Attention Deficit Hyperactivity Disorder (ADHD) has long been stereotyped as the condition of noisy, restless schoolboys, but for many women, the reality is often overlooked.

This Women’s Month, the South African Society of Psychiatrists (Sasop) is highlighting how ADHD in women and girls remains underdiagnosed, misunderstood and frequently mismanaged.

“ADHD in women is not less severe, it’s just less visible,” says Dr Wisani Makhomisane, Sasop member and specialist psychiatrist.

“Too many women are mislabelled as lazy, disorganised or overemotional, when in fact they are living with a neurodevelopmental condition masked by gender stereotypes.”

Girls are often misdiagnosed with anxiety or immaturity when in fact they may be showing early ADHD symptoms, including:

• Easily distracted, forgetful and frequently misplacing items
• Difficulty completing tasks, organising or managing time
• Emotional sensitivity and frequent mood shifts
• Verbally impulsive and hyper-talkative

In adulthood, ADHD presents differently again, with many women struggling with:

• Feeling chronically overwhelmed, forgetfulness and procrastination
• Low self-esteem and masking behaviours
• Emotional dysregulation, especially rejection-sensitive dysphoria
• Co-occurring anxiety and depression

Dr Makhomisane says that women often wait years longer than men for diagnosis, leading to mismanaged care and co-morbid conditions. Masking through perfectionism or people-pleasing may appear successful but is mentally exhausting, leading to burnout and self-doubt.

He urges greater awareness among families and healthcare professionals. Treatment options include medication, psychotherapy and lifestyle strategies such as exercise, nutrition and mindfulness.

“If we can shift the lens, we can transform lives,” he says.

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