Do you have ADHD and not know it? Doctor reveals ‘unspoken’ symptoms of growing condition
One psychiatrist is sharing four key symptoms of ADHD in women he said are often overlooked or misdiagnosed as other conditions.
Dr Ali Ajaz, a UK-based consultant psychiatrist, said on Instagram the lack of awareness about women-specific symptoms means their ADHD can go undiagnosed until well into their 30s.
And recent reports have found women are more likely to live with undiagnosed ADHD, whereas ADHD in boys is more likely to be recognized, diagnosed and treated in childhood.
This can lead to women suffering problems with self-esteem and relationships and can make it more difficult to navigate academic and professional goals.
Dr Ajaz said: ‘It’s staggering, the amount of undiagnosed women with ADHD in the world today.’
An estimated 7million American children had ADHD as of 2022 and as of 2023, about 15million US adults had a diagnosis. According to the National Institute of Mental Health (NIMH), an estimated 3.2 percent of adult women -about 5million- in the United States have a diagnosis of ADHD – and that number is rising.
About half of them received their diagnosis as adults, according to the CDC, though it’s unclear how many of those were women.
Experts say the increase in later diagnoses could be in part because doctors have become more focused on the ways that ADHD might be unique in women and girls.
Studies have shown that in adulthood, women are just as likely as men are to be diagnosed with ADHD. In childhood, however, boys are much more commonly diagnosed than girls
According to one 2024 study from Penn State as kids, boys are three to 16 times more likely to be diagnosed with ADHD than girls. That discrepancy levels out past 18 years old.
Dr Ajaz added: ‘Female ADHD often presents differently.’
First, Dr Ajaz said on his Instagram, women are more likely to internalize their symptoms of ADHD. When a person internalizes their condition, they experience stereotypical signs of the disorder on the inside, instead of acting them out.
This can come at the cost of their own well being.
For someone with ADHD, this might look like suppressing loud outbursts and fidgeting, which might lead the sufferer to feel greater feelings of anxiety, stress and poor mood regulation.
Second, women with ADHD tend to be more adept at ‘masking’ their condition.
Essentially, they may have learned to give the appearance that they’re coping with their condition and behave ‘normally’ around other people.
Though outwardly this may make a woman with ADHD seem like she’s got it all figured out, internally, Dr Ajaz said, this can lead to strong feelings of imposter syndrome.
In imposter syndrome, a person constantly feels as though they haven’t earned their place in the world.
Third, women with ADHD may have different experiences with their menstrual cycle than women without ADHD.
Every month, women go through a roughly four week cycle, in which hormones fluctuate, in order to prepare the body for pregnancy.
The first two phases, menstruation and follicular phase, involve bleeding.
The second two phases, ovulation and the luteal phase, an egg is released and travels to the uterus, where it’s either fertilized or shed from the body.
Dr Ajaz frequently posts on both Instagram and TikTok. On Instagram, he has over 5,000 followers who regularly engage with his posts and ask questions in the comments
He said women with ADHD tend to have more severe hormonal symptoms in the second two weeks of their menstrual cycle than in the first two.
According to ADDitudeMag, a specialist publication focused on ADHD, some doctors theorize the level of estrogen, the female sex hormone, released during the first half of the cycle can help a woman with ADHD feel more productive.
Then, when estrogen production drops off in the second half, a woman may feel her ADHD symptoms come ramping back up.
In the fourth and final symptom, Dr Ajaz said premenstrual dysphoric disorder (PMDD) might to be an ‘unspoken sign’ of ADHD in women.
PMDD is a condition that causes extreme physical and emotional symptoms in women in the weeks leading up to their period. It’s a separate and more severe condition than normal premenstrual syndrome (PMS).
This can include anger, feeling on edge, panic attacks, suicidal thoughts, fatigue and headaches.
It affects about 10 percent of women, according to Cleveland Clinic, though there isn’t data on how often PMDD coincides with an ADHD diagnosis.
Dr Ajaz frequently posts videos explaining different aspects of the ADHD experience that viewers may or may not relate to
But, according to Dr Ajaz, there may be some overlap.
In an older video, he explained women with ADHD are often misdiagnosed with anxiety or depression.
Also, some symptoms of their condition could be written off as personality traits, he said. Specifically, Dr Ajaz said instead of being labelled hyperactive, many women with ADHD are brushed off as ‘chatty’ or ‘overly emotional’.
Being diagnosed accurately and early can make a difference in how a person develops and their long-term self-esteem, Dr Peter Jaksa, a psychologist who specializes in ADHD, told the American Psychological Association.
Dr Jaksa said: ‘When ADHD is not diagnosed – when it’s not treated effectively- over time, chronic stress and frustration lead to anxiety…This has a very negative impact on self-esteem. It’s very common to see adults with ADHD grow up with a strong sense of underachievement.’
This can affect the level of education someone is able to achieve, the job they’re able to secure and their financial wellbeing in turn.
