Day 5: Evidence-Based Approaches to Diagnosing and Treating ADHD in Women

Welcome back to our series on ADHD in women for Women’s History Month! Over the past few days, we’ve explored how ADHD often goes undiagnosed in women, the emotional and practical toll it takes, and the biases that contribute to this issue. Today, we’re shifting gears to focus on solutions:

How can we better diagnose and treat ADHD in women?

This is where evidence-based approaches come into play. By using tools and strategies tailored to women’s unique experiences, clinicians can provide more accurate diagnoses and effective treatments—helping women reclaim their lives.

Diagnosing ADHD in Women: What Works

Accurately diagnosing ADHD in women requires a nuanced approach. Traditional diagnostic criteria don’t always capture the ways ADHD manifests in women, so it’s important to go beyond the basics.

1. Screening Tools That Address Gender Differences

Standard ADHD screening tools often focus on hyperactive and impulsive symptoms, which are more common in boys and men. For women, inattentive symptoms—like difficulty focusing, forgetfulness, and mental fatigue—are often more prominent.

Dr. Susan Young recommends using screening tools that incorporate questions about emotional regulation, organizational difficulties, and feelings of overwhelm, which are common in women with ADHD (Young, 2020). Tools like the Adult ADHD Self-Report Scale (ASRS) and the Conners Adult ADHD Rating Scale (CAARS) can be helpful, especially when paired with questions tailored to women’s experiences.

2. A Holistic Assessment

Diagnosing ADHD in women often requires looking beyond ADHD itself. Co-occurring conditions like anxiety, depression, and sleep disorders are common, and hormonal fluctuations can also play a role.

Dr. Sandra Kooij emphasizes the importance of assessing how ADHD symptoms interact with these factors, particularly during life stages like pregnancy, postpartum, and menopause (Kooij et al., 2019). A holistic assessment ensures that women receive care that addresses all aspects of their health.

3. Listening to Women’s Stories

One of the most powerful diagnostic tools is simply listening. Women with ADHD often describe feeling misunderstood or dismissed when they’ve sought help in the past. Taking the time to hear their experiences—without judgment—can uncover symptoms that might otherwise go unnoticed.

In my practice, I’ve found that asking open-ended questions like “What challenges do you face in your daily life?” or “How do you feel about your ability to stay organized and focused?” can provide valuable insights.

Treating ADHD in Women: Evidence-Based Strategies

Once ADHD is diagnosed, the next step is creating a treatment plan that works for the individual. Here are some evidence-based strategies that have proven effective for women with ADHD:

1. Medication

Medication is often a cornerstone of ADHD treatment, and it can be life-changing for many women. Stimulants like methylphenidate and amphetamines are commonly prescribed and have a strong evidence base for managing ADHD symptoms.

For women, it’s important to consider how hormonal fluctuations may affect medication response. Dr. Sandra Kooij notes that estrogen levels can influence the effectiveness of stimulants, so adjustments may be needed during menstruation, pregnancy, or menopause (Kooij et al., 2019).

2. Cognitive Behavioral Therapy (CBT)

CBT is another evidence-based approach that can help women manage ADHD symptoms. It focuses on building practical skills, like time management, organization, and emotional regulation, while addressing negative thought patterns that may have developed over time.

Dr. Martin Katzman’s research highlights how CBT can improve both ADHD symptoms and co-occurring conditions like anxiety and depression, making it a valuable part of a comprehensive treatment plan (Katzman et al., 2017).

3. ADHD Coaching

ADHD coaching is a specialized form of support that helps individuals develop strategies for managing their symptoms in daily life. Coaches work with clients to create personalized systems for organization, time management, and goal-setting.

Many women find coaching particularly helpful because it provides practical, actionable solutions tailored to their unique needs.

4. Lifestyle Changes

Lifestyle adjustments can also play a key role in managing ADHD. Strategies like regular exercise, mindfulness practices, and maintaining a consistent sleep schedule can help reduce symptoms and improve overall well-being.

In my practice, I often recommend starting small—like setting aside 10 minutes a day for mindfulness or going for a short walk—to create sustainable habits.

5. Support Groups

Connecting with others who share similar experiences can be incredibly validating. Support groups for women with ADHD provide a space to share challenges, celebrate successes, and learn from one another.

Organizations like CHADD (Children and Adults with ADHD) offer resources and support groups specifically for adults with ADHD, including women.

Creating an Inclusive Approach to Care

The Canadian ADHD Resource Alliance (CADDRA) and the World Federation for ADHD both emphasize the importance of gender-sensitive care. This means recognizing that women’s ADHD symptoms often differ from men’s and tailoring diagnostic and treatment approaches accordingly (CADDRA, 2020; World Federation of ADHD, 2021).

As clinicians, educators, and advocates, we have a responsibility to create a more inclusive approach to ADHD care. By listening to women’s experiences, using evidence-based tools, and addressing co-occurring conditions, we can help women with ADHD lead healthier, more fulfilling lives.

Looking Ahead

Tomorrow, we’ll wrap up our series by discussing how to advocate for women with ADHD—from raising awareness to pushing for systemic change. Advocacy is a powerful tool, and together, we can make a difference.

Until then, I’d love to hear your thoughts:

What evidence-based strategies have you found most helpful for women with ADHD?
How can we improve the way ADHD is diagnosed and treated in women?

Let’s keep the conversation going!

Reference:

Young, S. (2020). ADHD in Girls and Women: A Clinical Perspective. Frontiers in Psychiatry, 11, 578.
Kooij, S. J. J., Bijlenga, D., Salerno, L., et al. (2019). Updated European Consensus Statement on Diagnosis and Treatment of Adult ADHD. European Psychiatry, 56, 14-34.
Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry, 17, 302.
Canadian ADHD Resource Alliance (CADDRA). (2020). Canadian ADHD Practice Guidelines, 4th Edition. Retrieved from https://www.caddra.ca
World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. (2021). Neuroscience & Biobehavioral Reviews, 128, 789-818.

HEY, I’M THE AUTHOR…

Naomi Myrick, MSN, PMHNP-BC, is a Psychiatric Nurse Practitioner and CEO of Cardinal Care Psychiatric Services, operating two offices in Virginia. She specializes in Adult ADHD, health equity, and mentorship, earning the 2023 Outstanding Nurse Practitioner Preceptor Award. As the founder of Cardinal Academy, she provides education for psychiatric NPs. Naomi actively contributes to APSARD, CAADRA, and other professional organizations and serves on Tebra Technologies' Mental Health Advisory Board. She is now publishing blogs on ADHD to raise awareness and promote understanding.

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