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ADHD Looks Different in Women

Writer: Daniella Karidi, PhD
Daniella Karidi, PhD
Sep 24
5 min read

A conversation with Dr. Kathleen Nadeau about ADHD, women, and the work ahead By Daniella Karidi, PhD


A conversation I had been waiting for


Some podcast conversations begin when the recording starts. This one began years ago, when I first encountered Dr. Kathleen Nadeau’s work.

I have read most of her 18 books, and several have been on my shelves for years, marked with notes and returned to again and again. The book of hers I knew best was Understanding Girls with ADHD, first published in 1999. Long before ADHD in women and girls received the attention it does today, this book helped explain why so many girls were overlooked and how their experiences could differ from the traditional understanding of ADHD. This made the opportunity to speak with Dr. Nadeau about women with ADHD especially meaningful to me.


Another book that has been important to my work is Still Distracted After All These Years. It addresses older adults with ADHD, a population that remains underrepresented in both research and practical resources. As someone who works with adults navigating retirement and other major life transitions, I have long appreciated Dr. Nadeau’s willingness to focus on people and stages of life that the field has not yet understood well enough.


Sitting down with Dr. Nadeau for ADHDtime on Air was therefore more than another interview. Our conversation focused primarily on her newest book, A Clinician’s Guide to ADHD in Women: Diagnosis and Treatment, written with Patricia Quinn, MD, and Michael Morse, MD. It was exciting to speak with someone whose work has helped shape our understanding of ADHD across the lifespan, and affirming to hear her say so clearly what many of us have observed for years: ADHD does not look the same in every person, and it often looks different in women.


Daniella Karidi and Kathleen Nadeau on a black background with bold text, Why ADHD Women Get Missed; one wears headphones, the other glasses and gestures.
ADHDtime on Air #23

Being less visible does not mean being less affected


For a long time, the public picture of ADHD centered on a disruptive, visibly hyperactive boy. Girls whose struggles were quieter, more internalized, or hidden behind strong academic performance were easier to miss. Many learned to compensate, overprepare, apologize, and work much harder than the people around them realized.


Dr. Nadeau offered a distinction that stayed with me: boys with ADHD were often seen as bothersome, while girls with ADHD were more likely to be bothered internally. It is a memorable way of describing how distress can remain invisible when it does not disrupt the classroom or inconvenience the adults nearby.


Of course, there is no single female presentation of ADHD. Not every woman is inattentive, quiet, organized on the outside, or skilled at masking. Women can be hyperactive, impulsive, outspoken, visibly disorganized, or any combination of these. The point is not to replace one stereotype with another. The point is to recognize that our traditional picture has been too narrow.


A diagnosis is not the end of the story


One of the most important themes in our conversation was the need to look beyond a checklist of symptoms. A diagnosis can bring clarity, language, and access to care. It does not automatically erase years of shame, chronic stress, missed opportunities, or the practical demands that continue to overwhelm a person’s daily life.


Research consistently shows that girls and women with ADHD are more likely to be overlooked and may first receive treatment for anxiety, depression, or other co-occurring concerns. Studies also associate ADHD in women with higher rates of psychiatric comorbidity, self-harm and suicidal behavior, health care use, and other serious adverse outcomes.


A large matched cohort study using UK primary-care records found a substantial life-expectancy disparity among adults with diagnosed ADHD. Compared with adults matched by age, sex, and primary-care practice, estimated life expectancy was 8.64 years shorter for women with diagnosed ADHD and 6.78 years shorter for men with diagnosed ADHD (O’Nions et al., 2025). The study does not establish that ADHD itself causes shorter life expectancy. However, it documents a serious risk for adults with diagnosed ADHD. The authors point to modifiable risk factors and unmet support and treatment needs related to both ADHD and co-occurring mental and physical health conditions. This is an urgent reminder that recognition, appropriate treatment, and ongoing support matter.


This is why I appreciated Dr. Nadeau’s emphasis on quality of life. She encourages clinicians to understand the individual woman in front of them, identify the daily stressors affecting her life, and continue asking whether the support she receives is addressing what matters to her. The goal is not simply to reduce symptoms. It is to help her feel calmer, function more effectively, and create a life that works better with her brain.


The conversations we still need


Even in a rich conversation, we could only begin to touch the surface. I left with a longer list of questions I hope we continue exploring.

What does ADHD look like in women from racial, ethnic, religious, cultural, sexual, and gender-minority communities? How do stereotypes, unequal access to assessment, language differences, economic barriers, and justified mistrust of health care systems affect who gets recognized and who is missed? Much of the research on ADHD in girls and women has not adequately represented these intersecting identities.


I also want us to examine the difference between being diagnosed early and being diagnosed decades later. An early diagnosis can provide access to helpful support, but it can also come with stigma or lowered expectations. A later diagnosis may offer relief and self-understanding, while also bringing grief for the help that was not available sooner. Neither experience is simple, and neither can be reduced to a single narrative.


We need more conversations about hormones, pregnancy, the postpartum period, perimenopause, menopause, aging, relationships, caregiving, work, retirement, physical health, and the cumulative effects of masking. We also need to listen to women whose stories do not fit the most familiar social-media descriptions of ADHD.


Woman in a purple library reads ADHD in Women on a velvet chair beside a sleeping cat. style of a painting.

There is still work to do


Awareness has improved, but awareness is not the same as understanding. More women recognizing themselves in ADHD content is important. We also need clinicians who are trained to identify nuanced presentations, researchers who include diverse participants across the lifespan, and systems that offer practical, individualized support after diagnosis.


Most importantly, we need to keep treating women with ADHD as whole people. Symptoms do not exist outside a life. They interact with expectations, resources, health, relationships, culture, responsibilities, and environment.

When we understand that complexity, the question changes from “What is wrong with her?” to “What does she need in order to function well and live more authentically?”


My conversation with Dr. Nadeau reminded me how far the field has come and how much remains unfinished. I hope it encourages more women to share their experiences and more professionals to listen with curiosity rather than assumptions.


Join the conversation


Watch the full ADHDtime on Air conversation with Dr. Kathleen Nadeau, subscribe to the channel, and add your perspective in the comments:


Please share the episode with someone who supports, works with, or wants to better understand ADHD women.


I would especially love to hear from you: What has your experience been as a woman with ADHD, or as a clinician, coach, educator, partner, or family member who supports ADHD women?


Books discussed


  • A Clinician’s Guide to ADHD in Women: Diagnosis and Treatment By Kathleen Nadeau, PhD, Patricia Quinn, MD, and Michael Morse, MDhttps://amzn.to/4hwoQ8D

  • Understanding Girls with ADHD: How They Feel and Why They Do What They Do By Kathleen Nadeau, PhD, Ellen Littman, PhD, and Patricia Quinn, MDhttps://amzn.to/4xHM4xm

  • Still Distracted After All These Years: Help and Support for Older Adults with ADHD By Kathleen Nadeau, PhD https://amzn.to/4ydzK9f\


Research referenced


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