Unseen Struggles: ADHD in Women from Diverse Backgrounds
Growing up as a woman from a racially and ethnically diverse background, my academic journey was a maze of challenges that often went unnoticed. From primary school through to high school, I struggled with tasks that seemed effortless for others—clumsiness left me with scars from frequent falls, some severe enough to cause unconsciousness, while my illegible handwriting and aversion to essay-writing frustrated me endlessly. In my culture, academic success was not just expected; it was demanded. My parents enrolled me in weekend tuition and measured me against my high-achieving cousins, leaving no room for failure—only an unrelenting push for excellence.
School Years: Hidden Signs and Cultural Pressure
High school amplified these struggles. Maths and science lessons saw me daydreaming or resting my head on the desk, feigning illness to escape the pressure. Subjects I loved—English, French literature, and German—offered a reprieve, yet the weight of expectations never lifted. One teacher’s comment, “You’ve got potential if you’d just try harder,” cut deep and lingered. My parents echoed this sentiment, branding me lazy or academically weak, reinforcing my sense of inadequacy.
Teachers rarely noticed my difficulties. Their attention gravitated toward students who excelled or met the standard, while those of us floundering were overlooked. I narrowly avoided repeating Year 11 and had to retake a maths exam—a stark reminder of how I didn’t fit the mould. Cultural norms intensified this isolation; sports or extracurriculars were sidelined in favour of study, and skipping school or tuition became my only rebellion. Fear of punishment, including physical discipline, drove me to push harder, even as I felt myself unravelling. Socially, I faltered too. Friendships were fleeting and shallow. This disconnection mirrored my academic struggles, leaving me adrift.
Adulthood in Australia: New Challenges Emerge
Arriving in Australia for university thrust me into unfamiliar territory. After a sheltered upbringing where family dictated my path, managing bills, work, and studies felt overwhelming. Routine tasks others mastered easily were hurdles for me. I’d arrive late to lectures—sometimes locked out—or skip them entirely if the subject didn’t spark my interest. For classes I enjoyed, I made the effort, arriving on time. Over time, I adapted by aiming to be 30 minutes early for everything, though the waiting often grated on me, trading one challenge for another.
Why ADHD in Women Goes Unnoticed
Reflecting on these experiences, a pattern emerges: undiagnosed ADHD. For women, especially from diverse cultural backgrounds, ADHD often slips under the radar. Cultural expectations—like the academic rigidity I faced—mask symptoms, while misunderstandings about how ADHD presents in women compound the issue. Unlike the stereotypical hyperactivity seen in boys, women’s symptoms—daydreaming, disorganisation, or internalised pressure—blend into the background, unnoticed by educators and families.
A holistic approach to diagnosis is essential. It must look beyond checklists, weaving in cultural context, personal history, and co-existing conditions. Without this, ADHD in women remains a silent struggle.
The Science: Hormones, Mood, and Complexity
Research underscores why diagnosing ADHD in women is complex. Symptoms intertwine with hormonal shifts and mood disorders, muddying the picture. A 2023 study (Lundin et al.) found that girls and young women with ADHD face a higher risk of depression when using oral contraceptives compared to peers without ADHD. Hormonal phases—puberty, menstrual cycles, postpartum, and menopause—further complicate symptoms. For example, menopause heightens depression risk (Freeman, 2010), yet its link to ADHD remains under-explored, as do connections to premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD).
Women with ADHD also experience anxiety and depression more often and more severely than men (Solberg et al., 2018). Studies show earlier onset of depression, longer episodes, and elevated suicidality in women with ADHD (Fuller-Thomson et al., 2016). Since ADHD symptoms typically predate mood disorders (Kessler et al., 2005), it may amplify risks—like increased depression during pregnancy (Jones et al., 2018).
Differential diagnosis is critical to untangle these overlaps. Anxiety or depression might mimic ADHD, but reviewing childhood behaviour via school reports or family insights can clarify the timeline. This thoroughness ensures accuracy, especially given ADHD’s potential to worsen co-occurring conditions.
A Universal Struggle, Beyond Culture
My story, steeped in cultural expectations, resonates beyond my background. Women of European descent—or any heritage—may recognise similar threads: quiet battles, missed opportunities for support, and coping strategies like daydreaming. ADHD’s subtler presentation in women transcends culture, making awareness and tailored evaluation vital.
Who Assesses ADHD? A Collaborative Approach
In Australia, both psychologists—including those in clinical and educational/developmental specialties—and psychiatrists conduct ADHD assessments, but the best choice often depends on the individual’s needs. Psychiatrists, as medical doctors, are well-suited for adults seeking medication as part of their treatment, especially when differential diagnosis involves complex medical or psychiatric conditions (e.g., bipolar disorder or severe mood disorders). Psychologists, however, frequently assess adults too, particularly when other neurodevelopmental disorders—like autism or learning difficulties—might be in play, offering detailed psychological testing and non-medical interventions.
For school-aged children and teenagers, psychologists (especially educational and developmental specialists) often take the lead. They’re skilled at evaluating developmental milestones, academic struggles, and social challenges—key areas where ADHD symptoms surface early. Using school reports, teacher input, and behavioural observations, they build a comprehensive picture of a young person’s experience.
Here’s the catch: the line between what psychologists and psychiatrists do isn’t always clear-cut. Both professions assess attention, impulsivity, and executive functioning, and both can diagnose ADHD. At times, the distinction blurs—psychologists might refer to psychiatrists for medication, while psychiatrists might lean on psychologists for in-depth testing. It’s a bit messy, and that’s okay. The complexity of ADHD, especially in adults with co-occurring conditions, often means wait times for psychiatrists are long—sometimes months—prompting many to opt for psychologists who can offer quicker appointments.
Collaboration is key. Psychologists and psychiatrists working together ensure timely, thorough care—psychologists providing detailed assessments and therapy, psychiatrists stepping in for medical oversight when needed. This partnership cuts through the messiness, delivering support that fits each person’s circumstances.
Taking Action: Finding Clarity and Support
If this resonates with you, consider an ADHD evaluation—not to label flaws, but to understand yourself better. Whether you choose a psychologist or psychiatrist depends on your goals: medication might point you to a psychiatrist, while exploring therapy or other neurodevelopmental factors might lead to a psychologist. For kids or teens or adults, our clinic offers tailored assessments to catch ADHD early.
We provide a compassionate, culturally sensitive space where your experiences matter. Our evaluations weave together your history, challenges, and context—collaborating with psychiatrists when needed—to ensure an accurate diagnosis and personalised support. Don’t let stigma or logistical hurdles deter you. Psychiatrists might have waitlists, but our psychology team can often see you sooner. Reach out when you’re ready for the insight and care you deserve.
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Book List:
1. “Women with Attention Deficit Disorder” by Sari Solden
2. “The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done” by Terry Matlen
3. “A Radical Guide for Women with ADHD: Embrace Neurodiversity, Live Boldly, and Break Through Barriers” by Sari Solden and Michelle Frank
4. “Understanding Women with ADHD: How They Feel and Why They Do What They Do” by Kathleen Nadeau and Patricia Quinn
5. “ADHD According to Zoë: The Real Deal on Relationships, Finding Your Focus, and Finding Your Keys” by Zoë Kessler
6. “Your Life Can Be Better, Using Strategies for Adult ADD/ADHD” by Douglas A. Puryear
7. “Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder” by Edward M. Hallowell and John J. Ratey
8. “The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps” by Melissa Orlov
Online Resources:
Black Girl Lost Keys - A blog and resource hub specifically for Black women with ADHD, offering articles, support groups, and coaching services.
ADDA (Attention Deficit Disorder Association) - Offers resources, webinars, and support groups for adults with ADHD, including specific groups for women and people of colour.
CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) - Provides information, resources, and support for individuals with ADHD, including a section dedicated to women and minorities.
The Kaleidoscope Society - An online community and resource centre for women with ADHD, focusing on empowerment and support.
ADHD Women’s Wellbeing - A podcast and resource platform focusing on the wellbeing of women with ADHD, including episodes and resources for women of colour.
Dr. Russell Barkley - A clinical psychologist and ADHD expert who provides a range of online resources, including research articles, webinars, and books.