Earlier this spring, actress Busy Philipps announced that she was diagnosed with attention-deficit/hyperactivity disorder (ADHD) alongside her 15-year-old daughter. Philipps’ diagnosis is part of a recent trend of more and more women and girls being diagnosed with ADHD.
From 2020 to 2022, the rate of ADHD diagnoses in women has doubled, said Suwilanji Kuezi-Nke, a clinical psychologist at Transcend Counselling Chicago. This steep rise “may be due to the ways in which the pre-COVID-19 pace and structure of life masked symptoms,” she said, but also speaks to something larger.
“ADHD was once a diagnostic category that was dominated by boys with too much energy,” said Madison Perry, a psychologist and owner of Austin Holistic Psychology in Texas. In fact, boys are roughly three times more likely to receive an ADHD diagnosis than girls, according to Medical News Today.
“More women are being diagnosed with ADHD because information is spreading. With more awareness of the varied presentations of ADHD, more women are likely to be referred for an evaluation,” Perry said.
When thinking about ADHD, you likely imagine someone who is rambunctious and can’t sit still. While that isn’t wrong, that is not the way ADHD tends to show up in women and girls. A number of factors play into the differences in ADHD presentation, but one major one is the societal pressures and norms expected for women.
“There is a theory that this is more of a product of how women are socialised in the Western societies rather than a biological difference between men and women,” Perry said.
So when it comes to how ADHD presents in women, it looks a little different. Here are the signs of ADHD in women and girls:
Difficulty focusing on singular tasks.
Rather than the hyperactivity and impulse control issues seen in boys, “ADHD tends to present in women as more inattention [and] difficulty focusing and completing tasks,” Perry explained.
Your mind may feel like it can’t focus on one task — especially one that you don’t find interesting. For example, you might start cleaning the bathroom but get distracted halfway through. Or you may set out to try a new creative project ― like knitting ― but it doesn’t hold your interest long enough to finish the blanket.
Hyper-focusing on certain topics or situations.
It’s also not unheard of for people with ADHD to hyper-focus on certain topics while struggling to focus on others, noted Marcy Caldwell, a psychologist and the owner of the Center for ADHD in Philadelphia.
When you’re hyper-focused, it feels impossible to stop doing the task at hand, or you get totally lost in whatever project you’re working on. Your brain is only interested in the one thing you’re doing.
“A lot of the things that can create that hyper-focus are things that people are really interested in ... that’s one of the motivating factors for an ADHD brain,” Caldwell said. “So, they’ll judge themselves for like, ‘If I can hyper focus on this thing, which is really compelling, why can’t I focus on the assignments that my boss gave me?’”
Racing thoughts.
While women are less likely to visually show hyperactivity and impulsivity, it does still show up in a different way. “There’s still a lot of cognitive hyperactivity that can happen, so thoughts can be going a mile a minute, but it’s often less physically presented,” Caldwell said.
According to the non-profit Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), this may also feel like trouble focusing on one topic.
Trouble keeping friendships.
According to Kuezi-Nke, women with ADHD may have difficulty sustaining friendships, too. “A lot of hyperactive symptomatology presents relationally for women, which is very different — it’s not as easy to see,” Kuezi-Nke said.
This does not mean difficulty making friends, but instead keeping those friendships alive. You may feel too emotionally drained to text a friend after a big meeting or may be too focused on other things to return their call; the emotional labor it takes to maintain friends can be tough for women with ADHD, according to ADDitude magazine.
Emotional outbursts and dysregulation.
According to Caldwell, it’s common for folks with ADHD to deal with emotional dysregulation; it’s even more common in women.
“ADHD brains are very prone to having very big emotions very frequently, and so they’re more likely to experience their emotions in a way that feels to the outside world disproportionate to the event,” Caldwell said.
For example, if a friend cancels plans you may find that you’re overcome with sadness and think that friend no longer cares about you. Or you may lose your temper over a small inconvenience at work.
Talking a lot.
Talking excessively can be another sign of ADHD in women, Kuezi-Nke noted. “Or kind of not thinking before you speak — reacting impulsively in conversation.” Similarly, interrupting other people while they’re talking can also be a symptom of ADHD.
Overall, women are more likely to internalize their ADHD symptoms.
“Women are also more likely to mask their symptoms, they’re more likely to internalize their symptoms,” Caldwell said. “So, they’re more likely to end up with symptoms like depression and anxiety and low self-esteem.” (In fact, in many women, ADHD can be misdiagnosed as anxiety, Kuezi-Nke said.)
Men, oppositely, are more likely to externalize their symptoms — which is also one of the big reasons why boys are more diagnosed than girls, she noted.
For girls and women, the distress they feel is kept inside and doesn’t present until much later in life, Caldwell added.
If you have these symptoms ― or think you have ADHD ― it’s important to seek professional help.
“If you or a loved one suspect that you may meet criteria for ADHD, I would recommend searching for an appropriate evaluator near you,” Perry said.
Caldwell stressed that when looking for a provider, it’s perfectly OK to interview them to ensure they have ample experience treating people, specifically women, with ADHD. Caldwell said you can ask about their ADHD training, how they work with people with ADHD and how many clients of theirs have ADHD. “You just really want to be careful that people have a lot of experience,” Caldwell added, noting that CHADD has a provider directory you can reference, too.
Perry noted that for a comprehensive approach, which she recommends, you should seek out an assessment by a neurologist, primary care physician and a psychologist. This way, they can determine if you have ADHD or another diagnosis.
“You want to be sure that your team understands how to create a differential diagnosis so that you will leave the evaluation process with an appropriate treatment plan,” Perry said.
Additionally, “I really encourage all people, but specifically women ... to not let [mental health stigma] deter them from seeking the information that they need,” said Kuezi-Nke. “If anyone is noticing impairment, it is human. Right? We all struggle.”
ADHD runs on a spectrum, Kuezi-Nke added, so “even if you aren’t specifically diagnosed with ADHD, it doesn’t mean that those symptoms aren’t relevant and worth taking care of yourself for.” Never hold yourself back when it comes to getting proper support.