Women, Girls and ADHD: The Hidden Cost of Masking

ADHD isn’t just a childhood condition for boys. Women and girls live with it too but they are often missed, misdiagnosed, or diagnosed years later than boys. The impact of that delay is serious, from mental health challenges to increased risk of addiction.

Why women and girls are missed

• Later diagnosis: Research shows girls are diagnosed 4–5 years later than boys on average. Many women aren’t recognised until adulthood, often after years of anxiety, depression, or burnout (Ramtekkar et al., Journal of the American Academy of Child & Adolescent Psychiatry, 2010).

• Different presentation: Boys often show hyperactivity, while girls are more likely to be inattentive daydreaming, disorganised, or quietly struggling. These behaviours are less visible in classrooms.

• Masking: Many girls “camouflage” their ADHD by copying classmates, over-preparing, or staying quiet. This can hide symptoms from teachers and clinicians, but it leads to exhaustion and low self-esteem.

  
  

The cost of being overlooked

When ADHD goes untreated, the effects ripple across life:

• Mental health: Women with ADHD are almost six times more likely to experience depression and four times more likely to live with anxiety compared with women without ADHD (Young et al., European Psychiatry, 2020).

• Education and work: Missed deadlines, disorganisation, and the strain of masking often lead to underachievement and lost opportunities.

• Self-harm and suicide risk: Women with ADHD are at higher risk of self-harm and suicide attempts (Sokolova et al., Psychological Medicine, 2019).

• Relationships: Emotional dysregulation and impulsivity can put extra pressure on families and partnerships.

  
  

ADHD and addiction

Untreated ADHD is strongly linked to substance use disorders, and women are especially vulnerable.

• Up to one in four women in addiction services has ADHD (van Emmerik-van Oortmerssen et al., Drug and Alcohol Dependence, 2012).

• Girls with ADHD are 2–3 times more likely to develop substance misuse problems compared to girls without ADHD.

• Alcohol, nicotine, and cannabis are the most common, often used as “self-medication” to cope with low mood, restlessness, or poor concentration.

  
  

Moving forward

• Awareness matters: Teachers, parents, and clinicians must recognise that ADHD in girls often looks subtle and inward.

• Early intervention helps: Timely diagnosis reduces risks of depression, self-harm, and addiction.

• Challenge stereotypes: ADHD is not “just for boys.” Women and girls deserve equal recognition and support.

Bottom line

Women and girls with ADHD are too often left invisible. By unmasking the hidden signs, listening carefully, and providing early treatment, we can prevent years of silent struggle and protect futures that might otherwise be derailed by depression, addiction, or self-blame.

Do you also want me to design a quick-reference infographic (diagnosis gap, depression risk, addiction stats) to post alongside this blog for maximum impact on your website?