The silent struggles of women with undiagnosed ADHD

ATTENTION-deficit hyperactivity disorder (ADHD) isn’t just about hyperactive little boys who can’t sit still.

- VUYILE MADWANTSI

That's the outdated image many of us were taught, and it’s part of the reason why so many women are silently living with undiagnosed ADHD, blaming themselves for years of mental overload, emotional exhaustion, and never feeling “together enough”.

This Women’s Month, the South African Society of Psychiatrists (SASOP) is urging the public to reframe how we understand ADHD, particularly in women and girls.

For too long, ADHD has worn a masculine mask, hiding the often invisible reality of how it presents in females.

“ADHD in women is not less severe. It’s just less visible,” says Dr Wisani Makhomisane, psychiatrist and SASOP member. “These women aren’t lazy, disorganised or overemotional; they're living with a neurodevelopmental condition that’s been misunderstood through a gendered lens.”

Why does ADHD get missed in women?

It is often dismissed as stress, or worse, a personality flaw. Research backs it up. According to the CDC, boys are nearly twice as likely to be diagnosed with ADHD (14.5%) compared to girls (8%). As they grow older, the gap only widens — with many women waiting 4-5 years longer than men for a correct diagnosis.

Women are more likely to have the inattentive type of ADHD, marked by forgetfulness, poor time management, disorganisation and emotional overwhelm, not the impulsivity and hyperactivity more common in men. It often gets brushed off as stress, or worse, personality flaws.