ADHD in Women

“Drowning on the Inside:” Misunderstood Symptoms of ADHD in Women

ADHD stereotypes based on male paradigms lead to underdiagnosis of women, whose symptoms often include emotional dysregulation, “internal” hyperactivity, and mental fatigue. Here, our readers dismantle archetypes by sharing their most misunderstood symptoms.

A woman with ADHD looks into the distance.

A little boy bouncing off the walls of his classroom, blurting out and squirming incessantly. This is the image of ADHD burned in our popular culture — and in the minds of too many medical professionals. But for the majority of people with ADHD, particularly women, this representation does not match their experience. More troublesome than distractibility and external hyperactivity, you tell us, are ADHD overwhelm, volatile emotions, shame, racing thoughts and mental fatigue, rejection sensitivity, and social struggles. These symptoms, while common, are often overlooked and misunderstood.

So, we asked the women who read ADDitude to share their misunderstood symptoms, and to answer the question: What do you wish the world knew about ADHD? Read their answers below — and share your own thoughts in the comments section above.

“I just don’t feel believed, especially about how much my hormones and menstrual cycle deeply impact all of my symptoms. When I try to explain that my ADHD symptoms are more severe during the second half of the month, I’ve been told by more than one doctor that they’ve ‘never heard of anything like that.’” —Maria, Colorado

“Neurotypicals need to know that hyperactivity in women doesn’t present as the stereotypical ADHD little boy who fidgets and runs in circles. Our hyperactivity is invisible: it’s in our heads. My ADHD mind is like a L.A. highway with high-speed cars zooming here, there, and everywhere.” —Michelle, Mississippi

“I think the most misunderstood symptom of ADHD is emotional dysregulation. And particularly for women I think this piece gets either downplayed or used to justify mood disorder diagnoses that aren’t accurate.” —Em, New York

[Read: DESR – Why Deficient Emotional Self-Regulation is Central to ADHD]

“I wish health care professionals knew we struggle with many more medical issues than the general population.” —Elizabeth, New Hampshire

“I wish that women with ADHD were better represented in scientific studies and the media. The common assumption of what ADHD looks like is very outdated and stereotypical. And it’s still embedded within our education and health systems, leading to under and misdiagnosis of women with ADHD.” —An ADDitude reader

“I wish the world knew how severely inattentiveness can affect someone’s life. For me, it meant the difference between having and not having a successful career. For a lot of women, it means they are forced to be financially dependent on a spouse and prone to suffering from the ADHD tax.—An ADDitude reader

[Read: What Is Inattentive ADHD? ADD Symptoms, Causes, Treatment

You can be academically gifted and have ADHD. My psychiatrist told me that I was ‘too smart to have ADHD.’”  —Anna

“Undiagnosed ADHD in girls and women will lead to dangerous behaviors including substance abuse and suicidality. There is so much shame that comes from not being typical. I personally struggled with substance use disorder due to undiagnosed ADHD and even after my diagnosis at 40, I felt I could never live up to being a ‘good’ wife and ‘good’ mother.” —Beth, Colorado

“Some of us don’t look like we struggle, because we are working overtime not to disappoint, but this extra effort takes its toll on our physical and mental health and is often unsustainable. If we are asking for help, it’s because we can see the wall we are heading for at high speed and know the impact will be catastrophic.” —Sarah

“The most misunderstood ‘symptom’ to me is invisible to others and it is the deep shame I feel.” —Aimee, Maryland

“The difficulty, anxiety and misunderstanding that come from rejection sensitivity dysphoria. I find it really challenging across all areas of my life. It causes me great difficulty in my workplace, as I find it really difficult to take on constructive feedback even though rationally, I know it’s not a biggie.” —Madeline

“I wish the world understood that I don’t always read the underlying social cues around me and it makes navigating social situations difficult.” —Sara, New Hampshire

“We need medication on weekends too, not just 9-5, Monday through Friday, for work. Juggling tasks and responsibilities doesn’t stop when we clock out, especially for those of us with children.” —Lynette

“In conversation, if a thought comes into my head that is relevant, I have to say it then and there, otherwise the constant bombardment of thoughts means if I wait, it’s gone or forgotten. I don’t mean to be rude, I just want to join in and be accepted.” —An ADDitude reader

Misunderstood Symptoms of ADHD in Women: Next Steps


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