When we think of ADHD, the image that often comes to mind is that of a hyperactive boy—the class clown or the daydreamer. But what about women? ADHD doesn’t discriminate by gender, yet it’s frequently overlooked in females. “Women get stuck. They work late into the night and become overstressed, not once, but five times,” highlighting the unique struggles women with ADHD face.
Attention-Deficit/Hyperactivity Disorder (ADHD) is often misunderstood, especially when it comes to women. While the condition is commonly associated with hyperactive young boys, the reality is far more nuanced. Women with ADHD frequently exhibit subtler symptoms, such as restlessness, difficulty concentrating, and impulsive behavior. These signs are often brushed aside or misattributed to stress or anxiety, leading to a lack of proper diagnosis and support.
For many women, ADHD manifests in ways that aren’t immediately obvious. They might struggle with time management, feel overwhelmed by daily tasks, or experience chronic fatigue from trying to keep up with societal expectations. Hormonal changes, notably during menopause, can further complicate matters. fluctuations in estrogen and progesterone levels can intensify symptoms, making it even harder to manage the disorder effectively.
Psychologist Sandra Kooij emphasizes the importance of recognizing these unique challenges. “Women with ADHD frequently enough react differently than men, and hormonal fluctuations play a critically important role in their symptoms,” she explains. To help women identify the disorder, Kooij suggests using a simple checklist. This tool can serve as a starting point for understanding whether ADHD might be at the root of their struggles.
Understanding ADHD in women requires a shift in perspective. It’s not just about hyperactivity or impulsivity—it’s about recognizing the quieter, frequently enough internalized symptoms that many women face. By raising awareness and providing the right resources, we can help women with ADHD find the support they need to thrive.
“I had gloomy feelings, low self-esteem, didn’t feel like doing anything, and didn’t know how to get out of it,” recalls Shima Andalibi, a 30-year-old who shared her experience on the podcast Stand van Nederland: Generation Next. Looking back,she recognizes the signs of ADHD that went unnoticed for years. Andalibi struggled with concentration in high school, which stretched her pre-university education to eight years. At 20, she finally visited a doctor, but as she says, “He didn’t think about ADHD at all.”
The Overlooked Reality of ADHD in Women
Psychologist Sandra Kooij isn’t surprised by andalibi’s story. “We have this image that ADHD is a boys’ condition, but half of those affected are women. Doctors often miss it,” she explains. “Girls with ADHD tend to be less hyperactive but talk more. They’re also more prone to anxiety, depression, and withdrawal.”
“I used to be quite a quiet person. I talked a lot, but I wasn’t busy,” Andalibi adds, reflecting on how her symptoms differed from the stereotypical portrayal of ADHD.
Kooij emphasizes the serious consequences of failing to diagnose ADHD in women. “girls become weary, fall behind, and start doubting themselves. Some develop eating disorders or turn to self-harm as they feel guilty about their performance,” she says.
Women with ADHD often push themselves to the limit to compensate. “They work tirelessly and strive for perfection, which leads to burnout,” Kooij explains. “ADHD isn’t a minor issue. It’s a daily challenge that starts in childhood. Women often struggle in their careers, relationships, or health. They might smoke, drink, or engage in risky behaviors to cope. It’s crucial to name the problem so they can get the right treatment and unlock their potential.”
For years, Andalibi struggled with recurring symptoms that no therapy seemed to fully resolve. It wasn’t until she considered the possibility of ADD—a condition her brother also lived with—that the pieces finally started to fall into place. At 29, she received an official ADHD diagnosis. “It’s like you suddenly get to know yourself,” she reflects, describing the profound clarity that followed.
ADHD often presents differently in women compared to men, a nuance that can make diagnosis more challenging. According to psychologist Kooij, hormonal cycles play a significant role. “The menstrual cycle influences ADHD symptoms. In the week before menstruation, many women experience heightened issues like depression, restlessness, impulsivity, and trouble concentrating. In severe cases, the hormonal drop can even lead to suicidal thoughts,” Kooij explains.
Simple Screening for ADHD
Kooij has developed a straightforward checklist to help individuals assess whether they might benefit from further ADHD evaluation. “it’s a quick screener,” she says. “Answering ‘yes’ to even one of these questions could indicate ADHD.” The four questions are:
- Are you usually unfocused or easily distracted?
- are you usually impulsive?
- Are you usually busy, active, or hyperactive?
While one affirmative response might suggest ADHD, the fourth question is critical. “Have you always been like this?” Kooij emphasizes, underscoring the importance of lifelong patterns in diagnosing the condition.
For more insights, tune into the weekly podcast Stand van nederland, available on NPO Listen.You can also catch it every Friday night at 11 p.m. on NPO 2.
what advice would you give to women who suspect they have ADHD but are unsure were to start?
Interview with Dr. Sandra Kooij on ADHD in Women
Host (Archyde): Thank you for joining us today, Dr. Sandra Kooij. As a leading psychologist specializing in ADHD, particularly in women, you’ve shed light on a topic that’s often overlooked. Let’s start with the basics: why is ADHD in women so frequently misdiagnosed or ignored?
Dr. sandra Kooij: Thank you for having me. The issue stems from a historical misconception that ADHD is primarily a male condition. when we think of ADHD, we picture hyperactive boys or those who can’t sit still. However,ADHD manifests differently in women. They often exhibit internalized symptoms like chronic fatigue, emotional dysregulation, or anxiety, which are less obvious and easily misinterpreted as stress or mood disorders.
Host: That’s captivating. Could you elaborate on how thes symptoms differ from those typically seen in men?
Dr. Kooij: Absolutely. While men with ADHD may display more externalized behaviors—impulsivity, hyperactivity, or aggression—women tend to internalize their struggles. They might experience extreme overwhelm from daily tasks, have difficulty managing time, or feel perpetual exhaustion from trying to meet societal expectations. For example,a woman with ADHD might work late into the night to complete tasks,only to feel drained and stressed the next day. Over time, this can lead to burnout or depression.
Host: You’ve mentioned that hormonal fluctuations play a critically important role. Can you explain how hormones affect ADHD symptoms in women?
Dr. Kooij: Hormones, particularly estrogen and progesterone, have a profound impact on brain function. Women with ADHD frequently enough notice that their symptoms intensify during hormonal shifts, such as puberty, menstruation, pregnancy, or menopause.As an example, during menopause, the decline in estrogen can exacerbate issues like forgetfulness, poor concentration, and emotional instability. These fluctuations can make it even more challenging to manage ADHD effectively.
Host: That’s a critical point. How can women identify if they might have ADHD, especially if their symptoms have been overlooked for years?
Dr. Kooij: Awareness is the first step. I often recommend using a simple checklist to help women recognize patterns in their behaviour. Questions like: Do you frequently feel overwhelmed by daily tasks? Do you struggle with time management or procrastination? Do you experience chronic fatigue despite adequate rest? If these resonate, it’s worth exploring further with a healthcare professional. Additionally, women should trust their instincts—if they feel something isn’t right, it’s critically important to advocate for themselves.
Host: What advice do you have for women who suspect they have ADHD but are unsure where to start?
Dr. Kooij: First, educate yourself. There are many resources available on ADHD in women,including books,podcasts,and support groups. Second,seek a professional evaluation. look for a psychologist or psychiatrist who specializes in ADHD, particularly in adult women.don’t be afraid to share your experiences openly. Many women with ADHD feel isolated, but there’s a growing community of support waiting to embrace them.
Host: That’s incredibly empowering.what message would you like to send to women who are struggling with undiagnosed ADHD?
dr. Kooij: You are not alone, and you are not broken. ADHD is a neurological condition, not a character flaw. It’s never too late to seek help and understanding. With the right support, whether through therapy, medication, or lifestyle changes, women with ADHD can thrive. Recognizing your challenges is the first step toward building a life that works for you—not against you.
Host: Thank you, Dr. Kooij, for your invaluable insights. Your work is truly transforming lives and bringing much-needed attention to this often-overlooked issue.
End of Interview.
This interview highlights the nuances of ADHD in women, emphasizing the need for greater awareness, understanding, and support. Dr. kooij’s expertise underscores the importance of recognizing and addressing the unique challenges women face, offering hope and guidance for those navigating this often-misunderstood condition.
