ADHD in Girls: Symptoms, Diagnosis, and Treatment

When we think of ADHD in children, the image of a rambunctious and disruptive young boy often comes to mind. In fact, ADHD is often thought of as a “boys’ disorder” because of its prevalence in boys compared to girls. However, ADHD can still regularly occur in girls; they may just present differently. In this article, we’ll explore ADHD in girls and discuss the unique symptoms that characterize the condition across genders, its diagnosis, and effective treatment options.

Understanding ADHD in Girls

ADHD is often called a “hidden disorder” because girls experience it differently from boys. Girls are less likely to show hyperactive behavior, and they often have less trouble with self-control. Girls aren’t as disruptive in school and at home.

However, girls struggle with attention, which is a key ADHD symptom. They can seem distracted, lost in their own world, or have mental paralysis. This is often identified by doctors as the kind of ADHD that doesn’t include hyperactivity, otherwise known as inattentive ADHD. It is also sometimes called by its old name (attention deficit disorder or ADD).

Girls with ADHD who are inattentive rather than hyperactive do not stand out as much as children who are always in motion. This makes it easier to overlook their challenges. While girls have ADHD as often as boys do, they are not diagnosed as often in childhood [*].

This presents more challenges. Girls with ADHD might just be dismissed as having “daydreamy” behaviors. And teachers and parents may mistake girls’ struggles with focus for laziness. Girls who aren’t diagnosed properly may not get treatment or the types of support required to help them manage ADHD symptoms.

Girls are also more likely to use coping strategies to compensate for their symptoms. These may include:

• Spending more time to do schoolwork and chores in just the right way
• Repeatedly checking tasks or work to ensure completeness and correctness
• Avoiding tasks, events, or people they find challenging

Such coping mechanisms may offer short-term benefits, but they are more likely to create challenges, including making ADHD symptoms more difficult to recognize.

How is ADHD in Girls Different from Boys?

What ADHD in girls looks like is quite different from how it shows up in boys.

First, girls present symptoms differently. While boys tend to exhibit disruptive and impulsive behaviors, girls struggle with inattentive behavior and lack of focus. Their symptoms are usually more subtle and are difficult to identify as a result. Boys are twice as likely to receive an ADHD diagnosis than girls [*]. Girls also tend to be more verbally aggressive, while boys are more physically aggressive.

Studies also point to undiagnosed ADHD as harming females’ self-esteem [*]. Findings showed that girls with undiagnosed ADHD often dealt with childhood misunderstanding, self-blame, and rejection. And while boys externalize their frustrations, girls more typically turn their pain and anger inward. This increases the risk of depression, anxiety, and eating disorders.

Girls who have undiagnosed ADHD also have a higher likelihood of developing problems in school, social settings, and personal relationships.

ADHD Symptoms in Girls

ADHD symptoms in girls manifest differently and are characteristic of ADHD for their gender. They often:

• Have difficulty focusing and listening to instructions
• Struggle with concentrating and make careless mistakes
• Daydream often
• Forget things
• Lose things
• Avoid things that require a lot of attention

These symptoms of ADHD in girls may also show up more often than in boys:

• Anxiety
• Stress
• Low self-esteem
• Depression
• A greater chance of self-harm

Diagnosing ADHD in Girls

If your child is showing symptoms like the above or even signs like ADHD paralysis, then it might be time to schedule an appointment with a mental health professional for a proper diagnosis.

A mental health professional, such as a therapist, will start by asking questions about the following:

• Symptoms you may have noticed in your child
• Whether they have trouble completing tasks at home or in school
• How long your child has had these difficulties
• How the symptoms affect the daily life of your child
• Friendships and relationships with family members
• Strategies your child uses to manage their emotions
• Unwanted emotions or thoughts, like anger, frustration, or sadness

Therapists may also ask about other physical or mental health symptoms to rule out underlying conditions.

To be diagnosed with ADHD, girls must present a consistent pattern of inattention, hyperactivity, and/or impulsiveness. These symptoms characterize the three types of ADHD: inattentive, hyperactive/impulsive, and combination.

When it comes to girls, inattentive ADHD is the most common.

There must be six or more symptoms present in children under age 16. These symptoms need to be present for at least six months and cause significant interference in functioning in at least two areas of life (e.g., school, home, work). These symptoms must also be present before the age of [*].

Mental health professionals or therapists may also use other modes of assessment, such as questionnaires and psychological tests, to make an accurate diagnosis.

Treatment

ADHD treatment can look different for every girl, but there are several tried and tested modes of treatment that are implemented for the treatment of ADHD symptoms.

Behavior Therapy

Effective treatment plans typically involve at least one type of behavioral therapy. Therapy gives your child a safe space to learn and practice new behaviors and skills and to get support with accepting and managing difficult and overwhelming feelings.

Family therapy and parent training may also be recommended. These approaches allow parents and caregivers to learn helpful skills for parenting a child with ADHD, including positive discipline practices and organizing and structuring daily activities.

Medications

Medications are not always necessary to treat ADHD, but in many cases, they help alleviate symptoms and can be used in combination with therapy. For most children, stimulant medications are safe and effective. There are also non-stimulant medications. Both go a long way in improving girls’ daily function and quality of life.

Coping Strategies Parents Can Teach for Girls with ADHD

ADHD in children or ADHD in teenagers can be challenging to cope with. Here are several coping strategies that parents and caregivers can use to make dealing with ADHD more manageable.

Self-management techniques

Sometimes having too many distractions can cause symptoms like choice paralysis. Self-management techniques such as turning off gadgets and video games can help at home. You can also ask your child’s teacher to seat them away from windows and doors in the classroom.

It is also helpful to make your child aware of their tendency to drift off into her own thoughts. Communicate that while this is not a bad trait to have, it helps to be aware of it so that she can still focus on completing her tasks.

Building resilience

Young girls with ADHD can cultivate resilience by focusing on their strengths. This means finding activities they excel at, whether art, sports, or building things. By fostering these "islands of competence," they build self-esteem and a sense of accomplishment. This positive foundation helps them bounce back from setbacks and navigate challenges, knowing they have the power to succeed.

Peer and social support

Strong peer and social support systems are vital for building ADHD social skills in girls. These connections can provide a sense of belonging and acceptance, which can be especially important as they navigate challenging social situations. Supportive friends can be understanding listeners when girls with ADHD experience frustration or social missteps. They can also offer encouragement and celebrate successes, boosting self-esteem and confidence. This positive environment can help girls with ADHD thrive emotionally and socially.

The Bottom Line

Estimates suggest that ADHD in females is undiagnosed between 50 and 75 percent of the time. However, increasing awareness of the unique way that girls experience ADHD makes getting the right diagnosis and treatment possible. Supporting girls in this way can make a big difference in their relationships and performance at school. And most of all, supporting girls with ADHD means allowing them the chance to live life with good mental health and well-being.

For more tools for managing ADHD symptoms, don’t forget to check out our collection of ADHD worksheets.

References:

1. Skogli E, Teicher M, Andersen P, et al. ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures. 9 November 2013.
2. Centers for Disease Control and Prevention. Attention-Deficit / Hyperactivity Disorder (ADHD). 2024.
3. Atoe D & Climie E. Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. 30 March 2023.
4. Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance. June 2016.