What ADHD Actually Looks Like in Women By Shylah Ridgway, LCSW, LICSW

I have colorful hair. A full sleeve of 80s tattoos and an entire back piece, all 80s, all completely on purpose. Piercings. My favorite piece of clothing is my dinosaur overalls.

I am feral. I have always been feral. You couldn't tell little Shylah nothing.

I was obsessed with the Moai — the ancient stone figures on Easter Island, carved by the Rapa Nui people, standing in silence for hundreds of years with no satisfying explanation for how they got there. I was obsessed with the Bermuda Triangle. The La Brea Tar Pits. Dinosaurs. I adored Cyndi Lauper, Madonna, Punky Brewster, and Pippi Longstocking. I pretended I was Cheetara from Thundercats.

Everything became nunchucks.

A broom. Nunchucks. Barbie doll legs. Nunchucks. A wrapping paper roll. Nunchucks. A stick. Nunchucks. A nun. Nunchucks.

I still laugh every single time I read or hear Lake Titicaca. Every time.

I always refer to myself as weird. A nerd. People try to reassure me when I say it, like it's something that needs correcting. I stop them every time. Those are not insults. They are the most accurate and endearing words anyone has ever used to describe me. I am those things. I have always been those things.

The goal was never to stop being weird. The goal was to find a life where being weird was the whole point.

I was also, somehow, on the honor roll.

Nobody put those two things together for forty one years.

I was the weird kid and I knew it before anyone said a word.

I could feel it in my body before I had visual confirmation. My whole life. Not just as a kid. A sideways glance. A half attempted laugh. A smile where the eyes said yikes. Someone bugging their eyes out at someone else. About me. While I was standing right there. People starting new conversations while I was still talking. Walking away while I was still talking. Stopping talking altogether when I walked up.

Adults did it too. Grown adults who should have known better, who should have been safe. That kind of rejection stings differently. It gets into the foundation.

I have a PhD in everyone has already paired up with a partner.

I was picked last for PE in fifth grade. That was per usual. What was not per usual was the kid left in the thunderdome with me. He only had one eye.

One eye.

I remember that with perfect clarity. I cannot tell you what I had for breakfast. But I can tell you exactly how that gymnasium felt, exactly where I was standing, and exactly what it was like to be the last two kids looking at each other across that floor.

My brain remembers everything that ever made me feel like I didn't belong. It just can't remember to eat lunch.

I was also, somehow, the gifted kid.

I was in the gifted and talented program from first grade. Pulled out of class, given extra challenges, told I was exceptional. I was reading at a high school level before I lost my first tooth.

Our class would walk to the public library together. On one of those trips I checked out two books at the same time. An Amelia Bedelia book and Through the Looking Glass. A picture book and a full length novel written in 1871 full of made up words and language that made no sense to anyone, including the adults in my life. I went home and used the dictionary and the encyclopedia to look up everything I didn't understand. Which was a lot. My parents had no idea how to pronounce Jabberwocky. I still think about that.

Nobody thought any of this was worth mentioning. Not the books. Not the dictionary. Not the child who was desperate to understand things that were too big for her and too strange for everyone else. That's the part that gets me. Not that the adults didn't know what ADHD was. It's that nobody thought any of it warranted a second look. When adults treat a child like she's too much, like she's strange, like she's something to be managed rather than understood, they don't just hurt her feelings. They become her inner voice. The one she'll spend decades trying to talk back to.

I won the second grade spelling bee. Against my closest friend at the time. She left the n out of environment. I have carried that victory and that guilt for over thirty years.

I was also on local television. KOCO News 9 in Oklahoma City. A children's spelling program called something like Bas-a-Ball, spelling words, baseball bases, you get the idea. It aired Saturday mornings before the cartoons even started. Before any self-respecting child was conscious. I have never been able to find a single piece of evidence this show existed. We lost. I think. I'm fairly certain we lost, but honestly I remember the bean burrito betrayal more clearly than the score.

It was my first time at Taco Bell. I ordered a bean burrito and nobody warned me about the onions.

I was presenting extremely well on the outside. My nervous system was apparently already negotiating with betrayal.

I also had a side hustle as the Pope.

I set up shop in my closet, draped in the sheet off my bed, taking confession from my toddler brother through the crack under the door. We weren't even Catholic. He had a terrible speech impediment so I genuinely cannot tell you what he was confessing to but he showed up and that's what matters.

It ended the day my mom walked in and asked what he was doing. He looked up at her and said "I tawwtin to de poe."

She had no idea what that meant. Why would she. Why would anyone's mother expect to open a bedroom door and find her toddler kneeling outside a closet confessing to the Pope.

She jerked open the closet door and looked at me in disbelief.

Which was very common.

If the teacher asked for big strong boys to carry chairs, ya girl was already stacking them. Not because nobody asked me to. Because it was bullshit that nobody did. I was strong. Small and all. I could carry the chairs. The category was wrong and I was going to demonstrate that whether anyone was ready for the demonstration or not.

My parents put me in ballet because I walked around on my tippy toes constantly. It turned out I was actually good at it. Rockin' Robin was my favorite. I was talented enough to get placed dead center during every ballet and tap show and fearless enough to nudge out the girl in front of me and pull in the girl behind me. I fell out of trees and pulled my leotards over skinned up knees. I was also flexible enough to nail the scorpion pose (lying flat on your stomach and bending back until your feet come over your shoulders — it's exactly as unhinged as it sounds). I still catch myself standing in third position almost forty years later without even realizing I've done it.

Nobody caught any of it. Because I was presenting fine. Weird, sure. But fine.

Here's what ADHD memory actually feels like.

You know those chicken and egg prize machines at the Piggly Wiggly? The ones where the chicken simultaneously squawks and spins and out comes a colorful plastic egg full of surprises. A sticky hand. A plastic ring. A fake tattoo. You never know what you're getting.

That's my brain. That's my memory. I call it the egg machine.

It throws things at me. All William Nilliam. Completely unsolicited. My closest friend leaving the n out of environment in 1987? Here you go, full HD. What I had for breakfast yesterday? Eight ball says outlook not so good.

If I try to deliberately remember something it's worse. The harder I reach for it the faster it runs. But let someone say a word that my brain decides is somehow connected to something else entirely and suddenly I remember every word to Father Abraham and that one about the blood of the lamb that Matthew Mark Luke and John passed on. Songs I haven't sung since approximately 1990 in a church basement somewhere in Oklahoma. And the fourth grade Halloween program song. All of it. Every word. The connection doesn't have to make sense to anyone else. It only has to make sense to whatever is happening inside my particular egg machine.

Now back to those books. My brain needed an Amelia Bedelia book AND Through the Looking Glass at the same time. Not one or the other. Both. A picture book and a full length novel. Because my brain couldn't decide if it wanted something it could finish in ten minutes or something it could disappear into for days, so it said yes to both. That's not a reading preference. That's an egg machine making executive decisions.

And don't even get me started on basic physical needs. I cannot reliably tell you if I've eaten today. I genuinely cannot tell you how long it's been since I peed. I am a certified drink goblin. Three drinks minimum on my desk at any given time. Exclusive bar energy. They are still half full at the end of the day. My body sends signals and my brain just absolutely does not check that inbox.

This is called interoception, the ability to notice what's happening inside your own body. We are out here running on empty, somehow still holding everything together for everyone else. And nobody caught it because we looked fine.

Why it goes undiagnosed for so long.

Girls are socialized to internalize. Where a boy with ADHD might act out and get noticed, a girl with ADHD learns to suffer quietly and compensate publicly. She develops coping strategies that look like competence from the outside. She gets good grades through sheer anxiety-fueled effort.

I was in gifted and talented from first grade. I was reading at a high school level before I lost my first tooth. I won the spelling bee. I was on television before the cartoons even started. I carried the chairs nobody asked me to carry. I was talented enough to be placed dead center in every ballet and tap show and flexible enough to nail the scorpion pose.

And I was always the funny one. The wild one. Always on the outside looking in, orbiting around everyone else like I was part of the solar system but not quite a planet.

Loud. Laugh like a hyena and a witch met in an unholy union.

I had best friends. I'm just not sure I was ever anyone's best friend.

If I was wild I was only palatable in small doses. If I was tame I was forgotten.

So I learned to read the room. Dial it up or dial it down depending on what was needed. Perform the version of myself that would be tolerated longest. Become the class clown before anyone else could make me the punchline.

It wasn't confidence. It was survival.

Do you ever remember a girl going to the office at lunch to take her ADHD medication? Because I don't. Not once. But the boys? We all remember those kids. Girls were sitting right next to them, struggling just as much, and nobody noticed because we had already learned how to hide it.

By the time she gets to my practice she has usually spent decades believing the problem is her character rather than her neurology. That she is fundamentally broken in some way that more willpower should be able to fix. That she is too much and not enough at the same time and that this is somehow her fault.

It is not her fault.

I didn't set out to specialize in ADHD in women. When I left agency work and started my own practice I finally got to choose who I worked with. My branding, my website, my whole vibe was built around one principle: if you don't let your weird flag fly, the other weirdos can't find you.

I had two main requirements. No Karens. No mediocre white men.

What happened after that was not a plan. Women kept finding their way to me and something would start tugging at me during sessions. I think she might have ADHD. Then another client. Same feeling. Then another. It happened so many times I started to wonder if confirmation bias was at play. If I was just seeing what I wanted to see.

But the data kept coming. Session after session. Woman after woman. Exhausted, brilliant, weird, funny, too much, not enough, completely undiagnosed or misdiagnosed. Somewhere along the way that became a specialty I never set out to have. I kept referring them for testing. I kept being right.

I haven't been wrong yet.

Then my own psychiatrist suggested it about me. And I shut it down immediately. I was convinced I had somehow tricked her. That I was gaming the system or jumping on a bandwagon. I refused medication for months. When I finally did take it I would take half the dosage, skip days, or not take it at all. I told myself I was just making excuses and that I simply needed to try harder and stop feeling sorry for myself.

I know. I know.

That is how good we get at hiding it. Even from the people who should know better. Even from ourselves.

I cannot begin to tell you how significant it was to find out that many of the things I had hated about myself, things I had hated my entire life and felt intense guilt and shame about, were because my brain is wired differently. It's not because there is something inherently wrong with me. I have always felt different because I am different. Not because I am less than.

What actually helps.

Let me give you the disclaimers I give every prospective client during our consultation. From the jump.

I have ADHD. I forget words. I forget what I was saying mid-sentence. Sometimes it's like a rolling metal bodega door comes down in my brain, nothing in, nothing out. I have a tendency to meander. I will follow a thread down a rabbit hole and you might wonder where we're going.

I always land the plane.

Clients apologize to me sometimes for being all over the place. For jumping around too much. I stop them every time. I am locked in. I can follow easily. That is not a problem. That is just two egg machines in the same room finally speaking the same language.

I am not a blank slate therapist. If what your friend did to you was wack, my face is going to look like I smelled a fart. You will know exactly where I stand. I don't use the therapist voice. I don't code switch into clinical professionalism when I walk into a session. I am Shylah in every situation.

I never won't be again.

Therapy for ADHD in women is not about fixing you. You are not broken. It is about understanding how your brain actually works and building a life that works with it instead of constantly fighting against it.

That means learning to recognize your patterns without judgment. The hyperfocus and the avoidance. The emotional intensity. The drink goblin situation. It means building systems that fit your brain rather than forcing your brain to fit systems designed for someone else. It means addressing the anxiety and depression that almost always show up alongside ADHD in women because of how long we've been trying to be something we're not.

Even when I model grace and acceptance and self-compassion in session, it takes a long time before clients stop feeling like I'm trying to enable them. Like giving themselves any kindness at all is somehow making excuses for their behavior.

I get it. I still struggle with it myself. The pot and the kettle, sitting across from each other in a therapy session, both trying to figure out how to stop calling themselves black.

That's the real work. Not the diagnosis. Not the medication question. Not the productivity hacks. The real work is learning that understanding yourself is not the same as letting yourself off the hook. That compassion is not the same as complacency.

We have spent so long being told we are the problem that being offered a different explanation feels like a trick.

It is not a trick. I promise.

It also means grieving a little. Grieving the years of not knowing. The times you were told you were too much or not enough. The version of yourself that might have existed if someone had caught this sooner.

And then, and this is the part I love most about this work, it means building something new. A life that actually fits. A self that you actually recognize.

I got my diagnosis at 41 and it changed everything. It is genuinely never too late.

This is me. On a Sunday. At a flea market. Holding a sulcata tortoise named Diva.

Diva loves reggae. She bobs her head to it. So do I. It's my favorite music.

I almost adopted her. I still might.

This is also what it looks like when you stop trying to be something you're not.

If any of this resonated with you, I'd love to talk.

Shylah Ridgway, LCSW, LICSW is the founder of Ala Therapy Collective and specializes in ADHD in women, LGBTQIA+ affirming therapy, and EMDR. She is licensed in Oklahoma, California, Hawaii, Massachusetts, Texas, and Utah. Currently accepting waitlist inquiries. Schedule a free consultation at alatherapycollective.com.