ADHD in Women: why it needs a 'rebrand'
- Philippa Balazs
- Sep 1
- 3 min read
Updated: Oct 7
ADHD Is Due a Rethink
It’s been over 30 years since ADHD was reviewed in the DSM (Diagnostic and Statistical Manual of Mental Disorders). Despite huge progress in society’s understanding of neurodivergence, we’re still using an ADHD framework built in the 1980s. This framework is based almost entirely on research with school-age boys in the United States. No wonder so many women have been missed and feel unseen by the current medical model of assessment and diagnosis.
A Short History of ADHD
1950s–60s: Terms like “Minimal Brain Dysfunction” and “Hyperkinetic Reaction of Childhood” were used.
1980 (DSM-III): Attention Deficit Disorder (ADD) introduced as a diagnosis.
1987 (DSM-IIIR): Became Attention-Deficit Hyperactivity Disorder (ADHD) to reflect hyperactivity and impulsivity.
1994 (DSM-IV): Split into subtypes: inattentive, hyperactive-impulsive, and combined.
And that’s the last time it was meaningfully reviewed.
ADHD in Women: Why the Framework Doesn’t Fit
Thirty years on, we know far more than we ever have, but the diagnostic name still hasn’t caught up. The words “attention” and “hyperactivity” have locked ADHD into narrow stereotypes such as the hyperactive or disruptive primary-school boy.
But that image leaves out millions of others, including the quiet, inattentive boy who did well in school. For many adults, particularly women, ADHD shows up in very different ways. Not as visible disruption but as invisible exhaustion. It’s characterised by a private struggle to:
regulate intense emotions
manage impulses
tolerate distress
process information
stay afloat in an overwhelming world
The Missing Piece: Emotional Dysregulation
Emotional dysregulation isn’t listed in any of the official ADHD criteria, yet it’s one of the main reasons women contact me for therapy. It’s also one of the main reasons for misdiagnosis.
Many were once told they had Bipolar Disorder or BPD/EUPD long before ADHD was ever considered. To a practitioner not adequately trained in ADHD, those intense feelings, quick frustration, and rejection sensitivity, which are core parts of the ADHD experience, mimic other DSM disorders. However, an incorrect diagnosis can be devastating and life-altering.
Rejection Sensitivity Dysphoria (RSD)
RSD, also absent from the DSM, describes the deep emotional pain triggered by perceived criticism or rejection. It can bring overwhelming shame, anger, or withdrawal, and can be utterly debilitating. For some, RSD causes far greater disruption to daily life than “attention deficits” ever did. This is another area frequently brought to therapy, as clients explore relational difficulties, both past and present.
Why It Hits Women Hard
Emotional dysregulation and RSD often show up more intensely in women. Fluctuating hormones play a part, but so does social conditioning such as being taught to mask distress, appear composed, and prioritise others’ comfort. Women are often “not allowed” to be angry or dysregulated.
That double standard leaves many women internalising their struggles and labelling themselves as “too emotional” or “broken” rather than recognising ADHD’s role. This leads to a lifetime of internalised shame that needs to be carefully explored in therapy.
Why ADHD Needs a Rebrand
It’s probably obvious by now, but revisiting the name ADHD means focusing on accuracy, inclusivity, and social justice.
Updating the diagnostic framework should:
fully reflect the female and adult experience
challenge the outdated “hyperactive boy” stereotype
open doors to better understanding and appropriate support
The current label focuses on what we lack, rather than the unique way our brains feel, process, and connect.
Therapy
As a neuro-affirming therapist with a diagnosis of ADHD, I critically reflect on and consider the wider implications of an ADHD diagnosis. Together, we explore your unique history, your conceptualisation of ADHD in society, and the impact of internalised ableism. We work towards the goal of self-acceptance, understanding, and compassion.
