Constantly losing your keys, battling overwhelming mental chatter, feeling like people are going too slow for you, finishing other people’s sentences or interrupting conversations, missing appointments, arriving late or double booking and potentially avoiding three weeks worth of washing, might make you wonder if you have ADHD (Attention Deficit/Hyperactivity Disorder). But you question whether you just can’t get your shit together, or if it’s anxiety or depression, because after all, you're not bouncing off the walls like the stereotypical ADHD description, instead you're feeling quite exhausted at times.
If you think ADHD is only about young boys bouncing around the classroom, unable to sit still, interrupting the teacher and getting in trouble - this blog is for you! However, don’t worry - this is a very common misconception about ADHD which was driven by a bias in our research. Whilst this is one presentation, ADHD is incredibly complex and can present differently in males and females, leading to many females being misdiagnosed or being diagnosed later in life.
What is ADHD?
ADHD (Attention-Deficit/Hyperactivity Disorder) is a different way of thinking and processing information and is a natural variation in how the brain works. It is considered a neurodevelopmental ‘disorder’ that affects how the brain functions, particularly in areas related to attention, executive function, and impulse control. However, these differences can also be associated with unique strengths, such as creativity, adaptability, and a different way of problem-solving.
There are three main types of ADHD:
Inattentive (mainly troubles with attention)
Hyperactive-Impulsive (mainly hyperactivity and impulsivity)
Combined (all symptoms)
ADHD in Girls and Teenagers
While ADHD is most common in children and teens, it continues into adulthood. Historically, ADHD was only thought to impact boys. Meaning that studies looking at ADHD have mostly involved boys, which has led to diagnostic criteria that is often based on boys traits/behaviours. However, it is now recognised that whilst more boys are diagnosed with ADHD, girls too can also have ADHD - leading to an increasing number of women who are being diagnosed, often later in life. Which leads to the question - has our understanding of ADHD been skewed because girl ADHD brains are different to boy ADHD brains? And, you guessed it, the answer is yes.
If we look back at our three main types of ADHD, boys with ADHD more commonly have hyperactive-impulsive or combined type ADHD. In general, they tend to be more ‘hyperactive’ or ‘impulsive’ in nature - full of energy, fidgeting, interrupting others - and it’s often easy to recognise these traits because, well, you can see them! These behaviours are considered to be ‘extenalised’, which essentially means that they are directed toward the external environment and you can visibly see them, like not being able to sit still, talking over other people, or not being able to wait their turn etc.
Our girls on the other hand often experience ADHD in a way that is less outwardly visible. Instead of displaying external symptoms, they may show ‘internalised’ behaviors. This means their struggles are directed inward and may go unnoticed by others. These are the girls who quietly daydream, can appear disengaged in class, may have lower self-esteem, and who underperform academically despite their potential. As a result, they are at risk of being overlooked or misinterpreted as shy, lazy, or not particularly bright.
In our teenagers, ADHD can look like struggling with meeting school assessments, despite completing school work in primary school, and procrastinating on tasks especially those that one is not interested in. One’s room or bookwork could be very messy where before one took pride in presentation and they could be constantly doodling, day dreaming or appearing disinterested. Additionally, there can be an increase in emotions where you feel like one is going from 0 to 100 over a small thing, such as being asked to do a simple task like putting your dirty clothes in the laundry basket.
While girls/teenagers/women are more likely to have the inattentive type of ADHD, they can also experience hyperactivity and impulsivity—just in different ways than boys. As they grow into women, hyperactivity might manifest as constant mental chatter, difficulty relaxing, inner restlessness, perfectionism in academic or work settings, or high achievement in sports. These internal experiences are like the hidden part of an iceberg, often going unrecognised but profoundly affecting their lives and frequently misdiagnosed as anxiety.
ADHD in Women
Women can still internalise and mask the symptoms of ADHD relatively well. However, it’s not uncommon that when the demands of adulthood and/or motherhood increase, the ability to mask symptoms becomes increasingly challenging. Clinical Psychologist, Bianca Comfort From Comfort Psychology, has listed a number of signs and symptoms in women that we believe couldn’t be more accurate! We have listed them below and also added a couple more of our own to the list.
Hyperactivity/Impulsivity:
Feeling restless or agitated internally |
Fiddling or fidgeting (or the desire to) |
Constantly feeling like you should be doing something |
Difficulty relaxing and/or sleeping |
Being loud or difficulty speaking softly |
Difficulty doing activities quietly |
Always being busy doing something /excessively driven |
Cycles of high productivity followed by burnout/overwhelm |
Not respecting own boundaries around energy /tiredness |
Being talkative or finding it hard to stop talking when interested in the topic |
Can be tangential in conversations |
Saying things without thinking |
Completing other people's sentences or giving answers before people have finished speaking |
Difficulty waiting in queues or traffic |
Being impatient, interrupting others, or taking over |
Difficulty waiting your turn during conversations |
Difficulty regulating emotions eg going from 0 to 100 |
Ability to focus on interesting hobbies/tasks for hours at a time |
Really intensely interested in things until the novelty wears off and you become board and move on |
Feeling like others operate at a slow speed |
Seeking immediate gratification and/or struggle with delayed gratification |
Making decisions impulsively ie saying yes to things straight away without thinking |
Inattention:
Procrastination |
Poor attention to detail |
Not reading instructions carefully or working too quickly |
Needing to re-read information to absorb it |
Starting a task or project without reading or listening to the directions carefully |
Difficulty sustaining attention on boring or lengthy tasks |
Difficulty following the proper order or sequence of tasks or instructions |
Difficulty tolerating boredom |
Losing train of thought mid-sentence |
Working memory difficulties |
Easily distracted by own thoughts or external stimuli |
Tiring of new hobbies or interests quickly |
Difficulty concentrating on a conversation or forgetting what it was about |
Strong reliance on calendars, to-do lists and reminders/alarms |
Difficulty completing tasks once the novelty has worn off |
Needing a deadline to get things done |
Having a disorganized home or workplace |
Starting one task and getting distracted into starting many other tasks instead |
Double-booking things or arriving late |
Misplacing or losing personal items |
Finding it difficult to re-focus after being distracted |
Why misdiagnosis often occurs
As mentioned above, historically, ADHD was predominantly thought to affect boys. The diagnostic criteria were developed based on research involving a sample that was 79% male. As a result, the traits and behaviors typically associated with ADHD have largely been defined by how the condition presents in boys.
This gender bias in ADHD research and diagnostic criteria means that the signs and symptoms often exhibited by girls and women are frequently overlooked, particularly by those not trained to recognise them. Females tend to exhibit more "internalising" symptoms, which can lead to misdiagnosis, often as anxiety, depression, substance use, bipolar disorder, or eating disorders resulting in inappropriate treatment. Research strongly supports that ADHD is significantly underdiagnosed in females. Teachers, parents, and healthcare professionals often miss ADHD traits in girls and women, as they tend to report feeling anxious, prompting a focus on anxiety rather than a deeper exploration of other possible conditions. Sadly, studies show that girls and women are less likely to be referred for ADHD evaluation, receive a diagnosis when assessed, or be prescribed medication even if diagnosed.
Another contributing factor to misdiagnosis is that ADHD in women frequently goes unnoticed until life’s demands surpass their coping abilities. Major life transitions, such as starting high school, completing year 11 and 12, starting a new job or university, or becoming a mother, can overwhelm their ability to mask symptoms. Increased responsibilities, time pressures, and stress make it increasingly difficult to manage. For example, in motherhood, the constant juggling of tasks and managing schedules can push women with ADHD beyond their capacity, prompting them to seek answers. For teenagers, the challenge of handling multiple assessments and exams at one can prevent them from reaching their full potential as their level of achievement is not matching their intellect.
Additionally, the intersection of high intellectual ability and ADHD can lead to diagnostic overshadowing, as those with intellectual giftedness often develop compensatory strategies to mask their symptoms. For instance, some adults with ADHD may appear highly organised, but this often comes at a significant cost to their energy levels due to the extensive systems and mechanisms they rely on to stay organised.
Am I too old for an ADHD Diagnosis?
“Everything finally makes sense. I am not stupid, lazy or an idiot, my brain has always just worked a little differently”.
Doesn’t that sound like a relief?
Alex, our Senior Psychologist, who is passionate about assessing and diagnosing so that you can feel seen, heard, and understood, recently assessed and diagnosed a lady in her late 50’s who quoted the above words after Alex finished walking her through the process.
Being diagnosed later in life is often a ‘a-ha’ moment for people as they have a greater understanding of what previously made no sense or made them feel different from others. Having an explanation for what you once thought was just you being ‘broken’ can be a really life changing experience. It also means you can receive appropriate treatment, as opposed to being treated commonly for anxiety or depression as really the underlying cause could be our good friend ADHD!
So, the answer is no, It is never too late to seek out a diagnosis!
So, this sounds a lot like me - what now? Or my child has ADHD, does that mean I could have it too?
ADHD has a strong genetic component, with studies showing that it tends to run in families. The heritability of ADHD is estimated to be about 74%, meaning that genetics play a major role in the likelihood of passing on the condition.
If one parent has ADHD, the likelihood that a child will also have ADHD ranges from about 40% to 60%. This means that while it is not guaranteed, there is a higher risk compared to the general population so if your child has been diagnosed then yes there is a chance that you may have it too!
If you are questioning whether you may have ADHD or someone you love does and you want to know the steps to understand in greater detail the process of getting assessed and diagnosed, watch below as Alex might be able to help answer your questions.
Summary
For us at Wildflowers we summarise ADHD as a different way of thinking and processing information. People with ADHD often have vibrant, creative minds that are constantly exploring new ideas and possibilities. They may have a heightened sense of curiosity, a strong ability to think outside the box, and a knack for problem-solving in unconventional ways. While they might find it challenging to focus on tasks that don't capture their interest, they can become deeply engaged and passionate about subjects that truly inspire them. ADHD is a natural variation in how the brain works, and with the right support and understanding, individuals with ADHD can thrive and harness their strengths to lead fulfilling, successful lives.
If you would like to book an ADHD assessment or talk to our team about our assessments, fill in the enquiry form below or call us on (02) 4684 1080
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