#37: Unmasking ADHD in Women
JUNE 12, 2025
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In this heartfelt and illuminating episode of Courage to Heal, we dive deep into a conversation that’s long overdue—exploring the often misunderstood and overlooked experience of ADHD in women and those socialized as female.
Host Anna Khandrueva sheds light on the quieter, masked forms of ADHD that don’t match the typical, boy-centric stereotypes. Through tender storytelling and deep compassion, Anna unpacks the realities of emotional dysregulation, executive dysfunction, rejection sensitivity, and chronic burnout that so many women face—often without ever knowing why.
We’ll explore how high-functioning ADHD can mask inner struggles, the profound impact of hormonal shifts across a woman’s life, and the important but rarely discussed overlap between ADHD and autism (AuDHD). Anna also shares practical, healing steps toward self-compassion, support systems, and unmasking—the brave work of showing up as your authentic self.
Tune in to rediscover the truth: you were never broken—you were simply unseen. And now, it’s time to be seen.
Episode Links:
ADHD Coach for Late-Diagnosed Women
Transcript
Anna: Hello and welcome back to Courage to Heal, the podcast where we explore the tender, complex, and brave work of healing. I’m so grateful you’re here.
If you’re joining us today feeling a little scattered, a little weary, or maybe even holding a question mark in your heart about why life sometimes feels heavier or harder for you than it seems for others—you’re not alone.
Today, we’re opening up a conversation about something deeply personal for so many women and folks socialized as women: ADHD OR Attention Deficit and Hyperactivity Disorder. But not the version of ADHD that’s often portrayed in the media—the restless, impulsive little boy bouncing off classroom walls. No. Today, we’re talking about the quieter, masked, often invisible experience of ADHD in women.
Maybe you’ve always had a sense that something felt different for you. Maybe you’ve chalked it up to not trying hard enough, not being organized enough, not being enough.
If that’s been your experience, let’s take a deep, slow breath together.
You’re not lazy. You’re not broken. You’re not a failure.
And you are definitely not alone.
I, myself, was diagnosed with ADHD at the ripe age of 35. I have been navigating this journey for 7 years now, and it’s been difficult at times, but overall, I am so grateful for receiving the diagnosis and having an explanation for why my brain works the way it does. Before that, I will be honest, I just thought something was irrevocably wrong with me, and I could never be “fixed.” I’m happy to say that with medication, therapy, and coaching, I have learned how to manage my ADHD to a great extent.
But that’s enough about me.
Let’s start by unlearning some myths about this condition.
Historically, ADHD research has been focused almost exclusively on boys—specifically, young, hyperactive boys. As a result, the way ADHD shows up in women and girls has been overlooked for decades.
But here’s the truth: ADHD can—and does—affect women just as much. It just tends to manifest differently.
While boys with ADHD often exhibit more externalizing behaviors—things like fidgeting, interrupting, difficulty sitting still—girls and women are more likely to experience internalizing symptoms. Think daydreaming, disorganization, chronic lateness, difficulty following through, emotional overwhelm, and deep, exhausting fatigue from trying to “keep it all together.”
In fact, women with ADHD often become experts in masking—a psychological survival strategy where we learn to hide our struggles from the outside world.
I once worked with a client—we’ll call her Sarah—who didn’t get diagnosed until she was 36 years old. Sarah was the “good girl” growing up. Teachers loved her because she was quiet and polite. But behind the scenes, she was drowning in unfinished homework, messy lockers, missed deadlines, and an inner critic that never seemed to turn off.
By adulthood, Sarah had crafted a life that looked put together from the outside—a decent job, a tidy home, a social life—but inside, she felt like she was barely treading water. She thought everyone else had some secret manual she’d somehow missed.
When Sarah was finally diagnosed with ADHD, she cried—not just tears of sadness for the years of struggle, but tears of relief. Finally, she had a name for the thing that had shadowed her for so long.
Maybe you see parts of yourself in Sarah’s story. If you do, I want you to know: There’s nothing wrong with you. There’s a reason life has felt harder—and now, you have permission to start understanding yourself through a different lens.
Let’s dig a little deeper into how ADHD can show up in women.
First of all, there are three subtypes of ADHD: Hyperactive, Inattentive, and Combined. Women are more likely to present with the inattentive subtype, whereas boys and men are more likely to present with the hyperactive subtype, which is why ADHD can look so different in women.
Some common signs include:
Emotional Dysregulation: Feeling emotions more intensely than others seem to. Quick shifts from joy to sadness, frustration to overwhelm.
Time Blindness: A struggle to estimate how long tasks will take or difficulty sensing the passage of time.
Executive Dysfunction: Challenges with planning, organizing, starting, and finishing tasks.
Perfectionism and Procrastination: Two sides of the same coin, driven by fear of failure or criticism.
Chronic Overwhelm: Feeling like your mental to-do list is never-ending and unmanageable.
Rejection Sensitivity: An intense fear of being criticized, rejected, or judged, often resulting in people-pleasing or social anxiety.
Fatigue and Burnout: Not just physical tiredness, but a deep, bone-level exhaustion from the constant effort of keeping up appearances.
And here's a nuance that often gets overlooked: ADHD in women often coexists with other conditions like anxiety, depression, or even disordered eating patterns—making it even harder to spot on its own.
If you’re nodding along, maybe feeling some grief bubble up as you recognize yourself, please know: it’s okay to grieve the years spent struggling. It’s okay to feel anger, sadness, or even relief.
All of these emotions are welcome here.
Now, you might be wondering—what contributes to this difference in how ADHD shows up?
Part of it is biology, but part of it is also the deeply ingrained social conditioning many women experience. We’re taught from a young age to be quiet, to be good, to be accommodating. To make ourselves smaller, easier, more acceptable.
So when our brains are wired for spontaneity, creativity, and nonlinear thinking, we often internalize the message that there’s something wrong with us.
We hustle for our worth. We overcompensate. We pour our energy into masking. And masking, while adaptive in the short term, is exhausting and isolating in the long run.
Unmasking, on the other hand, is terrifying—but it’s also freeing.
It’s the process of laying down the armor we built to survive and finally allowing ourselves to be seen.
There’s another layer to this story that’s important to name—one that often goes unseen, even by those living it.
High-functioning ADHD.
Many girls with undiagnosed ADHD grow up to become wildly capable, creative, and successful women. They build impressive careers. They become doctors, lawyers, founders, educators, artists—deep thinkers with big hearts and endless wells of potential.
From the outside, they look like they’re thriving.
But if you peel back the layers, you’ll often find a different story—a quieter, hidden struggle.
Because when ADHD goes unrecognized or unsupported, even success can feel like a fragile house of cards. One missed email, one forgotten meeting, one small mistake—and it can feel like everything you’ve built might come crashing down.
You might recognize yourself in this.
Maybe you’re managing a heavy workload, showing up to meetings, meeting deadlines—while quietly battling imposter syndrome. That gnawing feeling that you’re just one slip-up away from being found out. That underneath the polished surface, there’s chaos barely contained.
Or maybe you find yourself ordering takeout again. Not because you don’t care about your health, but because the sheer executive function it takes to plan meals, write a grocery list, shop, and cook feels insurmountable after a long day.
Or maybe it’s the unpaid bills sitting unopened on the kitchen counter—not because you’re irresponsible, but because your mind is juggling a thousand spinning plates, and sometimes the urgent drowns out the important.
From the outside, it can look like you have it all together.
But behind the scenes, it can feel like you’re barely holding it together with string and tape—and that disconnect can feel deeply lonely.
The world sees your success. It praises your achievements. But it often misses the cost—the late nights, the overwhelm, the chronic self-doubt, the exhaustion that settles into your bones.
And here’s what I want to say about that:
Burnout isn’t a personal failure. It’s not proof that you’re not trying hard enough. It’s a signal from your nervous system whispering, I can’t keep doing this without help.
The truth is, high-functioning doesn’t mean low-struggling.
You can be brilliant—and still need support.
You can accomplish big things—and still feel lost in the small ones.
Living with high-functioning ADHD often means living with invisible labor—an endless mental to-do list, constant emotional self-regulation, and the exhausting work of appearing “fine” on the outside while fighting your own internal storms.
It’s okay to lay that burden down.
It’s okay to ask for help, to create scaffolding around your life, to recognize that needing support doesn’t diminish your brilliance—it makes it sustainable.
If you’re resonating with this, I invite you to take a moment—right here, right now—and breathe in the reminder that success doesn’t have to come at the cost of your well-being.
You don’t have to hustle for your worth.
You don’t have to carry this all alone.
You deserve systems that support you, communities that see you, and self-compassion that allows you to be human—not just high-functioning.
You are allowed to be both capable and cared for.
You are allowed to be both resilient and resourced.
And most of all—you are allowed to rest.
There’s another layer to this conversation that doesn’t get nearly enough attention—and that’s the role of hormones in ADHD.
If you’ve ever felt like your ADHD symptoms seem to shift with the tides of your body—becoming more intense at certain points of the month, or changing dramatically during big life transitions like puberty, pregnancy, or menopause—you are not imagining it.
Hormones play a much bigger role in ADHD than most people realize.
Throughout a woman’s life, hormonal changes can amplify ADHD symptoms in ways that feel destabilizing and, honestly, confusing. During times of hormonal fluctuation—like puberty, pregnancy, or perimenopause—rising or falling estrogen levels can have a powerful impact on the brain’s chemistry.
Estrogen supports the balance of key neurotransmitters like dopamine, which are already working a little differently in the ADHD brain. When estrogen dips, as it naturally does before a menstrual period or during perimenopause, you might notice that it becomes harder to focus, regulate emotions, or manage everyday tasks that usually feel doable.
And yet—so often—these very real shifts are dismissed. Labeled as moodiness. Brushed off as “just hormones.”
It’s heartbreaking—and enraging—to think about how many women have been misdiagnosed with depression, anxiety, or even told they’re simply overreacting, when what’s really happening is a natural, biological response to internal changes.
Here’s what we do know from emerging research:
During pregnancy, when estrogen levels are high, many women with ADHD actually report a calming of their symptoms. Focus feels easier, emotions feel more balanced. It’s not magic—it’s biology.
But later, as estrogen begins to decline—especially during perimenopause and menopause—those same ADHD symptoms can come roaring back. Things that used to feel manageable—like memory, attention, emotional regulation—can suddenly feel slippery and out of reach.
And here’s the important part: these patterns are normal for many women with ADHD. They don’t mean you’re losing progress. They don’t mean you’re failing at managing your symptoms.
They mean your body is changing—and your care and support need to change alongside it.
The truth is, we’re only at the very beginning of truly understanding how hormones intersect with ADHD. But what we do know is this: it matters. It matters for how we understand ourselves, how we advocate for treatment, and how we soften the self-judgment that so often clings to these experiences.
You deserve support that meets you where you are—not just in one chapter of life, but across all of them.
From the first stirrings of puberty to the waves of perimenopause, through the seasons of fertility, motherhood, and beyond—your neurodivergence doesn’t exist in a vacuum. It lives in a body that is changing, evolving, adapting.
And you are worthy of care that honors all of it.
Now, I want to open up a conversation that’s only just starting to get the attention it deserves: the overlap between ADHD and autism in women.
You might not hear about it often, but ADHD and autism frequently go hand in hand—more often than most people realize. In fact, research suggests that between 50 to 70 percent of autistic individuals also have ADHD, and about 20 to 50 percent of people with ADHD are also autistic.
When both are present, you might hear it referred to as AuDHD, spelled A-U-D-H-D.
But here’s where it gets complicated—and honestly, frustrating: most of what we know about ADHD and autism has been studied primarily in boys and men. Their experiences have shaped the diagnostic criteria, the research, the public understanding.
Which means that the way these neurodivergences show up in women—or in anyone socialized as female—often gets misunderstood, misdiagnosed, or missed altogether.
Just like with ADHD, autistic women often become masters of masking.
From a young age, they learn to study the social landscape like a script. They mirror the behaviors of their peers. They memorize how to fit in, how to make small talk, how to hide their sensory overwhelm or social confusion under layers of perfectionism and people-pleasing.
And for a while—it works.
On the surface, they seem engaged, successful, adaptable.
But beneath the surface, it’s a different story: exhaustion, anxiety, chronic self-doubt. A feeling of always being "off" but not knowing why. A gnawing loneliness that comes from feeling like you’re playing a part in your own life, rather than living it.
It’s important to say—this isn’t just an individual struggle. This is a systemic issue. A public health issue.
When autism and ADHD are missed or misdiagnosed, it shapes everything: your sense of self-worth, your access to appropriate care and support, your ability to feel understood—not just by others, but by yourself.
A late diagnosis—or no diagnosis at all—can leave women questioning their sanity, internalizing blame, and carrying around invisible wounds that could have been tended to with the right understanding.
If you’re listening and recognizing yourself in this—maybe for the first time—I want to gently say: you’re not broken.
You’re not failing at being a person.
You are a whole human being who has been navigating a world that often wasn’t built with your brain, your body, your way of being in mind.
And whether or not you have a formal diagnosis, whether or not you ever pursue one, you deserve understanding. You deserve support that honors the complexity of your experience.
You deserve to take up space exactly as you are.
Living with AuDHD—this intersection of ADHD and autism—often means living with a nervous system that feels everything a little more intensely. A brain that moves quickly, creatively, divergently. A heart that craves deep authenticity and meaningful connection, but has been taught to hide its fullness.
Healing, in this context, isn’t about erasing your differences. It’s about unmasking. It’s about laying down the scripts, the expectations, the exhausting performances—and slowly, gently, learning to trust that who you are is enough.
You don’t have to earn belonging by being palatable.
You don’t have to explain or apologize for the way you process the world.
You deserve to be seen—not the mask, not the version you think the world wants—but you.
And in your tenderness, in your complexity, in your neurodivergence—you are worthy of care, of community, of a life that feels like yours.
Now, let’s talk about healing.
Healing from the impacts of undiagnosed ADHD doesn’t mean erasing your neurodivergence—it means learning to work with your brain, not against it.
Here are a few tender starting points:
Self-Compassion as a Daily Practice:
Speak to yourself the way you would to a dear friend. When you forget something or miss a deadline, replace harsh self-talk with gentleness. Try whispering to yourself: “This is hard—and it’s also human.”Accommodations, Not Aspirations:
It’s not about fixing yourself. It’s about creating systems that work for you. Maybe that’s using visual timers, or keeping a whiteboard in your kitchen with the week’s priorities, or giving yourself permission to work in short, focused sprints instead of marathon sessions.Body Awareness and Regulation:
ADHD doesn’t just live in the brain—it affects the whole nervous system. Incorporating somatic practices like breathwork, gentle movement, or sensory grounding can be transformative.Therapy Through a Trauma-Informed Lens:
Not all therapy is created equal. Working with someone who understands the intersections of ADHD, trauma, and the nervous system can provide the safety and validation that’s been missing.Community and Connection:
Isolation fuels shame. Community soothes it. Finding others who understand your experience can be deeply healing. Whether that’s an ADHD support group, a few trusted friends, or online spaces that feel safe and resonant.
As you embark—or continue—on your journey of understanding ADHD in your life, I want to offer this gentle reminder:
You are not behind.
You are not too much, and you are not “not enough.”
You are exactly the right amount of human.
Healing isn't about fixing yourself—because, my dear, you were never broken. Healing is about coming home to yourself. About removing the masks, laying down the heavy burdens of shame and perfectionism, and letting yourself exist just as you are.
Thank you for sharing this sacred space with me today. If this episode stirred something inside you, I invite you to be tender with yourself in the coming days. Maybe journal about what resonated, or simply allow yourself some extra gentleness as you move through your routines.
And if you know someone who might need to hear this message—someone who’s been carrying their struggles quietly—I hope you’ll share this episode with them.
I hope you leave feeling a little more empowered. Remember, healing takes time and you're exactly where you need to be. Take care of yourselves, and until we meet again, be kind to your heart.
