The Wave of Women Getting Diagnosed With ADHD as Adults

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It was a relief to finally give it a name. For as long as they could remember, their brains had felt like “a pinball machine”; “a Wall Street trading floor in the 1980s”; “a constant CNN news ticker”; a department store at the end of the day, “when everything’s a little disheveled”; “15 computer tabs all open at the same time”; “a complicated intersection” without a traffic light. They had been good girls, smart girls, who coped with the nonstop motor of their minds by twirling their hair and picking their cuticles. By the time they grew up, they were perfectionists, neurotics, type A.

They had managed to get through college, graduate school, nursing school, law school. People praised their fastidiousness and how much they took on. They were constantly late, so they set timers. They scribbled notes and kept calendars; if they didn’t write it down, it was gone. They developed systems to elicit focus — spreadsheets, schedules, repetition — and once on task, they could do nothing else for hours or days. People praised how dogged they could be, their ability to go full throttle. Then suddenly, in their 30s, 40s, or 50s, the systems failed. They searched for the fault point and found an answer on TikTok, in a friend’s newsletter, through a co-worker. It came up during couples therapy or after their child was diagnosed or on the day they first sat across from a psychiatrist because they thought they were losing their mind. They asked themselves variations of the same question: If it had been there all along, why hadn’t anyone noticed?

Attention deficit hyperactivity disorder, a neurodevelopmental condition, has long been considered an affliction of fidgety boys, but a recent surge in diagnoses among women — many of them well into adulthood — is rebranding what’s commonly thought of as a childhood condition. Between 2020 and 2022, the number of women in the U.S. ages 23 to 49 newly diagnosed with ADHD nearly doubled, according to one analysis. While fewer children are on prescription stimulants now than a decade ago, a Justice Department report showed that it’s the urgent demand among women that may be pushing the country’s supply past its limits. Among the newly diagnosed is one unexpected cohort: high-achieving women, for whom ADHD seems, at least at the outset, antithetical to the image they have of themselves and how others have always perceived them.

Alex, a 41-year-old lawyer in New York, was always somebody who excelled: She was an editor at the law review, then clerked for a State Supreme Court judge and was hired at a top firm. But she also sensed she was expending more energy to get to the same place as the people around her. In school, it took her twice as long as her classmates to read something and understand it. “I would read it, and it would just evaporate from my head or I’d start to daydream or dillydally and have to bring myself back,” she says. She found a way to succeed by imposing a rigid structure on her life: In law school, she spent hours rewriting her notes from class to commit the material to memory. Starting in college, and for the next 20 years, she relied on a system of detailed to-do lists for every day of the week because she feared she would forget something. The lists, divided into columns, included meetings and appointments but also tasks like “drink coffee” and “shower.” This delicate balance between two extremes — outwardly achieving while internally maxing herself out — was hard-fought but almost felt normal.

It was motherhood that threw off Alex’s equilibrium. She was 36, a first-time parent, working from home during the pandemic with a husband who also had a demanding job, and the tools she used to navigate her life and career started to fail. Babies don’t care if you planned to drink a coffee at 8 a.m. or sleep through the night because you have an important call in the morning. Her life, she said, felt like a bucket full of water her son had tipped over. She was anxious and depleted but couldn’t rest even when he went down. In conversations at work, Alex was unable to pay attention; a thought would pop into her mind, and she would try desperately to hold on to it or else interrupt because she was worried it would vanish. “Every day felt so hard, and I felt so overwhelmed and I kept forgetting things and having to do sticky notes on top of lists on top of other lists,” says Alex. “I talked to my doctor, who was like, ‘Oh, it’s lack of sleep. It’s hard being a new mom. Give it some time.’”

She did but without improvement. Even when day care reopened and she and her husband weren’t trapped in the house together trying to parent and work, she couldn’t keep up with her to-do lists and found herself hastily rewriting them while trying to complete all the tasks more quickly. Transitions — between, say, writing an email and changing a diaper or working on a case and pausing for day-care pickup — were especially hard. “Any little thing that disrupted my schedule would just throw me into such a tailspin that I’d lose it,” she says. “I would start snapping at my husband. I would get very, very annoyed with my son, who was a baby and not trying to piss me off. I was starting to make mistakes at work, rushing through everything to get it off my list, to get back some semblance of being able to accomplish just normal tasks and work tasks and also this monumental task of caring for someone who cannot care for himself.” Her memory was suddenly off, too. One day, when she tried to open a bank account for her son, she was rejected because she kept giving the wrong first name.

In 2022, Alex was diagnosed with ADHD. At first, she tried to manage her symptoms with exercise and more lists and timers. Then she joined a private Facebook group for lawyer moms with ADHD, which had 2,400 members. In 2024, she decided to try a stimulant after asking the group, “What does it feel like? How do you know it’s working?” About an hour after her first dose, she says, “I was just like, Oh my God. It felt like a weighted blanket over my thoughts.” Her brain was quiet for the first time ever.

My own diagnosis came last year, when I was 41. I soon learned that three women I’ve known for more than a decade — a law-firm partner, a founder of an international company, and a fellow journalist at a national magazine — were also recently diagnosed, and they knew women in their social and professional circles who had been, too. Famous figures have come forward with similar stories. In a 2023 episode of her podcast, the CEO and best-selling author Mel Robbins, diagnosed at 47, shared that part of her success is owed to her ability to hyperfocus — “I literally have those blinders on that horses wear, those big Clydesdales” — but that when the work is done, she experiences “a complete collapse.” Emmy winner Ashley Nicole Black, a writer, actress, and producer, was diagnosed at 38 and partially credits ADHD with her success: “It makes sense why I’m good at it, you know … What it is is a job where there’s novelty and urgency, literally all day.” The following year, Paris Hilton released a song about the disorder, which she was diagnosed with in her 30s. In the lead-up to the Barbie premiere, the director Greta Gerwig shared that she had been diagnosed as an adult.

The surge of diagnoses in women is the product of forces both scientific and cultural. Researchers have improved medicine’s understanding of how the disorder can present differently in women and the role sex hormones play in their overall health. Add to that a new societal preoccupation with perimenopause, the yearslong transition to a woman’s final period. This awareness has reached millennial and Gen-X women just as they approach the hormonal downshift and also as they find themselves in a phase of peak burnout, many of them nearing the height of their careers while simultaneously taking care of children or aging parents or both. So though the diagnosis can provide answers, it leaves open questions about what’s really going on. “You’re like, Yeah, maybe that’s aging. Maybe that’s the type of job I’m in. Maybe that’s me having children a little bit older in life,” says Kristin Belkofer, 43, a psychotherapist in Wisconsin who was diagnosed with ADHD after the birth of her second child. “Everyone has anxiety. Everyone’s stressed. Everyone’s overwhelmed,” says Michelle Ruiz, 44, the journalist friend I mentioned, who was diagnosed a year and a half ago. “It’s kind of like, How much of it is our hormones? How much of it is ADHD? How much of it is just baseline womanhood?” The answers are still emerging, but they’re already changing how we think about ADHD and, potentially, how we treat it.

It’s a complicated time to talk about ADHD in women. While mental health and neurodiversity have become less stigmatized, there is also heightened scrutiny of overdiagnosis and overmedication, especially in children. Today, one in nine children in the U.S. between the ages of 3 and 17, the majority of them boys, have an ADHD diagnosis. By 2022, a million more children had been diagnosed compared with 2016, and roughly half of them are consequently on medication. Concern about boys being overdiagnosed with ADHD isn’t without merit; a national CDC study published in 2024 found that around a quarter of 17-year-old boys in the U.S. had a diagnosis, a staggering number attributed to everything from greater awareness of the condition to intensified academic pressures. The expansion of telehealth has also made it easier than ever to get a diagnosis and a script. Meanwhile, creators have flooded TikTok with ADHD content, roughly half of which was found to be misleading or contorts mundane behaviors — from keeping multiple drinks on your desk to having FOMO — into signs of the disorder.

These worries may overshadow a competing story, one that suggests historical underdiagnoses, at least in certain populations. The condition now known as ADHD was first entered into the Diagnostic and Statistical Manual of Mental Disorders in 1968 and updated in the ’80s and ’90s. To qualify under the DSM-IV, released in 1994, patients had to show at least six symptoms of inattentiveness (making careless mistakes, difficulty staying on task, not listening even when spoken to directly) or six symptoms of hyperactivity and impulsivity (squirming, talking excessively, blurting out answers), some of which had to be present before the age of 7 and significantly hinder daily life. Still, many doctors continued to look primarily for the second group of traits, which were more outwardly obvious. Ellen B. Littman, a clinical psychologist who treats high-IQ women with ADHD, remembers practicing in the ’90s and seeing plenty of girls who displayed signs of inattentiveness with less noticeable hyperactivity and impulsivity. They felt restless but, through a mix of intelligence and social conditioning, figured out how to manage their energy quietly, like by pulling split ends from their hair or doodling excessively. Because most of them weren’t disruptive in class, teachers didn’t raise any flags. “People used to call them ‘space cadets,’” Littman says. “At that time in the world, it was just, ‘She’s daydreaming. We have to call her five times to get her to pay attention.’” In many girls — even the inattentive ones — symptoms started after age 7, making them ineligible for a diagnosis.

Not until 2013, with the publication of the DSM 5, did changes to the diagnostic criteria for ADHD open the door wide enough for more girls and women to walk through. Authors noted three distinct “presentations” of ADHD — predominantly hyperactive-impulsive, predominantly inattentive, and a combination of the two. The criteria lowered the threshold for impairment for adults and created modifiers to show severity (for the first time, someone could have “mild,” “moderate,” or “severe” ADHD). Perhaps most crucially, the DSM 5 also raised the age of symptom onset from before 7 to before 12, when many girls’ symptoms become evident for the first time.

These updates to the DSM, as well as a more concrete framework for how ADHD presents differently in girls, are still making their way into public consciousness. Boys aren’t necessarily more prone to ADHD, yet they’re twice as likely to be diagnosed during childhood. This gender gap, a chasm in early life, has nearly vanished among adults. Caroline, 42, considered getting evaluated after a doctor determined her then-6-year-old daughter had ADHD. Her daughter was bright, a “reading savant” and teacher’s pet. But in first grade, when children returned to the classroom after the pandemic, her teacher said she couldn’t sit still in her chair, not even after being moved to the front row.

Since the ’90s, experts have known ADHD has a strong familial link. Once her daughter was diagnosed, Caroline suspected she might have the disorder, but she didn’t want to face it. It didn’t align with her image of herself as a “rock star” lawyer who could work for 14 hours straight. But her daughter “destigmatized it for me,” she says. (Lenard Adler, a professor of psychiatry and director of New York University’s adult-ADHD program, notes that a child’s diagnosis is one of the most common circumstances that brings adults in for evaluation.) At home on her computer, Caroline started researching ADHD and learned about the widely held theory that the disorder is linked to lower levels of dopamine, a neurotransmitter that signals pleasure and affects mood, memory, attention, and motivation. She began to recognize what she calls “dopamine-seeking personality quirks” in herself, the most worrisome of which was that, over the past several years, she had been drinking too much and binge eating. Caroline was also starting to fall behind at work; she couldn’t force her brain to lock in and cram the way she used to. She quit drinking, took up tennis and swimming, started meditating, and made an effort to get more sleep. She physically felt better, “but I was just forgetting things, forgetting words, forgetting obligations,” she says. “Things seemed more challenging cognitively than I ever remember them being.”

After she decided to get evaluated, the doctor handed her a survey for her own mother to fill out, similar to what Caroline had done for her daughter. An ADHD diagnosis requires that symptoms appear in childhood, so adults are asked about their early years; in a thorough evaluation, doctors gather “informant reports,” often from partners and parents, to paint a fuller picture of their history. But Caroline’s mom still saw her as a golden child, the stellar student who had gone on to build an accomplished career. “She was like, ‘Yeah, you don’t have ADHD. I’m not even going to answer these questions,’” says Caroline. “She basically sabotaged the whole process.” Caroline was evaluated a second time by a new provider who didn’t require such reports, and she was ultimately diagnosed with ADHD and prescribed Adderall.

Some hyperactive children appear to grow out of ADHD as their brains mature, the physical symptoms giving way to internal ones. For many women, the opposite is true: Their ADHD symptoms can suddenly become less manageable, and therefore more externally obvious, in adulthood. Sandra Kooij, a psychiatrist and professor at Amsterdam University Medical Center and the chair of the European Network Adult ADHD, and other doctors who treat women with the disorder say hormonal fluctuations may hold an answer as to why women who have long excelled spin out in midlife. Years ago, Kooij noticed that women came into her office after having a baby or when their estrogen levels dropped in their late 30s and 40s. “If they are intelligent, and they have coping skills, and they have enough support, and they have a job in which they can flourish, more or less, and they don’t have too many co-morbidities, those women — doctors, lawyers, highly educated women — can cope until perimenopause,” she says. “Then they collapse.”

Research on the link between hormones and ADHD remains limited, but there’s enough data to show that when estrogen levels dip, dopamine levels do too. Estrogen is a reproductive hormone, but it attaches to receptors in the brain also influencing mood and cognition. The two chemicals reinforce each other and impact each other’s production, says Kooij. This is why, when the revised DSM moved the age of symptom onset from before 7 to before 12, more girls could be diagnosed with ADHD: 12 is the average age when menstruation starts and the body boards a hormonal roller coaster, which can exacerbate symptoms to the point of making them recognizable. The same is true for adult women during other periods of hormonal transition. When estrogen levels decrease, especially for longer stretches like postpartum or during perimenopause, so does dopamine, resulting in a sustained state of disarray. Kooij says, “That’s when women tell us, ‘We can’t function. We’ve lost ourselves. I don’t recognize myself; this is not how I am.’”

When she turned 50, Rebecca, a lawyer in Southern California, started to feel as if she were having “an out-of-body experience.” She had so much to do but found herself in a state of paralysis, sitting on the sofa, staring at the wall, sometimes for hours, unable to get going. “I was losing time, and it was very stressful because it was like the hours would go by and I’d gotten nothing done and Oh my God, it’s four o’clock, and now I have an hour to do everything I was supposed to do all day,” she says. The strategies that kept her on task throughout her career — breaking work into segments with a Pomodoro timer, making bullet-point to-do lists, sending herself reminders on her iPhone — were suddenly useless. “I really felt like I was losing my mind,” says Rebecca. “I mean, I’m a lawyer. I can’t afford to just sit there and spend hours staring at the wall.” (Almost 13 percent of lawyers in the U.S. have ADHD, according to a study by the Journal of Addiction Medicine, a significantly higher number than among the general adult population. One theory is that the ever-changing, high-stakes environment is appealing to busy minds and the work lends itself to hyperfocus.)

Rebecca was diagnosed with ADHD but was already on an SSRI for anxiety and didn’t want to take another psychiatric drug if it could be avoided. She was also in the throes of perimenopause, and some of the symptoms blurred together — the forgetfulness, the brain fog, the inability to focus. Two-thirds of women experience cognitive impairment in the years leading up to their final period as estrogen levels decrease; in some women, it’s so severe they worry they are experiencing early-onset dementia. But the ADHD diagnosis made sense to Rebecca; she could recall noises being so distracting to her as a child that even the TV was like “nails on a chalkboard,” and she too had gotten through law school by writing her notes “over and over and over and over and over” out of fear that she’d forget something if called on in class.

Her estrogen levels were declining, and her joints had started to hurt, so her psychiatrist suggested she try to stabilize her hormones to see if that might alleviate her cognitive symptoms. Rebecca’s primary-care doctor started her on menopausal hormone therapy, sometimes referred to as hormone replacement therapy, in which estrogen is introduced into the body through gels, pellets, pills, or patches, though at a lower dose than in birth-control pills. The treatment has brought her “back to baseline,” she says, and her attentional coping strategies started working again.

Parsing what’s ADHD and what’s postpartum or perimenopausal brain fog largely comes down to a retrospective analysis, doctors say. Still, there is a subjective element to the diagnosis, dependent on a physician’s interpretation, and Lotta Borg Skoglund, a psychiatrist, an ADHD researcher, and an associate professor at Uppsala University in Sweden, says too many doctors view women’s hormones as an auxiliary issue rather than a central part of their health. “What worries me, and I think other researchers, is the general nonexistent interest in female hormones and the increased risk of developing psychiatric problems around these hormone-sensitive periods,” she says.

This creates room for both under- and overdiagnoses in women, says Skoglund, who has ADHD herself and co-wrote Female Hormones and ADHD: The Impact on Brain and Body, which will be published this spring. A doctor who doesn’t understand how hormones impact women with ADHD might chalk the symptoms up to PMS or perimenopause. They similarly might not know to look for undiagnosed ADHD in patients diagnosed with postpartum depression; a large-scale study found that women with ADHD are five times more likely to be diagnosed with depression or anxiety disorders in the months after having a baby. At the same time, Skoglund says, “I think, unfortunately, that there might be a lot of women today being diagnosed with ADHD because that is the diagnosis that is talked about the most and we have been very successful at decreasing stigma around ADHD.” If a middle-aged woman without a clear childhood history of ADHD symptoms suddenly appeared in her office with, say, an inability to focus and trouble controlling her emotions, Skoglund says she would first have her consult a gynecologist for hormone therapy to see if there was any improvement. If there was, the culprit would be unlikely to be ADHD.

Stimulants and behavioral interventions are still the default treatments for ADHD. But hormone therapy, though not FDA approved for ADHD specifically, is emerging as an additional prong for treating women with the disorder. It’s not one-size-fits-all, though. To keep hormones level, some doctors will prescribe oral contraceptives to women with ADHD who are still menstruating and instruct them to skip the placebo pills; doctors are also experimenting with having women take the placebos and increase the dosage of a stimulant to offset the mood changes that come with their periods, says Kooij. For women under 60 or within ten years of menopause who don’t have a personal history of breast cancer, heart disease, or blood clots, there is menopausal hormone therapy.

The strictest hormone-therapy guidelines don’t allow for its use in treating cognitive symptoms alone. Susan Loeb-Zeitlin, director of the Women’s Midlife Center at Weill Cornell Medicine, says that for now, physical signs of menopause, like hot flashes and night sweats, are necessary. “There’s not enough evidence to say that hormone therapy is beneficial for ADHD–slash–brain fog at this point.” Kathleen Jordan, an internal-medicine doctor and chief medical officer at Midi, a telehealth company that specializes in treatments for women in midlife and offers hormone therapy, says patients with ADHD have reported, anecdotally, that estrogen helps with their symptoms. “I do think the overlap in symptoms is significant,” Jordan says. “I don’t think menopausal hormone therapy is an isolated treatment for ADHD. I do think that we know it helps with mood, we know it helps with sleep, and we know those two can exacerbate ADHD.” She has started patients with ADHD on hormone therapy and then tried lowering the dosage of an antidepressant or stimulant; while she doesn’t promise those patients that their ADHD symptoms will improve, she says “it’s reasonable and it’s plausible that it may help.”

Aubrey Lane, 52, a business analyst in Florida, started hormone therapy for menopause in 2024. Even with the pellets implanted under her skin, certain idiosyncrasies got worse. She went to see a psychiatrist after an HR manager told her that colleagues had noticed a change in her behavior: She was speaking too fast and taking too long to make her point; people had to work to follow what she was saying. Lane was diagnosed with ADHD and prescribed a stimulant. But in her view, “the estrogen is the anchor” for managing her ADHD symptoms. “It’s keeping my anxiety at bay, the depression at bay. I think it’s helping stabilize whatever’s going on in my brain,” she says.

Her psychiatrist connected the dots between her ADHD and her hormones. She asked Lane about her menstrual cycles, whether she could ever remember, throughout her life, feeling calmer and then “out of her head” every month. “I was this wild person when I was PMS-ing and then I would go through this lull where I was calm and could think straight. Then it was back to amping up as my hormones changed,” she says. As a child and teen, Lane had frequent outbursts and was constantly shaking her leg to release the energy pulsing through her. Now, when the pellets start to wear off, she notices that she gets more aggressive, more agitated. The buzzing feeling is harder to manage, and she struggles to move between tasks.

Lane’s two daughters were diagnosed shortly after her. It’s a gift, she says, that she can help them understand how their minds work, and she translates their behaviors for their father. Her new knowledge about ADHD is changing the way they parent. She tells her daughters to give themselves grace but also pushes them to find their own solutions: “I want to give them tools on how to navigate life. Like, ‘This is what you have; these are the symptoms of it. Now, how are you going to deal with that?’ Because you can’t just blame it on ADHD. We’re not doing this blame game. We’re taking personal responsibility.”

This new cohort of diagnoses has clarified how much ADHD is a family disorder; how, rather than being confined to one person, it can reverberate through an entire household. Robert Riordan, a psychologist and couples therapist in New York and Connecticut, says ADHD often shows up when the partner without it feels they’re doing more than their fair share. In straight couples, the overburdened partner is typically female — but in the past five years, Riordan has seen more couples in which the gender dynamic is flipped. Riordan finds that some men struggle to recognize the things their wives can control versus what they can’t. “It’s this idea of, ‘This person, in my view, is supposed to have certain responsibilities and supposed to be good at certain things, and the fact that they’re not performing on them must be some sort of an act of defiance,’” he says. When one woman I interviewed told her husband she’d been talking to me about her ADHD, he threw his head back and half-joked, “You mean your excuse?”

It was a couples therapist who first suggested that Meg, a 42-year-old lawyer and mother of four, get evaluated. Her husband had attended West Point; he craved order and was by nature a disciplined person. Meg, for her part, had always operated in extremes, either hyperfocused or all over the place — the pendulum rarely came to center. Early in their marriage, she had juggled the start of her law career with her first years as a mother, white-knuckling her way through a one-hour commute, day-care drop-off and pickup, and managing dinner and bedtime most evenings because her husband worked late and often traveled for his job. But then there was a second child and, later, twins — who arrived the same year her father had a major medical event. Meg was put in charge of his care and finances.

Around then, she became scattered in a way that was new to both her and her husband. He was pulling his weight and would remind her when she wasn’t keeping up with her share of their family’s growing to-do list. When upset, he would name all the things she’d said she would handle but forgotten about. He grew exasperated with her now-untenable habit of thinking she could drive to the grocery store, shop and pay for food for a family of six, and be home in 15 minutes. He was also confused by her compulsive urge to take on more, as when she added a part-time gig that occupied her evenings. Meanwhile, Meg says, “I think I can do a million things. I think I’m Superwoman.”

Initially, her ADHD diagnosis didn’t feel real to her or to her husband, who saw her behaviors as something she could fix with more discipline. “I was like, I’ll take this medication, whatever, but how could it be that I’ve been successful this long and have ADHD? ” she says. She stopped feeling like “an ADHD impostor” after listening to the podcast ADHD for Smart Ass Women, hosted by Tracy Otsuka. The episode titles alone read like a checklist of her personal experiences: “ADHD and Repetitive Body Focused Behaviors (Also Known As Skin Picking, Nail Biting, Teeth Grinding)” and “Why Am I Always Late? ADHD and Time.”

Meg suspects her husband still sees her diagnosis as “a crutch.” Several nights a week, he asks her to come sit on the couch with him, “but in my head I’m running through the 94 other things I want to do in the next 27 minutes. I’m thinking to myself, If I sit down, how is everything going to get done? His mind-set is more that work is never done; there’s always something more to do.” On a recent morning, she saw her husband getting in the shower and told him she’d join him — a small window for intimacy. “Then I got distracted. I went into the bathroom, and the toilet-paper roll was empty, so I went to get more and there were no towels in the linen closet, so I went to get towels and then saw the laundry needed to be moved to the dryer.” Before she knew it, 30 minutes had passed and she found her husband getting dressed. ADHD hurts her marriage in other ways, too. She gets enraged when her husband or children interrupt her when she’s working. Once, she threw a sandwich across the room.

In 2019, Kooij and her colleagues updated the European consensus statement to include emotional dysregulation as a key feature of ADHD in adults, especially women, but doctors in the U.S. didn’t follow suit. “When my patients talk to me, it’s the emotional regulation almost all the time that is the most disruptive for them,” says Sasha Hamdani, a psychiatrist who specializes in ADHD and has the disorder; she makes videos about ADHD in women for her 2 million social-media followers. “For the most part, with the focus or the executive functioning, you can scrape by. You’ve done that since you were a kid.” For women who are successful, “clearly ADHD didn’t disable them. But the amount of effort it takes for them to do these things, the emotional tax, the internal distress that’s going on, is disabling.” All that overcompensating leaves less padding for what would otherwise be minor annoyances: a friend who cancels at the last minute, a partner who forgot it was his turn to make dinner, a child refusing to go to bed. Add in declining estrogen levels and even a tap can feel like a punch.

Research shows that when a parent with ADHD is treated, outcomes improve for their child. That child, Skoglund says, is already at increased risk owing to the disorder’s familial nature, and parents with untreated ADHD can unintentionally create an environment that raises the risk even more: “The parent who has struggled with their own ADHD symptoms the entire day in the workplace has to go and get the child from school, bring the kid back home, add on homework, try to cook a healthy meal, try to have quality time. That equation just does not happen.”

Belkofer, the psychotherapist in Wisconsin, decided to get evaluated for ADHD when she realized how reactive she was with her family after work — a switch from her otherwise calm, ebullient demeanor. Her husband was home with their toddler at the time, and “the moment I walked in, I just felt overstimulated. The walls were closing in on me, and I would be really irritated and angry, definitely overreacting to how disheveled the house was,” she says. For a while, she thought, This is just burnout. But it kept happening, and she didn’t like that version of herself, the angry mom walking through the door, the angry wife asking why there was clutter everywhere. When she calmed down, she would immediately regret how she’d acted.

My own path to being diagnosed with ADHD, I’ve learned, is a common one. Like many women I spoke with, I did well in school even though I procrastinated on assignments or daydreamed in class, in my case counting the wall tiles on repeat. I craved motion and started running long distances in middle school; the rhythm was soothing and still is. Professionally, I couldn’t slow down despite a near-constant overwhelm: In my 20s, I worked two jobs and went to graduate school at night. In my 30s, I gave birth to my first child and wrote a book before he turned 7 months old. I often felt anxious and twice went to psychiatrists looking for answers as to why I couldn’t shut off my mind. They told me I was fine, that my fast-paced brain matched the speed of the city where I live.

Whether from hormones or the demands of parenthood or both, the seams that had been holding me together came loose after my second child was born. For two years, I tried a mix of therapy and antidepressants until a psychiatrist, a woman, eventually asked if I’d ever considered being evaluated for ADHD. I was surprised and agreed to be tested. I didn’t like how irritable I felt much of the time, how I couldn’t go with the flow like so many of the moms around me seemed able to. Nor did I understand why I was suddenly forgetting things. I wondered if maybe motherhood was simply harder than I thought it would be or if I wasn’t a natural. But the childhood symptoms were there, and my doctor’s follow-up questions made it clear I met the criteria. “How do you feel about it?” she asked after the diagnosis. I told her I was curious, though I wasn’t sure about ADHD medication. Then I read a case study about a woman who, as a girl, was constantly trying to anticipate and adapt to the uneven moods of her mother, who had untreated ADHD. I never wanted my children to feel that way. I started taking 5 mg. of Ritalin once or twice a day.

Sometimes I think it helps, yet a small piece of me still wonders if I really have a disorder. I know numerous women who don’t have an ADHD diagnosis who seem one SignUpGenius email away from losing it. They’re tired and frustrated by the demands placed on them and that they place on themselves. When I tell another woman I have ADHD, I worry that she’s internally rolling her eyes. Aren’t we all, to some extent, operating past capacity? Psychiatrist Allen Frances, chair of the DSM-IV task force and an outspoken critic of the DSM 5, warned in his book Saving Normal that the changes to the ADHD diagnostic criteria could cause the disorder to become “the new diagnosis du jour” among adults. He hypothesized that “fake adult ADHD” would be popular among college students and people with demanding jobs and noted that it’s not unusual for perfectionists and people over 50 to think they lack concentration. The central questions Frances posed were fair: When do symptoms require a diagnosis, and when are they simply part of being human? In our quest to ease discomfort and explain parts of ourselves we may not like, are we pathologizing normal feelings and behaviors?

It’s impossible to say for certain how many women are being misdiagnosed with ADHD. The doctors I spoke with acknowledge it can happen if a provider doesn’t conduct a thorough evaluation, though they worry far more about the women and girls who remain overlooked. ADHD symptoms can stack up over time, says Adler of NYU. The earlier a person is treated, the better chance she has of preventing a crash later on. And the roles women and girls occupy, and how they’ve been socialized to accommodate and care for others, can make it difficult for them to see their own symptoms. “I had someone last week where she was the eldest of seven siblings and had blatant ADHD,” says Hamdani. “But she was so responsible. She could get stuff done because she had to take care of all those other people. She was a second parent at a very young age. And so you are asking her questions and she’s like, ‘Well, I get stuff done. Well, I don’t interrupt. I know better.’”

There is a certain sadness for women who have been diagnosed so late in life — the lingering question of What if? Gabby Etrog Cohen, a 45-year-old chief marketing officer and mother of two, was diagnosed with ADHD two and a half years ago after decades of being treated for OCD and anxiety. Her symptoms became noticeable at age 12. Her parents, both therapists, missed the signs themselves. “Their mantra was ‘You’re so smart. Why can’t you apply yourself?’” she says.

Etrog Cohen told me that, even though it sounds silly all these years later, she thinks she could have gone to an Ivy League university had she known she had ADHD and how to manage it. Caroline, the lawyer whose daughter was diagnosed at 6, has a female friend who was treated for ADHD as a child and went to Harvard. “I’m not saying I would have gone to Harvard, but I’m like, God, who in her life was like, ‘Maybe Miss Studious has ADHD?’ How fortunate for her that in the late ’80s, early ’90s, somebody flagged that, because she’s the only woman I know with ADHD who had that opportunity as a kid.” Another woman I spoke with, an oncology nurse diagnosed with ADHD in her 30s, thinks about whether she could have passed the MCAT and become a doctor had she been on medication to help her focus. She wonders if dating would have been easier. “I feel like my whole life could have been different,” she says.

At best, for women of a certain age, the diagnosis can provide a template for moving forward. It’s validating to have their symptoms taken seriously, and they’ve gained a new lens through which to view — and in some cases alter — their behavior. Meg starts her workday later than she used to; rather than staring at her computer in the morning, waiting for her brain to turn on, she gives herself time to work out and then heads to the office. Ruiz, the journalist, reminds herself that a call or an email isn’t a five-alarm fire, even if her nervous system processes it that way. “It’s a recalibration: I’m actually going to take a beat to get back to you and not have to be psychotically responding just to clear the blotter,” she says. In some ways, they’re doing what they’ve always done, which is to solve for their weaknesses. Except this time, not at their own expense.