Trying to determine why ADHD can be misdiagnosed in girls is a question that’s getting more attention in recent years. For decades, ADHD was thought of as a “boys’ disorder,” often associated with hyperactivity and disruptive behavior. But many girls go unnoticed or misdiagnosed because their symptoms present differently. The result? Countless girls grow up without the support they need—sometimes not getting diagnosed until adulthood. Many adults we see for ADHD therapy in Woodland Hills are recently diagnosed.

Why Is ADHD Missed in Girls?

ADHD can be difficult to diagnose regardless of sex, with stigma playing a large part in how ADHD is perceived, but it can be especially misunderstood and overlooked in girls. What makes ADHD harder to recognize in girls? Unlike boys, who may show more external hyperactive behaviors, girls often display internalized symptoms that get mislabeled as anxiety, daydreaming, or “just being shy”. Teachers, parents, and even healthcare providers may overlook the signs.

Common Reasons Girls Are Misdiagnosed or Overlooked:

• Subtle presentation: Symptoms may look like daydreaming or quiet inattentiveness.
• Masking: Many girls overcompensate by working harder or hiding struggles.
• Gender stereotypes: Hyperactivity in boys is flagged, but forgetfulness in girls may be dismissed.
• Mislabeling: Girls are often diagnosed with anxiety or depression instead of ADHD.
• Focus on academics: If grades are good, difficulties with focus or organization may be missed or ignored.

2 Tools to Spot the Signs More Clearly

1 – Look Beyond Academics

We hear often in our Woodland Hills ADHD therapy sessions that diagnosis was missed or delayed due to the apparent high functioning of the person in question. Because the stereotype of ADHD is that there is zero ability to focus, it follows that bad grades are a natural outcome. How could a person who has ADHD excel in school if they can’t sit still to do their homework? In actuality, many people who have ADHD are intelligent enough to make it through, though they suffer in the undertaking.

• A girl can have strong grades and still struggle with ADHD. She may be prone to putting off projects until the last minute; with the adrenaline of pressure, she may still pull off a strong mark, because she is intelligent and she does know what she wants to convey. From the outside, it may appear that she is just someone who is “lucky enough” to wait to start working until the last minute and still do well. In reality, ADHD often leads to procrastination. Despite wanting to get started, the brain doesn’t have what it needs to actually make that happen. This doesn’t eliminate the stress of the assignment. It will still be hanging over her head while she delays, and so she is probably also giving herself a hard time about why she can’t “just do it already”. She may also have trouble keeping track of assignments and their due dates, leading to a need to do it all at the last minute because she forgot entirely that it was due tomorrow.
• Actually sitting down to take on an assignment may end up taking all night. Pay attention to effort vs. outcome—is she spending hours on homework that should take 30 minutes? If you’re in and out of her room, or the area she’s doing homework in, how often do you enter to find her doing something else with her homework in front of her? Does she write a few sentences, then pick up a tablet because she just remembered something she meant to look at? Does she appear lost in thought, staring into the middle distance instead of working? While everyone works at their own pace, a person with ADHD will “clock out” from the task at hand in specific ways that can be observed when watching.
• The final grade isn’t the only indication of how she is faring academically. Notice struggles with organization, procrastination, or emotional regulation, even if schoolwork looks fine on the surface. Does she often seem to forget until the last minute that there is an assignment done? Are you aware of her issues with procrastination, but even with reminders, she still seems to avoid getting down to work until the last possible minute? When she is overwhelmed with work, or confused by a concept, do her emotions seem to run higher than you think is proportionate? You may notice that there is one subject or topic that she seems to hyperfocus on, locking in and working until it is done. This kind of hyperfocus can also be a sign of ADHD; losing track of time when working on something that stimulates dopamine. This often looks like not stopping for food or water, or to use the bathroom, and generally working without taking any sort of break.

2 – Watch for Emotional and Social Patterns

As an ADHD counselor in Woodland Hills, I know that the signs of ADHD go well beyond what happens in the classroom and on the report card. There are many social and emotional cues that can indicate a girl is struggling with ADHD. Unfortunately, many of these are especially stereotyped in girls, such as being emotionally sensitive, or seemingly irrational. These negative stigmas around girls and women pervade on many levels, and mental and physical health often suffers as a result.

• ADHD impacts more than just practical work and tasks. Girls with ADHD may be more likely to show emotional sensitivity, low self-esteem, or frequent overwhelm. Making decisions, even those that may seem simple to an outsider, can seem impossible for those who have ADHD due to analysis paralysis. If a disappointment or obstacle seems to impact her as if it were a catastrophic situation, she may not have the same emotional regulation capabilities as the people around her and seem to take it harder than one might expect. This can lead to harmful and hurtful commentary, such as being “spoiled” or “selfish” or “dramatic”. In actuality, what is happening in her body when she is trying to process a struggle is a complete overwhelm of her nervous system.
• Look for signs of social challenges. Difficulty maintaining friendships, impulsivity in conversations, or withdrawing from peers due to fear of rejection can all be signs of ADHD in girls. This can be tricker to monitor from the outside, as most of your child’s social interactions won’t take place in front of you. But you can listen to clues and cues about how friendships are going, you can take note of the socialization you do see, and you can pay attention to how much time your child is spending alone. If you have been looking solely to schoolwork for information, you may discover that emotional and social patterns provide the extra needed context in order to pursue a diagnosis.
• Compassion can help with both care for and recognition of ADHD. Recognizing emotional struggles as part of ADHD—not just “being moody”—can make a huge difference. Remember, these emotional and social struggles are being experienced by someone who doesn’t know any other way. Girls with ADHD who feel intense emotional responses to setbacks, misfortune, and criticism, can’t imagine an existence wherein they don’t respond that way. This is normal for them, whether they enjoy it or not. Have compassion for the emotional and physical experience of these emotions. Consider how the impact of ADHD can create social tension; forgetting plans can breed resentment, impulsive interrupting and lead to frustration. While those who have ADHD will need to learn over time how to combat these symptoms, it is not an overnight process. In the meanwhile, there may be patterns of distance from friend groups, feeling ostracised, and a desire to isolate out of fear of rejection. You may begin to pursue a diagnosis in this time. A diagnosis is a starting off point. Being able to say that you know the cause of it is one thing, but managing it is another. It will be a bit of a tightrope between accepting that these are manifestations of ADHD and also committing to working on how these behaviors show up. It will take kindness, care, and understanding.

Key Takeaways

• ADHD in girls often looks different than in boys—leading to underdiagnosis or misdiagnosis.
• Good grades or quiet behavior don’t rule out ADHD; symptoms can show up in effort, organization, and emotions.
• Paying attention to emotional patterns and struggles outside the classroom can help spot ADHD earlier.
• Attending in-person or online ADHD therapy can help learn to manage ADHD symptoms, such as regulating emotions and building effective habits and routines to counteract the challenges that ADHD can present.

How Therapy Can Help

Therapy can provide girls and women with tools to manage focus, organization, and emotional regulation. It can also help rebuild self-esteem, which is often damaged after years of feeling “not good enough.” Working with an ADHD-informed therapist ensures symptoms are recognized, validated, and addressed with compassion. Early support can change the trajectory of a girl’s life.

ADHD Treatment at Embracing You Therapy

ADHD symptoms can significantly impact daily life, making it hard to stay organized, focused, and connected in both work and personal relationships. When left unaddressed, these challenges can feel overwhelming. At our Woodland Hills office, we offer ADHD treatment tailored to the unique way your brain works. Together, we’ll identify your specific struggles and develop practical, easy-to-implement strategies to help you thrive in everyday life.

Contact us today for your complimentary 20-minute phone consultation with our Admin Team today!