What is ADHD?
ADHD is a lifelong neurodevelopmental and neurological difference that affects self-regulation and executive functioning.1 ADHD is characterised by:
- Challenges regulating attention and focus, and other executive functions
- Challenges managing hyperactivity and regulating energy levels
- Challenges with impulsivity, which can be related to emotional dysregulation
It's estimated that 5-7% of the population is ADHD.1 This would rise significantly if all adult women missed in childhood were diagnosed.2
ADHD is up to 88% heritable and tends to run in families.3 It is a natural part of human neurodiversity.
What ADHD is not
There are a lot of misconceptions about ADHD. Let's set the facts straight.
Not caused by poor parenting
Or too much screen time, sugar, or childhood trauma. Though many ADHD people experience trauma.
Not a trend
ADHD is not a fashion or a TikTok trend. ADHD is a real, under-diagnosed condition, especially in women and assigned female at birth (AFAB) people, and not merely a trend.
Not a mental illness
ADHD is a neurological and neurodevelopmental difference. Though ADHD people experience high rates of co-occurring mental illness.
Not an intellectual disability
ADHD does not affect intelligence or IQ.
Not a specific learning difficulty (SpLD)
The three specific learning difficulties (SpLDs) are dyslexia, dyscalculia, and dysgraphia.
Not a male‑only condition
Girls and women have been missed for decades.
Not binary
ADHD people are men, women, non‑binary or agender. Some people identify as transgender. Many ADHD people proudly identify as LGBTQ+.
Not a child‑only condition
ADHD is a lifelong neurological and neurodevelopmental condition.
Not something you grow out of
Many women experience a worsening of difficulties after midlife burnout, pregnancy, or menopause, leading to late diagnosis.
Am I ADHD?
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Discover if you have the same ADHD symptoms most commonly reported by late‑discovered women and non‑binary people.
I procrastinate and avoid starting tasks that I find mentally taxing or uninteresting.
I have a habit of playing with my hair, jewellery, or fidgeting with my pen.
I often switch tasks or give up on goals before finishing them.
I often "zone out" when I am listening to someone.
I spend a lot of time hunting for things I have misplaced at home, e.g., chargers, important documents, emails, or receipts.
I often forget what I was talking about or what I wanted to say next.
My mind jumps rapidly between thoughts or from one idea to another.
I often get so intensely focused that I lose all track of the time.
I go through spells where I am hyper-productive and work nonstop.
I have a tendency to act on impulse and without fully thinking things through.
I often go "off on a tangent" when I am talking.
There are times I feel like I might burst if I don't say something, because I've been holding back from speaking.
I am a talkative person, especially when I am feeling anxious, nervous or excited.
I am prone to "oversharing" when I am emotional.
I am easily distracted by interesting people, sights, sounds, or smells around me.
I experience bouts of "brain fog" when my mind feels cloudy and I struggle to think clearly.
I experience intense emotions that overwhelm me.
I must triple-check to see if I have my phone, purse, keys, or sunglasses before leaving the house.
I have a habit of overthinking and overanalysing everything.
I have trouble silencing the constant mental chatter in my brain.
No symptoms endorsed
Other signs someone might be ADHD
Many late‑discovered ADHD women, non‑binary and AFAB people say they have always felt different and have experienced many other challenges without knowing why.
I have an ADHD parent, sibling, or child.
I am autistic.
I have a specific learning difficulty (SpLD): dyscalculia, dyslexia or dysgraphia.
I have epilepsy.
I often struggle to fall asleep at night because of overthinking (insomnia).
I experience debilitating migraines.
I have longstanding IBS, TMJ, tinnitus, chronic back, neck, pelvic pain or fibromyalgia (CSS syndromes).
I have hypermobile joints or Ehlers-Danlos syndrome (EDS).
I have asthma, allergies or an autoimmune disorder such as MS.
I have struggled with severe PMS, hormonal mood swings and very painful periods (PME or PMDD).
I have polycystic ovary syndrome (PCOS/PMOS).
I have diabetes.
I have struggled with a sense of unease or conflict because there is a mismatch between my biological sex and gender identity (gender dysphoria).
I was singled out at school for bullying, cruelty, or exclusion by my peers or teachers.
I have found it really difficult to get or keep a job, more so than others.
I feel I must mask my true self at work or school to fit in.
I have a deep fear of rejection, criticism, exclusion or abandonment by others.
I have experienced chronic exhaustion or burnout where I have been unable to work or function for many months.
I have battled with depression and low self‑esteem.
I have struggled with crippling anxiety or panic attacks.
I have struggled with an eating disorder such as anorexia, bulimia, binge eating or obsessive healthy eating or exercise (orthorexia).
I numb my feelings or calm myself with food, drugs or alcohol.
I have been diagnosed with OCD, bipolar, or schizophrenia.
I have been diagnosed with borderline (BPD), PTSD or CPTSD.
I have struggled with self‑harm, suicidal thoughts or have attempted to take my own life.
None endorsed
Your experiences are valid
ADHD women face alarming rates of gendered violence and trauma. They are more likely to experience chronic physical or mental illness, long-term unemployment, homelessness and die by suicide than their neurotypical peers.
Try Uma
Uma helps adult women, non‑binary, and AFAB people safely self-screen for autism, ADHD, and CPTSD.
Signposting
ADHD Babes
ADHD Babes are a support group for Black women and Black non‑binary people of African-Caribbean descent with ADHD.
Why are ADHD women often missed?
2-3x as many boys and men are diagnosed with ADHD. ADHD women are missed, misdiagnosed, and later diagnosed more frequently than men.
Barriers to a medical diagnosis
Women and non‑binary people face significant barriers to accessing a medical diagnosis.
Gender bias in health
Women's health has historically been neglected in medical research. It was not until 1993 that women were legally required to be included in medical research. There is a gender gap in ADHD health data.
Medical gaslighting
Boys and men are given faster access to medical diagnosis and treatment compared to girls and women. Women are more likely to be dismissed, told the pain is in their head, and sent home with a prescription for antidepressants.
Outdated sex stereotypes
The "Naughty Schoolboy" persona does not fit many girls. Early studies primarily focused on boys and men, neglecting women and transgender ADHD people, which has created a binary perception of what ADHD looks like.
Gendered diagnostic criteria
The ADHD diagnostic criteria and screening instruments are based on outdated research about ADHD boys and men, lacking sensitivity to gender differences in presentation. The threshold is currently age 12, often before puberty for many girls. Puberty is the stage when ADHD symptoms often become more obvious.
Diagnostic overshadowing
Women are two to three times more likely to be diagnosed with mental illnesses like anxiety, depression, premenstrual dysphoric disorder (PMDD), and eating disorders. These conditions frequently co-occur with ADHD and can obscure the underlying ADHD, a phenomenon known as "diagnostic overshadowing". These are not simply misdiagnoses; they often co-exist.
Misdiagnosis of BPD
ADHD women are commonly misdiagnosed with borderline personality (BPD), especially those with a history of trauma and co-occurring CPTSD. Other common misdiagnoses include bipolar and OCD. These can and do co-occur.
Masking
The diagnostic process for ADHD depends heavily on clinician observation. Many late‑discovered ADHD women learn to hide their ADHD symptoms and mimic neurotypical behaviours to blend in. This can make their symptoms less visible to clinicians.
Inability to recollect childhood
Obtaining a medical diagnosis relies on evidence of childhood ADHD symptoms, which can be challenging for women with memory challenges caused by trauma, ADHD, or ageing to recollect. Many women do not have any living relatives who knew them in childhood or may be estranged from their family.
Global waitlist crisis for a diagnosis
Overstretched mental health services cannot meet current demand for ADHD and autism diagnoses. NHS wait times exceed several years.
Cost of a private medical diagnosis
The cost of a private combined AuDHD diagnosis can be up to £3,500. For many marginalised autistic women, the expense of a private diagnosis is unaffordable, resulting in unequal access to medical diagnosis.
Marginalisation
Intersectionality (race, gender identity, socio-economic status, etc.) compounds diagnostic barriers. People with multiple marginalised identities face greater challenges due to systemic bias, a lack of research, and non-culturally aware clinicians.
Breaking down barriers
Uma is designed to help late‑discovered women and non‑binary people challenge these barriers and access a medical diagnosis or support they need.
ADHD bookshelf
Questions? Ask Uma.
AuDHD is a term used by the neurodivergent community to describe a person who is both autistic and has ADHD. Rather than being a separate, official diagnosis, it highlights that the two neurotypes exist in one person and can overlap.
Research shows to 83% of autistic children 1 are also ADHD, and up to 30-65% of ADHD children 2 also have autistic traits. Many adults have just one diagnosis. A dual diagnosis was not available until 2013.
ADHD is a lifelong neurodevelopmental and neurological difference that affects self-regulation and executive functioning.
ADHD people often experience challenges regulating their attention and focus, energy levels and hyperactivity, as well as challenges with impulsivity, which is often related to emotional dysregulation.
ADHD is not a disease, disorder, or mental illness that can be prevented or cured. Some ADHD people take medications to help manage their ADHD symptoms.
For fact-checked, in-depth information about ADHD, we recommend visiting the Royal College of Psychiatrists website.
ADHD is thought to affect around 3–4% of adults and 5–7% of children and young people globally and in the UK. This translates to an estimated 2.5 million ADHD people in England, including those who are undiagnosed. However, the actual number is believed to be significantly higher, as boys are diagnosed at a rate up to twice that of girls, and women are, on average, diagnosed years later than men.
The short answer
Nobody knows what causes ADHD, or if it has a "cause". Research tells us ADHD is mostly genetic. Twin studies show ADHD is highly heritable and runs in families, with estimates up to 88% 3.
What does NOT cause ADHD
- Vaccines
- Dietary factors (e.g., sugar intake)
- Too much screen time
- Poor parenting
- Childhood trauma (though trauma can mimic ADHD symptoms or worsen their presentation)
The long answer
ADHD has historically been linked to differences in how key brain chemicals, or neurotransmitters, particularly dopamine and norepinephrine 4, work. Brain differences are also seen in ADHD people. Studies have found that certain parts of the brain that help with thinking, planning, and emotional responses, such as the prefrontal cortex, cerebellum, and amygdala 5, may be slightly smaller or mature more slowly in ADHD people. These areas are essential for managing attention and focus, as well as emotional regulation and impulse control.
Other earlier research looked at things that happen during pregnancy, known as 'prenatal risk factors' 6, which might increase the chance of having an ADHD child. For example, some studies have linked smoking, drinking alcohol, using drugs such as cannabis, or certain medications during pregnancy, to an increased likelihood of having an ADHD child.
However, these early studies often failed to recognise that ADHD is highly heritable, and many ADHD mothers in the research were likely undiagnosed ADHD women 7 at the time. ADHD women are also more likely to smoke, drink, or be on medications for co-occurring challenges like depression, bipolar, or epilepsy. Because of this, the findings from these early studies should be looked at with extreme caution.
Emerging research is also exploring the role of epigenetics, which are changes in gene activity that aren't caused by changes in the DNA sequence itself. This field studies how environmental factors, such as a mother's nutrition or stress level during pregnancy, might influence how certain genes are expressed. This suggests that while genetics provides the blueprint for ADHD, environmental factors can play a role in how that blueprint is expressed.
How hormonal changes 8 contribute to ADHD is a growing area of interest, especially among late‑discovered ADHD women. Emerging research indicates that differences in the oestrogen receptors and a brain chemical called GABA (gamma-aminobutyric acid) may also play a role.
To dive deeper, see
(Sahin et al., 20209; Smith & Davies, 201410; Sohrabji et al., 199511; Nalvarte et al., 202012; Hwang et al., 202113; Georgiou et al., 2019`). 14
ADHD is highly heritable and primarily genetic. If you have an ADHD parent, sibling, or close family member, you are more likely to be ADHD. Twin studies show ADHD runs in families, with heritability estimates up to 88% (e.g., Faraone et al., 2018) 15.
No, ADHD is not a mental illness. It’s considered a neurodevelopmental difference, meaning it’s a variation in how the brain develops and functions, affecting self-regulation, attention and focus, and other executive functions. It’s simply a natural variation in brain wiring.
ADHD is not a disease, disorder, or mental illness that can be prevented or cured. That said, some ADHD people take medications to help manage their ADHD symptoms.
Additionally, ADHD people, especially women and minority genders, can often experience mental health challenges like anxiety, depression, and CPTSD, which are often a result of trauma. But ADHD itself is a distinct condition, separate from these mental illnesses.
No, ADHD is not an intellectual disability (referred to as a general learning disability in the UK). ADHD is a neurodevelopmental difference that affects attention, impulse control, and executive functioning. It does not impact intelligence or IQ.
No, ADHD is not a specific learning difficulty (SpLD) . ADHD is a neurodevelopmental difference that affects attention, impulse control, and executive functioning.
Specific learning difficulties include differences such as dyslexia, dyscalculia, and dysgraphia, which affect reading, maths, and writing skills. Some ADHD people may also have SpLDs, and the two can co-occur.
Research suggests that up to 50 per cent 16 of ADHD people have a SpLD. However, ADHD itself is not classified as an SpLD.
Masking, or "camouflaging," refers to the active efforts marginalised people make to conceal or modify aspects of their identity, behaviour, or communication to avoid discrimination, exclusion, rejection, bullying, or abuse. This includes both conscious imitation of others" actions or language and unconscious imitation, where people blend in or conform to social expectations without realising it (Pearson et al., 2021). 17
Masking is increasingly recognised as a trauma response. Research shows that neurodivergent women mask more than men, and minority genders mask at higher rates still. (Hull et al., 2020) 18. Masking is also commonly reported among people who identify as LGBTQIA+.
Rejection Sensitivity Dysphoria (RSD), also simply described as "rejection sensitivity," is an extreme adverse emotional, physiological, or behavioural reaction to perceived or actual rejection, abandonment, criticism, blame, or exclusion.
While it is often discussed in relation to ADHD, RSD is not recognised as a symptom of ADHD nor included in its diagnostic criteria. Rejection sensitivity is a recognised symptom of Social anxiety, Avoidant personality, PMDD, BPD and CPTSD. These mental health conditions, in the general population, are 2-3x more common in women and people AFAB.
RSD is increasingly understood as a trauma response. Relationally, ADHD and autistic women face significantly higher levels of victimisation, bullying, exclusion, exploitation, and abuse compared to their neurotypical peers. Consequently, they may be more sensitive to rejection as adults.
Alexithymia is a trait which involves difficulty identifying, labelling and describing one"s own emotions.
While commonly reported by ADHD and autistic people, Alexithymia is not an ADHD symptom or an autistic trait. Alexithymia is theorised to be a trauma response.
Alexithymia is often conflated with both dissociation and Alexisomia 19 - which involves difficulties identifying, distinguishing and describing one"s own bodily sensations and physical feelings. You may also hear people describe this as "difficulties with interoception."
Alexithymia, in the general population, is more common in men 20 and people AMAB. Other research shows elevated levels of alexithymia amongst people who identify as trans. 21 Research shows a link with alexithymia and eating disorders 22 particularly in ADHD and autistic women and AFAB with anorexia or bulimia.
1. Matson, J. L., Rieske, R. D., & Williams, L. W. (2013). The relationship between autism spectrum disorders and attention-deficit/hyperactivity disorder: An overview. Research in Developmental Disabilities, 34(9), 2475–2484. https://doi.org/10.1016/j.ridd.2013.05.021
2. Sokolova, E., Oerlemans, A. M., Rommelse, N. N., Groot, P., Hartman, C. A., Glennon, J. C., Claassen, T., Heskes, T., & Buitelaar, J. K. (2017). A causal and mediation analysis of the comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 47(6), 1595–1604. https://doi.org/10.1007/s10803-017-3083-7
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9. Lin, Y., Li, H., Zhang, J., Yang, Z., Zhou, Y., Liu, L., & Qian, Q. (2023). Polymorphism of estrogen receptor genes and its interactions with neurodevelopmental genes in attention deficit hyperactivity disorder among Chinese Han descent. Psychiatry Investigation, 20(8), 775–785. https://doi.org/10.30773/pi.2023.0113
10. Mukherjee, J., Cardarelli, R. A., Cantaut-Belarif, Y., Deeb, T. Z., Srivastava, D. P., Tyagarajan, S. K., Pangalos, M. N., Triller, A., Maguire, J., Brandon, N. J., & Moss, S. J. (2017). Estradiol modulates the efficacy of synaptic inhibition by decreasing the dwell time of GABA-A receptors at inhibitory synapses. Proceedings of the National Academy of Sciences, 114(44), 11763–11768. https://doi.org/10.1073/pnas.1705075114
11. Solum, D. T., & Handa, R. J. (2002). Estrogen regulates the development of brain-derived neurotrophic factor mRNA and protein in the rat hippocampus. The Journal of Neuroscience, 22(7), 2650–2659. https://doi.org/10.1523/JNEUROSCI.22-07-02650.2002
12. Varshney, M. K., Yu, N. Y.-L., Katayama, S., Li, X., Liu, T., Wu, W.-F., Töhönen, V., Krjutškov, K., Kere, J., Fan, X., Inzunza, J., Gustafsson, J.-Å., & Nalvarte, I. (2021). Motor function deficits in the estrogen receptor beta knockout mouse: Role on excitatory neurotransmission and myelination in the motor cortex. Neuroendocrinology, 111(1–2), 27–44. https://doi.org/10.1159/000506162
13. Hwang, W. J., Lee, T. Y., Kim, N. S., & Kwon, J. S. (2020). The role of estrogen receptors and their signaling across psychiatric disorders. International Journal of Molecular Sciences, 22(1), 373. https://doi.org/10.3390/ijms22010373
14. Georgiou, P., Zanos, P., Jenne, C. E., & Gould, T. D. (2019). Sex-specific involvement of estrogen receptors in behavioral responses to stress and psychomotor activation. Frontiers in Psychiatry, 10, 81. https://doi.org/10.3389/fpsyt.2019.00081
15. Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562–575. https://doi.org/10.1038/s41380-018-0070-0
16. Crisci, G., Caviola, S., Cardillo, R., & Mammarella, I. C. (2021). Executive functions in neurodevelopmental disorders: Comorbidity overlaps between attention deficit and hyperactivity disorder and specific learning disorders. Frontiers in Human Neuroscience, 15, 594234. https://doi.org/10.3389/fnhum.2021.594234
17. Pearson, A., & Rose, K. (2021). A conceptual analysis of autistic masking: Understanding the narrative of stigma and the illusion of choice. Autism in Adulthood, 3(1), 52–60. https://doi.org/10.1089/aut.2020.0043
18. Hull, L., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., Petrides, K. V., & Mandy, W. (2020). Gender differences in self-reported camouflaging in autistic and non-autistic adults. Autism, 24(2), 352–363. https://doi.org/10.1177/1362361319864804
19. Oka, T. (2020). Shitsu-taikan-sho (alexisomia): A historical review and its clinical importance. BioPsychoSocial Medicine, 14(1), 23. https://doi.org/10.1186/s13030-020-00193-9
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21. Kallitsounaki, A., & Williams, D. M. (2023). Brief report: An exploration of alexithymia in autistic and nonautistic transgender adults. Autism in Adulthood, 5(2), 210–216. https://doi.org/10.1089/aut.2022.0113
22. Nowakowski, M. E., McFarlane, T., & Cassin, S. (2013). Alexithymia and eating disorders: A critical review of the literature. Journal of Eating Disorders, 1, 21. https://doi.org/10.1186/2050-2974-1-21
23. Faraone, S. V., Bellgrove, M. A., Brikell, I., Cortese, S., Hartman, C. A., Hollis, C., Newcorn, J. H., Philipsen, A., Polanczyk, G. V., Rubia, K., Sibley, M. H., & Buitelaar, J. K. (2024). Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 10(1). https://doi.org/10.1038/s41572-024-00495-0
24. McCrossin, R. (2022). Finding the true number of females with autistic spectrum disorder by estimating the biases in initial recognition and clinical diagnosis. Children, 9(2), 272. https://doi.org/10.3390/children9020272