ADHD in adult women: years of invisibility, compensations and a diagnosis that arrives late

For many years, attention deficit hyperactivity disorder (ADHD) has been associated primarily with children with behavioural difficulties, impulsivity, and high physical activity. But this image corresponds only to one part of the disorder and has contributed to leaving many women undiagnosed. Often, the solution arrives when they are already adults.

The symptoms in women are less physical

It is estimated that ADHD affects between 2% and 5% of adult women, but many have spent years without an explanation for what was happening to them or have received alternative diagnoses. Professionals warn that ADHD in women remains underdiagnosed because it often presents different characteristics to those traditionally associated with the disorder.

In many women, inattention predominates: difficulties concentrating, getting distracted easily, losing the thread of a conversation, getting absorbed in their thoughts, or having problems organising and planning. In contrast, physical hyperactivity, which is more visible and typically associated with ADHD, may not be present in the same way in women as in men.

“When we talk about hyperactivity, we often think of a person who cannot sit still, but in many women it manifests primarily as mental hyperactivity: not being able to stop thinking, having many ideas at once, or feeling that your head never rests,” explains Helena Huerta, a neuropsychologist and researcher at Parc Sanitari SJD.

Listen to the full conversation on the programme Les dones i els dies on Catalunya Ràdio with Dr Helena Huerta, a neuropsychologist and researcher at Parc Sanitari Sant Joan de Déu, and Nàdia, who shares a first-person account of her experience after receiving a diagnosis of ADHD, autism, and high abilities in adulthood.

A different way of experiencing ADHD

This less visible reality means that many women spend years trying to adapt to their environment without understanding what is happening to them. They develop strategies to compensate for difficulties, control forgetfulness, organise themselves better, or prevent others from noticing their difficulties.

This constant need to adapt can generate severe emotional exhaustion. Many women have grown up with labels such as “scatterbrained”, “disorganised”, or “lazy”, without knowing that there could be a disorder behind these difficulties.

“The diagnosis did not surprise me much because I have always been described by my family as a bit weird or special, with quirks.” “At school they used to tell me I was lazy”, explains Nàdia.

“I have always lived as a scatterbrained person,” she adds.

For her, the diagnosis has allowed her to reinterpret many experiences and understand that certain behaviours were not a lack of willpower or effort, but a different way of functioning.

“With the diagnosis, I have unlocked many memories,” she explains. “The diagnosis has helped me understand certain behaviours.”

A hyperactivity that can also cause suffering

Mental hyperactivity, despite not being visible, can become very exhausting. The feeling of not being able to “switch off your head” when you need to rest or disconnect can cause distress and interfere with everyday life.

Furthermore, people with ADHD may experience difficulties in emotional regulation: experiencing emotions very intensely, having high emotional sensitivity, or needing more time to manage certain situations.

“You always think differently and you believe it is your fault,” summarises Nàdia.

Perimenopause or menopause accelerates its detection

In women, ADHD symptoms can also be conditioned by hormonal changes. Menstruation, pregnancy, the postpartum period, perimenopause, and menopause can alter the intensity of difficulties with attention, memory, planning, and executive functioning.

Specialists point out that, even in women without ADHD, perimenopause can lead to changes in these cognitive functions. When there is underlying ADHD, these difficulties are often accentuated, which explains why some women receive the diagnosis at this stage of life.

It is also common for the discovery to come after a son or daughter is diagnosed with ADHD and the mother identifies many of the disorder’s traits in herself.

A diagnosis that brings relief and opens up new tools

For many women, receiving the diagnosis is not just getting a label, but finding an explanation for a life trajectory marked by the feeling of being different. The diagnosis helps to reduce guilt, understand certain difficulties, and acquire tools to better manage day-to-day life.