ADHD in Girls: The Invisible Epidemic of Missed Diagnoses

We often think of ADHD as something that affects young boys who can't sit still in class or focus for long. But what many don't realise is that countless girls around the world are dealing with ADHD too, and it often goes unnoticed, and there is a much higher rate of undiagnosed ADHD in girls worldwide.

ADHD in girls is like a quiet battle, as how ADHD presents in girls is very different and can often be missed or overlooked. Many women are being diagnosed in their 20s and 30s. In this article, we're going to dive into this hidden problem, looking at why ADHD in girls often flies under the radar and the unique challenges they face. We'll discuss everything from the misconceptions about ADHD in girls to how societal factors play a role in it not being diagnosed as often.

The Misconceptions Surrounding ADHD in Girls

• ADHD is primarily a boys' issue. This stereotype stems from the fact that boys tend to display more overt symptoms, such as hyperactivity and impulsivity, which are often associated with ADHD. As a result, girls who exhibit more internalised symptoms, like daydreaming or inattentiveness, may be overlooked or dismissed as simply being shy or spacey.

• Girls are more likely to be "well-behaved" and compliant than boys, leading to the assumption that they cannot have ADHD. This misconception not only undermines the experiences of girls with ADHD but also perpetuates the idea that their struggles are not valid or significant.

• Girls with ADHD are always academically underperforming. While it is true that many girls with ADHD struggle in school, especially in subjects requiring sustained attention and organisation, some manage to mask their symptoms and achieve good grades. These girls often develop compensatory strategies or rely on their high intelligence to cope, which can further camouflage their ADHD.

• ADHD is a childhood condition that is outgrown with age. While it is true that some children may experience a decrease in symptoms as they enter adolescence or adulthood, ADHD is lifelong and can continue to impact individuals well into adulthood. This misconception can prevent the timely diagnosis and appropriate support for girls with ADHD, leading to a host of difficulties in adulthood, including academic and employment challenges, relationship problems, and mental health issues.

Differences in Symptoms and Presentation

It is important to recognise that ADHD can manifest differently in girls compared to boys. While the symptoms of hyperactivity and impulsivity are often more prominent in boys, girls may exhibit more internalised and subtler symptoms.

For instance, instead of being physically restless and fidgety, girls with ADHD may display the following symptoms:

• Daydreamy

• Frequently lost in their thoughts

• Quiet/Shy

This difference in symptom presentation can make it easier for girls to go unnoticed or be mislabeled as "quiet" or "shy."

• Difficulty in organisation

• Time management

• Self-regulation

These difficulties can impact their academic performance and overall functioning. However, they may be attributed to other factors, such as laziness or a lack of effort, which can lead to a delay in diagnosis and appropriate intervention.

• Prone to internalising mental health issues, such as anxiety and depression

The unique symptom presentation and the societal expectation that girls should be well-behaved, compliant, and focused can make it challenging for girls with ADHD to receive the necessary support.

Girls with ADHD: The Overlap with Anxiety and Depression

Girls with ADHD are significantly more likely to experience anxiety and depression, often beginning in adolescence. This is partly because many girls go undiagnosed for years, leading them to internalise their struggles and blame themselves for difficulties in focus, organisation, or social interactions. The constant effort to “mask” their symptoms, to appear calm, compliant, and capable, can be mentally exhausting and emotionally damaging over time.

Signs of co-occurring anxiety or depression may include:

• Frequent self-criticism

• Withdrawal from social situations

• Mood swings

• Chronic fatigue

• Sudden dips in academic performance.

These emotional challenges are sometimes dismissed as personality traits or typical teenage behaviour, which can delay appropriate support.

To help with early identification of these patterns, schools, charities, and individuals often use tools like the Discovery Journal’s neurodiverse version. It provides a structured way to track mood changes, emotional triggers, and thought patterns over time, offering valuable insight into when emotional health may be fluctuating and helping girls better understand and express what they're experiencing.

Discovery Journals - Neurodiverse Version

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How to Identify ADHD in Girls and Women

Identifying ADHD in girls and women can be challenging, as their symptoms often don’t align with the more widely recognised (and researched) male presentation. Rather than hyperactivity or disruptive behaviour, girls are more likely to exhibit inattentiveness, emotional sensitivity, and chronic internal overwhelm. Many develop strong masking strategies, like perfectionism or people-pleasing, which can hide their struggles from adults, teachers, or even themselves. Here are some of the more subtle and common signs to look out for:

• Chronic daydreaming or seeming mentally “checked out”

• Forgetfulness (e.g., frequently losing items, missing deadlines, or zoning out mid-conversation)

• High sensitivity to criticism or emotional rejection (sometimes called “rejection sensitive dysphoria”)

• Mood swings or emotional outbursts that feel hard to control

• Anxiety or low self-esteem, often developed from years of trying to "keep up"

• Procrastination or paralysis when faced with tasks that feel overwhelming

• Perfectionism that masks underlying disorganisation

• Restlessness or fidgeting, which may be subtle (e.g., tapping feet, chewing, skin picking)

• Difficulty following through on multi-step tasks, even when motivated
  

If these signs are consistent and long-standing, especially if they’ve been present since childhood, it may be worth seeking a professional evaluation from someone experienced in diagnosing ADHD in women and girls.

Hormones and ADHD: Why Symptoms Can Fluctuate in Girls and Women

Hormonal changes play a significant role in how ADHD symptoms present and fluctuate in girls and women. Many females report feeling more distracted, emotionally sensitive, or overwhelmed during key hormonal shifts, such as puberty, menstruation, pregnancy, and menopause. Estrogen in particular influences neurotransmitters like dopamine, which is closely linked to attention, motivation, and emotional regulation. When estrogen levels drop, ADHD symptoms often intensify. For girls, this can mean worsening focus or emotional outbursts during certain points in their cycle, symptoms that may be misinterpreted as typical “teenage moodiness.” Recognising this pattern is essential, as it can inform better self-awareness, medical care, and support strategies throughout a woman’s life.

Monitoring your cycle and connecting it to your mood and focus can give you an early warning of any changes. This information can also aid in a diagnosis if shared with a healthcare professional or assessor.

Considering an ADHD Diagnosis?

In the UK, we are fortunate to have free healthcare through the NHS; however, a diagnosis of ADHD is usually available through several different governing bodies, and their wait times vary significantly. Here are the July 2025 updates from those bodies, as reported by ADHD UK:

ADHD 360

July 2025 Update: Open for Right to Choose bookings. Current waiting times are:

• Private adult assessments: 7–10 days

• Private child assessments: 4 weeks

• NHS (contracted activity): 1 week

• Right to Choose (RTC): 12–16 weeks
  

Psychiatry UK

July 2025 Update:

• Adult diagnosis wait time: Approximately 22 months

• Post-diagnosis medication titration wait time: 8–9 months, with possible delays due to ongoing national medication shortages
  

Dr J and Colleagues

July 2025 Update:

• Currently accepting Right to Choose bookings for ADHD and ASD

• Estimated wait time: 10 to 14 weeks
  

Clinical Partners

July 2025 Update:

• For referrals made after January 1st, 2025, current waiting time is around 32 weeks (~8 months)

• Earlier referrals will be contacted shortly for the next steps
  

Evolve

July 2025 Update:

• Wait time: Over 24 months

• Only accepting referrals for ages 0–19

• Still accepting private and insurance referrals for adults

Which Discovery Journal is suitable for users with ADHD...

While all versions of the Discovery Journal are designed to encourage structure and self-reflection, the Neurodiverse edition is especially well-suited for individuals with ADHD. Its layout supports executive functioning by breaking tasks into manageable sections and using consistent, easy-to-follow prompts.

The Neurodiverse version also takes into account the sensory needs often associated with ADHD, featuring carefully chosen fonts, colours, and categorisation that reduce overwhelm and promote focus. This format has been used by individuals, schools, and charities alike as a practical tool for building routine, tracking emotional patterns, and making sense of day-to-day experiences in a supportive, structured way.

Discovery Journal's Neurodiverse version

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