Attention-Deficit/Hyperactivity Disorder (ADHD) in women has historically been underrecognized and underdiagnosed due to differing symptom presentations compared to men. Women with ADHD, particularly those who are high functioning, often develop compensatory strategies that enable them to perform well in academic and professional settings (Young et al., 2020). However, they may also experience heightened perfectionism, increased stress, and difficulty maintaining long-term productivity without burnout (Hinshaw, 2021).
Women with ADHD frequently exhibit inattentive symptoms rather than hyperactivity, which can lead to late or missed diagnoses (Young et al., 2020). They are more likely to experience internalized struggles, such as anxiety and self-doubt, as opposed to the more externalized behaviors commonly observed in males with ADHD (Camara et al.,2021). These factors contribute to a phenomenon known as "high-functioning ADHD," in which women develop adaptive mechanisms that mask their difficulties, enabling them to excel in structured or high-pressure environments (Hinshaw, 2021).
Some women with ADHD demonstrate enhanced focus and efficiency in high-stress situations. Research suggests that the adrenaline released during periods of intense pressure can temporarily enhance executive functioning, allowing individuals to hyperfocus and meet deadlines effectively (Brown, 2018). However, this pattern is often unsustainable, leading to cycles of extreme productivity followed by periods of exhaustion and burnout (Sibley, 2024). This paradox highlights the need for sustainable coping mechanisms and support systems to balance performance with mental well- being.
High-functioning women with ADHD often develop perfectionistic tendencies as a compensatory strategy (Hinshaw, 2021). While this drive for excellence can lead to academic and professional success, it may also contribute to heightened anxiety and self-criticism (Autism Connect Editors, n.d.). Perfectionism can manifest as an overwhelming fear of failure, difficulty delegating tasks, and excessive self-monitoring. In many cases, these women engage in “masking” behaviors, where they consciously suppress ADHD-related tendencies in order to conform to societal expectations (Younget al., 2020).
Beyond professional and academic settings, women with high-functioning ADHD often struggle with interpersonal relationships. They may have trouble maintaining friendships and romantic relationships due to challenges with emotional regulation, impulsivity, and social anxiety (Kok et al., 2016). Many of these women report feeling misunderstood, as their external success does not always reflect their internal struggles (Camara et al., 2021).
High-functioning women with ADHD often excel in structured, high-pressure environments but may struggle with self-regulation, perfectionism, and social functioning. While their ability to mask symptoms can contribute to professional success, it can also lead to emotional exhaustion and long-term stress (Hinshaw, 2021). Recognizing and addressing these challenges is essential to ensuring that these women receive appropriate support, allowing them to thrive without sacrificing their well- being.
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Sibley, M. (2024, October 26). ADHD symptoms may lessen under high stress, experts suggest. The Guardian. Retrieved from Link
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