If your mind never shuts off, it’s easy to think you have it anxiety— but that may not be the whole story.
This is especially true for women, who are diagnosed with anxiety in part because of their overwhelming mental burden. A study by the Pew Research Center shows that women still take on a disproportionate share of the household and care responsibilities, even when working comparable hours to their partners. It’s not hard to feel when your brain is constantly tracking schedules, anticipating needs, and managing details.
But for some women, it’s not just about that stress or mental stress. This is something deeper and often overlooked: ADHD.
Hidden misdiagnosis in women
In clinical practice, women are often misdiagnosed for years – sometimes decades. Until recently, ADHD was mostly studied in boys, which means that the entire female generation has never been properly reflected in research. It wasn’t until the early 2000s that women began to be included, and even later we learned how ADHD can manifest differently in them.
As a result, many women are treated for anxiety without emotional relief. Not because they aren’t trying hard enough, but because the underlying issue may not be anxiety at all. What is often labeled as anxiety in women may actually be inner restlessness – a symptom of ADHD. Instead of external hyperactivity, it manifests as a constant internal “engine”: planning, scanning, worrying, waiting. It is a mind that feels very little even in moments of peace.
Where ADHD and Anxiety Intertwine
Part of the confusion comes from how these experiences feel. From a diagnostic standpoint, ADHD and anxiety share several overlapping symptoms, including:
- Negligence
- Difficulty concentrating
- Race thoughts
- Disruption of sleep
- nervousness
- A constant sense of overwhelm
They don’t feel like separate categories when you live in them; instead, they feel like your everyday reality. And on the surface, they can be almost the same. But repetition does not mean the same thing, because the main difference is that it causes symptoms.
Why do these symptoms feel like anxiety?
Both ADHD and anxiety can involve intrusive and repetitive thoughts that are difficult to control. Both can leave you emotionally drained and withdrawn. But they are not produced by the same brain systems.
Anxiety is usually triggered by a response to a threat. The brain looks for danger, which is often rooted in the activation of the amygdala, and thoughts tend to revolve around it fearuncertainty or worst-case scenarios.
ADHD, on the other hand, is more about differences attention reward regulation and processing. As the brain struggles to filter, prioritize, and shift focus efficiently, thoughts can pile up. The result can be overwhelming – but it’s less about fear and more about the burden. Too many inputs and not enough efficient sorting.
Anxiety or ADHD? The main differences
Understanding the difference often depends on patterns. With anxiety, the worry is usually related to perceived threats and is relieved when those threats are resolved or reassured. With ADHD, the sense of urgency or mental noise often improves when attention is gained or when a task is involved. In other words, the anxiety associated with ADHD is often a response to them dopamine. A change in motivation, novelty, or focus can bring significant relief in a way that anxiety usually does not.
The content of thoughts also tends to be different. Anxiety is more likely to be fear-based – something bad is going to happen, something is going wrong, or a general feeling of dread. The anxiety associated with ADHD is often more practical, but just as relentless: forgetting something important, missing a step, falling behind, not looking or feeling like everything needs to be done.
At the neurological level, anxiety is closely related to heightened threat detection systems, while ADHD differs in executive activity and frontostriatal dopamine pathways. Both may involve hyperarousal, but the source—and therefore the most effective intervention—may be quite different.
It is also important to clarify that these conditions often coexist. Many women experience both. However, in practice, once ADHD is properly identified and supported, it is not impossible to see significant improvement in anxiety, which for some is the primary problem with ADHD.
Why women are often overlooked
ADHD in women is often overlooked because it doesn’t fit the old image of what ADHD is “suspected.” Instead of being disturbed, many women are highly adaptive and overactive. They do this by compensating and holding it all together until they can’t.
This can lead to internal struggles such as chronic self-doubt, mental exhaustion, emotional stress, and a quiet but persistent feeling that they are working harder than anyone else to maintain. Not surprisingly, countless women with ADHD also struggle with them imposter syndromebecause they appear capable, but internally their anxiety is minimized or misunderstood.
Cost of errors
When ADHD is misdiagnosed as just anxiety, the impact can go far beyond the symptoms. Women may develop coping strategies that are evaluated rather than understood—as much as possible. burnusing food or shopping for a quick dopamine rush, or turning to substances to calm the mind.
Over time, this type of chronic impairment can affect mental and physical health. Many women feel like they are always running on empty, trying to live up to their expectations without the right support or a real understanding of how their brain works. The result may look like anxiety on the surface, but underneath it can be chronic stress, sleep disturbances, shameemotional exhaustion and a growing feeling that nothing is completely helping. Emerging research also suggests that ADHD may be associated with a broader health burden, including inflammation and other medical concerns from chronic stress and strain.
What do we need now?
For many women, an accurate diagnosis of ADHD can be a turning point. Treatment may include: medicinebut it can also involve learning how to work with your brain—by structuring, supporting, and intentionally creating activities that regulate focus and energy. And often, something else happens as well. Women understood themselves differently. Story from “What’s Wrong With Me?” to “That makes sense.”
With this understanding, many also treat others differently – letting go of some of the constants to disguisethe overcompensation and self-control that was once considered necessary to maintain it. Many also report that when their system is better supported, constant stress is relieved not only mentally, but physically as well. Only this change can provide profound relief, because from there real change becomes possible.
Portions of this post are adapted from my book Overcoming ADHD: Strategies and Exercises for Women to Use Their Untapped Gifts.
