When Kate Jarvis was a little girl growing up in the 1980s, school came easily. She earned straight A’s, brimmed with creativity, and was so organized that she’d prep her toothbrush with toothpaste every night before bed. Her mother called her bright-eyed and bushy-tailed. Then puberty hit, and everything began to unravel. Her focus scattered, her grades slipped, and her self-esteem cratered. Teachers wrote on her report cards that she had so much potential if only she’d apply herself. In high school, she was diagnosed with anxiety and depression. But it wasn’t until her late 30s that Jarvis finally learned what had really been going on all those years: attention deficit hyperactivity disorder. The diagnosis felt revolutionary, she says, because something she had been wrestling with for 25 years suddenly had a name and an explanation.
Researchers say Jarvis’s story is strikingly common among women. For decades, ADHD was viewed primarily as a childhood condition affecting boys, and boys were the focus of most research, according to Julia Schechter, a clinical psychologist who co-directs the Duke Center for Girls and Women with ADHD. But the disorder often shows up differently in girls. They tend to appear distracted or disorganized, lost in daydreams rather than bouncing off walls and disrupting classrooms. Those subtler symptoms are easier to miss, which helps explain why girls typically receive diagnoses years later than boys — often not until adulthood. Many women spend years being treated for anxiety or depression without anyone addressing the underlying cause.
The cost of those missed years is steep. Compared to women without ADHD, those with the condition are more likely to experience abusive relationships, teen pregnancies, feelings of worthlessness, and self-harm or suicide attempts. They also face higher rates of obesity, eating disorders, type 2 diabetes, and cardiovascular disease, says Dr. Patricia Quinn, a developmental pediatrician who has specialized in ADHD in women and girls for decades. She points to a combination of factors including impulsivity, poor sleep, chronic stress from unmanaged symptoms, and dopamine-seeking food choices. A large UK study published last year found that women with ADHD die nearly nine years earlier on average than their peers without the disorder — and two years earlier than men with the condition.
Often, women reach midlife before their coping systems collapse under the weight of mounting responsibilities. Ellen Littman, a clinical psychologist specializing in women with ADHD, says many spend years masking their symptoms until life becomes too complex to manage. For Amy Reyer, that breaking point arrived at age 48 while she was raising two teenagers, caring for aging parents, and working a demanding job that kept her constantly on call. She had spent most of her life working three times as hard as everyone around her just to keep up, assuming everything would be more difficult for her without understanding why. Even after earning a doctorate and building a successful media career, perimenopause tipped the balance entirely. Emerging research suggests estrogen fluctuations can worsen ADHD symptoms, making midlife a particularly vulnerable time for women whose diagnosis was overlooked in youth.