10 Ways That ADHD Looks Different in Adult Women

Oct 10

When most people think of ADHD (AKA attention deficit/hyperactivity disorder, a name I loathe to the moon and back), the image that often comes to mind is a hyperactive young boy who can’t sit still in class.

At least, that’s what I used to think it meant. Never in a million years could it apply to someone like me: a bubbly young girl who got excellent grades, loved talking with classmates, and yeah, sometimes daydreamed, but only because I was bored…

As I learned much later (about 20 years later, to be exact), ADHD actually can be present in someone like me. After learning about this condition much later in life, I realized that all of my daydreaming, distracting classmates by talking and socializing, and constantly bouncing from activity to activity were all indicators that I was understimulated, AKA the hyperactivity behind my ADHD.

Turns out, ADHD often looks very different in girls and women, and it’s frequently overlooked or misdiagnosed because of this.

First, it’s important to understand that there are 3 types of ADHD:

Predominantly inattentive type: This was initially presumed to be the least common type, but it’s actually the most common type in women (go figure). Folks with this type most often struggle with forgetfulness, daydreaming and chasing novelty, or difficulty concentrating, especially on mundane tasks. Think of someone having 50 browser tabs open in their brain at one time.
Predominantly hyperactive/impulsive type: This is the most “visible” type, the kind most people think of when they hear ADHD. Folks with this type are often very active, almost like they are driven by a motor, have difficulty sitting still, and exhibit frequent fidgeting or restlessness.
Combined type: Folks with this type, which is the most common of the three, have traits that encompass both inattentive and hyperactive types.

ADHD in women can be subtle, hidden behind frequent masking with coping mechanisms or people-pleasing. Many women struggle for years before they even realize that ADHD is the source of their challenges. ADHD tends to manifest differently in women due to social conditioning and hormonal factors, which can make it harder to identify. This, of course, leaves women missing out on so many resources that could have been available to them.

If you’re wondering how ADHD presents in adult women or suspect that you or someone you know might have undiagnosed ADHD,

here are 10 ways ADHD might look different in women:

1. Perfectionism and overwhelm

Adult women with ADHD often struggle with perfectionism. Society tends to place high expectations on women to "have it all together" whether it’s managing a career, household, or relationships (or all of it). For women with ADHD, the pressure to meet these expectations can feel overwhelming, often leading to perfectionistic tendencies like self-criticism, rigid thinking, avoidance, or a freeze response. You’re not inadequate; you’re just stuck in rigid thinking and unrealistic expectations. And for many women with ADHD, this perfectionism may have even developed as a way to compensate for other challenges from their ADHD. So, this can look like:

Constantly striving for perfection, but never feeling good enough
Feeling paralyzed by tasks because they seem too overwhelming to start
Spending hours on simple tasks, redoing work to get it “just right”

2. Difficulty with time management, including procrastination

Time blindness (losing track or incorrectly perceiving the passage of time) is a common feature of ADHD, which can lead to struggles with balancing daily responsibilities. Time blindness makes it hard to estimate how long tasks will take, resulting in chronic lateness or procrastination. If you’ve ever had difficulty juggling your million responsibilities, this may be a factor. It can look like:

Frequently running late or losing track of time
Procrastinating on important tasks, even when deadlines are looming
Feeling “stuck” when faced with a to-do list, not knowing where to begin

3. Emotional sensitivity and rejection sensitivity

Women with ADHD are often more emotionally sensitive than their male counterparts, experiencing intense emotions that can feel overwhelming (remember we discussed hormonal impacts earlier? Add that to the mix here too). Many women also experience rejection sensitive dysphoria (RSD), a heightened response to perceived rejection or criticism. You’re not “too much” or “too sensitive” — you have a brain that responds to situations with heightened emotion, and can learn how to better regulate. Emotional sensitivity or RSD might look like:

Difficulty taking criticism, even when it’s constructive
Feeling easily overwhelmed by emotional stress
Experiencing mood swings or feeling deeply affected by small setbacks

4. More frequent masking of symptoms

Women are often socialized to be caretakers, people-pleasers, and nurturers. As a result, many women with ADHD learn to mask their symptoms from a young age. They hide their struggles by overcompensating, working harder to appear "normal" to others. That perfectionism we talked about earlier? That’s often a masking strategy. This can also look like:

Overcompensating by staying hyper-organized in certain areas while neglecting others
Presenting a calm and capable exterior while feeling chaotic inside
Overextending yourself to avoid being seen as lazy or incompetent

5. Misdiagnosed as anxiety or depression

While you can certainly be a person with both ADHD and anxiety or depression, historically, ADHD in women is often misdiagnosed because a) the symptoms can overlap and b) many providers don’t know how inattentive ADHD actually looks. Women with this subtype might struggle with staying focused or feel mentally exhausted from constantly trying to manage their symptoms, leading to feelings of hopelessness or frustration. This may look like:

Zoning out during conversations or tasks
Having trouble following through on commitments or plans
Feeling scattered or overwhelmed, leading to bouts of anxiety or depression

6. Hyperfocusing on certain interests

While many think of ADHD as primarily an inability to focus, one lesser-known symptom is hyperfocus — the ability to become intensely absorbed in something that captures interest. Adult women with ADHD may hyperfocus on specific tasks, hobbies, or work projects, often to the detriment of other responsibilities. If you’ve ever been told you’re lazy or just not disciplined, think about all the times you’ve successfully completed interesting tasks. ADHD is not a condition that prevents productivity; it’s a dopamine-based condition that is directly related to your level of interest in something. So this can look like:

Becoming so engrossed in a task or hobby that you lose track of time
Neglecting other important duties because of intense focus on a particular interest
Struggling with task completion for mundane tasks, but being able to power through interesting ones without much difficulty

7. Difficulty managing household and work responsibilities

Women are often expected to juggle multiple roles — whether it’s managing a career, taking care of children, or running a household. For women with ADHD, this balancing act can be especially challenging. Tasks that seem simple to others, like organizing a home or keeping up with paperwork, can feel insurmountable. It’s not that you’re incapable or inadequate, it’s that your brain is literally struggling to remember all the cogs in the machine due to its ability to get easily overwhelmed. This can look like:

Chronic disorganization, especially in personal spaces like closets or desks
Forgetting to pay bills, missing deadlines, or losing important documents
Feeling like you’re constantly playing catch-up with household or work responsibilities

8. Hormonal fluctuations intensifying ADHD symptoms

Hormonal changes — especially during menstruation, pregnancy, postpartum, or menopause — can exacerbate ADHD symptoms in women. Estrogen plays a significant role in regulating dopamine, a major neurotransmitter involved in attention and focus, and fluctuating hormone levels can make ADHD symptoms more severe at certain times. This can show up as:

Worsening ADHD symptoms during the menstrual cycle
Increased forgetfulness, lack of focus, or emotional sensitivity during pregnancy, postpartum, or menopause
Feeling “off” or more scattered than usual during hormonal changes

9. Relationship challenges

Women with ADHD may experience difficulties in relationships, both romantic and platonic. Many of the executive functions impacted by ADHD can affect relationships, such as difficulty remembering important dates, following through on plans, or communicating effectively. Remember the emotional sensitivity and RSD we talked about earlier? That also plays a huge role here. This can show up as:

Frequently forgetting important events, like anniversaries or birthdays
Difficulty responding to calls or texts, leading to guilt or frustration
Feeling like you’re letting loved ones down because of disorganization or forgetfulness

10. Low self-esteem, especially impostor syndrome

Women with ADHD often struggle with low self-esteem because they feel like they’re constantly falling short of expectations. This can lead to imposter syndrome — feeling that they don’t deserve their accomplishments and being fearful that they are going to be "found out" as frauds. This can look like:

Feeling like you’re not as capable as others, even when you succeed
Constantly comparing yourself to others and feeling inadequate
Avoiding taking risks or new opportunities due to fear of failure

Understanding how ADHD manifests in adult women can lead to more compassionate self-awareness and effective management of its impact. Proper diagnosis and treatment can make a world of difference in managing ADHD and reclaiming control over your life. Remember, the goal is not to force yourself to become neurotypical, but rather to understand and better manage the specific needs of your ADHD brain!

If this resonates with you, I recommend reaching out to a therapist with special training and expertise in ADHD. You can book a free 15-minute consultation with me here.