When ADHD Doesn’t Look Like the Stereotype

For decades, the cultural image of ADHD has looked like the energetic young boy who can’t stay in his seat. Loud, impulsive, disruptive. But what happens when the person with ADHD is a high-performing adult woman who seems perfectly put together on the outside, yet feels chronically overwhelmed inside?

In my work as a psychotherapist, I often meet women who have quietly battled exhaustion, perfectionism, and self-doubt for years. Many were never flagged in childhood because their ADHD looked different from the stereotype. While boys often display outward hyperactivity, girls and women are more likely to experience inattentive symptoms like daydreaming, mental “clutter,” or difficulty sustaining focus- easy to overlook when masked by good grades or relentless effort.

How Biology and Life Stages Play a Role

Hormones add another layer of complexity to ADHD, and understanding this connection can be eye-opening for many women. Estrogen, in particular, plays a significant role in regulating dopamine- the neurotransmitter that helps us stay motivated, focused, and able to filter distractions. When estrogen levels rise, dopamine activity typically improves, and many women notice that concentrating feels easier. When estrogen drops, dopamine dips as well, and ADHD symptoms can become noticeably stronger.

This ebb and flow shows up throughout a woman’s life. During the menstrual cycle, for example, estrogen is highest in the first half (the follicular phase) and drops sharply in the days leading up to a period. Many of my clients report that the week before their period feels like wading through fog: tasks that were manageable a few days ago suddenly feel overwhelming, and emotional regulation takes extra effort.

Pregnancy often brings its own surprises. For some, the naturally higher estrogen levels during pregnancy can create a temporary sense of focus and calm. For others, the fatigue and changes in sleep, combined with ADHD, can make organization feel impossible. Postpartum, when hormones shift dramatically, symptoms can rebound or intensify, sometimes alongside mood changes like postpartum depression or anxiety.

Perimenopause and menopause can also be particularly challenging. As estrogen gradually declines, many women experience a noticeable uptick in ADHD traits- things like forgetfulness, distractibility, difficulty finding words- sometimes for the first time in years. These changes can coincide with major life transitions, such as career shifts or caring for aging parents, creating a perfect storm of stress.

Recognizing the biological rhythm behind these experiences is empowering. Instead of wondering “What’s wrong with me this week?” you can see the pattern and plan around it. Some women track their cycle to anticipate more distractible days, adjusting their workload or adding extra reminders. Others find that therapy, lifestyle changes, or medical support can help buffer these hormonal swings.

Our biology isn’t something to fight against; it’s information. When we understand how our brains and bodies move through each life stage, we can build strategies that honour those natural rhythms and give ourselves the compassion we deserve.

The Professional Camouflage

By the time they reach professional life, many women have become masters of adaptation. They develop colour-coded calendars, endless to-do lists, and late-night catch-up sessions. From the outside, they appear organized and successful. Internally, they may feel like they’re sprinting just to keep pace. This high-achiever persona delays recognition and feeds the familiar sense of imposter syndrome. Never doing enough, never being enough, even when the evidence says otherwise.

Professional women often carry more than a job description. They shoulder the “mental load” of home life (planning meals, scheduling appointments, remembering birthdays) while meeting high expectations at work. ADHD adds another dimension: difficulty prioritizing, time-blindness, and an easily overstimulated nervous system. Burnout, anxiety, or depression often follow, and these symptoms are frequently treated without anyone realizing that ADHD is at the root.

Reframing the Narrative

A diagnosis can bring enormous relief. Finally, there’s a reason for years of struggle. But a diagnosis is more than a label- it’s an invitation to understand how your brain works and to approach life with compassion. Your brain is wired for creativity and quick thinking. Self-worth isn’t measured by how many tasks get crossed off a checklist. Support, whether that’s therapy, ADHD coaching, or medication – is a tool, not a weakness.

Moving Toward Support and Self-Compassion

In therapy, we focus on practical, evidence-based strategies: cognitive behavioural techniques to challenge the “I’m lazy” narrative and build sustainable routines; mindfulness to anchor attention and reduce overwhelm; external systems like shared calendars or body-doubling (working alongside someone else) to keep momentum; and workplace accommodations such as flexible schedules or structured check-ins, which are both reasonable and protected by law.

Every woman’s story is unique, shaped by culture, race, and life experience. A thoughtful therapeutic approach honours these layers and recognizes the strengths that come with an ADHD brain: creativity, resilience, and an ability to think outside the box.

If any of this resonates, know that you are not “too much” or “not enough.” Your brain simply works differently, and that difference carries gifts as well as challenges. Consider gently asking yourself: When do I feel most focused or alive? What strategies have I outgrown? Where could I allow more compassion for myself?

At Brant Mental Health Solutions, I work with women professionals exploring these very questions. Together, we move beyond constant catch-up and toward living fully. If you’ve ever wondered whether ADHD might be part of your story, reaching out for assessment or therapy is a courageous and hopeful first step. Support is available, and you deserve it!

This blog was written by Emily Castracane, Psychotherapist at Brant Mental Health Solutions. For more information, or to book with someone on our team, reach out to us at 519.302.2300 or email reception@brantmentalhealth.com