The Grief of Late ADHD Diagnosis in Women

We have spent decades looking for ADHD in boys, while completely missing the quiet fire in girls. In childhood, boys tend to show signs of external hyperactivity, such as excessive physical activity, being disruptive in the classroom, an inability to stay seated, and frequent interruptions. Girls, however, tend to internalize their hyperactivity, which may appear as fidgeting or restlessness. Because hyperactive symptoms in boys are often more disruptive, they tend to prompt earlier evaluations and diagnoses. As a result, many girls fly under the radar and struggle without a diagnosis. According to the Centers for Disease Control and Prevention (2023), boys (15%) are more likely to be diagnosed with ADHD than girls (8%).

Women are often dismissed by their doctors when they bring up the possibility of having ADHD. Instead, they are frequently diagnosed with other conditions, such as anxiety or depression, before ADHD is recognized (Attoe, 2023). While there can be overlap in symptoms, this misdiagnosis can prevent women from receiving effective treatment, leaving them feeling confused, frustrated, and ashamed.

Undiagnosed ADHD in women can appear more subtle. It may show up in everyday challenges such as paying bills late, letting laundry pile up, regretting impulsive decisions, or experiencing difficulties in relationships with family, friends, and romantic partners. Women with ADHD may feel stuck when making simple decisions, miss work deadlines, or have to reread the same page of a book multiple times due to difficulty focusing. Daydreaming during important conversations or meetings can leave them feeling lost because they barely heard what was said. Criticism may feel like a personal insult rather than an opportunity to improve, which can lead to decreased self-esteem

and feelings of inadequacy. In addition, risk-taking behaviors related to impulsivity can be dangerous and may result in lifelong consequences.

The consequences of a missed or ignored diagnosis can be significant. Many women develop maladaptive coping strategies in order to raise families, maintain careers, and sustain relationships. Some coping strategies may seem relatively harmless but can still be exhausting, as women must constantly mask their symptoms in order to conform to societal expectations. Other consequences can be more profound, “potentially contributing to low self-esteem and relationship difficulties, and increasing the risk for psychiatric comorbidity (i.e., anxiety and depression) and early mortality” (Babiski, 2025). In some cases, women may attempt to self-medicate their ADHD symptoms with alcohol or illegal drugs, which can lead to additional problems throughout their lives.

A diagnosis can feel like an “aha” moment—a point at which things finally begin to make sense. It can help explain many of a woman’s experiences and provide answers and clarity to questions she may have carried for years. However, a diagnosis can also bring feelings of guilt and shame. There may be grief over being let down, cheated out of time, and forced to endure unnecessary suffering (Holden). These realizations can lead women to wonder how their lives might have been different. Would they have had better careers, earned more money, or been more patient while raising their children?

Increased awareness of how ADHD presents in women is essential to preventing future generations from experiencing the same confusion and hardship. When symptoms are recognized earlier, women can receive the support, understanding, and treatment they need to thrive rather than simply survive. While a late diagnosis may bring grief for lost time, it can also mark the beginning of a new chapter—one grounded in self-understanding rather than self-blame. By sharing their experiences and advocating for greater awareness, women diagnosed later in life can help challenge outdated assumptions about ADHD and ensure that others are seen, heard, and supported much sooner.

References

American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). 

Attoe, D.E., Climie, E.A. (2023). Miss. Diagnosis: a systematic review of ADHD in adult

women. Journal of Attention Disorders Vol 27 Issue 7 Pp. 645-0657

https://doi.org/10.1177/10870547231161533

Babinski, D. E., & Libsack, E. J. (2025). Adult Diagnosis of ADHD in Women: A Mixed Methods Investigation. Journal of Attention Disorders, 29(3), 207-219.

Centers for Disease Control and Prevention. (2023). Data and statistics about ADHD. https://www.cdc.gov/adhd/data

Holden, E. & Kobayashi-Wood, H. (2025). Adverse experiences of women with

undiagnosed ADHD and the invaluable role of a diagnosis. Scientific Reports.

15:20945 pp. https://doi.org/10.1038/s41598-025-04782-y

About the author:

Jennette Gerts is a Psychiatric Mental Health Nurse Practitioner (PMHNP) who provides compassionate, comprehensive care for children, adolescents, and adults experiencing mental health challenges and substance use disorders. Her approach is therapeutic, trauma-informed, and client-centered, creating a safe and supportive space for healing and personal growth.

She believes effective mental health care is built on collaboration. She works closely with her clients to develop shared goals that support meaningful and lasting change. By combining evidence-based practices with empathy and understanding, she helps individuals strengthen emotional well-being, resilience, and balance in their daily lives.