Girls in Circles, One Left Out: The Hidden Face of ADHD in Women
On a school oval, girls sit in circles, chatting and bonding effortlessly. At the edge, one girl lingers nearby, never quite part of it. For many women, this is the first chapter of an ADHD story that goes untold.
I am a psychiatrist, and when I share this imagery in education sessions, women often approach me afterwards to say: “It felt like you were telling my story.” ADHD affects around five to six people in every hundred worldwide, yet women are still far less likely to be recognised or diagnosed until adulthood. The reason is not that ADHD is rarer in women, but that it looks different, and society has not learned to see it.
The Early Signs: Quiet but Real
ADHD in girls does not always appear as restless energy or disruption. Instead, it often looks like daydreaming, distraction, or a quiet sense of not fitting in.
The boys are out on the field playing footy or soccer. Their friendships are built in the game itself. Joining in can be as simple as running onto the field and taking part. The activity makes the connection easier, more fluid, and more inclusive.
By contrast, many girls with ADHD hover on the edges of friendship groups. The circles of conversation can feel closed, difficult to enter, and unforgiving if you miss a social cue. They may be labelled too sensitive, too intense, or simply not trying hard enough. These early messages leave a lasting mark, shaping identity long before academics become more demanding.
High School and Puberty: When the Cracks Widen
By Year 9, the demands of school shift. Success now depends on planning, organisation, and managing multiple assignments. For many girls with ADHD, this is when cracks widen. Grades slip, teachers say, “You’re capable, but lazy,” and family conflict often follows.
At the same time, adolescence brings powerful biological shifts. The teenage brain undergoes neural pruning, trimming away connections that are rarely used and strengthening those that are. Think of it as the brain’s spring cleaning, keeping what is most useful and letting go of what is not. For those with ADHD, this process unfolds differently, leaving gaps in attention, planning, and emotional regulation.
Hormones add another layer. Oestrogen and progesterone interact with dopamine and serotonin, systems that already work differently in ADHD. Many young women notice their symptoms fluctuate with the menstrual cycle, feeling sharper some weeks and overwhelmed or more emotionally sensitive in others.
The patterns described here are common in inattentive and combined presentations of ADHD. But hyperactivity in women is also real. It may look like inner restlessness, rapid speech, or impulsive choices, often dismissed as “personality” rather than recognised as ADHD.
Perfectionism and Rejection Sensitivity
Despite the challenges, moments of success still come: a subject that sparks interest, a teacher who believes in her. These moments become fuel, but also reinforce a dangerous belief: “I am only worthy when I excel.”
This cycle drives perfectionism and a painful vulnerability to failure. Small setbacks can feel devastating, a phenomenon known as Rejection Sensitivity Dysphoria. To cope, many women push harder, mask better, and eventually burn out.
Friendships and Emotional Exhaustion
The result is often overextending themselves, saying yes too often, and feeling drained. These patterns are not flaws of character. They are the downstream effects of a brain that works differently.
It is also important to recognise that ADHD rarely exists in isolation. Many women experience overlapping conditions such as anxiety, depression, trauma-related difficulties, sleep problems, premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), metabolic issues or even personality vulnerabilities. These can complicate the picture, delaying diagnosis and making treatment less straightforward. Understanding ADHD means not only recognising its core features but also appreciating the common comorbidities that walk alongside it.
Career and Parenthood: The Breaking Point for Many
For some women, ADHD only becomes undeniable in adulthood. Careers demand consistent focus, organisation, and time management. What once could be covered with last-minute effort unravels under professional pressure. Feedback from managers often echoes old school reports: “brilliant ideas but inconsistent,” “capable but struggles with follow-through.”
Parenthood can magnify these struggles further.The constant multitasking and unpredictability of raising children push even well-practiced coping strategies to their limits. Many women first seek assessment only when they feel they are failing at work, at home, and as parents, even though what they are experiencing is ADHD that has always been there.
The Mask of Competence
Perhaps the most striking truth is how many women adapt so hard they do not realise how exhausted they are.
Masking takes many forms: over-preparing, excelling in areas of strength, working longer hours, or constantly scanning the social world for cues on how to fit in. It hides ADHD not just from teachers, families, and colleagues, but often from women themselves.
The cost is chronic fatigue, burnout, and a fragile identity tied only to achievement. Increasingly, I also see a connection between this long-term physiological strain and activation of autoimmune conditions such as thyroid disease, rheumatoid arthritis, or alopecia. While research
is still emerging, the overlap is striking and raises important questions about the link between prolonged stress, ADHD, and immune system health.
ADHD as Human Diversity
It is crucial to recognise that ADHD is not rare and not simply a deficit. Around 5–6% of people worldwide live with it, making it part of the natural variation in how human brains are wired.
When recognised and supported, ADHD can be a strength. Creativity,, innovation, and energy often flourish. Many of the very traits that once drew criticism become assets in the right environment. ADHD reflects not just struggle but resilience and brilliance, contributing to the diversity of human minds.
Why Women Are Missed
- Stereotypes: ADHD is still imagined as a restless boy in a classroom. Quiet, distracted girls do not fit the picture. Hyperactive women are overlooked because their restlessness or impulsivity is dismissed as personality.
- Masking: Women often overcompensate with effort, organisation, or perfectionism, concealing difficulties.
- Misdiagnosis: Anxiety and depression overshadow ADHD, leading to partial treatment without addressing the root cause.
- Cultural expectations: Girls are socialised to be compliant, responsible, and nurturing, roles that disguise ADHD until life demands overwhelm them.
A Call to Rethink ADHD
For women who recognise themselves in this story, the moment of clarity is often bittersweet. Years of self-blame finally make sense. The truth is not laziness, weakness, or oversensitivity. It is difference.
Recognising ADHD is not only about reducing suffering. It is about unlocking potential and allowing women to stop living in constant overdrive. With the right support, whether medication, therapy, or coaching, ADHD can shift from silent struggle to source of strength.
Final Thoughts
ADHD in women has been hidden in plain sight for too long. Clinicians, teachers, and families need to broaden their view beyond stereotypes.
And for women living with it: know this. You are not broken. You are part of the wider spectrum of neurodiversity that enriches humanity. Recognition is not the end of the story. It is the beginning of seeing ADHD not just as a challenge, but as one of the many ways human minds shine.
Author bio:
Dr Jubin Roomiani is a psychiatrist specialising in ADHD and mental health. He works with individuals across Australia through Wellvue, a telehealth platform dedicated to innovative, high-quality psychiatric care.
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Disclaimer: The information in this article is general in nature and does not replace personalised medical advice. It is not intended to diagnose, treat, cure or prevent any condition. If you have concerns about your mental health, please speak with your GP, psychiatrist, or another qualified health professional. In an emergency, call 000 in Australia.