The years leading up to menopause bring a maelstrom. We’re talking countless physical, mental, and emotional changes and disturbances. There are the usual suspects: hot flushes, mood swings, brain fog, exhaustion. All quite irksome at best; at worst, positively debilitating. For a growing number of women, me included, these years are uncovering something else entirely: hitherto undiagnosed ADHD.
Often dismissed or misunderstood, usually attributed to boisterous little lads who are wired to charge around punching each other, Attention Deficit Hyperactivity Disorder isn’t just a childhood condition. It doesn’t always look like the hyperactive stereotype. For many of us, it’s been there all along. We just kept it hidden beneath coping mechanisms, people pleasing, conflict avoidance, perfectionism, and a constant feeling of being a bit odd; not quite fitting in. We ‘masked.’
Growing Up “Weird”
The realisation came in 2021/2022, when we’d all gone a bit bonkers anyway, from lockdowns and ongoing uncertainty. There was something of a Eureka moment. Suddenly, everything made sense. The chronic lateness. The doom piles of unread bills and threatening letters. The dopamine chasing debt. The ridiculous procrastination (including pathological inability to return items bought when dopamine chasing). The overthinking. The ongoing struggle to fit in. However, that clarity came with an overwhelming sadness for the confused and misunderstood child who could never quite get it right.
Back then, ADHD was seen as something that happened to boys who couldn’t sit still. Girls were rarely diagnosed, especially when clever enough to mask their struggles. I should’ve excelled at school. But ‘could do better’ was the story of my high school years – but because I did well enough, passing everything with little effort, that was good enough. Instead of being recognised as neurodivergent, girls like me were labelled lazy, disorganised, chaotic, forgetful, oversensitive, or emotional.
And those labels stick.
Overwhelm and Overthinking
By now, we’re starting to understand the world of difference between stereotypical ADHD and the common ADHD symptoms in girls. For example, my ‘hyperactivity’ is all in my head. I can start three new business before lunch. Sadly, I’ll then leave them to stagnate. I’ll have entire conversations – or replay specific conversations from 1987 – in my head wishing I’d reacted differently, agonising even. All while forgetting to complete today’s tasks. I’ll wake in the early hours, mind full and thoughts racing for hours.
I’m not alone – though until recently, I always thought I was.
Common ADHD Traits in Girls
Sometimes it’d be easier if we could just explode in physical activity, like rough and tumble little boys. However, our ADHD is more internal and nuanced:
- Inattention: This could be difficulty paying attention, zoning out, misplacing things, struggling with organisation and easily distracted.
- Emotional Sensitivity: We are wounded by criticism and scared of conflict, prone to overthinking or worrying. I’m resilient, but quick to cry and extremely sensitive to perceived rejection, which can make friendships tricky. Disagreements feel devastating.
- Low Self-Esteem and Perfectionism: With their ADHD unrecognised, many girls grow up believing they’re not good enough. My constant thought was ‘why am I so bloody useless?’
- Executive Function Challenges: ADHD affects the brain’s executive functions – the mental skills that help us plan, focus, and manage time. Oh yes, time management. That’s my biggie. I’ll buy new miracle planners month after month. Spoiler alert – they don’t work, save your money. I struggle to make small decisions but will leap into life changing decisions with a hearty ‘f*ck it.’ Too many choices or tasks result in a form of paralysis.
- Masking and People-Pleasing: ADHD is often missed in girls due to masking – hiding difficulties by emulating others or working twice as hard to seem normal.
We might look calm and capable. Underneath, we’re mired in chaos and mentally exhausted. Oh, and skint.
ADHD and Girls: The Struggle is Real
Because of these patterns, girls with ADHD may experience:
- Chronic stress from trying to keep up.
- Anxiety from constant self-monitoring.
- Friendship struggles (talking too much, missing social cues, or taking things personally).
- Sleep problems (overthinking, racing mind at night).
- Perfectionism and burnout.
- Hormonal impacts: symptoms often worsen during puberty, perimenopause, or PMS.
And therein lies the answer. Menopause lays bare previously undiagnosed ADHD. Even without a side of neurodivergence, the years leading up to menopause feel like someone has quietly rewired their brain. Tasks suddenly feel overwhelming. Focus disappears. Emotions run high. Memory slips.
Perimenopause Makes ADHD Pop
Many women hit their 40s or 50s and start to feel like their brain has changed overnight. It’s easy to blame menopause alone… but for some, it’s undiagnosed ADHD. During perimenopause, oestrogen levels begin to fluctuate. Oestrogen plays a crucial role in regulating dopamine, the brain chemical that controls focus, motivation, and mood. When oestrogen drops, ADHD can suddenly intensify.
Tasks we once juggled seem impossible. We forget words, appointments, and why we walked into a room. We feel emotional, scattered, and exhausted by the noise in our heads. The ADHD was always there, but coping strategies used to hold it together. Now, as hormones shift and energy dips, those strategies stop working, and the fog lifts to reveal what’s really been happening all along.
Recognising ADHD in perimenopause isn’t about a label. It’s about finally understanding yourself. We’re not broken. I’m not ‘useless.’ Our brains just work differently. In some ways, they work brilliantly.
ADHD Advantages
Don’t come at me here. I am very aware that some people really do struggle. However, most people with ADHD have great skillsets which neurotypicals may lack. Their creativity, empathy, intuition, and curiosity are incredible strengths. They just need environments that work with their brains, not against them. I’ll be honest. I’ve not received a formal diagnosis. But the more research I’ve done and the more ND people I’ve met, the more it’s blindingly obvious. Will I chase a diagnosis? No. I have no interest in medication, or in expecting anyone else to understand. I’m freelance, so there’s no employer to consider. I can just work the way that suits me best (yep, ALL the work done within an hour or so of a deadline) and accept myself for who I am.
However.
I wish I’d known sooner.
I wish school had been different.
I wish I hadn’t spent so long thinking I was useless.
I’m so sad for the girl who struggled in silence, the young woman who burned herself out trying to fit in, the mother who blamed herself for being disorganised or forgetful. But every experience, every struggle, has shaped my resilience and empathy.
And superpowers. I have a few. I can see straight through bs. I can achieve an unholy amount of work in a short time. If you have a problem, I’m not great with the sympathy and shoulder to cry on but I’ll spring into action with practical help. I’m creative and a real problem solver. Who cares if the house is a tip, I spend money like water, and I can only eat breakfast with a certain spoon? Minor details.
Kate