ADHD in Women E-Book

Pascale De Coster

• Herausgeber: Mardaga - INT
• Kategorie: Geisteswissenschaft
• Sprache: Englisch

Seitenzahl: 194

Veröffentlichungsjahr: 2026

Beschreibung

Women with ADHD face specific challenges, whether managing their symptoms, navigating the professional world, or flourishing in their relationships. The impacts of their disorder on their self-esteem, mental health, and well-being are profound and yet rarely acknowledged.

What are the specific symptoms of ADHD in women? How can it be diagnosed? How can one learn to manage it and explain it to those around them? And above all, how can it be turned into a strength? In this book, the author addresses the topic from a specific perspective, highlights the difficulties faced by women affected by ADHD, and above all provides solutions and concrete tools to live better with the disorder and transform it into an asset.

Having faced this disorder herself, Pascale De Coster has a concrete understanding of the needs of women who struggle daily with their ADHD. Through testimonies, she explores every facet of women’s lives: childhood, adolescence, diagnosis, misunderstanding, the judgments they encounter, and their daily lives as women, partners, and mothers.




ABOUT THE AUTHOR

Pascale De Coster is the author of children’s books and numerous works dedicated to ADHD.

Founder of the association ADHD Belgium, she has been helping people affected by the disorder for many years.

With Mardaga, she is also the author of the books “ADHD in Adults” and “ADHD in Children.”

Leseprobe

Cover

Title page

Dedication and Acknowledgments

To all the women who live with ADHD every day.

To those of you who opened your hearts to enrich this book with your stories.

Thank you for giving me your time and your trust.

Thank you for sharing your lives, your struggles, your pain, your doubts, your battles, your dreams, your victories, your hopes...

Thank you for being who you are: courageous, empathetic, brilliant, bold...

To Audrey, Candice, Rose, and Sabine.

To Iris, my wonderful friend without whom my life would be far less joyful.

To my adorable Marichéri.

Preface

Attention Deficit Hyperactivity Disorder (ADHD) is a topic that has sparked (and continues to spark) much research, discussion, and debate over the years. Historically, however, the majority of studies and media portrayals have focused on how ADHD manifests in boys and men. For many, ADHD conjures the image of a boy who can’t sit still, gets easily upset, or is constantly losing his belongings because he forgets them. This focus has unfortunately overshadowed an equally important and complex reality: ADHD in girls and women.

As a psychologist specializing in neuropsychology with a significant interest in ADHD for nearly a decade, I have often witnessed the challenges faced by girls and women with this condition. Today, more than ever, I also realize how often I failed to recognize or adequately support them. Indeed, symptoms can manifest differently, often more subtly, leading to misdiagnoses, late diagnoses, or misunderstandings by healthcare professionals (myself included) and the patient’s close environment. Added to this are the social and cultural stereotypes women face, which can exacerbate their difficulties and impact their overall quality of life.

This is why this book is so valuable—not only for women with ADHD but also, and especially, for healthcare professionals, so they can better understand and support their patients. It sheds light on a topic too often overlooked in scientific research. By focusing on ADHD in women, it offers a rich and nuanced perspective that helps us better understand the specificities of this condition in this particular group, moving beyond a mere description of the disorder.

Women with ADHD face unique challenges, whether it’s managing their symptoms, navigating the professional or healthcare world, or maintaining interpersonal relationships. The impacts on self-esteem, mental health, and overall well-being can be profound and often go unrecognized. It is therefore essential to understand how ADHD presents in women, to recognize it medically, and to support these women on their journey.

This book is a major contribution to the literature on ADHD. It reminds us that understanding this condition requires an inclusive approach that considers all facets of the human experience. By highlighting ADHD in women, it offers an opportunity to rethink our diagnostic, therapeutic, and support approaches.

I commend Pascale for this bold and necessary initiative. For many years, she has written to raise awareness of ADHD among the public. To me, she is a pioneer in educating both patients and their close circles about the condition. By addressing ADHD in children, adults, in schools, and now in women, she is fulfilling a broader mission of societal recognition of the disorder while urging us to rethink how we perceive it in daily life. Beyond presenting the condition clearly, she encourages us to integrate, accept, and adopt an inclusive view of this disorder in a society that is often far too critical of those with mental health challenges.

Through this text, I strongly encourage all healthcare professionals, educators, parents, and anyone interested in ADHD to dive into these pages. You will discover valuable insights that, I hope, will contribute to better care and greater awareness of this often-overlooked aspect of ADHD.

Sébastien Henrard, psychologist specializing in neuro­psychology

Foreword

Dear Mrs. De Coster,

Today, I’ve just finished reading your book ADHD in Adults: Learning to Live Peacefully with Your Attention Disorder, and I want to thank you.

Finally, a book that talks about ADHD in adults!

Finally, a book that offers practical tools!

I want to thank you, and yet, I’m disappointed.

Four pages!

Only four pages of your book are dedicated exclusively to ADHD in women.

And you? And us? And me?

Why don’t you talk more about my life, my struggles?

The challenges my condition forces me to face every day, both in my personal and professional life?

The difficulty of being a child, a teenager, a woman, a mother, a wife living with ADHD?

My extreme hypersensitivity?

My mind that’s constantly racing?

The endless ruminations that ruin my existence?

My brain spinning out of control, unable to slow down, stop, or move on?

You don’t hide it—you have ADHD!

So please, write a book that talks about me, about us. About us, the women, facing this little-known condition every single day, especially when it’s experienced through a feminine lens!

Mélanie

Introduction

After the publication of my book ADHD in Adults, I received numerous messages from women with ADHD, including one from Mélanie.

They shared their sadness over the years lost before finally receiving an accurate diagnosis, the complexity of their daily lives, the lack of information about ADHD in women, the absence of understanding for their struggles, and the relentless judgments they faced.

Mélanie had left her phone number. I called her, and we met.

She described at length her journey and the many challenges her ADHD continued to force her to confront, despite her diagnosis and treatment.

She explained how ashamed she had felt about her different way of functioning.

How the judgmental looks had hurt her.

How she had felt utterly alone in the world, alone in living with her condition.

How her diagnosis had changed her life.

How she had finally become aware of her potential.

We cried together, laughed together.

Our lives with ADHD were so similar, and yet, so different.

It was from this first meeting that the idea for this book was born. To write for women living with ADHD by sharing the experiences of other women with the same condition: their childhood, their adolescence, the moment they were diagnosed, what it changed in their lives, the misunderstandings—their own and those of their close and not-so-close circles—the judgments they face, their personal and professional lives, their daily lives as women, as mothers, and also everything they’ve implemented to learn to live better with their differences.

I met about twenty women affected by this condition, our condition.

This book draws heavily, and anonymously, from our many conversations.

I will never be able to thank them enough for their trust and immense generosity in sharing their realities with me.

Strong, brilliant, intelligent, bold, creative; they fight countless battles every day.

I hope that, thanks to them, we can finally make progress in recognizing ADHD in women.

With friendship and Belgian chocolate,

Pascale De Coster

62 years old, ADHD tamer

Chapter 1**ADHDa in Women: How Is It Diagnosed?

A. A Quick Recap of Key Concepts

In my book ADHD in Adults: Learning to Live Peacefully with Your Attention Disorder,1 I delved deeply into the theoretical aspects of ADHD. However, if you haven’t read it, I’d like to recap a few essential concepts to help you better understand what follows.

ADHD stands for “Attention Deficit Hyperactivity Disorder.” As the name suggests, it is a disorder, meaning a variation from the norm. This term is used when the patient or those around them experience distress, or when significant impairments in social, academic, professional, or family functioning are evident. Thus, an ADHD diagnosis is not considered when “everything is fine.”

As early as 1798, ADHD in children was described by ­Alexander Crichton.2 While this complex neurodevelopmental and neurobiological disorder has long been recognized in young people, its persistence in those over 18 years old has only been acknowledged since the late 20th century. Yet it affects about one in twenty-five adults.3 Most are unaware of it, and barely 10% of them receive treatment. Among these are a significant proportion of individuals diagnosed in childhood who continue to experience dysfunctions due to their syndrome in adulthood,4 or others who recognized themselves through their child’s ­diagnosis.

Attention Deficit Hyperactivity Disorder is a common neurodevelopmental disorder. Diagnostic classification systems (ICD-10,5 DSM-56) identify three forms of ADHD.

●Inattentive type when inattention prevails;

●Hyperactive-impulsive type when motor agitation and impulsivity dominate;

●Combined type which combines, to varying degrees, attention difficulties, motor hyperactivity, and impulsivity.

This polygenic developmental disorder is caused by a constellation of defects in thousands of genes, though its etiology remains to be fully clarified.7

ADHD leads to difficulties in regulating thoughts, actions, emotions, and behaviors. It affects implementation and organization, sustained attention and vigilance, working memory, consistent effort, maintaining motivation, and planning. Its symptoms manifest, vary, and evolve throughout life, depending on the individual’s personality, age, gender, comorbidities,b life circumstances, context, treatments implemented, and support from their surroundings.

ADHD cannot be cured. However, personalized and multimodal treatment,c in the short, medium, and long term, can effectively control its symptoms.

Psychoeducation, psychosocial interventions,d cognitive-­behavioral therapies,e rehabilitative approaches,f lifestyle improvements, environmental management, changes in daily life strategies, coaching, appropriate accommodations, medication, etc., have been the subject of numerous studies proving their effectiveness in alleviating ADHD symptoms.

B. ADHD Symptoms in Adults

Adults with ADHD primarily experience attention problems, disorganization, and difficulties controlling their impulses and emotions.

Attention Deficit

The different forms of attention are:

●Sustained attention: for example, being able to read a book without losing focus;

●Divided attention: for example, having a phone conversation while cooking;

●Selective attention: for example, working in a noisy office.

Distracted, hypersensitive to distracting stimuli (external or internal), adults with ADHD struggle greatly to mobilize or maintain their attention. Often inattentive to details, they make numerous careless mistakes. Additionally, their difficulties with organization and planning make them the kings and queens of procrastination.g

These symptoms worsen in situations lacking appeal or novelty, or with monotonous and repetitive tasks. They may improve if the environment is new or if they are engrossed in particularly interesting tasks. The brain then produces chemicals that enhance concentration and alertness, allowing it to function normally. It is, in a way, “repaired” by passion.

Their faulty attention process demands hidden efforts from people with ADHD throughout their lives.

Motor Hyperactivity

As they age, hyperactivity changes in “quality.” It shifts from overt, observable motor activity to a more subtle and subjective “internal” restlessness. This is often interpreted as nervousness, impatience, or boredom.

Intellectual Hyperactivity

Intellectual hyperactivity is characterized by an accelerated pace of thoughts. Ideas race at a frenetic speed, making them impossible to control.

Impulsivity

Impulsivity is characterized by difficulties inhibitingh actions, gestures, words, thoughts, and emotions. Enthusiastic, passionate, and overly spontaneous, adults with ADHD act hastily, without considering the consequences of their actions. While they regret their haste and suffer from the repercussions, they learn little or nothing from their mistakes.

Waiting is emotionally taxing for adults with ADHD. Impatient, they frequently interrupt others in their activities, work, or conversations. Highly sensitive, they struggle to manage their emotions. Easily frustrated, moody, quick to anger, they lose their temper easily.

They find it difficult to follow rules, including traffic laws. Their impulsivity annoys others and causes numerous conflicts, leading to frequent job changes, unstable interpersonal relationships, and often tense family climates.

International Consensus Statement from the World Federation of ADHD: 208 Evidence-Based Conclusions for ADHD:https://www.adhd-federation.org/_Resources/Persistent/774a104424c1e60e268a5d4daf601ff4c486670c/International%20Consensus%20Statement.pdf

DSM-5 Diagnostic Criteria for ADHD

Criterion A

A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, characterized by (A1) or (A2):

(A1) Inattention

Six (or more) of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activitiesi:

a) Often fails to pay close attention to details or makes careless mistakes in schoolwork, work, or other activities (e.g., overlooks or misses details, work is inaccurate).

b) Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).

c) Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).

d) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).

e) Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; poor time management; fails to meet deadlines).

f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).

g) Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile phones).

h) Is often easily distracted by extraneous stimuli. For older adolescents and adults, this may include unrelated thoughts.

i) Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

(A2) Hyperactivity and Impulsivity

Six (or more) of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:

a) Often fidgets with or taps hands or feet or squirms in seat.

b) Often leaves seat in situations when remaining seated is expected (e.g., leaves their place in the classroom, in the office or other workplace, or in other situations that require remaining in place).

c) Often runs about or climbs in situations where it is inappropriate (note: in adolescents or adults, this may be limited to feeling restless).

d) Often unable to play or engage in leisure activities quietly.

e) Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).

f) Often talks excessively.

g) Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).

h) Often has difficulty waiting their turn (e.g., while waiting in line).

i) Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).

Criterion B

Several symptoms of hyperactivity/impulsivity or inattention were present before age 12.

Criterion C

Several symptoms of inattention or hyperactivity/impulsivity are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).

Criterion D

There must be clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

Criterion E

The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

Clinical presentations:

●Combined presentation: Criteria A1 and A2 have been met for the past six months;

●Predominantly inattentive presentation: Criterion A1 has been met for the past six months but not Criterion A2;

●Predominantly hyperactive/impulsive presentation: Criterion A2 has been met for the past six months but not Criterion A1.

The Five Essentials for Living Better with ADHD

1.A smartphone with apps that make life easier.

2.A planner to record all private and professional appointments.

3.A notebook to jot down everything you want to remember: phone numbers, to-do lists, ideas, addresses, all kinds of lists (books to read, movies to watch, meal ideas, etc.).

4.A catch-all tray by the front door to always place your keys in.

5.Anti-loss trackers to locate your keys, bag, car, coat, etc.

C. An Underdiagnosed Disorder in Women

ADHD is a persistent, evolving, and complex syndrome. From childhood, issues with attention, distraction, disorganization, mental hyperactivity, heightened emotional sensitivity, and relational difficulties are constant symptoms that significantly affect us throughout our lives, in every domain.

In the earliest studies on ADHD prevalence, the boy-to-girl ratio was estimated at 6 to 1, meaning six times more boys than girls. These findings, based solely on data collected from clinical settings, suffered from significant sampling bias.

Later, epidemiological research based on surveys of general population samples reported a ratio closer to three boys for every girl. Today, in childhood, the ratio is estimated at two boys for every girl. However, when the prevalence of the disorder is assessed in adulthood, this proportion balances out to a ratio closer to one man for every woman.

Why this disparity in prevalence? Several explanations are possible.

The manifestations of the disorder generally appear more subtly in girls than in boys. For most women, inattention problems tend to dominate, while boys more frequently exhibit symptoms of hyperactivity, restlessness, and disruptive ­behaviors.

Since girls’ symptoms are less dramatic and considered less problematic by those around them, they are less often referred early on to specialists who could provide a diagnosis.

Louise: “Gabriel, my brother, and I are twins. Gabriel was a perpetually restless, impulsive, defiant, destructive, and aggressive child, both with his friends and with authority figures.

As a result, as soon as he started primary school, his teacher, overwhelmed by his disruptive behavior both in class and on the playground, advised our parents to consult a specialist. His symptoms were textbook. He was diagnosed with ADHD at the age of six.

As for me, I was a sweet, kind little girl, always ready to help, who didn’t bother anyone. Living alongside this perpetual whirlwind, no one noticed my attention problems, my distraction, my tendency to daydream, my slowness, my anxiety... As a result, none of the adults around me ever imagined that I could have the same disorder as my brother.

I had to wait until adulthood to finally be diagnosed.”

Linda: “Dreamy, shy, and withdrawn, I spent my childhood and teenage years playing alone and watching others. Different, I was quickly rejected and then bullied. I was the one no one wanted to play with, the one not invited to birthday parties, the one who was weird or stupid.

In class, even when I seemed to be listening to instructions, I wasn’t. I heard them, but I didn’t understand. Completely disorganized, I struggled immensely with punctuality or doing what was expected of me. Constantly overwhelmed, I drowned in endless anxiety. To escape, whenever a situation became demanding or stressful, I increasingly retreated into my daydreams.

People described me as not very bright, anxious, but not disruptive. Back then, no one talked about ADHD!”

Agnès: “Sociable, friendly, eager to please my friends and meet the expectations of the adults around me, I made incredible efforts throughout my childhood and teenage years to hide my difficulties.

By working ten times harder than my friends, internalizing my impulsive and hyperactive behaviors, and mimicking my peers as much as possible, I managed to mask my symptoms.”

Girls diagnosed during childhood are often those who exhibit symptoms of hyperactivity or impulsivity.

Sally: “As a child, I was like a wild animal. Whenever something upset me, I would fly into a rage, hitting, screaming, breaking everything within reach. In my fury, I would even bang my head against walls. No one wanted to take care of me or babysit me. Luckily, when I started preschool, I had a teacher who knew about ADHD. Her son had the disorder, and I was his spitting image. Yet, it wasn’t until I was six that a doctor finally agreed to diagnose me with ADHD.

As a result, my father, exhausted, left home because he couldn’t bear living under the same roof as me. At the time, he even refused shared custody or every-other-weekend visits.”

Garance: “In my day, no one talked about ADHD, but if I had been younger, I think I would have been diagnosed quite easily because I exhausted everyone around me, and my behavior matched the stereotypical profile of a boy with ADHD.”

In the 20th century, the idea that women could have ADHD was uncommon. Clinical studies conducted in the 1970s focused exclusively on the experiences and symptoms of hyperactive boys.8,9j Evaluation scales were thus originally designed for boys, and these same scales are still predominantly used today.

Interest and research specifically concerning ADHD in women began in the early 2000s. Yet, even though it is now acknowledged that women exhibit a somewhat different set of behaviors, symptoms, and comorbidities compared to men, the tools like evaluation scales and questionnaires used to diagnose the disorder still largely fail to account for female profiles.

As a result, even when a parent or teacher notices that a girl is not reaching her full potential (academically, personally, socially, athletically, or within her family) and believes they recognize traits of Attention Deficit Hyperactivity Disorder, the questionnaires they are asked to complete to establish a diagnosis describe hyperactive, impulsive, and behavioral symptoms that correspond to only one type of female ADHD—the one that most resembles male ADHD.

For women, symptoms of the disorder must therefore be more pronounced than in boys to be recognized.

Barbara: “I noticed that Stéphanie was different very early on. She walked later, talked later, in fact, did everything later than her siblings. Perpetually distracted, I had to repeat things to her ten times, and each time, she looked at me as if she were hearing it for the first time. I thought she had hearing problems, Fragile X syndrome, an intellectual delay, etc. The doctors I consulted downplayed her difficulties and accused me of putting too much pressure on her.

By adolescence, she continued to constantly lose her belongings: her coat, her pencil case, her dance gear... Her reading comprehension remained weaker than her peers. She could grasp ideas in a text but couldn’t connect them and got completely lost in the instructions for her assignments and tests. She had big ideas but couldn’t organize herself to complete her projects. Her results didn’t reflect the time she spent studying.

She also struggled with friendships because she didn’t understand social cues and couldn’t follow conversations. At school, she was the one who was rejected, isolated, and mocked.

She was 14 when I saw a program about ADHD. It was a revelation for me. That’s what Stéphanie was suffering from! Yet, it still took two more years for her to be diagnosed. I first consulted our general practitioner and pediatrician, who said she couldn’t have ADHD because she wasn’t hyperactive. Then I saw two child psychiatrists. The first said ADHD disappears in adolescence, so it couldn’t be that. The second said her problems stemmed from not finding her place in the family and suggested family therapy. After six months, nothing had improved—in fact, it had worsened. It was during this time that someone told me about an association10 that could guide me to a specialist. A month later, we had our first appointment with a child psychiatrist experienced in ADHD. A few weeks later, we finally had a diagnosis. Stéphanie has ADHD, dyslexia, and dysorthographia.

It took 12 long years from the moment I noticed her differences to her diagnosis! So many wasted years!”

When will we finally see the systematic use of questionnaires specifically designed for women, which would save so many years in diagnosis?

The rate of diagnostic errors is significantly higher in girls and women than in boys and men. Those who exhibit symptoms of inattention, disorganization, poor time management, and hypersensitivity are more likely to be misdiagnosed as suffering solely from anxiety or depression.11