Unmasking ADHD in Women: The Overlap Between Anxiety and Undiagnosed ADHD
- sussexpsychtherapy
- Dec 1, 2025
- 4 min read
Anxiety is a common experience for many women who later receive a diagnosis of ADHD. For years, their symptoms may be misunderstood or misdiagnosed, often attributed solely to anxiety or other mental health challenges. This happens because ADHD in women frequently presents differently than in men, with more internalising symptoms that can hide the true cause. Emotional dysregulation, a hallmark of ADHD, often gets mistaken for anxiety, making it harder to identify the root problem. Understanding this overlap is crucial for better diagnosis and support.
Why ADHD Often Goes Undetected in Women
ADHD has traditionally been viewed through a male-focused lens, with symptoms like hyperactivity and impulsivity being the most recognised. Women, however, tend to exhibit more subtle signs, such as inattentiveness, daydreaming, and emotional sensitivity. These internalising symptoms do not fit the classic ADHD stereotype, so they often go unnoticed or are mistaken for anxiety or depression. Hormonal fluctuations can worsen symptoms, further complicating the picture.
Many women report struggling with feelings of overwhelm, chronic worry, and mood swings. These experiences can cause clinicians to diagnose anxiety disorders without considering ADHD as a potential underlying cause. This often results in years of treatment that target anxiety symptoms but fail to address the ADHD behind them.
How Anxiety Masks ADHD Symptoms
Anxiety and ADHD share several overlapping features, including difficulty concentrating, restlessness, and emotional challenges. When anxiety is the focus, the ADHD symptoms can be overshadowed or misinterpreted. For example:
Difficulty focusing may be seen as anxiety-related worry rather than ADHD inattentiveness.
Emotional outbursts may be described as anxiety-driven mood swings rather than ADHD-related emotional dysregulation.
Restlessness can be mistaken for nervous energy linked to anxiety, not hyperactivity or impulsivity.
Rejection sensitivity might be interpreted as low self-esteem or contribute to other mental health problems that become the primary focus.
This overlap means women with ADHD often receive treatment for anxiety without addressing the ADHD itself. Without an accurate diagnosis, coping strategies may fall short, and symptoms can worsen over time.
How Does ADHD Affect Emotions?
Emotional dysregulation refers to difficulty managing intense emotions, which is common in ADHD but less recognised in women. Women with undiagnosed ADHD may experience:
Sudden mood changes, particularly around hormonal transitions
Overwhelm in response to stressors, which can feel disproportionate
Difficulty calming down after emotional upset. This can contribute to the development of specific fears, relationship challenges or negative beliefs.
A general sense of not feeling safe due to being in a constant state of fight, flight or freeze.
How Does ADHD Affect Thoughts?
ADHD brains are often very busy! Women with undiagnosed ADHD may experience:
Difficulties letting go of negative thoughts or beliefs, or general worries.
A tendency to ruminate, going over past events in great detail, on repeat.
A pattern of forecasting into the future, thinking through every potential eventuality, including the most extreme catastrophes.
Because these experiences resemble the core characteristics of anxiety, they can be confused with anxiety conditions, leading to misdiagnosis. Recognising emotional dysregulation as part of ADHD is essential for accurate diagnosis and effective treatment.
How Do I Stop My ADHD Brain Working Against Me?
The core characteristics of ADHD can include many gifts as well as challenges.
Your capacity to feel things deeply can cultivate strong empathy and enable you to connect with others emotionally, fostering meaningful relationships.
Having intense emotional reactions emphasises your passionate character and commitment to your relationships and experiences.
Being sensitive to your surroundings allows you to identify potential issues early and take proactive measures to address them.
The busyness of an ADHD brain can be a source of creativity and innovation. Your mind generates a wealth of ideas and possibilities, allowing you to think outside the box and approach challenges with unique solutions.
Although you may find it hard to let go of negative thoughts or worries, this tendency can lead to a deeper understanding of yourself and your experiences. By recognising what troubles you, you can gain further insights and make meaningful changes in your life.
A tendency to ruminate and predict various outcomes shows that you are thoughtful and considerate about your choices. This skill can help you prepare for potential challenges and take advantage of opportunities that align with your values and goals.
The tendency to consider every possible outcome—even the most severe catastrophes—may mirror your desire for thoroughness and readiness. Although this can sometimes feel overwhelming, it also motivates you to find creative solutions, advocate for yourself, and strive for a better future.
Understanding Yourself is Key
If you suspect you might have ADHD, typical treatments for anxiety are less likely to be effective. It’s important to work with someone who understands ADHD and can tailor treatment accordingly. Working with someone who is neuroaffirming can help you make sense of your experiences and learn how to value and harness your unique strengths.
Practical Tips
If you have struggled with anxiety and suspect something else is underlying your anxiety, consider these steps:
Track your symptoms over time, noting patterns of inattention, impulsivity, and emotional challenges. ADHD is a lifelong diagnosis, and there should therefore be indicators of ADHD that go back to childhood, even if they went unnoticed at the time, which impact several areas of your life.
Masking is common in women. Seek a specialist familiar with ADHD in women, as they are more likely to recognise the unique presentation.
If you have been struggling with mental health, it is important to have a comprehensive assessment with someone who is experienced in mental health as well as neurodevelopmental conditions, including high masking presentations. An accurate assessment takes time, allowing the assessor to really get to know you and your history. This is a lifelong diagnosis and therefore should not be rushed.
If you would like to explore whether an ADHD assessment is indicated, you can book a Pre-Assessment with one of our highly experienced clinicians. If you have an questions please email contact@thepsychologicaltherapycentre.com
If you would like a free initial telephone consultations to explore therapy options, please use the link below.
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