Understanding Adult ADHD in Women

When Kate Jarvis was a young girl in the 1980s, she excelled in school, receiving straight As and being well-organized. Her mother called her ‘bright-eyed and bushy-tailed.’ However, upon reaching puberty, things shifted dramatically. Jarvis found concentration challenging and her grades suffered. By high school, she was diagnosed with anxiety and depression, struggling to fit in, while teachers noted, ‘Kate has so much potential, if only she’d apply herself.’

Jarvis later realized these struggles were due to undiagnosed ADHD, a diagnosis she received in her late 30s. Receiving this diagnosis clarified what she had struggled with for 25 years but also presented challenges as she felt pressured to ‘fix’ herself.

Jarvis’ experience mirrors that of many women with ADHD. Julia Schechter, a clinical psychologist from Duke Center for Girls and Women with ADHD, explains that ADHD in girls often manifests differently than in boys. Girls may appear distracted, disorganized, and have their ‘head in the clouds,’ making these symptoms easy to overlook compared to the more noticeable hyperactive behavior seen in boys. Consequently, girls are diagnosed later than boys, often not until adulthood.

Missed ADHD diagnoses can lead to years of untreated conditions. ADHD is a neurodevelopmental issue impacting social relationships, impulse control, and self-esteem. For women, this can mean increased problems with friendships, higher risks of teen pregnancy, and susceptibility to abuse by partners. Dr. Patricia Quinn, an expert in ADHD among women, notes that these women also face higher incidents of obesity, eating disorders, type 2 diabetes, and cardiovascular issues.

ADHD remains misunderstood as merely an excuse for tardiness or disorganization, yet its impact is significant. Greater awareness now exists of its gender differences, leading to a rise in diagnoses among adult women, with nearly 7 million women in the U.S. diagnosed as of 2023. Although boys are still diagnosed more frequently during childhood, these rates equalize in adulthood.

A Breaking Point

Women may conceal their symptoms for years, but life’s increasing complexities can lead them to a breaking point. For Amy Reyer, this occurred at age 48. Juggling responsibilities for her children, aging parents, and a demanding job, Reyer felt overwhelmed by her focus and anxiety issues. Despite achieving a doctorate and a successful career, perimenopause heightened her struggles.

Emerging research suggests fluctuating estrogen levels can worsen ADHD symptoms, making perimenopause particularly challenging. Studies indicate women with ADHD often enter perimenopause sooner and experience heightened symptoms. Neuropsychologist Jeanette Wasserstein noted brain fog and executive functioning problems as major issues during this time.

Reyer’s awareness of her condition began when her son was diagnosed with ADHD, recognizing the genetic link. At 48, her diagnosis finally allowed for effective treatment. Finding the right medication made an enormous difference for her.

Treatment Options

While medication is a standard part of ADHD treatment, it isn’t the only solution. Dr. Patricia Quinn highlights the potential benefits of hormone replacement therapy for women in perimenopause. Additionally, cognitive behavioral therapy can be crucial to address internalized shame and change negative thought patterns.

Psychologist Ellen Littman stresses the importance of redefining women’s self-perception, moving from feelings of inadequacy to understanding ADHD’s neurological basis. Lifestyle changes such as regular exercise, meditation, and a healthy diet can also prove beneficial. Finding environments that capitalize on strengths instead of weaknesses is advised by clinical psychologist Kathleen Nadeau.

Embracing the Diagnosis

For women like Ruth Danoff, receiving an ADHD diagnosis transformed their lives. Diagnosed at 50, Danoff gained insight into a lifetime of struggles and changed her career path. She now advocates for other women with ADHD and emphasizes the importance of not experiencing the same struggles she endured.

Kate Jarvis believes seeking an ADHD diagnosis is worthwhile at any age. Her adult diagnosis led to medication, therapy, and self-acceptance, revealing a sense of joy and understanding she hadn’t experienced before.