A psychiatrist shares four key symptoms of ADHD in women, which he says are often overlooked or misdiagnosed as other conditions.
Dr Ali Ajaz, a UK-based consultant psychiatrist, said on Instagram that a lack of awareness of women’s specific symptoms means their ADHD may go undiagnosed until their 30s.
And recent reports have found that women are more likely to live with undiagnosed ADHD, while ADHD in boys is more likely to be recognized, diagnosed and treated during childhood.
This can cause women to suffer from self-esteem and relationship issues, and make it more difficult to achieve their academic and professional goals.
Dr Ajaz said: “It’s staggering the number of women with undiagnosed ADHD in the world today. »
An estimated 7 million American children had ADHD in 2022, and by 2023, approximately 15 million American adults had been diagnosed. According to the National Institute of Mental Health (NIMH), about 3.2 percent of adult women – about 5 million – in the United States have a diagnosis of ADHD – and that number is increasing.
According to the CDC, about half of them received their diagnosis as adults, although it’s unclear how many of them were women.
Experts say the increase in later diagnoses could be partly due to doctors focusing more on how ADHD might be unique to women and girls.
Studies have shown that as adults, women are just as likely as men to be diagnosed with ADHD. However, in childhood, boys are diagnosed much more often than girls.
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According to a 2024 Penn State study, boys are three to 16 times more likely to be diagnosed with ADHD than girls. This gap stabilizes after the age of 18.
Dr Ajaz added: “ADHD in women often presents differently. »
First, Dr. Ajaz said on her Instagram, women are more likely to internalize their ADHD symptoms. When a person internalizes their illness, they internally experience stereotypical signs of the disorder, instead of acting them out.
This may come at the expense of their own well-being.
For someone with ADHD, this may look like suppressing loud outbursts and agitation, which could lead the sufferer to experience greater feelings of anxiety, stress, and poor mood regulation.
Second, women with ADHD tend to be better at “masking” their condition.
In essence, they may have learned to appear as though they are coping with their illness and behave “normally” around others.
While outwardly this can make a woman with ADHD seem like she has everything figured out, internally, Dr. Ajaz said, it can lead to a strong feeling of imposter syndrome.
In imposter syndrome, a person constantly feels like they haven’t earned their place in the world.
Third, women with ADHD may have different experiences with their menstrual cycle than women without ADHD.
Each month, women go through a cycle of approximately four weeks, during which hormones fluctuate, to prepare their bodies for pregnancy.
The first two phases, menstruation and the follicular phase, involve bleeding.
During the second two phases, ovulation and the luteal phase, an egg is released and travels to the uterus, where it is either fertilized or excreted from the body.
Dr. Ajaz posts frequently on Instagram and TikTok. On Instagram, he has more than 5,000 followers who regularly interact with his posts and ask questions in the comments.
He said women with ADHD tend to have more severe hormonal symptoms during the second two weeks of their menstrual cycle than during the first two.
According to ADDitudeMag, a trade publication focused on ADHD, some doctors hypothesize that the level of estrogen, the female sex hormone, released during the first half of the cycle may help a woman with ADHD feel more productive.
Then, when estrogen production declines during the second half of the year, a woman may feel her ADHD symptoms return.
Regarding the fourth and final symptom, Dr. Ajaz said Premenstrual dysphoric disorder (PMDD) may be an “unspoken sign” of ADHD in women.
PMDD is a condition that causes extreme physical and emotional symptoms in women in the weeks before their period. It is a distinct and more serious condition than normal premenstrual syndrome (PMS).
This may include anger, nervousness, panic attacks, suicidal thoughts, fatigue and headaches.
According to the Cleveland Clinic, it affects about 10 percent of women, although there is no data on how often PMDD coincides with an ADHD diagnosis.
Dr. Ajaz frequently posts videos explaining different aspects of the ADHD experience that viewers may or may not relate to.
But, according to Dr. Ajaz, there could be some overlap.
In an older video, he explained that women with ADHD are often misdiagnosed as having anxiety or depression.
Additionally, some symptoms of their condition could be considered personality traits, he said. Specifically, Dr. Ajaz said that instead of being labeled hyperactive, many women with ADHD are labeled “talkative” or “overly emotional.”
An accurate, early diagnosis can make a difference in a person’s development and long-term self-esteem, Dr. Peter Jaksa, a psychologist specializing in ADHD, told the American Psychological Association.
Dr Jaksa said: “When ADHD goes undiagnosed – when it is not treated effectively – over time, chronic stress and frustration lead to anxiety… This has a very negative impact on self-esteem. It is very common to see adults with ADHD growing up with a strong sense of failure.
This can affect the level of education a person is able to achieve, the employment they are able to obtain, and therefore their financial well-being.