The Rise of Adult ADHD is a National Geographic exploration of new research that is upending old notions about who the condition affects—and how those diagnosed with it can thrive. Learn more.
At age 23, Rach Idowu was convinced she had dementia. She found herself forgetting birthdays, missing work meetings, and struggling to manage her credit card debt. Her Google searches suggested that she had early onset dementia, which her doctor quickly dismissed. It would take her another four years and the assessments of two psychiatrists before Idowu was finally diagnosed with ADHD.
Suddenly, everything in her life began to make sense: her constant fidgeting as a child, the caffeine-fueled all-nighters she spent finishing school assignments, and the weeks it took to answer messages from friends. “It was a massive eureka moment,” Idowu, now 31, says. She is one of millions of women diagnosed with ADHD in adulthood, according to the Centers for Disease Control and Prevention. That number has continued to rise in recent years. Researchers attribute the increase to multiple factors, including greater public awareness, the expansion of telehealth, and the historical underdiagnosis of ADHD in women. The topic has become pretty popular on social media, which has prompted some psychologists to worry that there might be potential for overdiagnosis or people misdiagnosing themselves. A recent national survey by researchers at Ohio State University found 25 percent of adults now suspect they may have ADHD.
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Part of the issue may be that people with ADHD typically fall into one of three categories: hyperactive, inattentive, or combined. Girls and women are more likely to have the inattentive presentation, characterized by disorganization, forgetfulness, and struggles with starting and staying on task. “They’re more likely to be seen as daydreamers or lost in the clouds,” says Julia Schechter, co-director of the Duke Center for Girls and Women With ADHD at the Duke University School of Medicine.
Even girls with hyperactive or combined diagnoses may display their symptoms differently than boys, such as talking excessively, twirling their hair, constantly shaking their legs, or reacting emotionally. “Their symptoms are just as impairing,” Schechter says, “but can fly under the radar.”
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Read more of our reporting in The Rise of Adult ADHD
Not that long ago, one of the first major attempts to characterize how ADHD appeared in young girls was widely ridiculed. When clinical psychologist Kathleen Nadeau co-authored Understanding Girls With ADHD in 1999, the research community still thought of ADHD almost exclusively as a disorder for boys. “We were laughed at during conferences,” Nadeau says. “They said, We’ve got these guys that are in the principal’s office three times a week, getting suspended and throwing spitballs. And you’ve got these quiet girls making honor roll grades, and you think they have ADHD?”
While that attitude has started to change, the overwhelming majority of research on ADHD has been done in boys and men, leading to the hyperactive and disruptive stereotype of people with ADHD. But girls with ADHD may excel in school, though it comes at a different price. They may get an A on a paper but stay up the night before writing it after being unable to focus for weeks.
“Girls work very hard to hide their problems: ‘I don’t want the teacher to be mad at me,’ ” Nadeau says. Psychologists refer to this as masking, or how individuals who are socialized as females tend to find ways to compensate for their symptoms because of societal expectations. “They have to put in at least twice the effort of other people if they’re determined to do well,” Nadeau says.
Janna Moen, 33, a postdoctoral scientist at the Howard Hughes Medical Institute, felt trapped in her own exhausting cycle before being diagnosed with ADHD in her late 20s. “You can’t let people know that you’re falling apart,” Moen says. Like many women who enter adulthood untreated, Moen scored top grades in school and went on to have a successful career. Still, years of masking her symptoms contributed to her developing mental health and self-esteem issues and struggling in personal relationships.
Moen now realizes that her symptoms appeared during childhood. But girls and women are more likely to have their symptoms mistaken for emotional or learning difficulties and are less likely to be referred for assessments. Gender bias also may play a role: In two different studies, researchers found that when teachers are presented with vignettes of children with ADHD, when the child’s names and pronouns were changed from female to male, they were more likely to be recommended for treatment and offered extra support.
All these misconceptions mean that girls with ADHD are being overlooked and untreated well into adulthood. As David Goodman, the director of the Adult Attention Deficit Disorder Center of Maryland and a professor of psychiatry at the Johns Hopkins University School of Medicine, points out, the ratio of boys to girls with ADHD in childhood is about three to one, while in adults, it’s about one to one. This suggests that ADHD prevalence is equal across genders, except that women are diagnosed later. “Children get diagnosed because they’re disruptive and a pain to other people,” Goodman says. “The adults get diagnosed because they’re a pain to themselves.”
As women move into adulthood, there are societal demands to more actively manage their behaviors and emotions, so symptoms can become even harder to recognize as ADHD. Hyperactivity may manifest as inner restlessness, inattention may appear as difficulty completing chores or meeting deadlines, and impulsiveness can manifest as difficulty managing a budget. Despite these challenges, many women with ADHD may appear externally as high-achieving perfectionists. But the consequences of a missed or incorrect diagnosis can be severe.
Compared with their neurotypical peers, women with ADHD are more likely to have anxiety, depression, substance abuse, and eating disorders. Canadian researchers recently found that adults with ADHD are over five times more likely to attempt suicide than those without it, and nearly one in four women with the disorder reports having attempted suicide. And Danish-led research has revealed that the risk of premature death in women with ADHD was higher than that of men with the disorder, potentially because of women being less likely to be diagnosed and receive treatment.
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Even for those who decide to get a proper medical evaluation, finding a skilled provider can be particularly challenging. “Psychiatrists get about half a day of training in adult ADHD over three years,” Nadeau says. An assessment can require several sessions to determine if symptoms were present in childhood.
“My doctor told me she didn’t think I had ADHD because I graduated from university and had a job,” Idowu explains. Women are also more likely to have their ADHD symptoms mistaken for anxiety or depression. Moen spent almost 20 years being misdiagnosed with and treated for major depressive disorder and anxiety, only to find her symptoms resolved once she was treated for ADHD with therapy and medication. She thinks her anxiety and depression were more of a response to the pressure she put on herself to mask symptoms while struggling to keep up.
“Psychiatrists think, Let’s treat the anxiety, let’s treat the depression. And when those are better, let’s see if there really is any ADHD,” says Nadeau. “When it should really be the opposite.”
Meanwhile, social media continues to spread awareness—and possibly confusion. When researchers at the University of British Columbia looked at the hundred most popular TikTok videos about ADHD for a 2022 study, for instance, they found that about half of what was shared was misleading. “This is not a disorder where you lose your keys sometimes,” Schechter says. “When we reduce ADHD to a social media post, that real functional impairment gets lost in the mix.”
Researchers also emphasize that attention issues brought on by the COVID-19 pandemic, remote work, and more time spent on social media are not enough to warrant an ADHD diagnosis. “Just because you have a hard time working from home, or get distracted by your phone, or can’t do your homework with the TV on does not mean you have ADHD,” Schechter says. “We’re looking for this pattern of symptoms and challenges that have been present across time and across settings.”
Ultimately, Schechter doesn’t think social media posts can lead to women who visit clinicians being misdiagnosed. “The ADHD was always there,” she says. “We as clinicians are finally catching up and getting better at diagnosing ADHD in adult women. That said, we still have much work to do.”
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For her part, Idowu has found that since seeking professional treatment, including a prescription to help with focus, she has gained control of her finances, is thriving at work, and has improved her relationships.
Her journey and the lack of available information prompted her to start a newsletter, “Adulting With ADHD,” in 2020, which she says has helped people get diagnosed. “It’s very difficult to exist in a world where you feel like there’s something wrong with your brain,” Idowu says. “There’s a power in just knowing.” That’s the first step toward a solution.
This story originally published January 16, 2024. It has been updated.
A version of this story appears in the November 2025 issue of National Geographic magazine.