not mean that every emotional reaction is caused by ADHD, and it certainly does not mean that women with ADHD are simply "overly emotional". But if someone has spent years being told that they are too sensitive, too dramatic or that they need to calm down, it is worth considering what might actually be happening underneath the reaction.
Sometimes the behaviour people see is only the final part of a much bigger story.
ADHD can become more obvious when life gets harder
Another interesting thing about ADHD in women is that some people do not realise they may have it until adulthood becomes more demanding.
A person may cope reasonably well at school because there is a clear timetable and lots of external structure. University, work or becoming a parent can completely change that. Suddenly there are appointments to remember, bills to pay, meals to organise, emails to answer, deadlines to meet and other people relying on you. The number of things you have to keep track of increases dramatically.
Someone who managed perfectly well with a relatively simple routine may suddenly find themselves overwhelmed. They may wonder why they can no longer cope with things that used to seem manageable. Sometimes it is not that the person has changed. The demands on their executive functioning have changed.
Hormones and ADHD in women
There is also growing interest in the relationship between hormonal changes and ADHD symptoms in women. Some women notice changes in their ADHD symptoms around their menstrual cycle, pregnancy, after giving birth or during perimenopause and menopause.
This is particularly interesting for women who have spent years feeling that they were "managing" their ADHD, only to reach a particular stage of life and suddenly find their usual coping strategies are no longer enough.
It can be tempting to think, "What is wrong with me? Why can't I cope anymore?" But sometimes a more useful question is, "What has changed, and what support do I need now?"
Hormones are only one possible factor, of course, and changes in concentration, mood, sleep and energy can have many causes. If these changes are affecting your life, it is worth discussing them with an appropriate healthcare professional rather than trying to work it out alone.
Perhaps the biggest misconception is that ADHD should be obvious
There is no single way for ADHD to look. Two women can both have ADHD and have completely different experiences. One might be very restless and impulsive. Another might be quiet and dreamy. One might struggle primarily with organisation. Another might be highly organised but emotionally exhausted from maintaining that organisation. This is why awareness matters.
The aim is not to convince every woman who recognises herself in an article that she has ADHD. There are many reasons someone may struggle with concentration, organisation, overwhelm, sleep, anxiety or emotional regulation, and an online article cannot diagnose anyone. Instead, awareness gives us another question to ask: Could there be a reason this has always felt harder than it seems to for other people?
Looking beyond the label
Perhaps the most useful thing we can do for women with ADHD is to look beyond what we see on the surface.
The woman who is always late may care deeply about being respectful. The woman who forgets your message may genuinely have intended to reply. The woman who seems disorganised may be trying incredibly hard to stay on top of things. The woman who appears to have everything under control may be using every ounce of energy she has to keep it that way.
Understanding does not mean removing responsibility. It means replacing judgement with curiosity.
Instead of asking, "Why can't you just do it?" we can ask, "What is making this difficult, and what might help?" That is a much more useful conversation.
For women who recognise themselves in some of these experiences, perhaps the message is equally important: struggling with certain things does not make you lazy, careless or incapable. You may simply have been trying to solve a problem without having all the information.
ADHD Awareness Month is an opportunity to change that.
How can counselling help?
Receiving an ADHD diagnosis can bring a huge sense of relief, but it can also bring up a lot of feelings. You may find yourself looking back at your childhood, relationships, education or career and seeing things differently. You may wonder why certain things have always felt harder than they seemed to for other people. You may also be dealing with years of self-criticism, low confidence, anxiety or the exhaustion that comes from constantly trying to keep everything together.
Counselling can provide a space to explore some of this without judgement. You don't have to arrive knowing exactly what is wrong or have everything explained. Sometimes it is simply helpful to have someone listen and help you make sense of what you are experiencing.
For women with ADHD, counselling can also be a place to explore self-esteem, overwhelm, perfectionism, people-pleasing, emotional regulation, relationships and the impact of masking. It can help you understand patterns that may have been around for years and begin to develop more compassionate and realistic ways of responding to yourself.
Counselling is not about "fixing" who you are. It is about understanding yourself better, recognising what you need and finding ways of moving forward that feel manageable and authentic to you.
If anything in this article has resonated with you and you would like to talk things through, please get in touch. You don't need to know whether you have ADHD, and you don't need to have all the answers before you reach out. We can start with where you are now and explore what support might be helpful for you.
Get in touch today to arrange a confidential conversation about counselling and how I may be able to support you.
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