The ADHD women's experience

In this conversational episode of Indie Out Loud, Danielle Ralston and Britt explore how ADHD manifests uniquely in women. They begin by highlighting the profound effect of menstrual cycles, perimenopause, and menopause on medication efficacy and symptom severity, noting that many women experience a weekly “insane” period where focus collapses. The discussion moves to how hyperactivity in females often appears internal—manifesting as loud inner thoughts, anxiety, and higher rates of comorbid depression and trauma, rather than the external restlessness seen in many men. They introduce concepts such as justice sensitivity, heightened emotional empathy, and rejection sensitivity dysphoria (RSD), linking these to a higher prevalence of developmental (big‑T) trauma among women with ADHD. The hosts compare masking styles, describing women’s masking as socially polite and norm‑conforming versus men’s tendency to mask competence. Spatial awareness and proprioceptive challenges are presented as a gendered complaint, with women reporting frequent collisions with objects. Relationship dynamics are examined through personal anecdotes about neurodivergent couples learning to communicate—using “listening post” metaphors, avoiding unsolicited solutions, and navigating differing emotional outputs. Practical coping strategies are shared: unmasking, multisensory inputs (dual AirPods), fidget tools, scheduled breaks, and honest disclosure to clients about fluctuating ADHD states. Throughout, they stress that ADHD experiences are highly individual, shaped by trauma, hormonal cycles, and gender socialization, and that clinicians should tailor support accordingly.
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Be like, you look really tired. Are you okay? And like, just genuine observation and concern. And I was like, thank you so much. But I know that like other people would have been like, yeah.
So good morning. This is Danielle and Britt, and we are here for Indie Out Loud talking about the ADHD women's experience. So I'm in college again, taking classes, and there was a discussion the other day About the diagnostic criteria for ADHD, da da da da da. And I'm like, as a woman, I don't experience any of that. I got this, this, this, and this, but I don't have this, this, this, and this. And Britt and I are like, we talk about these things all the time, how it's so different. And the one thing I'm going to bring up right now, and this may be way too much TMI, is let me tell you, meds and everything in my ADHD is 9,100 billion times worse. when I have my period, which is where I am today. So there is nothing that helps when I have my period. Forget it. End of story.
Mm-hmm.
And I don't think there's one of us that don't experience that.
I've yet to meet anyone who does. And I have to be honest, when I have menstruating clients, not, you know, sometimes you're in menopause, sometimes There's a whole bunch of reasons women may not be menstruating, but, um, whenever my menstruating clients are like, hey, like, I don't know what it is about this week, I just can't focus, it's like my meds aren't working, the first question I always ask is, are you menstruating? Where are you in your cycle?
Yep.
Because this could solve the mystery.
And it does because those hormone shifts— and I'm, I'm in perimenopause, menopause, whatever, and my ovaries are officially shrinking and all of that, which I didn't know that they will shrink to little pea-sized things. Like, something learned— I knew I learned, um, but, um, I'm like, seriously? Anyway, uh, like, as I'm going through this, I have months where I don't, but man, those hormone shifts are Still there. And I, I've actually talked to— I have a couple clients who have had hysterectomies, and they still— like partial hysterectomies and stuff— and they're still experiencing that one week a month where everything is funky. So—
That is so rude.
Yeah. And I'm like, I mean, that menopause isn't the end of this BS? Seriously? I might still have this even after menopause? And then I think back and I have so many clients over the age of 60 who have been like diagnosed and all of that. And none of them— like, I actually went through— God bless my clients for the fact that they know I'm in college and asking questions constantly of them. And I went through and asked them all, do you still have your period? Do you still experience XYZ? And every single one of them— none of them still have their period. And every single one of them still experiences it. It's something they don't tell us. As a matter of fact, they say their ADHD is way worse overall, and then they have one week a month that they feel literally insane.
Great, great. I'm really looking forward to this.
Like, we don't get a break. And I think that's only one piece of how women experience ADHD differently.
Absolutely. Absolutely. I know that, you know, one of the biggest things that women and girls point out from a young age is how hyperactivity tends to show up differently in women. Now, this isn't the be-all end-all rule. I know men for whom their hyperactivity shows up like this. But this is one of the ways, especially when I was growing up, that ADHD was missed In girls. We weren't getting up and running around. We weren't necessarily fidgeting or kicking or screaming, but our internal world was loud. All of that hyperactivity that was external in our male classmates was internal for us, and that seemed to continue for many of us as we age.
It's loud, but it's also that loudness causes— I think for most of us women, and I didn't even realize this as somebody who's known almost their whole life, I didn't even realize that this is what it was, is it causes anxiety. And I didn't realize it was anxiety. I just thought it was ADHD, like craziness. But anxiety, depression is much higher in us. Other serious mental health diagnoses are also part of a women's experience where a lot of men don't necessarily have dual mental health. I mean, not all, so this is not for all, but a lot of men don't necessarily have dual mental health diagnoses. Like, um, and there's a lot of question right now with testing and all of that, whether bipolar disorder, um, schizophrenia, things like that are in fact those things, or are they just ADHD, autism, or are they a combined thing? I fully— I mean, I've been doing this 25 years. I fully believe they're combined. They can absolutely be combined. And that is something that very few of my male clients— I'm not saying all, but very few of my male clients deal with that at the same level. But again, hormone shifts are insane for us as women.
Yeah.
Oh, this sucks.
What is the most prevalent difference you see between your female clients and your male clients?
Justice.
Say more.
Justice sensitivity. Women, um, especially my autie-HDers on that end of that scale, and I call it one scale, the ADHD and autism is just one scale, um, the, the more Autistic type symptoms that a lot of us have, justice sensitivity goes through the roof. We're less likely to care about social norms. Colored, pink colored hair, anyone? Blue hair? I mean, piercings, tattoos, and literally don't give a crap what anybody thinks of them in a social situation and will stand up for anyone. And be the voice. I don't see that in ADHD males as much. My ADHD males tend to be more— well, they can be impulsive and have those anger outbursts and stuff, and you see a lot of that in men, but they don't just have as much justice sensitivity for the most part.
Huh.
Now, my autism spectrum people, absolutely, justice sensitivity is very much part of that autism side, but with my ADHD or WIMP ADHD women, justice sensitivity is way higher, way higher, but so is our emotional empathy and intuitiveness. We're way more emotionally aware, like to the point of it's overwhelming to us a lot of the times.
Yes. Now, do you think, in your professional opinion, do you think that is Sort of innate, right? Like if we were all raised the same, women would have higher dose sensitivity, or do you think part of this is the way men and women are socialized?
Actually, I think it's more the way we're socialized, and ADHD women are 98% more likely to experience serious big T trauma. In developmental years, and I think that big T trauma is a huge part of that.
So you think there's, um, like, I, I would say even like CPTSD playing into that?
Absolutely, absolutely, because When you experience trauma, and, and I say big T trauma, because unfortunately, when you're on the spectrum, the neurodivergent spectrum, even, even something that a neurotypical person may think of as tiny t trauma, like micro t trauma, is much more impactful to us. So everything. Um, so Tiny t trauma. I got yelled at for wearing, okay, a purple dress and it looked bad on me and it looks stupid and I should never wear that by my mother once.
Okay.
Now to a neurotypical child, you get angry, you roll your eyes, you take it off, you go away. You might never think about that again, but I will tell you that to me, this is actual life experience for me. Anybody know my favorite color? Anybody know what I am determined to wear and paint things and be all of the time, but it took me 20-something years to even be willing to think about wearing the color or doing any other things?
Hmm.
Because it was extremely impactful and it was a 2-minute or less moment in my— I think I was like 4 or 5.
Yeah.
So it has a much bigger, bigger impact, the words people say, anger towards us, because we don't necessarily process it the same.
Hmm.
Because again, rejection sensitivity dysphoria, all of the things that we as ADHDers experience, pipes that up to a 20. So a lot of, and I know a lot of boomers, and I've had this conversation, there are a couple boomers in one of my classes. who are going back to college because they're bored in retirement.
Okay. Honestly, I wish I could be bored with that kind of money.
Yeah, me too. Me too. And their, their opinion of a lot of younger people and everything is traumatic and everything is horrible. And they're like, just get over it. They are neurotypical. Okay, just Just putting this out there, they're absolutely neurotypical. And the rest of us, I'll look at them and go, you have zero emotional sensitivity, connectivity, anything here. This is an issue. And they don't really— and like the discussions that we've had around emotional sensitivity and the RSD and all of that, they don't understand that at all. To them, that's just an overreaction. Everything is trauma to you. And I'm like, but it is. I mean, we can map it on a brain scan. It is actual trauma to our brains.
Yeah.
One of the best examples, and thank God for the ADHD brain in class. I was like, have y'all seen the videos of the man using the period cramp simulator on their stomach and they can't even handle it at like 3 or 4? And then you put that same on a woman who has periods. And they could turn all the way up to 10 and be like, yeah, I wish my periods were this light.
Yeah.
And they're like, well, yeah, but that's not— and I'm like, yes, but for those of us with ADHD and autism, everything's always up all the way. All the way. So I think that, that justice sensitivity comes in from experiences where we've been traumatized by even the simplest thing, the one word somebody said to us, somebody called us lazy once because we were having a hard time starting a task. You know, all of those things cause that trauma. And while we will never defend ourselves against any of the trauma, we're darn well sure we don't want anybody else to experience it. So we're going to stand up for other people. And I think that's why so many therapists, psychiatrists, Coaches, things like that, are neurodivergent.
We're like, hey, yeah, no, heard.
No, we heard, and we never want this to happen to anybody else, so we're gonna fix, fix that for other people, but we don't fix it for ourselves very well.
That's why we help each other.
This is— yeah, absolutely. So we have emotional hyper-awareness. What is— what's some of your emotional hyper-awareness, like things that really set you off?
Um, I— this is, this is one of the reasons I think I became such a people pleaser when I was younger is I am really attuned to when other people are angry. Even like a little sliver of anger, I will pick up on. And it has taken me 33 years, uh, to realize I can just notice it and I don't have to do anything about it. And like, other people's anger, not my responsibility. What a concept. Yeah, I love people to feel their feelings. Um, but definitely that, that anger, and I think some of that absolutely stems from From not knowing what RSD was and not understanding what that was doing. Um, but picking up on people's anger became a way for me to protect myself from them launching it at me and then having to deal with the, like, very physical and emotional pain that came from RSD. So, like, if someone is even the littlest bit upset, I can tell.
So for me, my husband is also neurodivergent and has the impulsivity, angry outbursts that come with that for most men. I mean, that's a pretty typical male experience with being neurodivergent. Yet living with me, who has the opposite experience of being neurodivergent, who is hypersensitive to all those things, it took me a long time And he would be like, I'm not angry at you. I'm just angry and I can't— just like you can't not tell me the 9,000 things that are in your head and you've got to tell me, I have to get it out. That doesn't mean I'm angry with you or at you or any of those things, but I need to be able to vent. And it took us a long time as a couple to learn to be okay with the other's emotional output. Ah, because I would internalize his stress, anxiety, anger at something that happened at work that had like zero to do with me, right? I wouldn't feel that coming off of him.
Oh, and that would be incredibly stressful.
Exactly. But now it's— now we've both learned to verbalize, not angry with you, I need to vent, can you please just be my listening post? As in, stand there, do not react, I don't care, just you need to be standing there like a, like a round post. And this was the illustration he came up with, a round post that it just goes around you and goes by you and you don't have to worry about it.
Oh, I love that visual.
Stand there strong, listen, be there, don't react because it's gonna go right by me. That's all it needs to do.
Great.
And the same thing, I have to tell him, I need you to listen, not come up with a solution. Don't give me an answer. I just need you to listen. I have to tell him the same thing. Because being a man, he wants to solve whatever the issue is.
Come in and Mr. Fix-It.
Well, it— but I also do that, not for nothing. Somebody tells me something, I want to fix it for them because I see the problem, I know the solution. I'm positive I know the solution because that's how my brain works, and I want to fix it. But that doesn't mean we always have to. And I think learning that was a huge step forward for me in my anxiety and my RSD and my justice sensitivity and all of those things. And it makes marriage a whole— being in a relationship a whole lot easier too. It takes so much stress out of it. So what, what's some of the goofy things that is different for you than a guy with ADHD? I'm gonna tell you.
I think I, I, I mask differently than men.
Yeah. How do you mask differently, do you think?
I think like, like, in my experience with ADHD men, like, they're masking to seem like they have it all together. And I, my masking is more to seem polite or nice. My masking has always been more about like trying to understand socials. Social norms, not necessarily gender norms, if that makes sense.
Yeah, yeah, that makes me think, but that, that's another conversation. So for me, one of my, my big things with that, that in the masking, is my husband is very quiet. When he's masking, he's just stepping back and observing and all of that. And when I'm masking, I'm the life of the party.
Mm.
I did not realize this until about a year ago that I was not as extroverted as I thought I was. I thought, and I had been tested, and every psychiatrist, psychologist, therapist has told me this my whole life, man, you're the most extroverted person I know.
Nope, it was all a mask.
If you take control of the situation, social situation, and are the life of the party, You don't have to try to fit in. Everybody else is following you.
Boom.
So being super extroverted, everybody thought I was the fun one and everybody would want to hang out with me, and I didn't have to try to adapt to their social whatever. And I have very much learned, and I was actually talking to Jessica on my team about this the other day, is CHAD is coming up. We're going to CHAD next month, and I'm— only in 3 weeks, actually. It's not even next month anymore. Um, and I need a break.
Mm-hmm.
And we're taking Friday. We decided Friday is going to be our break away from everything because last year I ended up crashing so hard because I couldn't Now that I've unmasked, I can't keep that up for 4 days straight.
Yeah. Yes, I like to describe unmasking as like when you finally get over a cold and you realize how great it feels to not have a stuffy nose. Mm-hmm.
That's actually a really good explanation. I like that.
Like, oh God, I can breathe. I didn't appreciate breathing this much before.
Yeah. And no, I'm not going back to that.
Not willingly.
Yeah, exactly. So, I mean, that's one of my things. The other one, which is completely goofy, is I'm convinced that all of us women with ADHD have zero spatial awareness.
I never—
how many of you walk into doorways and walls and the edge of the table and the— all of that? My husband, my husband says we need to have all rounded furniture here because You know, I'm always walking around bruised shins, bruised thigh, like from walking into everything. I have zero spatial awareness, zero. And I really think that's a female thing. Any men who are ADHD want to discount, like fight with me on that, I'm happy to hear. But my—
Yeah, it's all about the times you run into stuff.
Yeah.
Yeah.
Are you running into things as much as I am, which is like 20 to 30 times a day? And no, I'm not kidding.
I don't—
I currently— and I'm not going to show you because it's nasty looking— I currently have a cut and a bruise on my forehead because I turned right into a doorway.
I sat down. I didn't hit the chair this weekend. Like, I was like a swing chair and I sat too close to the edge and it like busted off. I landed my butt right on the metal.
Yep. I think, I very much think that's a uniquely women's thing. We're always, if you see the people kind of some of the misinformation about being ADHD out there, that's one of those things that women walking into things and forgetting where they are and all of that stuff. Absolutely. I definitely think that's more of a woman thing than a man thing.
I mean, we know ADHD does affect Proprioception.
But I do think women have a harder time with that than men do, at least in my experience.
I don't know. Maybe we're just talking about it more.
Maybe. I mean, that is a possibility. So if you're a man with ADHD, yeah, tell us, are you— is this something you trouble— have a whole lot of trouble with? We want to know. And then the other thing is, I think my brain blanks out more than most men's. I've decided that, but maybe that's because I'm surrounded by autistic men more than ADHD men. That, that could be a thing, um, where I'm that combination. But my brain, like, totally— I will stop in the middle of a sentence and the rest of the words and whatever I was talking with, totally gone. Just gone. With my period, it's so much worse. That brain fog is just, ugh.
That brain fog is brutal.
It is so bad some days. Like, I actually, a couple weeks ago, I can't— or a month ago, last month, I canceled Okay, Rick says I blank out and lose a thought frequently. Okay, so it's not just— it is just an ADHD thing, not just me. I always wonder, is this just me? Is this every— because other ADHDers I talked to don't seem to do that as much as I do. But it's— I canceled coaching calls one day because I'm like, I did one call and it was with one of my clients. I adore her. She, she's like, you're not okay today. You might not want to talk to people.
That's cool.
You're really good at listening, but that's about all you got for anybody today.
Okay then.
I guess I maybe should cancel the rest of my calls. And knowing that though, but learning that it's okay. And my clients have found, if you are an ADHD coach and you're like, oh my God, I could never do that. No, your clients appreciate and love that you are accepting of your ADHD ebbs and flows and willing to talk about them and willing to accommodate them. It's one of an amazing lesson that we could be teaching our clients.
Yes, leading by example.
Absolutely.
Is so, so, so important. I cannot tell you, I still get a little like, ooh, when I have to cancel because I'm not feeling well. And my clients are like, it's so good to see you taking time off when you feel sick. Like, it's a good reminder for me. Or even when I just take time off for like a vacation and I let them know, like, oh, I'm so glad you're doing that. Like, because a lot of ADHDers aren't.
People pleasers, overworking themselves, all of these things. So Rick says, I have days where I literally feel like I can't think. Yeah.
Okay.
So it's not just a female ADHD thing. I think again, though, periods. Kind of add to some of that some days.
Absolutely.
But our clients really appreciate when we are honest with them about how we're experiencing ADHD today or autism today, or, or like for me, MS, I'm having a really bad MS day and I just need to like adapt and accommodate myself. Clients really, really, really appreciate that.
Yeah.
So what is, what is one of the biggest things you think really affects you differently with your ADHD?
Compared to men or just in general?
In general, maybe.
Um, my brain is never quiet.
Ever.
Never. Never. Literally never. And I meet a lot of ADHDers who are like, yeah, my brain goes blank, and when it goes blank, it's quiet. My brain went quiet once in 2000 and One. And I— it freaked me out so badly to not have any thoughts, noise, images, nothing for the grand total of 20 seconds that I made my mother schedule me an appointment with a doctor who then politely informed me that's called zoning out. My brain has never been quiet since. There is— and not only is it not quiet, I've got songs, I've got images, I've got, uh, other random earworms, I've got a bunch of thoughts. It's like everything.
Yeah.
It's like a 3-ring circus. And I— that's why I feel very comfortable In places like Las Vegas or New York City because it mirrors what I'm experiencing.
I liked that before, like those situations before, but now I have a harder time with it. Like right now, and I can't illustrate this for you guys, I have 2 separate sets of AirPods.
Hmm.
One AirPod is playing the theme music for Galaxy's Edge as you walk into Galaxy's Edge, and the other has Brit so I can hear her in it. Because if I don't do that, I can't focus in on our conversation at all because my head is just so loud and I can't do it. But for me, it was— I've had to learn how to adapt to do those things. And it's— otherwise, I do literally about once a week crash. And there is— I'm gone. Like, mentally, I can't handle another conversation. I can't handle eating, drinking, remembering to go to the bathroom. Like, I shut down and it's not even dissociation because my head is still going. Like my brain never shuts up.
Wow.
Learning how multisensory inputs and other things help me was a big, big thing for me.
Yeah.
And like fidgeting constantly. Obviously is a really, really big one. Um, and I mean, there's so many ways, so many ways that we learn to adapt that, but that, that full disassociation piece, or, or I call them my squirrel brain days. I have to give myself squirrel brain days where I just follow whatever it is my brain needs. And that could mean doing 12 things literally at the same time. I could be watching a movie, watching TikTok, playing a game on my phone, reading a book, like all at the same time.
Yeah.
And my husband just walks way around me when I'm doing that and moves on because that's overwhelming to him.
Yeah, my fiancé gets so— she's like, I don't know how you do that. Because like we'll be watching a movie and I'll make one comment while I'm on my phone while I've got a fidget toy and she'll lose entire plot of whatever we were watching. And she'll be like, what, what just happened? And I'll be like, um, this, this, this, this, this, this, this, this, this, and then she said this. She's like, what?
My husband doesn't lose track of it all. It just annoys him that there's that many things going on at the same time, because my husband is also neurodivergent. So he notices that, like, he can— you can— I could be talking to him, and he'll be playing guitar or playing pool or doing like 12 things at once. And he'll be able to recall the conversation Word for word. I can't do that, but he can do that. Uh, I think the big thing here though is to understand that if you are ADHD, we've said this a billion times, if you know one ADHD person, you know one ADHD person. Their experience is going to be their very own because trauma, life experience, all of these things affect how we experience our own ADHD. But If you're a man or a woman with ADHD, don't expect that the opposite sex also experiencing exactly like you do, because we don't. We very much don't. Rick, Rick has let us know that some things aren't uniquely just for women, which is awesome. Thank you.
Because again, I love learning that.
Yeah. It's things I don't know. Um, he says, I'm not trying to poke holes. I'm like, no, please do.
We don't know. Poke them.
Poke them. Please poke them. Uh, but it's, it's always interesting to hear how and what affects us differently.
Absolutely.
If you need any help, if you don't know how to deal with your own ADHD, if you're really frustrated, any of those things, please let us know. We are both here. Our links are below, below this video. You can reach out to either of us anytime. We are here to help. Follow us on LinkedIn, follow us on TikTok, whatever, wherever you want to follow us, find us and follow us. We are pretty much everywhere. I hope you have an amazing rest of your week. If you have questions, again, ask away. We are always here to answer them.
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