ADHD is often missed or misdiagnosed in girls and women. Although the first signs start to appear in childhood, most girls and women aren’t diagnosed until adolescence or adulthood. This is because the diagnostic criteria is based on research into its appearance among school-aged boys. As a result of the misconception that ADHD is for ‘active boys only’, girls are often overlooked or mislabeled a ‘daydreamer’ or ‘Chatty Cathy’. Further, despite the fact hormonal fluctuations impact dopamine and norepinephrine–which are directly linked to ADHD–girls and women who report a spike in symptoms during puberty, the premenstrual phase, pregnancy, and perimenopause are often dismissed as ‘hormonal’.
Girls and women are also missed because their struggle is internalized. In childhood, girls learn to mask to conform to gender norms, avoiding criticism and social stigma. This leads to a secret inner struggle, marked by feeling ‘too much’: too intense, too impulsive, too scattered, too sensitive, too talkative, and ‘not enough’ despite their best effort. This impossible contradiction can result in intense shame and self-blame.
To prevent pain from shame, missed and misdiagnosed girls learn protective strategies such as avoidance, procrastination, perfectionism, and/or people-pleasing. While helpful, these can lead to chronic stress. Imagine how hard it would be to hold a beach ball under water. It might be manageable at first, but sustaining such effort against so much pressure would become exhausting and lead to burnout.
Missed and misdiagnosed ADHD can be caused by and contribute to mental health conditions such as anxiety and depression. For this reason, women often seek support for a co-occurring mental health condition first. But without an accurate diagnosis, such support falls short and leaves women feeling misunderstood, stuck, and struggling with self-doubt.
For those who have been dismissed, missed or misdiagnosed, an ADHD diagnosis offers an explanation and an invitation to improve self-understanding, self-compassion, self-esteem and confidence. But you don’t need a diagnosis to be seen and supported in a safe, neurodivergent-affirming space. Whether you have a diagnosis, are starting the process, or are self-identified, you–and all of your parts–are welcome just as you are.
How Caroline Can Support You
At Sarah Terwilligar & Associates, Caroline uses a neurodivergent-affirming approach to support adolescents, adults and families better understand their neurodivergent brain, recognize their strengths, cultivate self-compassion and strengthen self-confidence. If you’re feeling stuck, struggling with shame, or seeking support as you navigate life as a neurodivergent person–or someone who thinks they have ADHD–connect with Caroline. She understands, and offers in-person sessions in Burlington as well as online support across Ontario.