When people imagine ADHD, they often picture restlessness, visible disruption, or academic struggle. But for many high-achieving girls and women, ADHD looks nothing like that. Instead, it hides in plain sight—behind good grades, high performance, responsibility, and a reputation for being organised and reliable. These are the women who appear to “have it all together” while privately using every ounce of energy to cope.
For this group, ADHD isn’t a lack of ability. It’s the invisible mental load required to function at a level that masks the symptoms entirely. And because their struggles don’t match the usual stereotypes, diagnosis is often delayed until adulthood—sometimes long after burnout, anxiety, or exhaustion have already taken hold.
The hidden reality of high achievement with ADHD
Many girls with ADHD grow up hearing they’re bright, capable, or mature for their age. And they often are. But high intelligence and strong verbal skills can compensate for underlying executive function challenges, especially in structured environments like school.
Behind the scenes, though, the experience is very different. These girls may rely on last-minute adrenaline to complete assignments, feel constantly overwhelmed by deadlines, or spend far longer than others completing simple tasks because their brain struggles to filter distractions. For some, the pressure to perform becomes the driving force – success not because things come easily, but because failing feels unbearable.
This creates a lifelong pattern: achievement on the outside, exhaustion on the inside.
Masking: the reason so many girls slip through the cracks
Masking is one of the most common reasons ADHD is overlooked in girls and women. It refers to the learned behaviours used to cope with symptoms and blend into social or academic environments.
For young girls, masking might look like:
- copying classmates’ social cues
- becoming extra compliant or quiet
- overstudying to avoid mistakes
- staying under the radar to avoid drawing attention
In adulthood, masking often becomes more sophisticated. Women may develop elaborate organisation systems, overbook themselves to avoid forgetting commitments, or take on extra work so they’re never seen as dropping the ball. They say yes when their capacity is already stretched, overprepare for every meeting, and rarely let others see how much effort is required to maintain their reputation.
Masking becomes so automatic that many women don’t realise they’re doing it. They simply assume they’re working harder than everyone else—and that the constant internal tension is normal.
Internalised symptoms: the quiet presentation that gets missed
Girls are far more likely than boys to show internalised ADHD symptoms. Instead of outward hyperactivity, they may experience:
- mental restlessness
- daydreaming
- emotional sensitivity
- rumination
- anxiety or fear of making mistakes
Because these behaviours are quiet, non-disruptive, and often interpreted as “shy” or “well-behaved,” they rarely raise concerns. Many women later report feeling misunderstood or dismissed when they sought help for these symptoms, often being told they were simply anxious, sensitive, or overwhelmed.
As a result, it’s incredibly common for women to receive diagnoses of anxiety or depression before ADHD is ever considered – even though the underlying difficulty with executive function has been present their entire life.
Perfectionism and people-pleasing: coping mechanisms that hide the struggle
High-achieving girls quickly learn that being responsible, helpful, and diligent earns praise – and that any signs of chaos or disorganisation can lead to criticism. Over time, perfectionism becomes a shield. So does people-pleasing.
These strategies help them stay afloat, but they also hide the symptoms that would otherwise prompt earlier support. The cost is significant: chronic tension, performance pressure, low self-worth, and a sense that life only works if they push themselves harder than everyone else.
When life transitions overwhelm coping strategies
Many high-achieving women seek diagnosis only when a major life shift makes their old strategies unsustainable. Common triggers include:
- starting university or a demanding new job
- managing increasing responsibilities
- becoming a parent
- navigating perimenopause and hormonal shifts
What once felt manageable suddenly becomes impossible to juggle. Women often describe a sense of “holding everything together with tape,” or feeling like their brain isn’t working the way it used to—when in reality, they simply no longer have the bandwidth to mask.
Recognising the signs and accessing support
If you’ve spent years feeling like you’re constantly overextending yourself just to keep up, it’s worth exploring whether ADHD may be part of your experience. Difficulty starting tasks, relying on deadlines, emotional overwhelm, chronic disorganisation, or inconsistent productivity can all be clues—especially when they contrast with how capable you appear to others.
Support can make an enormous difference. A comprehensive assessment helps bring clarity, and for many women, understanding their brain provides immense relief. From a functional lens, addressing stress physiology, nervous system regulation, sleep, and hormonal influences can also make symptoms far easier to manage.
High achievement shouldn’t hide struggle. And if you’ve spent years wondering why everything feels harder than it “should,” you’re not alone—and there’s a deeper story worth exploring.