6 Little-Known Ways Women with ADHD Struggle Day-to-Day

Women with ADHD are wildly underdiagnosed, a fact which has been gaining traction as more and more women speak out about their experiences with neurodiversity. Few people are aware of the ways that ADHD specifically impacts women. Girls and women with the disorder often suffer in silence, and are more likely to suffer from generalized anxiety and major depression than their male peers. As a woman with ADHD pursuing a masters in educational psychology, I have learned a few things about my condition that I think more of us should be aware of.

There are several explanations for why ADHD is underdiagnosed in women:

1. Women internalize their symptoms. Studies have shown that girls learn to turn their hyperactivity inwards, unlike boys, who experience less social stigma for their disruptive behavior. Girls' hyperactivity tends to manifest in racing thoughts, nail biting, cheek biting, over-planning, obsessive rumination, and even, in extreme cases, self-harming behaviors. Women with ADHD often feel like they appear calm on the surface, but internally, they are running laps at warp speed. For me, this is a problem I encounter every day. On the surface, especially at work, I look collected and grounded. Inside, I'm screaming, caught in an endless hamster wheel of disjointed, rapid thoughts. If it weren't for my fear of being judged, I would be biting my nails 24/7 to syphon off some nervous energy. Instead, I save that for when I'm at home, pacing around my house like I'm trying to wear trenches into the hardwood floor.

2. Women with ADHD tend to space out a lot, but get good at hiding it. Girls are trained from a young age to appear attentive and show respect to teachers, parents, and other adults in their lives. This social conditioning means that they are less likely to admit they missed an important part of a lesson. Instead, they fly under the radar, masking their confusion with kind smiles and rote nodding when they know from the tone of the person speaking that they are expected to respond. I am a master at looking like I'm listening even when I'm not. I've learned when to nod and how to ask clarifying questions that don't expose how little I'm listening. I've learned to be a master researcher, frantically googling explanations for concepts I missed in a lecture or meeting. My intel gathering is second only to the CIA; I know how to craft texts to my friends and coworkers that will get them to divulge information I missed while I was staring blankly into the middle distance, entirely disconnected from the present moment.

3. Women with ADHD are pros at something called masking. Masking is when neurodivergent people pretend to be neurotypical by suppressing their self-soothing behaviors. ASD and ADHD TikTok is filled with incredible examples of neurodivergent creators showing what it looks like when they stop masking, versus when they are "on" for the world. One of the biggest difference is stimming. Stimming is self-soothing through seeking ways to cope with sensory overload. Many people stim through repetitive movements or sounds, or by seeking specific sensations. When I stop masking, my entire demeanor changes. I stop looking in one place for fixed amounts of time. I shake my leg or rock up and down on my heels while I think. I find smooth surfaces to rub on my thumb. Sometimes I make noises or sing the same phrase over and over. Stimming looks different for everyone, but women with ADHD often stim in secret, reserving these activities for the privacy of their own home. Many of us find ways to stim in public that don't draw any attention. While masking can mean appearing less "odd" to neurotypical friends, colleagues, and employers, the process is exhausting and leads many of us to feel intensely burnt out at the end of the day.

What does this mean? A few things. Firstly, it means that women with ADHD make up a bigger percent of the population than we think we do. For women with ADHD, we experience some aspects of our disorder a bit differently.

Here are six problems women with ADHD struggle with:

1. We are incredibly sensitive to sounds, textures, and smells. Women with ADHD often find busy spaces incredibly overwhelming due to sensory overload. A close friend of mine finds the touch of velvet enraging and can't even look at a velvet dress while shopping, for fear the mere sight of the fabric will ruin her day. For me, the perpetual echo of a ticking clock is enough to derail an entire work day. The stimuli that bother you can vary on the individual level. Some of us can't stand white noise, while others thrive on it. The difference between having ADHD and being bothered by a sound or smell is that women with ADHD can't simply brush it off or ignore the offending odor. We are consumed by it until we eliminate it altogether, often spending copious amounts of time trying to hunt down the source of a particular hum or whistle.

2. Low self-esteem is another common problem for women with ADHD. Many of us have spent our whole lives not living up to the expectations society puts on us. We feel like failures, not only as human beings, but as women, who are constantly told they should be able to do everything, all the time, for everyone. Life is hard enough being a woman; the emotional labor expected of any one of us it exhausting to consider. But compound that with ADHD symptoms like forgetfulness, lack of organization, and extreme sensitivity, and you have a cocktail designed for burnout. When you have a hard time even remembering to brush your teeth and brew coffee each morning, juggling work responsibilities while caring for your loved ones and staying on top of your own personal needs feels like an insurmountable daily challenge. Because we are constantly worried we aren't living up to our responsibilities, women with ADHD also have a tendency to overcompensate by taking on too much. This leads us to feel overburdened and out of control.

3. Women with ADHD are very sensitive. We pick up easily on the emotions of others, which, coupled with our habit of forgetting important events or interrupting others, means we are constantly on edge, wondering who we have offended or what we may have done to make our friends angry at us. Rejection Sensitive Dysphoria (RSD) is an extremely common experience for women with ADHD, and yet we don't talk about it often. RSD makes us sensitive to perceived rejection. It operates as an extreme form of social anxiety. This means that criticism, no matter how slight, sends us into anxiety spirals. Even when we know practically that the feedback isn't personal and is designed to help us, we react with extreme levels of self-loathing and horror. RSD is compounded by the fact that ours brains are constantly telling us the people around us hate our guts. I have written a lot about my experiences with RSD and how it has played a role in my life in another post, linked here.

4. Women with ADHD struggle with time blindness. Time blindness is the inability to keep track of how long you've been working on a project, how long the rest of the project will take, and when you will need to stop in order to be on time for your next commitment. Many women with ADHD experience intense anxiety over the fear we will be late for dinner dates, parties, appointments, work -- you name it. We internalize this fear until it starts to feel normal, often feeling intense shame and embarrassment when we don't make it to a minor engagement on time.

5. Impulsivity in every aspect of life is a problem for most women with ADHD. We often say things without speaking and interrupt others during conversations. Women with ADHD struggle with turn-taking in conversation because we have a hard time remember thoughts long enough to wait for our loved ones to stop speaking. We speak quickly, often blurting out responses before our friends have finished their point or question. We finish other people's sentences, finding it hard to keep our predictions inside any longer. Spending is another issue for many of us, because we have a hard time remembering to save money. This is part due to problems in long-term thinking and other executive function skills that women with ADHD lack. If we see something we think we need, we buy it, often entirely forgetting about looming bills or a costly trip just around the corner.

6. Object permanence is the ability to remember an object exists once it leaves our sight. Women with ADHD have a very hard time with object permanence; if we can't see it, it ceased to exist. This makes it incredibly hard for women with ADHD to tackle their other struggles, such as time blindness. To a neurotypical person, it might seem like the obvious solution for women with ADHD to use day planners and calendars to organize their lives. Sure, that would be great, if we could remember we bought that nice planner last week. Once we put it down, unless we leave it in a location that forces us to notice it, these organizational tools become useless dust-collectors. In my own life, I have probably purchased hundreds of planners in fruitless attempts to get myself organized. This year, I began writing on my mirror in dry erase marker, which seems to have helped me trick myself into noticing reminders. My bathroom mirror has a full schedule for each day, including basic tasks like stretching, setting out my clothes the night before, and taking my medication. Without these obvious visual cues, I would be completely lost in a cycle of wandering from room to room, unsure what it is I'm supposed to be doing each day.

The good news is that it is possible to find strategies to combat all six of these challenges. A less emotionally draining, calmer way of living is possible, but it takes time and patience to find the systems that work for you. By speaking more openly about our symptoms, women with ADHD can help one another feel a little bit less alone.