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More and more women are identifying with a neurodiverse condition as adults. Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are usually diagnosed in childhood. But the signs can be easy to miss.
The behaviors associated with these conditions can seem common. Trouble focusing can look like a sign of ADHD. Mild social awkwardness can look like a sign of ASD. And the symptoms can seem so subtle that formal treatment may not seem necessary.
Having an undiagnosed condition can lead to other challenges. You might’ve felt like there’s something wrong with you and never known why. Or you might’ve struggled with things like paying attention or social cues.
If that sounds familiar, it can be validating to learn more or even get a diagnosis. And it can be helpful to take advantage of the wide range of resources available.
Why are women sometimes diagnosed with ADHD or autism as adults?
On average, boys are diagnosed with ASD 4 times more often than girls. But at least one study suggests that women may be even more likely than men to have this condition.1
That’s because early ADHD and ASD research focused on behaviors that were more obvious in boys. So when girls got evaluated, they didn’t always show the signs that clinicians expected.
Dr. Thomas Crawford is a psychologist with the Kaiser Permanente San Jose Autism Spectrum Disorder (ASD) Center in San Jose. He also specializes in ADHD.
“These conditions are usually found when kids start school,” Dr. Crawford said. “With ADHD, the challenges might include difficulty paying attention, making eye contact, staying organized, or following instructions. With ASD, there tend to be social challenges, like narrow fixations and difficulty communicating, socializing, making friends, or responding to social cues.”
For girls, those challenges can be harder to notice. Girls, on average, tend to develop socially faster than boys. Because they’re more socially aware, they can have more developmental resources to help them mask signs of ASD or ADHD. Or those signs may appear more mild than the same signs seen in boys.
“Boys tend to be more active and impulsive around the age they start school. The fixations and social awkwardness can be more obvious,” Dr. Crawford continued. “Girls tend to be less disruptive, even with ADHD or ASD. They’re also more able to tune in socially and mimic neurotypical behaviors to fit in.”
Even if the signs of ADHD or ASD are subtle, they can still bring challenges in adolescence and adulthood.
Living with undiagnosed ADHD or autism as an adult
Many of the symptoms of ADHD and ASD are very common — even for people without those conditions.
- People with ASD may struggle with communicating, making friends, or feeling overwhelmed. It’s also common for women and men with ASD to have narrow interests and repetitive behaviors.
- People with ADHD might struggle with paying attention, acting impulsively, or staying organized.
People without ADHD or ASD may have some of the same struggles. For people with undiagnosed ADHD or ASD, those symptoms can be more severe or persistent throughout their lives. They can also lead to new challenges as adults.
“Picture someone with very mild ASD starting high school, college, or a new job,” Dr. Crawford said. “They realize that their old routines were helping them function. Now they have to come up with new routines, and they’re finding it challenging.”
Those new challenges can feel overwhelming. They can also bring back feelings of otherness that likely started in childhood.
“Often people will say that they’ve felt different throughout their lives. They’ve felt disconnected and not known why,” Dr. Crawford said. “This can be normal. Being a little different isn’t a bad thing. But not knowing why can lead to bad feelings.”
Living with that sense of mystery, on top of the challenges of ADHD and ASD, can lead to other mental health struggles. This is common in both men and women. Some studies have found it common for women with ASD to have anxiety, depression, or sleep or eating disorders.2
“If you’ve struggled with even mild ADHD or ASD, over the course of your life, it takes a toll,” Dr. Crawford said. “Not just because of the condition itself, but also due to stress, depression, or anxiety that may go along with it.
Of course, feeling different or disconnected doesn’t mean you have a neurodevelopmental condition. People with anxiety or trauma can have the same perceptions.
What to do if you think you have ADHD or autism
Having some of the signs of ADHD or ASD doesn’t mean you have a condition. But if you struggle with attention, socializing, or staying organized, it doesn’t hurt to learn more about these conditions.
“There are a lot of great books by professional psychologists that can help you recognize symptoms of ADHD or ASD,” Dr. Crawford said. “These conditions can appear very different from person to person. But if you’ve had symptoms since childhood, it might be worth evaluating.”
Kaiser Permanente has resources and information about evaluation for ADHD or ASD. But be careful not to self-diagnose. Self-assessment tools can help you decide if you want to talk to your doctor about your symptoms.
If you would like an assessment for ADHD or ASD, you can start with your Kaiser Permanente doctor or care team. They will likely refer you to a local department of psychology to see a specialist.
What options are available to people with neurodiversity?
Whether you have an ADHD or ASD diagnosis or not, there are many social resources available in-person and online. Do you struggle with paying attention, social interaction, or general mental health? If so, therapy, classes, groups, or medication might help.
“Behavioral therapy and social skills classes can be good for people at any age. There are many kinds of groups and classes available,” Dr. Crawford said.
It’s important to remember that ADHD and ASD aren’t diseases or mental illnesses. They’re classified as disorders. The difference between having a “disorder” and just being ”neurodiverse” can be subtle, and in the end they’re only labels. Neurodiversity is just a different way of seeing and interacting with the world.
If you have a form of neurodiversity that is causing day-to-day problems, a formal diagnosis might answer some questions. It can also be validating. But it might not mean you need treatment.
“Getting a diagnosis can be a step in the right direction. It can take some of the mystery away,” Dr. Crawford said. “Before, you felt out of step and didn’t know why. Now you know the issue and can start to work around it. Remember that these are just labels — not your identity. A diagnosis isn’t who you are.”
You can learn more about mental health and resources for healthy living on Kaiser Permanente’s women’s health page.