Midlife Women and ADHD: Why So Many Are Diagnosed Late, and Why Life Feels So Hard
When women in their 40s and 50s say things like I feel like my brain is broken or I used to juggle it all, and now I can’t keep up, they’re not being dramatic or hyperbolic.
The overwhelm is a very real, very common experience. In fact around 80% of the women I work with share these concerns.
Gen X and Elder millennial women are knee deep in midlife and realizing the struggles they’ve carried for decades - difficulty staying organized, easily fatigued, sensory sensitivity, rejection sensitivity, trouble with motivation, and generally on top of things - may have a name: ADHD.
ADHD, or Attention-Deficit/Hyperactivity is a neurodevelopmental difference that affects how the brain manages attention, focus, impulse control, and executive functions like planning and organization.
“In my practice, I don’t treat ADHD as a disorder. It is very much just another way of being and experiencing the world, though given our culture is not set up to support folks who process information in this way, it can feel like a problem or a disorder.”
While often associated with hyperactive children, ADHD can also appear as inattention, distractibility, emotional sensitivity, and difficulties with time management — especially in women, where symptoms are often more internal and less obvious.
For many, that diagnosis comes as both relief and heartbreak — relief in having an explanation, heartbreak in wondering what life might have looked like if they’d known sooner.
Why ADHD is so often diagnosed late in women
1. ADHD was defined around boys, not girls.
For decades, ADHD was seen as a disorder of hyperactive young boys who couldn’t sit still. Girls and women, who are more likely to show inattentive symptoms (daydreaming, difficulty organizing, feeling overwhelmed), were often overlooked.
2. Women mask their symptoms.
Many girls learn early to “overcompensate” — by staying up all night to finish assignments, making endless lists, or striving for perfection. Girls and women are often misdiagnosed with anxiety rather than the underlying cause. These strategies work until life responsibilities multiply. In midlife, when career demands, caregiving for both kids and aging parents, and personal health changes collide, those coping strategies collapse.
3. The science left women out.
Clinical studies for ADHD long focused on boys and men. Only in recent years has research turned toward how hormones, life transitions, and gendered expectations shape women’s experiences with ADHD.
4. Life gets more complex with age.
Instead of “outgrowing” ADHD, many women find their symptoms intensify in midlife. As Salon writer Andi Zeisler put it in her September 2025 article, “Gen X women don’t have the bandwidth to figure out why they feel so terrible.” She describes women in their 40s and 50s who “arrive at middle age feeling like their brains are failing them” — wondering if the culprit is perimenopause, ADHD, or both. Salon
The perimenopause–ADHD overlap: A double hit
One reason midlife feels especially hard is that perimenopause and ADHD symptoms overlap.
Both can cause brain fog, memory issues, sleep disruption, mood swings, and difficulty concentrating. That overlap means many women are told their struggles are “just menopause” — when ADHD may also be at play.
Zeisler highlights this confusion, noting that clinicians often miss the connection: “Because women’s health is so undertaught in medical school, doctors don’t know to connect the dots between fluctuating hormones and ADHD.” Salon.
There’s science behind this. Estrogen and progesterone influence dopamine and serotonin — the very neurotransmitters involved in attention, motivation, and mood regulation. As estrogen drops in perimenopause, ADHD symptoms often worsen. One physician quoted in the Salon article explains: “Estrogen is important to maintaining certain neuropeptides, like dopamine, which help regulate mood and focus. When estrogen drops, those systems take a hit.”
So for midlife women, it’s not just one thing — it’s two forces converging: ADHD and perimenopause amplifying one another.
Why life feels so overwhelming
Even without hormonal changes, ADHD makes the executive functions of daily life difficult: planning, organizing, starting and finishing tasks, managing time. In midlife, these demands skyrocket. Women are often simultaneously:
managing careers or businesses,
raising teens or launching adult children,
caring for aging parents,
navigating financial pressures,
and tending to their own shifting bodies.
No wonder Zeisler writes that so many women feel “in shambles.” Salon.
Add in the sleep disruptions of perimenopause (night sweats, insomnia) and the emotional dysregulation common in ADHD, and it’s a perfect storm.
Moving through Grief to Clarity
For women who receive an ADHD diagnosis in midlife, the emotions are complex. There may be grief for the years lost to self-blame. But there is also relief, a new framework to understand why life has felt so much harder than it “should.”
What helps:
Finding a clinician who understands ADHD in women. Ask directly about training in ADHD and menopause (or reproductive mental health). This is true for both psychotherapists and psychiatrists.
Educational reframing. Learning that struggles are neurological, not moral failings, can be liberating.
Experimenting with treatment. For some, ADHD medication or hormone therapy makes a dramatic difference. For many, skill-building and psycho education are enough.
Scaffolding focus in a digital age. Strategies like time-blocking, app blockers, and accountability partners can support attention.
Connecting with peers. Knowing you’re not alone in this struggle reduces shame and isolation.
The takeaway
As I’m wrapping up here I want to say this: women in midlife aren’t falling apart, they’re finally being seen. There’s no shame in that game. It’s actually time to take a sigh of relief.
Late ADHD diagnoses are common because the research, education, and cultural narratives ignored women for too long. Perimenopause adds another complicating layer, and technology creates a world that challenges even the most robust attention systems.
But naming the struggle is essential to advocating for specialized care. Women deserve that care. And I’m proud to be part of that support network.
Till next time, wishing you health & ease,
Jessika
Support for women’s healing, growth + Wellness in Oakland throughout California
A little about me …
Hi, my name is Jessika Fruchter LMFT and I’m a feminist psychotherapist, expressive arts therapist, writer and educator. I provide online holistic psychotherapy for women throughout California who are navigating the perimenopause transition and all things midlife. Together we tend to matters of the mind, body and spirit.
I believe personal healing is a revolutionary act. I say it often. And in these (continued) turbulent times, I believe it now more than ever.
If you think spiritually-integrated therapy might be right for you, and you live in California, I’m here to support. Here are a couple of steps to move forward …
Schedule a free initial consultation here
Of if you have questions … Let's chat.I’m happy to answer any questions you have.
Also please know there are directories where you may seek out other feminist therapists in your area. Inclusive Therapist and Therapy Den are two great places to start.