April 21, 2025, 12:34 pm | Read time: 6 minutes
ADHD is one of the most common mental illnesses in children and adolescents. Studies show that boys are affected four times more than girls. Yet ADHD is often not diagnosed until adulthood, especially in women. An expert explains to STYLEBOOK why this is the case.
ADHD, which stands for “Attention Deficit Hyperactivity Disorder,” is one of the most prevalent mental health conditions among children and adolescents. The symptoms that occur with ADHD are usually noticeable at school or when dealing with concentration tasks. Children with ADHD may exhibit high levels of activity, restlessness, and difficulty focusing, often struggling to concentrate on a single task. Current estimates suggest that approximately 5 to 6 percent of children and adolescents aged 3 to 17 in Germany are affected by ADHD. In fact, boys are diagnosed with ADHD around four times more often than girls. But why is that? Are girls really less affected—or is there a connection with the fact that ADHD is often not recognized until adulthood, especially in women?
Overview
- Expert Explains: “These Are the Symptoms of Women with ADHD
- Differences in ADHD Between Women and Men—and the Role Hormones Play
- The Special Challenges for Women with ADHD in the Social Environment
- How Can Women with ADHD Counteract the Excessive Demands of Everyday Life?
- How Can the Environment Support Women with ADHD?
Expert Explains: “These Are the Symptoms of Women with ADHD
Research indicates that the prevalence figures are influenced by diagnostic criteria that are tailored more towards boys. Girls with ADHD are therefore often not recognized. They often notice it themselves when they are already adults.
We asked Katharina Eder, a systemic therapist: Do women or girls have different symptoms when it comes to ADHD? “In women with ADHD, there are often specific symptoms that occur more subtly than in men and are therefore often overlooked,” she explains and continues: “Women are often better at concealing their inattention and inner restlessness. As a result, the symptoms are not as noticeable and are therefore not diagnosed or misdiagnosed”.
Instead of the stereotypical hyperactivity such as fidgeting or not being able to sit still, women are more likely to show symptoms such as daydreaming, forgetfulness and strong emotions. “Symptoms such as emotional dysregulation, chronic disorganization, exhaustion and irritability are often misunderstood and dismissed as stress or ‘normal’ mood swings.” However, these can also be signs of ADHD.
So is this misinterpretation the reason why women are often not diagnosed with ADHD until adulthood? Also, however: “ADHD is often diagnosed late in women because society’s expectations of them are different,” says Eder. Societal expectations often dictate that women should be highly organized, conscientious, and adaptable. They are expected to take care of many things, be compassionate and calm. “This leads to them adopting strategies early on to compensate for their symptoms. In addition, many diagnostic criteria were originally tailored to male behavior, so female ADHD symptoms are less noticeable,” explains the therapist.
Differences in ADHD Between Women and Men—and the Role Hormones Play
Although ADHD can manifest itself differently in women or girls—such as the daydreaming mentioned above—the differences in symptoms between the sexes do not necessarily have to be the same. According to Eder, one of the main differences in ADHD between men and women is due to hormones. “Hormones like estrogen affect brain neurotransmitters, notably dopamine and serotonin, which are pivotal in ADHD. During the menstrual cycle and in phases of life such as puberty, pregnancy and menopause, hormone levels fluctuate greatly, which can lead to an increase in ADHD symptoms in women.” This can either be misunderstood, misinterpreted—or even overlooked.
However, social role expectations are also reflected in the interpretation of the symptoms: “Women are often expected to be calm, organized and socially adapted. As a result, many girls and women are better at hiding or compensating for their ADHD symptoms—they ‘mask’ their difficulties.” So instead of standing out through hyperactive behavior, they develop strategies to conform to social expectations, according to the therapist.
The Special Challenges for Women with ADHD in the Social Environment
But what special challenges do women with ADHD face in their relationship or in everyday family life? These multiple burdens—partner, mother, professional and household manager—to which women are often exposed at the same time, quickly lead to excessive demands for women with ADHD, as they struggle with everyday organization and time management, says Katharina Eder. “Women with ADHD tend to be emotionally dysregulated. This often manifests itself in mood swings, irritability or sudden outbursts of anger.”
These intense emotions can be difficult for the partner to understand and put a strain on the relationship. “Mothers with ADHD often find it particularly difficult to keep their own symptoms under control while at the same time having to meet the needs of their children,” says Eder.
Distractibility, difficulties with organization and impulsivity can make it difficult to maintain the structure and routine in everyday family life that children often need. “In addition, ADHD is hereditary and often leads to children with ADHD. Mothers with ADHD often struggle with feelings of guilt because they feel they are not there enough for their children or are not able to support them sufficiently. Women are often seen as the ones who manage the household and provide emotional support for others”.
These external demands and expectations are often at odds with the difficulties that women with ADHD experience within themselves on a day-to-day basis. “The constant discrepancy between what is expected of them as a society and what they can actually achieve increases the pressure,” says the expert.
How Can Women with ADHD Counteract the Excessive Demands of Everyday Life?
How can women with ADHD more effectively manage their professional and personal responsibilities without becoming overwhelmed? According to the therapist, fixed, easy-to-implement routines are primarily important in order to structure everyday life and maintain an overview. “But a certain amount of compassion towards yourself is also important, as is not having unrealistic expectations,” she says. In a partnership or social context, open communication about the specific challenges is also essential. After all, not every person with ADHD is the same, says the expert. “But of course, therapy and coaching can be a valuable support in developing coping strategies.”
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How Can the Environment Support Women with ADHD?
As with almost all mental illnesses, the environment also plays a major role in ADHD. But how can the people closest to them support women with ADHD? “Partners, family or friends can best support women with ADHD by showing understanding and offering support,” says the therapist. People with ADHD often find criticism especially challenging to handle. “Instead of criticizing them for being messy or forgetful, be patient and work with them to find solutions.” Recognizing (small) successes can also be necessary.