Attention Deficit Hyperactivity Disorder (ADHD) has long been considered a childhood condition common among hyperactive boys. But for countless women, ADHD is an invisible force that shapes their lives and is often misdiagnosed or ignored altogether. Unlike men, women face hormonal fluctuations, social pressures, and emotional burdens that exacerbate the challenges of ADHD. Not only do these factors affect daily activities, but they also contribute to an increased risk of anxiety, depression, and other mental health issues. By uncovering the nuances of ADHD in women, we can break the cycle of underdiagnosis and provide them with the support they so desperately need.
To better understand ADHD in women, OnlyMyHealth spoke to Dr. Sandra Kooy, professor of adult ADHD at the Amsterdam University Medical Center in the Netherlands, and Jo Ostlund, director of Pearson Clinical.
How ADHD impacts women’s mental health
“Women with ADHD are significantly more likely to experience anxiety and depression,” says Dr. Couey. These symptoms may occur as a result of ADHD symptoms or independently. ADHD can exacerbate everyday challenges like organization, focus, and time management, leading to chronic stress, feelings of helplessness, and burnout.
Women often internalize their distress, which leads to a mental health landscape where anxiety and depression are rampant, says Dr. Kooigi. Additionally, women with ADHD often experience mood swings before their period and are more susceptible to seasonal affective disorder (SAD), especially in areas with less sunlight. The cyclical nature of hormonal changes exacerbates these mood disorders, making ADHD a multi-layered condition for many women.
Hormonal cycles and ADHD symptoms
Hormones play a key role in the development of ADHD symptoms in women. According to Dr. Couey, estrogen interacts closely with dopamine, a neurotransmitter that is already deficient in people with ADHD, directly affecting mood, memory, and cognitive abilities. During major hormonal changes, such as premenstrual, postpartum, and menopause, ADHD symptoms can worsen dramatically.
Women with ADHD report a two- to three-fold increase in mood-related symptoms during this time, due to the sudden drop in estrogen levels. “Menopause poses particularly serious problems because it is associated with a long-term decline in estrogen, and hormone levels never fully recover,” says Dr. Couey. “Not only do these fluctuations worsen ADHD symptoms, but they also negatively impact emotion regulation, decision-making, and cognitive abilities.”
Read more: Alia Bhatt reveals she has Attention Deficit Disorder; Signs and symptoms to look out for
Misunderstanding and underdiagnosis
ADHD in women often goes undetected or misdiagnosed due to a common misconception: the condition has traditionally been associated with hyperactivity in children, leading to a failure to identify symptoms of inattention and withdrawal that are typically seen in women.
Screening for ADHD, especially in adulthood or during menopause, is essential. As Dr. Kooij explains, distinguishing between ADHD and menopausal symptoms requires determining its onset and persistence across the lifespan. Symptoms such as poor concentration, impulsivity, and mood swings may seem similar to menopausal symptoms, but they arise from a different neurodevelopmental origin.
Addressing ADHD Symptoms in Women
Tailored treatment strategies for women with ADHD can significantly alleviate their challenges, and Dr. Couey emphasizes the importance of both medication and hormone therapy: Adjusting ADHD stimulant medications during the premenstrual phase may reduce depression, and hormone replacement therapy may address mood swings, hot flashes, and associated physical symptoms.
In addition to medical treatment, Jo Östlund speaks about the importance of a holistic approach, such as cognitive behavioral therapy (CBT) and mindfulness practices, to help women manage their symptoms and improve their ability to regulate their emotions.
Read more: Adult ADHD: Doctors Share Tips for Effective Control
Breaking down barriers and raising awareness
A lack of awareness of ADHD in women means many women remain underdiagnosed and do not receive effective treatment. Understanding the interplay between ADHD, hormones, and mental health can help healthcare providers create a more comprehensive diagnostic and treatment framework.
ADHD is not just a childhood condition or a disorder that predominates in men, but a lifelong challenge for many women. Recognizing the unique symptoms that present in women is essential to foster greater empathy, support and solutions. By raising awareness and providing timely interventions, women with ADHD can lead more balanced and fulfilling lives.
