Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD is a neurodevelopmental condition involving patterns of inattention, hyperactivity, and/or impulsivity that impact daily functioning. In adults, ADHD often looks different than the classic childhood presentation — it can show up as chronic disorganization, difficulty with follow-through, emotional reactivity, or a lifelong sense of underperforming relative to one's effort. ADHD is frequently under-recognized in adults, and especially in women, whose symptoms are more often inattentive rather than hyperactive and can be masked or misattributed to anxiety, mood issues, or personality traits. ADHD is a neurodevelopmental disorder and to meet diagnostic criteria symptoms have to have existed in childhood.
How ADHD Is Assessed
Extensive clinical history — a detailed review of symptoms across the lifespan, including childhood functioning (school performance, behavior reports), academic and occupational history, and current day-to-day impact
Collateral information — when possible and appropriate, input from a parent, partner, or close contact who can speak to longstanding patterns, since self-report alone can miss symptoms the patient has adapted around
Validated diagnostic tools — standardized, evidence-based rating scales and assessments used to support clinical judgment.
Differential evaluation — ruling out or identifying overlapping conditions (anxiety, mood disorders, sleep disorders, thyroid dysfunction) that can mimic or coexist with ADHD, since accurate diagnosis affects treatment choice
ADHD in Women: Hormonal Considerations
ADHD symptoms in women can fluctuate with hormonal changes across the menstrual cycle, pregnancy, postpartum, and perimenopause/menopause — periods when declining or fluctuating estrogen can affect dopamine regulation and, in turn, attention, working memory, and emotional regulation. Many women notice their ADHD symptoms feel more pronounced premenstrually or during perimenopause, and some are not diagnosed until these transitions bring underlying symptoms to the surface.
Treatment Approach, including integrative and functional medicine strategies
Pharmacologic management — stimulant and/or non-stimulant medications, selected and titrated based on symptom profile, coexisting conditions, and individual response
ADHD coaching and psychotherapy— practical, skills-based support around organization, time management, and executive functioning strategies [note whether you provide this directly or refer to coaches. Approaches such as CBT adapted for ADHD can address the emotional and behavioral patterns that build up around living with untreated ADHD.
Sleep — poor sleep quality or insufficient sleep can worsen attention and impulsivity and is often addressed as a first step
Nutrition and healthy lifestyle— healthy nutrition, awareness of triggering foods, and ensuring healthy habits that support energy and focus throughout the day
Nutrient status and gastrointestinal health —lab testing to identify root cause of symptoms may be recommended
Exercise and movement — as a component of a broader management plan
Stress and hormonal factors- particularly for women navigating the transitions described above