And why it’s never too late to get treated.
Ever find yourself struggling to pay attention during meetings, starting new to-dos before finishing your old ones, or constantly losing your keys? Those mundane flaws might mean you’re stressed or tired — or you might have adult attention deficit hyperactivity disorder (ADHD). And this brain disorder is much more common than you might think, especially among women.
While diagnoses have been on the rise for decades, the number of women from the ages of 23 to 49 receiving an ADHD diagnosis nearly doubled from 2020 to 2022 alone. There are a couple of different theories for this, including the rise of telehealth and more public awareness around the fact that it isn’t just a “boy disorder.” (Still, most of the research that has been done has been focused on males.)
“It’s not like all of these adult women suddenly developed ADHD,” researcher and Duke University professor Jennifer Gierisch, Ph.D., tells Katie Couric Media. “This recent increase in diagnosis rates in women is likely an increase in recognition of a brain-based condition that they have likely had their whole lives.”
We did a deep dive into this commonly misunderstood condition — and how you can spot some of the often-overlooked signs and symptoms.
What is adult ADHD?
Simply put, ADHD — or its shortened version, ADD — is a neurodevelopmental disorder that affects behavior.
“The brain is chemically bored and looking for stimulation,” Dr. Carol Robbins, who’s a clinical psychologist, tells Katie Couric Media. “So a lot of what people with ADHD do is a form of cell stimulation, even though it’s an unconscious practice — so they might tap their leg, fidget, fiddle, or doodle.”
The American Psychiatric Association has identified three main types of the condition: People with inattentive ADHD typically struggle with paying attention to details, and can get easily distracted from finishing everyday tasks, like paying bills or responding to a text. Someone with hyperactive-impulsive ADHD may have a hard time sitting still — they’re also often the ones talking and interrupting during a meeting. Others might have a combination of the two, which is relatively common.
But up until relatively recently, the research community thought the disorder almost exclusively affected boys and men. According to the Centers for Disease Control and Prevention, boys are more likely to be diagnosed with ADHD than girls (12.9 percent vs. 5.6 percent). But that isn’t because boys are necessarily more susceptible to it but rather because girls are consistently underdiagnosed or misdiagnosed.
How does ADHD show up in women?
Many women with ADHD symptoms tend to fly under the radar. Some experts think that they may be more likely to have inattention than hyperactivity, and therefore may not be noticed by others. Common symptoms of inattentive-type ADHD include:
- Disorganization
- Daydreaming
- Feeling overwhelmed
- Lack of attention to details or making seemingly careless mistakes
- Problems with completing daily tasks (or forgetting about them altogether)
- Difficulty with time management
- Trouble with managing stress and handling day-to-day frustrations
- Frequent mood swings
- Excessive talkativeness (you may have been called a “chatty Cathy” before)
These symptoms may get better or worse over time because they can be exacerbated by hormonal changes during your menstrual cycle, pregnancy, and menopause.
“As women reach puberty, they actually get more ADHD and then when they get pregnant, it improves,” Dr. Robbins tells us. “And then later when they’re going through perimenopause and menopause, it gets worse again because the lack of estrogen will exacerbate it.”
Why is ADHD in women often misdiagnosed?
There are a few different reasons why this might be the case. One theory is that girls and women often develop better coping strategies than boys and men to mask their symptoms. “This ability to mask symptoms may be one of the reasons that ADHD in women is more apparent in times of transition, such as starting a new job, becoming a parent, or the huge transition we all went through together with the global COVID-19 pandemic and lockdown,” explains Dr. Gierisch. “These periods can stress the house of cards that women have built to cope with their symptoms.”
Getting a diagnosis is also difficult because there are a lot of conditions, including learning disorders and depression, that can mimic ADHD symptoms. Dr. Gierisch says she has personally helped women who were initially diagnosed with and treated for anxiety for years before their ADHD was recognized and treated. “While ADHD is a disability, it doesn’t need to be a liability,” she says. “If it isn’t properly diagnosed and treated, it comes with real functional impairment and serious consequences for girls and women.”
To make things even more complicated, women with ADHD are more likely to have a co-existing mental health issue and other issues. “Being female and diagnosed with ADHD is associated with additional and unique harms, such as being six times more likely to experience pregnancy as a teen, five times more likely to be a victim of intimate partner violence, and twice as likely to engage in self-harm behaviors compared to girls and women without ADHD,” adds Dr. Gierisch.
Gender bias may even play a role: Studies have shown that teachers were more likely to recommend their male students for ADHD treatment and extra support than their female ones. That said, it’s not impossible to get a diagnosis, so don’t get disheartened. The first step toward diagnosis is to talk with your healthcare provider, whether that’s a psychiatrist or primary care physician.
While there isn’t a singular ADHD test that can definitively tell you whether you’re afflicted, a trained professional will use the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual. In most cases, adults can be diagnosed with ADHD if they have five or more of the symptoms of inattentiveness, or five or more of hyperactivity and impulsiveness.
Since ADHD is genetic, you also might be asked about your family’s medical history. “ADHD is highly heritable and it’s passed through both mothers and fathers,” says Dr. Robbins. “It’s almost always important to the diagnostic process to ask for family members that may have been diagnosed, or have symptoms that look like ADHD.”
What are some of the treatment options?
While there isn’t a cure for ADHD, it can be relatively easy to treat through a combination of medication and lifestyle changes. There are a couple of different options, but Dr. Robbins typically recommends psycho-stimulant drugs, because they have the most immediate and direct impact on the brain.
Along with meds, she also advises making sure you’re getting enough sleep. (Experts typically recommend that adults sleep between 7 and 9 hours per night.) “Our body and brain and emotions and cognitive functioning all need adequate sleep to function properly,” she says.
Getting regular exercise is also “hugely important,” says Dr. Robbins. That’s because when you exercise, your brain releases dopamine (often called the “feel-good” hormone), which helps with attention and clear thinking. But don’t forget about exercising your brain as well — studies have shown that meditation can help improve focus and attention, especially for those struggling with ADHD.
Last but not least, there are some environmental modifications you can make to manage your condition better. In a work setting, this could look like investing in some noise-canceling headphones to minimize potential distractions or taking little breaks throughout the day to stand up and walk around. There are also some simple strategies you can try at home — like creating a schedule that involves going to bed and waking up at the same time each day. It could also include making a rule to silence or switch off your digital devices an hour before bedtime.
The good news is that it’s never too late to get help: Dr. Robbins says she treats patients well into their 70s. “There are many ways that ADHD can be treated to improve your quality of life,” she explains, “no matter how old you are.”
