One psychiatrist shares four key symptoms of ADHD in women that he says are often overlooked or misdiagnosed as other conditions.
Dr. Ali Ajaz, a British-based psychiatrist, said on Instagram that the lack of awareness about women-specific symptoms means their ADHD can go undiagnosed well into 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 in childhood.
This can cause women to have problems with their self-esteem and relationships, and can make it more difficult to achieve academic and professional goals.
Dr. Ajaz said: ‘It’s staggering how many undiagnosed women with ADHD there are in the world today.’
An estimated 7 million American children had ADHD in 2022, and approximately 15 million American adults had a diagnosis in 2023. According to the National Institute of Mental Health (NIMH) an estimated 3.2 percent of adult women – approximately 5 million – in the United States are diagnosed with ADHD – and that number is rising.
About half of them were diagnosed as adults, according to the CDC, although it is unclear how many of those were women.
Experts say the increase in late diagnoses may be partly due to doctors becoming more focused on the ways in which ADHD might be unique to women and girls.
Studies have shown that women are just as likely to be diagnosed with ADHD in adulthood as men. However, in childhood, boys are diagnosed much more often than girls
Your browser does not support iframes.
According to one 2024 research from Penn State As children, boys are three to sixteen times more likely to be diagnosed with ADHD than girls. This discrepancy stabilizes after 18 years.
Dr. Ajaz added: ‘Female ADHD often presents differently.’
First of all, Doctor Ajaz said on his Instagram: women are more likely to internalize their symptoms of ADHD. When a person internalizes their condition, they experience stereotypical signs of the disorder from within, rather than acting it out.
This can be at the expense of their own well-being.
For someone with ADHD, this may look like suppressing loud outbursts and fidgeting, which can cause the patient to experience greater feelings of anxiety, stress, and poor mood regulation.
Second, women with ADHD are generally better at ‘masking’ their condition.
Essentially, they may have learned to appear to be coping with their condition and to behave “normally” around other people.
While this may outwardly give a woman with ADHD the impression that she has it all figured out, internally, Dr. Ajaz said, it can lead to strong feelings of imposter syndrome.
With imposter syndrome, a person constantly feels like he has not earned his place in the world.
Third, women with ADHD may have different experiences with their menstrual cycle than women without ADHD.
Every month, women go through a cycle of roughly four weeks, during which hormones fluctuate to prepare the body for pregnancy.
The first two phases, menstruation and 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 fertilized or expelled from the body.
Dr. Ajaz regularly posts on both Instagram and TikTok. On Instagram he has more than 5,000 followers who regularly comment on his posts and ask questions in the comments
He said women with ADHD have more severe hormonal symptoms in the second two weeks of their menstrual cycle than in the first two weeks.
According to ADDitudeMag, In a specialized publication focused on ADHD, some doctors theorize 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.
When estrogen production decreases in the second half, a woman may feel like her ADHD symptoms are increasing again.
In the fourth and final symptom, Dr. Ajaz premenstrual dysphoric disorder (PMDD) could be an ‘unspoken sign’ of ADHD in women.
PMDD is a condition that causes extreme physical and emotional symptoms in women in the weeks leading up to their period. It is a separate and more serious condition than normal premenstrual syndrome (PMS).
This can include anger, feeling tense, panic attacks, suicidal thoughts, fatigue and headaches.
According to research, it affects about 10 percent of women Cleveland Clinicalthough there is no data on how often PMDD coincides with an ADHD diagnosis.
Dr. Ajaz regularly posts videos explaining different aspects of the ADHD experience that viewers may or may not relate to
But according to Dr. Ajaz, there may be some overlap.
In one older videohe explained that women with ADHD are often misdiagnosed with anxiety or depression.
Also, some symptoms of their condition can be written off as personality traits, he said. Specifically, Dr. Ajaz said that many women with ADHD are not labeled as hyperactive, but are dismissed as “talkative” or “overly emotional.”
An accurate and early diagnosis can make a difference in the way a person develops and their long-term self-esteem, says Dr. Peter Jaksa, a psychologist who specializes in ADHD. American Psychological Association.
Dr. Jaksa said: ‘If ADHD is not diagnosed – if it is not treated effectively – chronic stress and frustration leads to anxiety over time… 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 underachievement.”
This in turn can impact the level of education a person can achieve, the job they can secure and their financial well-being.