When Competence Meets Change: ADHD in Women and the Midlife Shift
In my neuropsychology practice, I’ve seen a steady rise in women seeking assessment for attention and executive functioning concerns—often after years of coping successfully in demanding roles at work and home. These are women who describe themselves as organized, capable, and high-functioning—until suddenly, things begin to feel harder to manage.
For many, this shift coincides with perimenopause or menopause, when hormonal changes can significantly affect cognitive and emotional regulation. Tasks that once felt routine—remembering details, maintaining focus, staying organized—begin to require more effort. What’s often uncovered during evaluation is something that was there all along: ADHD that has been masked, compensated for, or misdiagnosed for decades.
A recent National Geographic article on ADHD in women highlights why these diagnoses are increasing—not because the disorder is new, but because we’re finally seeing it clearly. Historically, ADHD was defined around the “hyperactive boy” model. Women, however, tend to present with inattentive symptoms: forgetfulness, difficulty initiating and completing tasks, disorganization, and internal restlessness rather than overt hyperactivity.
Many women learn to “mask” their symptoms through structure, over-preparation, and perfectionism—strategies that can succeed for years but often come at a cost of chronic stress or self-criticism. When hormonal fluctuations disrupt those fragile systems of compensation, difficulties can suddenly surface.
Why more women are now being diagnosed:
Greater awareness among clinicians and the public that ADHD looks different in women.
Telehealth making assessment more accessible.
Online communities and media coverage normalizing the conversation and reducing stigma.
Accurate diagnosis is crucial. Mislabeling ADHD symptoms as anxiety or depression can delay effective support and treatment. When ADHD is recognized for what it is, interventions can target attention, regulation, and self-management more directly—and with far better outcomes.
Understanding ADHD through a gender-informed and lifespan-sensitive lens is essential. For many women, realizing “this might have been ADHD all along” can be the start of not only greater self-understanding, but genuine relief.
Source: “Why more women are being diagnosed with ADHD,” National Geographic, 2025.