Women and girls experience the same general symptoms of ADHD as men and boys. However, the way the symptoms are expressed in their behaviors can appear different from their expression in men and boys.

This difference in expression has historically been one of the reasons girls and women are underdiagnosed. Clinicians, parents, and other adults who work with children look for the male model of ADHD symptoms that focuses on hyperactivity and impulsiveness. When girls demonstrate symptoms of inattention, overly sociable behavior, forgetfulness, talkativeness, or difficulties with time management, those behaviors are attributed to other causes or cultural expectations.

Symptoms of ADHD

ADHD has three main presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined inattentive and hyperactive.

Women and girls can have any of these presentations, and presentations and symptom severity can vary across their lives. However, both research and lived experience indicate that girls and women most often appear to have the inattentive presentation:

• Fails to give close attention to details or makes careless mistakes
• Has difficulty sustaining attention, does not appear to listen
• Struggles to follow through with instructions, has difficulty with organization
• Avoids or dislikes tasks requiring sustained mental effort, loses things easily
• Is easily distracted, is forgetful in daily activities

To assume that women and girls only experience the inattentive presentation would be incorrect. Many women and girls report and describe “internal” hyperactivity and other unrecognized symptoms, with behaviors often ascribed culturally to very “social” girls:

• Talks excessively
• Fidgets and often needs to get up and walk around
• Acts impulsively or speaks before thinking
• Appears to daydream but will explains that her thoughts feel like they are “going a million miles a minute” and she has trouble keeping her mind on one topic
• Easily makes friends but has difficulty sustaining friendships
• Self-harming activities, or activities that require extreme and unhealthy self-discipline
• Adopts compensatory strategies, leading to working two to three times as hard as her peers in order to be equally successful
• Fears rejection by peers or friends and clings to other people or remains in unhealthy relationships

Additional indications of ADHD

Though not often listed as symptoms, other indications of ADHD in girls and women include co-occurring depression and anxiety, difficult romantic relationships that can lead to intimate partner violence, trouble maintaining friendships, and at least one space in her life in disarray (messy house, messy bedroom, or similar personal space).

Often girls with ADHD will become sexually active at a younger age than their peers, due to impulsivity, poor planning, or a desire to be cared for by their partner. When they do so, they are at a greater risk of being pressured into unwanted sexual activity or becoming victims of sexual violence, and are less likely to use or be able to insist that their partners use contraception.