Food Mood Therapists

You may have undiagnosed ADHD if you: have spent your life holding everything together for everyone else, while chaos constantly brewed on the inside; have cycled through anxiety and depression diagnoses with only mild relief; and are burning out from carrying a constant mental load that nobody else seems to struggle with. There are research-backed reasons why many women are being missed.

TL;DR

Most of what we know about ADHD is based on how boys present with ADHD; girls and women tend to present differently. Girls tend to internalize symptoms more, are more likely to mask to meet expectations, be less disruptive, and frequently get funneled into anxiety or mood disorder labels first. The result: women are often diagnosed later in life than men.

1) ADHD has long been modeled on boys’ behavior

On some level this makes sense because much of the beginning research was focused on boys who more commonly present with outward/hyperactive symptoms. Girls, on the other hand, often turn their struggles inward (think daydreaming, easily overwhelmed, and procrastination), which are far less disruptive to a classroom or family. Since these symptoms often don’t impact people around them, they often don’t get flagged.

Even worse - for some girls they get praised for being so “good,” which just reinforces that they shouldn’t need or ask for support.

What has changed and where we are still lagging: The DSM 5, which is the tool used for diagnosing mental health conditions, now includes adult-onset criteria and example presentations across the lifespan. Unfortunately, referral cultures among providers remain rooted in older models.

2) Internalizing symptoms get mislabeled as mood disorders

Without an “ADHD lens,” it can be easy for clinicians to miss underlying executive function struggles because many women present with internal ADHD symptoms. Symptoms like racing thoughts, emotional overwhelm, irritability, and exhaustion from trying to “keep up” do look like anxiety and depression. Which means that the clinician has to be assessing for ADHD in order to not miss it.

The result for many women is years of trial and error treatment for the wrong condition. Some experience some positive impact, but never get the full benefits. Identifying ADHD as the root allows women to get support that makes life feel less overwhelming.

3) How masking hides the real story

Everyone with ADHD feels the pressure to hide their struggles, but girls and women often feel even more pressure to do so. We have all heard the saying “boys will be boys,” which emphasizes that as a society we tend to put less pressure on young boys to be self-controlled, kind, and capable - traits that conflict with how ADHD naturally shows up. Over time, the pressure on girls can lead to “performing” competence: overpreparing, mimicking others, or pushing through to appear reliable.

Research has shown that this kind of masking is especially common among women with ADHD and is linked to higher anxiety, depression, and delayed diagnosis. These women are often “successful” and appear to be high-functioning, but that is the result of intense effort to meet expectations that were never designed with neurodivergent brains in mind.

While masking isn’t unique to women, the social cost often is - because there tends to be less room for women to “fall short” or make mistakes.

4) Hormones matter (and it isn’t talked about enough)

Estrogen plays a significant role in regulating dopamine and norepinephrine, which are the very neurotransmitters ADHD medications work with. When estrogen levels drop, ADHD symptoms can flare. That is why many women notice more distractability, irritability, and low motivation in the days before their period, or a spike in symptoms postpartum and during perimenopause.

Some research also suggests that women with ADHD are more likely to experience severe PMS or PMDD, reporting more intense mood and focus changes across their cycle. These shifts aren’t just “hormonal moodiness,” they reflect real neurochemical changes that can affect emotional regulation and executive function.

When clinicians don’t connect these dots, women are often told it is just “normal hormones,” missing how ADHD and hormonal patterns interact. Meaning they miss out on the support and treatment that could make their lives feel smoother.

5) The cost of being missed

The impact is deeper than distraction or laughing off a missed appointment. Research shows that women diagnosed later in life experience higher rates of anxiety, depression, and burnout.

By the time many finally get the right diagnosis, they’ve built their lives around coping mechanisms like perfectionism, people-pleasing, very loud inner critics, or overworking. These strategies help them survive, but leave them exhausted. Identifying ADHD can offer relief, language, and a path toward support that actually fits.

The takeaway

Women with ADHD have always been here. They are bright, creative, capable, and often feeling burnt out, behind, and constantly overwhelmed from constantly navigating systems that weren’t designed for their brains.

If this sounds familiar, know that you’re not alone and you’re not imagining it. There’s a growing body of research validating your experience and support that’s designed to help your brain thrive.

If you are looking for support in your community check out CHADD to find a provider near you. For folks in Kansas or Missouri wanting to learn more about ADHD evaluations and support, schedule a free discovery call here.

Women and ADHD - why they are often missed

3) How masking hides the real story

The takeaway

Women with ADHD have always been here. They are bright, creative, capable, and often feeling burnt out, behind, and constantly overwhelmed from constantly navigating systems that weren’t designed for their brains.

Further reading and reserch