ADHD in Women: Why It Is Often Recognized Only in Adulthood

For a lot of women, the question of ADHD comes up only after school is long over. A new job, a promotion, a baby or a household to run can add more moving parts than the old workarounds can carry, and the gap starts to show.

Why it gets missed

The National Institute of Mental Health (NIMH) says ADHD symptoms in girls and women are especially likely to have been missed in childhood. NIMH also says there are many reasons a person may not be diagnosed until adulthood. One it describes is a milder form that is managed well until the stresses of adult life pile up.

What it can look like now

NIMH describes ADHD in adults as an ongoing pattern of inattention, hyperactivity and impulsivity, or some of these, that makes it hard to function in at least two areas of life, such as home and work. It notes that adults with ADHD often have a history of school struggles, work problems or strained relationships. Sleep is a common trouble spot: NIMH says sleep problems affect up to 70% of adults with ADHD.

Why your history matters so much

For an adult diagnosis, NIMH says symptoms must have started before age 12, which is one reason diagnosing adults is complicated. A diagnosis relies heavily on past reports of behavior, so a provider may talk with people who know you well or look at school reports and other childhood records. If you still have old report cards, bring them. Attention-deficit/hyperactivity disorder is a DSM-5-TR diagnosis made by a qualified clinician.

Other conditions can look similar

NIMH notes that ADHD often occurs alongside other mental disorders and can make them harder to treat. Anxiety, depression and poor sleep can each scatter focus on their own, so a careful evaluation looks at every one of them before reaching a conclusion.

How evaluation works at Hope Behavioral Medicine

If you have not had a formal ADHD evaluation or testing before, ADHD testing is required before treatment can begin. Testing usually follows an initial evaluation with one of our providers. If your provider finds you may meet criteria for ADHD, you will complete an objective, FDA-cleared, web-based assessment of attention, activity and impulsivity on your own computer, between visits and on your own time. The results give your provider objective information to support an accurate diagnosis and the best treatment recommendations, but on their own they are not enough to diagnose ADHD. Testing is never done at the first visit. The assessment is self-pay and not covered by insurance; when we call to schedule, we can walk you through the cost and answer any questions. Your initial evaluation and follow-up visits with your provider may be billed to your insurance according to your plan. Read how ADHD testing works and what it costs.

Treatment

NIMH says treatment for ADHD can reduce symptoms and improve functioning, and that medication and psychotherapy are among the most common treatments for adults. Medication when indicated is decided jointly with the patient. Counseling can focus on organization, planning and coping skills. Let your provider know about pregnancy plans or breastfeeding so the plan fits your life.

Read more on our ADHD in women page, or request an ADHD evaluation in West Ashley or by secure video anywhere in South Carolina.

Sources: NIMH, ADHD in Adults: 4 Things to Know (2024); American Psychiatric Association, DSM-5-TR (attention-deficit/hyperactivity disorder).

This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.