ADHD and autism in women: Neuropsychologist explains brain-based differences, what they mean for diagnosis

Symptoms of ADHD or autism: Women with ADHD or autism sometimes don’t look the way “classic” cases do — hyperactive, poorly socialised (Image: Pexels)

ADHD and Autism Spectrum Disorder (ASD) are neurodevelopmental conditions that influence how the brain metabolises information, emotion and social interactions. Both have traditionally been studied and diagnosed almost exclusively in males, so their presentations in women frequently go unrecognized. This bias in the research and diagnostic criteria has left many women misunderstood, misdiagnosed or even dismissed all together.

Women with ADHD or autism sometimes don’t look the way “classic” cases do — hyperactive, poorly socialised. They compensate by, among other things, becoming adept at masking behaviours and coping in a social setting. Sometimes, this can make their difficulties harder to detect — but that doesn't mean they aren't suffering just as much internally and feeling just as exhausted.

"Knowing these gender differences support women the right way,” Dr Neha Verma, a Delhi-based consultant neuropsychologist tells Moneycontrol. “Women often internalise their symptoms. Rather than acting up, they withdraw, overachieve or work so hard trying to fit in with what society expects of them that they experience burnout, anxiety or depression,” she says.

Also read | Manage ADHD: Avoid multitasking, overcommitting, and other expert tips to manage symptoms

Knowledge of these distinctive forms will enable doctors and families to acknowledge and approve women’s experiences earlier.

ADHD in Women: Hidden struggles

ADHD in women is commonly missed because symptoms such as disorganisation, forgetfulness or emotional overwhelm are mistaken for stress or hormonal imbalance. Women with ADHD are much more likely to display inattentive symptoms — difficulty focusing, daydreaming or struggling to follow through on tasks — than hyperactive ones.

They can look all cool, calm and collected on the outside but struggle inside or are just being worn out by thoughts of trying to keep things in order. Emotional regulation is also a hard thing to manage — individuals may swing between such moods, become temperamental, take things personally or fear incompetence. A lot of women receive their diagnosis in adulthood when these symptoms are coming into conflict with relationships, parenting or work.

Also read | Do you have ADHD? Here are 6 ways to manage this neurodevelopmental disorder effectively

Signs of autism in women: Telling traits

Autism in women also looks different than it does in men. Girls and women, too, often have better social imitation skills — they learn to “mask” their autistic traits by mimicking social behaviors, maintaining eye contact or imitating facial expressions. As a result, they may be swept under the carpet when it comes to challenges with communication, sensory bombardment or fixed thought processes.

Women who are on the spectrum may flourish academically but feel depleted mentally after socializing. They typically share intense focus on certain interests or routines, and sensory sensitivities — such as irritation at certain fabrics or noises — are common. Unlike the stereotypical view of autism, these skills are not seen but are disguised beneath social endeavour and perfectionism.

The emotional toll of masking

Both women and girls with ADHD or autism frequently mask — that is, suppress or camouflage their symptoms in an attempt to seem “normal.” Masking may enable them to negotiate social norms, but it also can result in chronic stress, anxiety or identity confusion. This emotional weight can compound, and lead to burnout – or may coexist with depression.

By identifying these patterns, women are able to seek the help they need—therapy, lifestyle changes and as a last resort medication. Early recognition and understanding can profoundly change the way a person lives one’s life every day and, ultimately, how well a person feels.

Why awareness matters

By recognising the unique presentation of ADHD and autism in women, healthcare providers and families can support earlier identification and treatment. It also breaks down stigma — empowering women to replace shame or self-blame with a sense of power and acceptance toward their neurodiversity.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.