Inattentive ADHD in women

When most people think of ADHD, what comes to mind is the hyperactive/impulsive type. Someone who can’t sit still, interrupts, or seems really easily distracted. But the disorder doesn’t always look like that.¹ There are actually three types of ADHD: hyperactive/impulsive, inattentive, and combined (which is both).

Girls and women with ADHD are more likely to have the inattentive type of ADHD.² They’re less likely to be bouncing around and more likely to be zoning out. It’s easy to miss — or to misunderstand.

Gender differences in ADHD

Researchers believe that boys and girls have ADHD at similar rates. But studies show that kids with inattentive behavior (often girls) are less disruptive than kids with impulsive behavior (often boys). So their inattentive ADHD is more likely to go undiagnosed.³

If you struggled with inattentive ADHD in school, your teachers may not have realized what was going on.⁴ Your daydreaming and disorganization may have been misinterpreted as lack of cooperation or even lack of ability. 

Some women with inattentive ADHD face gender bias in the workplace. If you’re having a hard time managing your tasks, some people may think of you as “scatterbrained,” a term that’s rarely applied to disorganized men. 

Because of social pressures, women are more likely to keep an ADHD diagnosis to themselves. They’re also less likely to ask for accommodations that could help them perform better at work. 

Symptoms of inattentive ADHD in women

From the outside, inattentive ADHD symptoms don’t always look like what they are. Instead, they may seem like carelessness, forgetfulness, or being “spacey.”⁵

One of the challenges of inattentive ADHD is that the symptoms can seem like no big deal. Maybe you put off tasks that require sustained attention, or just “zone out” during meetings. That may not sound like much — everyone avoids work or spaces out sometimes. But when it happens consistently and causes stress for you or the people who depend on you, it can be a problem. 

The ADHD iceberg is a great visual tool for understanding the hidden challenges ADHD can cause.

Inattentive ADHD symptoms can include: 

1. Lack of attention to detail: This can look like trouble following multi-step directions, or accidentally skipping over questions on a test or form.

2. Poor follow-through: You might struggle to finish projects or read long books — even when you’re excited at the beginning.

3. Trouble organizing tasks and activities: Maybe you plan a vacation but forget to book the hotel room. Or you’re in charge of organizing the bake sale but don’t realize you never sent an email asking people to participate.

4. Daydreaming: You might space out and suddenly realize you missed what someone was saying. Or not notice you’ve zoned out on the train and missed your stop.

5. Misplaced items: In school, you may have been in the lost-and-found every week, hunting for your coat and your lunchbox. Now you may spend a lot of time looking for your glasses, your keys, your wallet, your phone…. 

Women and girls with ADHD tend to be really good at “masking.” This means finding ways to hide or compensate for ADHD symptoms. Unfortunately, if you’ve done a really good job of masking, that may have kept you from getting a diagnosis and support. Masking is also a lot of work. Keeping up with it day after day can lead to burnout and even mental health challenges.⁵

Impact of inattentive ADHD on women

The consequences of inattentive ADHD symptoms can add up.

School: You may have had trouble following along during class. You may have left your textbook at school so you couldn’t do your homework — or you did your homework but forgot to turn it in. Your grades may have suffered. This can all lead to girls feeling “stupid.” Or ashamed and frustrated that you can’t seem to achieve what you’re capable of.

Work: Inattentive symptoms can cause big challenges at work. Loud, open offices can make it hard to concentrate. Trouble with time management can lead to missed meetings and deadlines. Difficulties with organization, switching tasks, or dealing with multi-step directions can make projects feel overwhelming, and leave you scrambling to finish. And when you are achieving, there’s a good chance you’re working twice as hard as your colleagues to get the same results. It can be exhausting.

Health: Inattentive ADHD symptoms can also make it hard to take care of yourself. You might forget to schedule annual checkups or screenings. Or have trouble making time to consistently plan healthy meals. Some women with ADHD also struggle with depression, anxiety, and eating disorders. ADHD symptoms are also affected by your menstrual cycle. Some women find that their inattentive symptoms increase around their periods. 

Relationships: ADHD can create big challenges in family life, friendships, and romantic relationships. Inattentive ADHD can make it hard to manage emotions, remember important information (like birthdays or anniversaries), and stay focused during conversations. 

Self-esteem: All of this can lead to serious struggles with self-esteem. Starting in girlhood, many women with inattentive ADHD report feeling “stupid” or “crazy.” Women also talk about feeling like they’re less capable than their neurotypical peers. 

Diagnosing inattentive ADHD

Getting diagnosed as an adult can take a lot of time and effort. If you go through this process, the evaluator will lead you through a lengthy evaluation. They’ll ask questions about family history, childhood, school, work, and daily life. To be diagnosed with inattentive ADHD, you need to show at least six symptoms of inattention as outlined by the DSM — the reference book evaluators use.⁶

Women with inattentive ADHD often are diagnosed with depression or anxiety before their ADHD is finally identified.⁷ In some women, this is because ADHD symptoms were misdiagnosed as depression or anxiety. But many women have ADHD and depression, anxiety, or other mental health or learning challenges. As a result, doctors may miss underlying ADHD symptoms. Or it may take extra time to sort out which conditions are causing which symptoms.

Managing inattentive ADHD

There are many ways for women with inattentive ADHD to manage symptoms. 

Medications: Experts often recommend stimulant medications. Non-stimulants may also be effective.⁸ Medications can have side effects or cause other problems for some people, though. If you go this route, you’ll work with a doctor to find the best type and dosage. 

Behavioral therapy: For this, a psychologist creates rewards to help change negative behavior into positive actions. Cognitive behavioral therapy (CBT) is a type of talk therapy where you discuss your thoughts and feelings. CBT can be especially helpful for women with depression and anxiety. 

ADHD coaching: You can work with an ADHD coach to make a game plan for tackling symptoms. There are one-on-one coaches as well as community and peer groups where people share challenges and offer support.

Mindfulness and meditation: Studies show that mindfulness and gentle movement can help with inattentiveness.⁹ Exercises like yoga, tai chi, or qigong are great examples of mind-body meditation activities. 

If you’re undiagnosed and beginning to wonder if you may have inattentive ADHD, talk to your health care provider. Getting a diagnosis at any age is a good thing, even if it takes a while. Women who were never diagnosed as girls often say they feel like failures, blaming themselves when they struggle. Getting diagnosed — and finally having a “name” for your challenges — can be a relief, and set you on the path to getting the treatment and support you need to thrive.

Summary

There are three types of ADHD: hyperactive/impulsive, inattentive, and combined. Women and girls with ADHD are more likely to be inattentive, while boys and men are more likely to be hyperactive or impulsive. Inattentive ADHD is harder to pick up on than hyperactive ADHD. People often assume women with ADHD are just being careless or “spacey.” This means women are more likely to wait for their diagnosis or to be misdiagnosed. 

If you have ADHD, you may blame yourself for your symptoms. Unfair expectations from society can make these symptoms even harder to cope with. But thanks to new research and focus on inattentive ADHD, you have a better chance of accessing the treatment and support you need and deserve.