ADHD in Women Is Hard to Diagnose and Mostly Goes Unnoticed, Expert Insights

ADHD or Attention-Deficit/Hyperactivity Disorder is very commonly misdiagnosed in women who are told they have depression and anxiety. According to mental health experts, the condition, a neurodevelopmental

disorder, is characterized by persistent problems with inattention, hyperactivity, and impulsivity. Symptoms of this condition, which begin in childhood, continue into adulthood and significantly impact a person's ability to function in social, academic, and professional settings.

Why are women often misdiagnosed?

According to UK-based consultant psychiatrist Dr Ali Ajaz, ADHD is frequently misdiagnosed or remains undiagnosed for years, mostly in women, because the symptoms in female patients are often much less disruptive than those in male patients. “Why ADHD looks different in women, and why most doctors miss it,” he asked his followers on Instagram. “We all know this stereotypical ADHD image is of a hyperactive young boy disrupting class, but here's what that picture misses,” he added. A few reasons given by Dr Ajaz say that women are:

Extremely chatty

Dr Ajaz said one of the most prominent symptoms of ADHD in women is being 'chatty', or 'overly emotional' - rather than being hyperactive. While usually in college or school classrooms, they might be labeled 'daydreamers' or 'chatty', rather than being flagged for assessment, which would be the port of call for boys with the condition.

Perfectionists

“Number two, masking symptoms much better than men through perfectionism and overachieving," Ajaz shared. Experts believe that many women who have ADHD start to cope with the condition by overcompensating, which leaves them mentally drained. Many women strive for perfection to overcompensate for difficulties with organization, focus, or other ADHD traits, but this can lead to a cycle of exhaustion, procrastination, and avoidance due to fear of not meeting high personal standards.

Put together the appearance

The doctor continued: "Number three, struggling silently with organization or maintaining a put-together appearance." While women with the condition may seem in control by looking neat, reliable, and high-functioning, in reality, they may be overwhelmed by the effort it takes to keep up appearances. Experts believe that the meticulously maintained facade is often the result of "masking"—a coping mechanism to be able to live up to social expectations.

Burnout

Burnout is the most prominent sign of ADHD in women, especially because the constant effort of managing symptoms leads to physical and emotional exhaustion. Women with ADHD often experience burnout from the chronic stress of masking symptoms, dealing with executive dysfunction, and juggling societal expectations. “Women are much more prone to burning out from trying to maintain multiple roles perfectly. This is why women often get misdiagnosed with anxiety or depression first. As a psychiatrist who's worked with many women with ADHD, I see these patterns regularly. Understanding these differences is crucial for proper assessment, diagnosis, and treatment,” he said.