ADHD, or Attention-Deficit/Hyperactivity Disorder, is a neurodevelopmental disorder that affects how the brain regulates attention, impulse control, and behavior. It is commonly associated with differences in the brain's executive functions, particularly in areas involved in focus, decision-making, and behavioral regulation.

Neuroscientifically, ADHD is linked to irregularities in neurotransmitter systems, particularly dopamine, which plays a crucial role in attention and motivation. Imaging studies have shown that people with ADHD often have structural and functional differences in brain regions such as the prefrontal cortex, which helps control attention and impulse regulation. These brain differences contribute to challenges with focus, organization, and task completion.

ADHD is classified into three main types according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders):

1. ADHD, Inattentive Type: This type is characterized primarily by symptoms of inattention, such as difficulty focusing on tasks, forgetfulness, disorganization, and trouble following through with instructions.

2. ADHD, Hyperactive-Impulsive Type: Individuals with this type exhibit signs of hyperactivity and impulsivity, including fidgeting, difficulty staying seated, excessive talking, and making impulsive decisions without thinking of the consequences.

3. ADHD, Combined Type: This type includes a mix of both inattention and hyperactive-impulsive symptoms. Individuals with this subtype experience challenges in both maintaining focus and controlling impulsive behaviors.

Women with ADHD often experience symptoms like forgetfulness, disorganization, procrastination, and emotional dysregulation. However, many women develop coping strategies, such as perfectionism and people-pleasing, to mask these symptoms, meet societal expectations, manage feelings of inadequacy, and earn respect. These strategies can make a diagnosis more challenging. High-achieving women with ADHD, for example, may appear "on top of things," but internally, they are struggling. These coping behaviors, which often serve as survival mechanisms to avoid rejection and criticism, can only be sustained for so long before burnout inevitably sets in.

Cultural conditioning and societal expectations have a significant impact on how ADHD manifests in women. Women are often expected to be organized, multitask efficiently, and maintain emotional control, which may lead to the masking or suppression of ADHD symptoms. This is particularly true for hyperactivity and impulsivity, which are less socially accepted in women.

Here’s how ADHD may be influenced by cultural factors:

• Masking Symptoms: Women may hide behaviors like fidgeting, interrupting, or impulsively speaking out of fear of judgment, leading to internalized symptoms like anxiety and self-doubt.

• Multitasking Pressure: Societal expectations place a high value on women managing multiple roles, such as being a caregiver, professional, and homemaker. This constant juggling may exacerbate ADHD symptoms like disorganization and forgetfulness.

• Higher Emotional Sensitivity: Cultural norms often expect women to be emotionally attuned and regulated. This can make emotional dysregulation associated with ADHD more pronounced and harder to differentiate from other mental health issues.

• Risk of Burnout: Women with ADHD may try to overcompensate for their symptoms, leading to excessive effort and eventual burnout, especially when they feel pressure to meet external expectations.

Cultural conditioning makes it essential for women to receive ADHD assessments that take these gendered experiences into account.

Psychologically, past experiences, personality traits, and cognitive patterns influence how individuals perceive and respond to stress. Traumatic events or chronic stress can create a predisposition to anxiety. Environmental factors, such as high-pressure situations, relationship conflicts, or societal expectations, also contribute to anxiety.

Importantly, anxiety is not a personal failing; rather, it is an adaptive response that can sometimes become maladaptive. While it serves a protective purpose, helping us navigate potential threats, it can also lead to problems when it becomes chronic. Understanding anxiety through a compassionate lens helps us recognize its legitimacy and encourages effective coping strategies and support for those who experience it.

ADHD and anxiety share overlapping symptoms like difficulty concentrating, restlessness, and feeling overwhelmed, but they have key differences. ADHD is a neurodevelopmental disorder marked by persistent struggles with attention, focus, organization, and impulse control across all areas of life. Anxiety, on the other hand, is typically triggered by worry or fear about future events or specific stressors, leading to temporary difficulty concentrating and emotional distress.

ADHD and anxiety can also coexist, which is known as comorbid anxiety and ADHD. When both conditions are present, the symptoms can intensify, causing more difficulty with task completion, decision-making, and emotional regulation. Understanding whether you have ADHD, anxiety, or both is crucial for finding effective therapy for ADHD in women. A professional evaluation can help determine the right treatment plan tailored to your needs.

The frustration often arises not from anxiety itself but from feeling trapped in a constant state of hyperarousal. This prolonged state can lead to burnout and depression, which many people with anxiety experience. Instead of aiming to eliminate anxiety, I encourage my clients to reframe their understanding of it. By exploring the root causes of your distress and cultivating compassion for how anxiety has tried to protect you, you can learn to identify when it’s helpful and when it’s time to shift back to a more regulated state.

Executive dysfunction refers to difficulty with cognitive processes like planning, organizing, time management, and decision-making. It is a core feature of ADHD and can contribute to symptoms like procrastination, forgetfulness, and impulsivity. For women with ADHD, executive dysfunction can be compounded by anxiety, which may intensify feelings of overwhelm and lead to avoidance behaviors. Addressing both ADHD and anxiety is essential to improving executive functioning and overall well-being.