Day 4: The Profound Impact of Undiagnosed 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 manifests differently in women, why it remains hidden, and the biases that contribute to underdiagnosis. Today, we’re focusing on the real-life impact of undiagnosed ADHD—how it affects women’s relationships, careers, mental health, and overall quality of life.


This is a topic I see play out every day in my practice. For many women, finally receiving an ADHD diagnosis is a moment of clarity, validation, and relief. But before that diagnosis, the effects of untreated ADHD can ripple through every aspect of their lives, often leaving them feeling overwhelmed and misunderstood.

The Emotional Toll: Self-Doubt and Shame

One of the most common feelings women with undiagnosed ADHD describe is shame. They wonder why they can’t seem to “get it together” like everyone else. Why do simple tasks—paying bills, meeting deadlines, keeping track of appointments—feel so difficult?


This constant struggle often leads to self-doubt. Dr. Susan Young points out that women with undiagnosed ADHD frequently internalize their difficulties, blaming themselves for what they perceive as personal failures (Young, 2020). Over time, this self-blame can erode self-esteem and contribute to chronic anxiety and depression.


In my practice, I’ve seen how transformative it can be when women learn that their struggles aren’t due to laziness or lack of effort—they’re symptoms of a neurodevelopmental condition. That shift in understanding can be deeply empowering, helping women let go of shame and embrace self-compassion.

Strained Relationships

ADHD doesn’t just affect the individual—it often impacts their relationships as well. Women with undiagnosed ADHD may struggle with forgetfulness, emotional sensitivity, or impulsivity, which can lead to misunderstandings and frustration in their personal lives.


For example, a woman may forget important dates or appointments, leaving her partner or family members feeling hurt or unimportant. Or she may have difficulty managing emotions during conflicts, leading to arguments that escalate quickly. Dr. Martin Katzman has highlighted how emotional dysregulation—a common feature of ADHD—can strain relationships and contribute to feelings of loneliness and isolation (Katzman et al., 2017).


When ADHD is properly diagnosed and treated, women often find that their relationships improve dramatically. Understanding the root cause of these challenges allows both the individual and their loved ones to approach conflicts with greater empathy and patience.

Career Challenges

The workplace is another area where undiagnosed ADHD can create significant challenges. Women with ADHD often struggle with organization, time management, and attention to detail—skills that are highly valued in most jobs.


Dr. Sandra Kooij notes that women with ADHD are more likely to experience job instability, underemployment, and burnout due to their difficulties meeting workplace demands (Kooij et al., 2019). Many women describe feeling like they’re constantly “playing catch-up,” unable to keep up with deadlines or expectations despite working harder than their peers.


This pattern can lead to feelings of inadequacy and frustration. Some women may even avoid pursuing certain careers or promotions because they believe they’re not capable of succeeding. Proper diagnosis and treatment can help women develop strategies to manage their symptoms and thrive in their careers.

Financial Struggles

Another overlooked impact of undiagnosed ADHD is financial instability. Women with ADHD often struggle with impulsive spending, difficulty keeping track of bills, and forgetting important financial deadlines. Over time, these challenges can lead to debt and financial stress.


In my practice, I’ve seen how addressing ADHD symptoms can significantly improve financial management. Tools like reminders, budgeting apps, and support from financial counselors can help women regain control over their finances and reduce stress.

The Intersection of ADHD and Physical Health

Untreated ADHD doesn’t just affect mental health—it can also impact physical health. Women with ADHD are more likely to experience chronic stress, which can contribute to conditions like high blood pressure, gastrointestinal issues, and sleep disturbances. Hormonal fluctuations during menstruation, pregnancy, and menopause can further exacerbate ADHD symptoms, creating a cycle of physical and emotional strain.


Dr. Sandra Kooij emphasizes the importance of addressing these intersections, noting that holistic care is essential for improving both mental and physical health outcomes in women with ADHD (Kooij et al., 2019).

Breaking the Cycle

The good news is that the cycle of undiagnosed ADHD can be broken. With proper diagnosis and treatment, women can begin to address the root causes of their struggles and build healthier, more fulfilling lives. Evidence-based treatments like cognitive behavioral therapy (CBT), ADHD coaching, and medication can help women manage their symptoms and develop practical strategies for success.


As clinicians, educators, and advocates, we have a responsibility to ensure that women with ADHD are seen, heard, and supported. By increasing awareness and improving diagnostic practices, we can help more women access the care they deserve.

Looking Ahead

Tomorrow, we’ll explore evidence-based approaches for diagnosing and treating ADHD in women. From screening tools to treatment strategies, we’ll discuss how we can create a more inclusive and effective approach to care.

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


  • How have you seen undiagnosed ADHD affect women’s lives?
  • What strategies have you found helpful in supporting women with ADHD?


Let’s keep the conversation going! Together, we can make a difference.

References

  • 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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