Abstract
This study aimed to examine the experiences of late-diagnosed Indian women with Attention Deficit Hyperactivity Disorder (ADHD), focusing on gender-specific challenges. Six women, aged 25 to 33, participated in semi-structured, in-depth interviews, which were analyzed using thematic analysis. The participants’ experiences were conceptualized and thematically organized into three main themes: Theme 1: Not Wrong but Different–The Importance of Diagnosis, Theme 2: Negotiating with Normal–ADHD in Women's Daily Lives, and Theme 3: Embracing Authenticity–Aligned with, Not Against, the Self. The findings reveal how intersectional stigma shapes the struggle of Indian women with ADHD to meet societal expectations of neurotypicality and gender norms. Cultural expectations surrounding femininity heighten the pressure to mask ADHD traits, contributing to emotional exhaustion, anxiety, and burnout. The diagnosis offered a sense of validation and a path to self-acceptance, challenging long-held feelings of inferiority. By centring the intersectional experiences of Indian women, this study highlights an urgent need to understand ADHD not merely as a biomedical condition, but as a lived experience deeply shaped by societal and cultural norms.
Lay Abstract
This study aimed to examine the experiences of late-diagnosed Indian women with Attention Deficit Hyperactivity Disorder (ADHD), focusing on gender-specific challenges. Six women, aged 25 to 33, participated in semi-structured, in-depth interviews, which were analyzed using thematic analysis. The participants' experiences were conceptualized and thematically organized into three main themes: Theme 1: Not Wrong but Different — The Importance of Diagnosis, Theme 2: Negotiating with Normal — ADHD in Women's Daily Lives, and Theme 3: Embracing Authenticity — Aligned with, Not Against, the Self. The findings reveal how intersectional stigma shapes the struggle of Indian women with ADHD to meet societal expectations of neurotypicality and gender norms. Cultural expectations surrounding femininity heighten the pressure to mask ADHD traits, contributing to emotional exhaustion, anxiety, and burnout. The diagnosis offered a sense of validation and a path to self-acceptance, challenging long-held feelings of inferiority. By centring the intersectional experiences of Indian women, this study highlights an urgent need to understand ADHD not merely as a biomedical condition, but as a lived experience deeply shaped by societal and cultural norms.
Introduction
The term neurodiversity was developed collectively within autistic communities in the late 1990s (Botha et al., 2024). Bertilsdotter et al. (2020) describe the neurodiversity paradigm as a response to, and a challenge against, existing models that frame neurodivergence as deficits located solely within the individual. In contrast to the biomedical paradigm–which views conditions such as autism, attention deficit/hyperactivity disorder (ADHD), dyslexia, and other deviations from the norm as disorders or impairments–the neurodiversity framework understands these conditions as natural variations in the human brain. The neurodiversity paradigm emphasizes how environments are often not designed to accommodate diverse ways of processing information.
This approach de-centers the medical model and advocates for understanding the lives of neurodivergent individuals through their own perspectives. It incorporates an awareness of societal power structures, introducing the concept of neurotypical hegemony, which refers to the social dominance of cognitive ideals and the marginalization of atypical experiences and perspectives (Radulski, 2022). The paradigm challenges the assumption that there is only one “correct” way to think, learn, or engage with the world. Rooted in the biopsychosocial model of disability, the neurodiversity paradigm offers pathologized individuals tools for self-representation and advocacy.
Neurodiversity emphasizes lived experiences, critically examines prevailing cognitive ideals, and encourages new research and treatment questions. Lived experiences are recognized as essential for identifying the social causes of barriers to equality for neurodivergent individuals. Exploring social and cultural contexts underscores the need for structural changes that embrace neurodiversity (Bertilsdotter-Rosqvist et al., 2020). Finally, the paradigm promotes a strengths-based approach, moving away from the notion of neurodivergence as a “problem to be fixed.”
ADHD: Neurodiversity Perspective
Attention deficit/hyperactivity disorder (ADHD) has been conceptualized within the medical model as a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and/or impulsivity that interfere with functioning or development (APA, 2013). From a neurodiversity perspective, however, ADHD is understood as a cognitive variation—a unique way of processing information, paying attention, and interacting with the world—that should be recognized and respected as part of the broader spectrum of neurodiversity. Supportive societal structures can significantly improve the quality of life for individuals with ADHD by providing emotional, social, and practical support, enabling them to navigate daily challenges and thrive in various environments (Young et al., 2020).
Research has sought to address how the lives of individuals with ADHD—particularly women and gender minorities—have been misunderstood and largely ignored. Historically, ADHD was often perceived as a condition primarily affecting boys, leading to substantial underdiagnosis and misdiagnosis among girls and women (Attoe & Clime, 2023). Gender bias in the diagnosis and treatment of ADHD remains a significant concern. Martin (2024) observes that girls with ADHD are less likely to be diagnosed, receive later diagnoses, and are less likely to be prescribed ADHD medication. Quinn and Madhoo (2014) reviewed studies and found that boys typically present with more hyperactive-impulsive symptoms, while girls often exhibit inattentive symptoms, such as poor concentration, forgetfulness, and disorganization. These differences in symptom presentation contribute to boys being more frequently diagnosed, as their behaviors are more disruptive to their environments, whereas girls’ symptoms are often internalized, manifesting as shyness, anxiety, or depression. More recently, this sex-dependent presentation of hyperactivity has been challenged by Wettstein et al. (2024), who propose that hyperactivity in girls may be hidden rather than absent, underscoring the influence of social and gendered norms on the presentation of ADHD. Qualitative studies emphasize the significant role of sociocultural environments in shaping how women experience ADHD—often perceiving it as both challenging and, at times, beneficial (Nordby et al., 2023; Langvik & Holthe, 2017). Studies have identified recurring themes such as difficulties in accessing a diagnosis, minimal mental health support, loneliness, impact of gender stereotypes and masking (Morgan, 2023; Visser et al., 2024).
Neurodivergent girls and women often bear a significant burden of co-occurring physical and psychological conditions that have been overlooked by medical professionals (Kelly et al., 2024). These women frequently experience intersectional stigma, referring to the compounded or layered forms of stigma that arise when multiple marginalized identities intersect (Turan et al., 2019). In the context of ADHD, individuals often face stigma not only due to their neurodivergence but also because of factors such as gender, race, class, caste, religion, and other intersecting identities (Bergey et al., 2022). For instance, children of color are less likely than white children to receive an ADHD diagnosis, partly due to racial stereotypes (Morgan et al., 2013). Intersectional stigma highlights that various forms of stigma do not operate in isolation but interact to create unique and context-specific forms of marginalization and discrimination. Therefore, the struggles of women with ADHD are distinct and must be understood through their own lived experiences and perspectives.
Neurodivergence and India
Information regarding neurodivergence has been growing in past few years in India, however, diversity in learning styles and information processing in individuals continues to be shrouded with stigma and misinformation. Autism was mentioned for the first time in the Indian law in 1999, however it was not until 2016 that it received full legal recognition as a disability in the country. A famous Indian movie Taare Zameen Par about the struggles of a neurodivergent boy with dyslexia released in 2007 brought widespread attention to neural differences in children. Soon after the release of the movie the national educational board, Central Board of Secondary Education (CBSE) made significant progress and introduced special provisions for children with learning disabilities, autism, mental illnesses, and neurolgical conditions. Although children with ADHD tend to receive support under related categories, particularly when it co-occurs with other recognized disabilities, ADHD is not listed as a separate disability under the Indian laws.
There is a paucity of studies examining ADHD in India (Gore & Morgan, 2025). ADHD research in India in the past has examined ADHD from the medical model. Research primarily pertains to the prevalence rates and correlates. Studies that examine prevalence rates tend to align with global findings. Gender differences reported in studies in the West are replicated for Indian samples; ADHD in India is diagnosed less frequently in females (Venkata & Panicker, 2013). Consistent with the popular myth that ADHD is a condition of childhood, the majority of the studies focus on children. Few studies engage with topics like ‘awareness’ and ‘stigma’ (Shah et al., 2019, Mukherjee et al., 2016; Slagboom et al., 2021). Cultural beliefs have been found to significantly influence the perception of ADHD. A qualitative study with Indian parents found ADHD symptoms are perceived as behavioral issues rather than a neurodevelopmental condition (Wilcox et al., 2007). David (2013) reported that primary school teachers in India explained ADHD-like behavior as a result of child's unique learning difficulties or faulty parenting.
Literature in the recent past has examined lived experiences of women with ADHD in the West, however, to our knowledge, there are no studies focusing on lived experiences of Indian girls or women with ADHD. Researchers have highlighted the marginalization of scholarship and voices within neurodiversity studies in the Global South, emphasizing the importance of understanding the intersectional experiences of racialized neurodivergent individuals (Nair et al., 2024). A recent study on the current scenario of diagnosis and treatment of ADHD in urban India concluded that there is a “need to revisit the ADHD narrative in the Indian context” (Basu & Banerjee, 2021, p. 298).
Present Study
The present study is a qualitative investigation through an interpretivist paradigm that understands how people experience, perceive, and feel about their reality. This approach allows for exploration of nuanced and context-dependent experiences providing rich and detailed oriented insights (Creswell & Poth, 2018). The objective of the exploratory study was to understand the lived experiences of women with ADHD. In particular, the study focused on how the gendered expectations interact with the neurotypical expectations to contribute to the challenges experienced by Indian women with ADHD. The focus of the study was not to address the issue of accuracy of the ADHD diagnosis, instead to get in-depth understanding of the everyday lives of Indian women diagnosed at adulthood. The study is unique since it allows for inclusion of women with ADHD who are self-diagnosed. Self-diagnosis finds favour amongst neurodivergent population for whom official diagnosis may be unaffordable, inaccessible, and/or inaccurate (Fellowes, 2024). This is true in case of India where there is a serious scarcity of mental health professionals (Murthy, 2017). Second, in south-Asian countries like India, the stigma of mental disorders especially amongst women is an additional factor that prevents one from seeking an official diagnosis. Third, females with ADHD are likely to be missed out or overlooked or underdiagnosed by mental health professionals. Finally, inclusion of self-diagnosed individuals is consistent with the ethos of inclusion and empowerment within the neurodiversity paradigm. According to Fellowes (2024), self-diagnosing individuals often do intensive research; reach out to friends and family, access online communities and medical professionals. While self-diagnosis plays a crucial role in helping individuals understand their experiences—especially in the face of systemic barriers to formal diagnosis—it's important to also acknowledge its limitations. In many institutional contexts such as healthcare, social support systems, legal accommodations, or even in academia, self-diagnosis is not recognized. Self-diagnosis may also lead to misinterpretation of conditions overlapping with ADHD (e.g., anxiety, depression, autism, etc.) It is also vulnerable to confirmation bias. Keeping in mind the systemic barriers to obtaining formal diagnosis of neurodivergence, it is important that discussions around self-diagnosis both validate lived experience and address the systemic changes needed to make recognition and support more accessible. Isufi (2024) asserts that although self-diagnosis is prone to misdiagnosis, the surge of self-diagnosis is a response to inadequacies of mental health care systems in many parts of the world. Keeping in mind the limitations of self-diagnosis, we believe that by incorporating the experiences of self-diagnosed individuals screened for ADHD in exploratory qualitative research, we can gain valuable insights into the experience of having ADHD, particularly in populations that are often under-researched and under-diagnosed. Two broad questions guided the choice of research method, interview, and analysis.
Research Question 1
How do the six Indian women diagnosed with ADHD as adults perceive and describe their everyday lives?
Research Question 2
How does gender affect the experience of ADHD for these women?
Sample
Participants were six Indian women with ADHD. Requirements for participation included being female, aged 25 years or older, self or formally diagnosed with ADHD, fluent in the English language and scored equal to or greater than 14 on Adult ADHD Self-Report Scale (ASRS). The six participants were adult women aged 25–33 years. Four out of six women were born and brought up in urban cities namely, Delhi NCR, Mumbai, and Hyderabad. Remaining two moved to the city for higher education. All but one participant was residing in a metropolitan city in India at the time of the interview. Three out of the six participants (Saraswati, Parvati, and Kali) were self-diagnosed in adulthood. Remaining participants (Durga, Lakshmi, and Sita) had received a formal diagnosis (two by psychiatrists and one by a clinical psychologist), also in adulthood. All the participants were highly educated and all (except one) were employed. While there is no age-related cut-off when one examines late-diagnosis, 25 years and older was kept as an inclusion criterion, because it is typically the age in urban Indian context when women have finished their education, are likely to be employed, and/or be in an intimate relationship. We believe that participants 25 years or older typically would be able to reflect on their developmental history, challenges in education, work, intimate relationships and undiagnosed condition over time. Similarly, fluency in English language was kept as a criterion for three reasons. First, India is one of the most linguistically diverse countries in the world, and mother tongue for many individuals can vary. Secondly, the medium of instruction in most higher education in India is English. Thirdly, English is a dominant language in urban, clinical, and academic settings. To maintain parity, English fluency was selected as a criterion. Many of the participants suspected neurodivergence (ADHD) since many years, however they self-diagnosed or received a formal diagnosis (as the case might be) in adulthood. Demographic details and scores on Adult ADHD Self-Report Scale (ASRS) for the participants have been presented in Table 1.
Demographic Details and Scores on ASRSa for the Participants.
Note. aAdult ADHD Self-Report Scale.
Procedure
Before the beginning of the interviews, all participants were screened for ADHD using the Adult ADHD Self-Report Scale (ASRS) developed by Ustun et al. (2017) in conjugation with the WHO. ASRS is a widely used tool for screening for symptoms of ADHD in adults. According to authors, a score of 14 or above suggests a presence of ADHD. All the participants qualified for presence of ADHD.
Information about the study along with informed consent form was emailed to eight potential research participants by the first author of the study. In non-Western cultures, conversations on mental health (especially women's mental health) continue to be shaped by silence, shame, and stigma. Some of the potential participants had in the past reached out to the author and disclosed their diagnosis looking for psychological counseling referrals. Remaining participants were reached out through snowball sampling technique. Since some of the participants had already established a professional rapport and trust with the first author of the study it was believed that they would be both open and feel safer in participating in the study concerning topics that were personal, sensitive and stigmatized. Participants are also more likely to open up when they come through a trusted referral. Six out of the eight participants agreed to participate in the study.
A semi-structured interview guide was developed based on existing literature and exploratory conversations. Interviews explored the following broad themes: 1) Path to diagnosis and treatment of ADHD, 2) Living everyday with ADHD (academic, occupational, social, interpersonal functioning, self-esteem, strengths and identity), 3) Gender and social expectations. In-depth interviews were conducted each lasting between 1.5 and 2 h. All interviews were conducted online using the Google Meet software between September and November 2023, and were digitally recorded, transcribed, and analyzed. The first author of the study was the primary interviewer. The remaining authors were part of the interview but their role included taking notes, recording and transcription of the interviews. The first author of the study comes from an academic background with research interest in gender studies and mental health. All the authors of the study recognize the underrepresentation of the experiences of women of colour in mental health literature. They approached the research through a feminist and neuroaffirmative lens that values lived experience as a legitimate form of knowledge.
The study does not have an ethical approval from a recognized institutional ethics board. The ethical review board of the university, also known as the Delhi University Institutional Human Ethics Committee, was only recently constituted. While the exact date of its constitution is unavailable, however the body was registered as recently as December 2024 with the Central Drugs Standard and Control Organisation (Ethics Committee Registration Division) of India. Public universities in India, including the University of Delhi have only recently begun establishing formal Institutional Ethics Committees to provide systematic ethical oversight for research activities. Prior to that it has been an accepted practice to conduct research by adhering to established ethical principles and guidelines. For our paper we have used the APA guidelines, ensuring respect for participants’ rights, confidentiality, and informed consent. Participants were provided with full information about the study, including its aims, methods, voluntary nature, and confidentiality assurances. Second, informed consent was obtained via email before participation. Third, participants had the right to withdraw at any stage without consequence. Finally, all identifying details were anonymized; pseudonyms were used.
Data Analysis
The interviews were analyzed using thematic analysis (Braun & Clarke, 2006, 2019). The author engaged in repeated reading of the interview transcriptions in the familiarization phase of the analysis. After which initial codes were generated through line-by-line coding. The analytical approach comes close to a mixed approach since it was guided by the semi-structured interview schedule (deductive) and interpretation of raw data i.e., the interview text (inductive). Several of these codes were then grouped based on patterns of shared meaning. The categories were refined for development of themes making sure that the data within each theme were coherent and meaningful and the distinct from data outside the themes. The three core themes are described in Table 2.
Main Themes Generated and Corresponding Quotes.
To ensure the validity and trustworthiness of the findings, each participant was provided with a summary of the findings that included interpretations, themes, and conclusions drawn via email. They were asked for their honest feedback and were asked to highlight any discrepancies or inaccuracies. Out of the six participants responded, five provided feedback, which was primarily confirmatory in nature, with minimal new information emerging from the participants. One participant did not respond to follow-up requests for member checking. Member checking helps in providing validation and credibility to the findings of qualitative research (Birt et al., 2016).
Results and Discussion
The three core themes generated from the data analysis guide the presentation of findings (Table 2). Theme 1 covers the meaning that diagnosis of ADHD holds. Theme 2 gives a rich description of negotiating the normal in everyday lives of women with ADHD. And finally, theme 3 emphasizes on the active process of living an authentic self in light of the neurological differences and social context of one's existence.
Theme 1. Not Wrong but Different: The Importance of Diagnosis
This theme explores how Indian women with ADHD navigate lifelong feelings of being ‘different’ and ‘not normal’ due to unmet neurotypical and gendered expectations. Diagnosis of ADHD in adulthood serves as a pivotal moment of validation, helping them reframe self-criticism as neurodivergence rather than personal failure.
Women with ADHD encounter implicit expectations of normalcy shaped by neurotypical standards and gender norms growing up. “My normal was NOT other's normal” (Parvati). Although all the participants of the study realized they had ADHD as adults, they shared childhood experience of ‘being different’, “I always felt different. I always felt that I do not operate the same way as all my other classmates did in school. (Sita).” Many participants recalled being reprimanded for in childhood for behaviors such as forgetfulness, fidgeting, restlessness, excessive talking, difficulties with organization, emotional sensitivity, distractibility, and sensory differences. These traits align with what are now recognized as symptoms of ADHD (Barkley, 1997; Gnanavel et al., 2019; Posner et al., 2020). However, the experiences of the women with ADHD reflect that ADHD traits are perceived differently in girls relative to boys. Inattentive ADHD behaviors like forgetfulness, zoning out, disorganization, carelessness, etc. may go unnoticed by those around them (Quinn & Madhoo, 2014; Gershon, 2002). “I am busy here (points to the head), not physically. So, how would you pick me out?” (Lakshmi). Behaviors related to physical hyperactivity were often perceived as being viewed as behaving like a “wrong kind of girl.” A participant shared, “My friends and family would tell me that Kali was supposed to be born a boy, but she's a girl. In my head I was always like I don’t want to be like a girl because it was so suffocating but at the back of my head I was thinking that I am a girl, I should be like that.” (Kali).
The inability to fit into the social expectations for girls (quiet, demure, silent, proper, compliant, and well-behaved) would result in not only being reprimanded, but also shamed. Agents of socialization in India perceive hyperactivity in children as a discipline problem. David (2013) found that ADHD behaviors were attributed to parent disciplining styles and environmental factors such as over exposure to electronic media in India. Studies on parenting in Indian and South-Asian cultures show that there are higher rates for physical punishment among Asian (mainly Pakistani, Bangladeshi, Indian) compared to White parents highlighting cultural variations in disciplinary practices (Jambunathan & Counselman, 2002; Pinquart, 2021). In girls, hyperactivity as a discipline problem is compounded by the gendered expectation for girls to be quieter and less active than their male counterparts. “I have lost the number of times as a child I was told, you talk too much or like why are you speaking so much? Why are you speaking out of turn? You should be quiet, shouldn’t give your opinion too much.” (Parvati)
Not only hyperactivity, traits like argumentativeness or independent thought considered acceptable for male counterparts were perceived differently for women. For instance, in Indian society, cultural norms make it challenging for women to express dissent, especially towards older male family members, “Even as a kid I would talk back to uncles (older unrelated men) so that was technically not a good girl behavior. But that was where I couldn’t keep quiet. Boys were allowed to be rude. I couldn’t be rude. I had to be nice.” (Durga) Overall, women with ADHD were left with a feeling of being “not normal”. They used words like “stupid”, “weird”, “awkward”, “too much”, or “difficult” to describe their behaviors that did not fit into social expectations.
“Now that I think about it there were days before TV and electricity, like there were lots of times, I remember I would just lie on the floor and I’d tell my mom, “Mom I’m bored” and she’d be like “It's all in your head, just think you’re not bored” but I used to lie down on the floor and just think I want to do something, you know. I used to tell her I feel like something is inside me and someone is banging on my chest and she’d just brush it off. I think that was also one thing that was weird about me” (Kali)
Arriving at the words ‘A-D-H-D’ is a long-standing struggle for late diagnosed Indian women with ADHD. Most participants grew up in pre-Internet India, a time when public discourse and education around mental health were virtually non-existent. Mental health awareness was minimal, and conditions like autism or ADHD were largely unheard of, especially in girls. Childhood conditions were often narrowly perceived through the lens of intellectual disability, which was severely stigmatized. Notably, autism was only officially recognized in India in 1999. Prior to that, children exhibiting autistic traits were often misclassified and received the same interventions as those with intellectual disabilities (Srivastava et al., 2024). While autism and dyslexia are recognized as disabilities under the Indian law, ADHD is not.
Some participants who sought help from mental health professionals in adulthood reported that their condition was either overlooked or misidentified. A woman shared, “But my argument was that I think the anxiety was caused by the undiagnosed condition and I needed my answers. I was even blocked by a few psychiatrists because I asked too many questions.” (Saraswati). The National Mental Health Survey of India (2015–2016) reported a serious shortage of professionals in the country, with fewer than 9,000 psychiatrists available to serve a population of over 1.4 billion (Murthy, 2017). In the absence of mental health infrastructure, individuals are likely to access the Internet for information. A study conducted in New Delhi India, found that those with higher education, and those from upper-middle and higher socioeconomic backgrounds being more likely to engage in online health information-seeking behavior (Parija et al., 2020). All the women had done excessive reading and researching on the topic of ADHD. Some of them received professional diagnoses, while others refrained from going to professionals. Some women felt a general apprehension at being misunderstood or misfit where diagnostic criteria are concerned. A participant shared, “Hesitancy is because I don’t know who to go to? Who would get the nuances?” (Kali) In all cases, learning about ADHD helped reduce long held perceptions of inferiority and helped remediate some shame and guilt. The participants learnt over time that their differences had a name and that they are not alone. Adult or late diagnosed neurodivergent women have been found to experience feelings of relief and validation after years of self-doubt (Wilson et al., 2023; Langvik & Holthe, 2017).
Diagnosis, treatment, and psychoeducation contribute to a shift in perspective in ADHD individuals, reducing feelings of inadequacy and foster a sense of empowerment (Barkley & Murphy, 2006). The realization that one does not lack intelligence or ability in general, was a common. A participant shared, “When I got diagnosed I realized. I am intelligent. I’m not stupid. I’m just struggling.” (Sita) Scientific terms such as time blindness, emotional dysregulation, executive functioning, attentional difficulties, etc. come to replace the previously held hypercritical views about self. For the women learning about their neurodivergence provided them with an opportunity to liberate themselves from the shackles of “normalcy” defined by neurotypical and gender hegemony. “There's a term, it's an official thing, and it is scientifically proven. It just takes so much pressure away you know.” (Kali)
Overall, ADHD behaviors were perceived as personal flaws or discipline problems, for females who were expected to be quiet and compliant. This led to internalized shame and low self-esteem for the participants. A late understanding of their neurodivergence offered the women a sense of validation, allowing them to reframe their behaviors as differences rather than personal failings.
Theme 2: Negotiating with Normal: ADHD in Women's Daily Lives
This theme explores how Indian women with ADHD experience the concept of ‘normalcy’ as a rigid, gendered construct, leading to constant negotiations, masking, and emotional labor in order to manage misunderstandings and meet societal expectations. Participants shared that misunderstandings often emerged in family, social, and professional settings when their differences clashed with socially defined expectations of normalcy rooted in neurotypical and gendered norms. These misunderstandings became sources of conflict that required frequent clarifications. For instance a participant remarked, “I am often told that how are you playing a game and watching (TV), like why are you not listening? I’m like no, I’m actually listening better, you know while doing this.” (Parvati).
Executive functions like planning, time perception, organization, task initiation, and emotional regulation (Barkley & Fisher, 2019) facilitate task and self-management, however, the expectations surrounding both are influenced by gender norms. Indian women are expected to disproportionately take up the responsibility of tasks that heavily employ the use of executive functions such as caretaking, caregiving, and household management. By contrast, in Indian society, men are not typically expected to participate in domestic labor. According to a recent report, Indian women spend 6 h per day on unpaid household and care work, compared to 52 min by men. This is among the highest levels of unpaid domestic labor for women in the world (OECD, 2020). Women participants experienced being shamed for struggling with cooking, cleaning, multitasking, organizing, planning, and remembering. A participant shared “When people come to my home they are like this looks like as if a bachelor is living here. I was so ashamed that I didn’t bring people home.” (Lakshmi). Middle and upper middle class Indian women participants with ADHD reported finding support in hiring domestic support (who are often women from marginalized backgrounds).
Where emotional regulation is concerned, women with ADHD perceive themselves to be more sensitive than others around them. Many described their struggles with rejection sensitivity i.e., an extreme response to a perceived or an actual rejection leading to significant distress (Bedrossian, 2021). A participant shared her experience of heartbreak, “we are very emotional people. It's very difficult for me to go through pain. I’ve seen people go through heartbreak and pain and with more ease without it being so gut-wrenching. It's very tough to go through pain because it's a lot more painful, I guess.” (Sita) Difficulties with regulating emotions, experiencing emotional highs and lows were found to conflict with the social expectation that women should be calm and composed. Concurrently, some of the women were at the receiving end of the ‘dramatic or unstable woman’ trope as a result of their emotional struggles. A participant shared, “My PMS symptoms were so bad, it came to an extent that it would be like a totally different person. The week before the periods I was like, you know I don’t want to talk to anybody….. my mind would be like f*** it, we’re not going to do anything, we just want to lie in the bed and not talk to anybody” (Lakshmi). Research has shown that women with ADHD experience premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS) characterized by mood swings, irritability, depression, and anxiety (Dorani et al., 2021). Women with ADHD are likely to be misdiagnosed with disorders like bipolar disorder and borderline personality disorder (BPD) largely because of the emotional dysregulation. Moukhtarian et al. (2021) reported that emotional dysregulation should not be used in clinical practice to distinguish between ADHD and BPD.
Women with ADHD go to extreme lengths to hide disorganization, forgetfulness, emotional outbursts or time blindness, often by meticulous planning, using excessive reminders, social monitoring, or withdrawing emotionally. Protective compensatory mechanisms like masking or camouflaging which means suppression of socially atypical behaviors and alignment with the neurotypical standards (Quinn & Madhoo, 2014; Barkley & Fischer, 2019) is heavily employed in everyday lives as means of accessing ‘normal’. One of the participant uses the term “cosplaying normal” to communicate her attempts at masking her atypical traits. Conscious attempts to reduce ones physical hyperactivity or emotional reactivity to fit in are a common experience.
“I get very excited when I’m talking about things I like, whether it's a new book, whether it's something like what happened at work, or something, even this, right. Like if I get very excited, I know I can go on for hours, I can talk a lot, right. And so, it's almost like a conscious thing like when I notice myself getting excited, especially when I’m with my friend, we’re talking about something we both like, umm, I kind of try to consciously taper ki zyaada toh nahi ho raha (is it too much?)” (Parvati)
Although principles of accommodations in disability are rooted in the idea of equity and access, it is also gendered. Participants shared experiencing barriers that are not there for their male counterparts. “Lets say I was not reading or something, for the boys it might be accha khelna hai, iska khelne ka man nhai, khelne do (he wants to play, let him play), let him walk it off kind of a thing. I would say the threshold of tolerance is higher, right? But for a girl, it's almost like what are you doing? Why are you doing this? The kind of restriction is more. So I think the need to mask is more.” (Parvati) Male privilege allows social setups to be more accommodating to make space for men, “If it were a guy, the system would have changed. His job description may change, depending on how valuable he is.” (Lakshmi) In this way the women perceive accommodations less accessible. The construct of ‘normalcy’ itself is less accessible for neurodivergent women interviewed due to intersectional stigma experienced. One participant highlighted the importance of physical safety that Indian women continue to be deprived of in public spaces, “If I’m feeling too stimulated, boys can go out for a run, but I would not be very comfortable, I would have to think of my safety.” (Saraswati).
Indian women with ADHD face unique challenges in fulfilling socially expected roles like caregiving and managing domestic responsibilities, which are compounded by gendered expectations. Additionally, they experience heightened scrutiny and limited accommodations compared to their male counterparts. The intersection of neurodivergence and gender creates barriers that make negotiating with ‘normalcy’ an everyday challenge.
Theme 3: Embracing Authenticity: Aligned with, Not Against, the Self
Authenticity in ADHD women involves coming to terms with a lost childhood, management of everyday conflicts, creating safe spaces for self expression, honing of personal strengths and advocating for one's needs and well being. After years of masking, overcompensating, and striving to meet neurotypical and gendered standards, many participants described a gradual shift towards honoring their own strengths, limits, capacities, and needs.
Embracing authenticity involves a conscious and often challenging process of unlearning internalized expectations rooted in both gender norms and neurotypical standards. Knowledge of one's neurodivergence is experienced as “an answer to all the questions”. Late diagnosed women with ADHD often experience grief upon receiving a diagnosis of ADHD (Sander-Williams, 2024; Craddock, 2024). Reading and researching about living with ADHD helped the participants see their own struggles with fitting in. “It's always them trying to fit me into a mold, which I cannot fit in.” (Lakshmi). Reflections on the gender biases in ADHD also help women understand that their struggles were also gendered in nature, “When I saw that colleague of mine could be his ADHD self I was like, “Oh! I can be that as well and people won’t mind”. I’ve been masking all my life, but he isn’t masking. I’d be like, “okay, so that is acceptable, I can be like that.” (Kali) There is an acknowledgement of trauma that comes with being a neurodivergent woman living a society that is unaccommodating and even unforgiving of differences. Research has found a bi-directional relationship between trauma related disorders and ADHD (Boodoo et al., 2022). A participant shared her understanding, “Show me one neurodivergent person who is not traumatized because the Venn diagram is very overlapping.” (Durga). The women are able to see themselves growing up as children who needed support, care, empathy, and understanding of adults around them. Something they are working towards being able to give to themselves today.
Unmasking or being able to express oneself in a manner that is more true to self in safe spaces helps women with ADHD embrace their authenticity. While women realize that unmasking is not possible in all spheres, they are coming to separate the mask from the true self more and more everyday. There is a growing acceptance of behaviors they did not allow themselves to have earlier. For instance a participant shared, “knowing is being able to say that the it's okay if I’m zoning out. Understanding that there are things that are okay, that had to be hidden (earlier).” (Parvati) The women perceive social support to play a crucial role in unmasking. Studies have found that social support plays a crucial role in managing the everyday struggles with ADHD, especially for women (Young et al., 2020). One of the ways in which ADHD women have been able to manage their life is by asking for help. From being a shame-inducing act, there is movement to perceive getting support as a right.
A practice in authenticity involves greater appreciation of one's strengths, something women with ADHD were unable to see underneath the heavy weight of critical comments. ADHD is characterized by unique strengths, such as creativity, hyperfocus, high energy, resilience, and strong interpersonal skills (Honos-Webb, 2008), “I think it has been nice because I think ADHD makes you very impulsive and in-the-moment, so my friends always find it comfortable to be with me, around me. We always have a lot of fun. So in that aspect it is great. The crowd-pulling ability is like, good, (laughs), when required. Like a jester, if I might say so.” (Lakshmi). The inherent curiosity and passion for learning among individuals with ADHD (Steglich-Petersen & Varga, 2023) motivate them to delve into scientific literature about their condition, “At least I found language to explain my experiences because I still continued to read and know more about neurodivergence, I still consume a lot of content about it from reliable sources and as much as I can and where I can I do try to stand up for myself.” (Saraswati). Creativity and out of box thinking enable women with ADHD to come up with novel solutions that work for them (Sedgwick et al., 2019). Self-compassion although not always easy, helps women to embrace their challenges and cultivate more supportive inner dialogues. It helps shift perspective from “right” (neurotypical/gendered) way of functioning to ones that work for them. Women with ADHD shared making small changes are made in everyday lives to support their needs (e.g., quiet spaces, visual reminders, timers, planners, calendars, colourful notes, apps etc.). “I take notes when someone is speaking something verbally as it takes time for me to process it verbally. Earlier I used to feel they will judge me. I also ask them to repeat, even if they judge, I don’t care because this will help ME” (Lakshmi). “I’m trying to own my life, a little bit more everyday and call it mine so that my self-esteem is built on my reality, rather than what I’m being told to believe. My parents have told me that the vibe you give now is how you were as a kid. So I think that is something really nice, because as a young kid, I was blissfully happy.” -(Lakshmi)
Discussion
The stories of the participants of the study present an insight into the lives of urban Indian women who find themselves deviating from the acceptable standards of normalcy within their cultural contexts. The findings provide support to the idea that neurodivergent women tend to experience intersectional stigma. It underscores how normative constructs of girlhood and womanhood in India can obscure ADHD behaviors, contributing to delayed recognition, misunderstandings, and chronic invalidation. Executive function challenges become more visible when tasks aligned with gendered expectations—such as caregiving, household management, and emotional labor—demand constant self-regulation and organization from women. For these women, learning about ADHD later in life acts as a profound shift in perspective—reframing lifelong struggles not as personal failings but as presentation of an under-acknowledged condition.
A key strength of this study is the detailed and multifaceted personal accounts obtained through the interviews. Indian society is deeply influenced by traditional gender norms, which often emphasize certain roles and behaviors for women, such as being nurturing, calm, and well-behaved. Findings illuminate how cultural scripts around femininity, discipline, and caregiving heighten the pressure to mask, contributing to emotional exhaustion, anxiety, and identity confusion. Women with ADHD engage in the everyday task of challenging the deeply ingrained societal norms that have shaped their self-perceptions and coping strategies in an attempt to carve out a more authentic existence. The findings highlight the need for greater awareness among researchers and practitioners regarding the cultural contexts that influence how ADHD is lived, perceived, and often misunderstood in women.
There are also some limitations to this study. First, the small sample-size calls for cautiousness in the interpretation and transferability of findings. All the women learned about their neurodivergence as adults. The participants are highly educated, urban, English speaking, and belong to middle-upper-middle SES. All but one woman were employed. As such, the findings may not represent the experiences of Indian women from rural areas, non-English-speaking populations, or those with limited access to education or healthcare. Half of the participants were self-diagnosed and may raise concerns of validity of the diagnosis. Self-identification, while valid and empowering within neurodivergent communities, may not be accepted in more conservative clinical or cultural settings, where formal diagnosis is often viewed as the only legitimate marker of a condition. While the study considers gender and cultural context, the scope of intersectionality is limited. Factors such as caste, religion, disability status, and sexual orientation—which can further shape the experiences of neurodivergent Indian women—are not systematically explored.
While the study cannot claim generalizability, it provides critical insight into a population that is understudied and often overlooked in both global and Indian mental health frameworks. Ultimately, this work affirms the urgent need to understand ADHD not just through a biomedical lens but also as a lived experience shaped profoundly by societal norms. Future research should expand to include more diverse voices and explore systemic pathways for early recognition, gender-sensitive diagnosis, and culturally informed support. Finally, this study calls for raising greater awareness for ADHD in adult women in India, where it is largely seen as a childhood condition mostly affecting boys.
Footnotes
Acknowledgements
We acknowledge with gratitude all the participants of the study who made space for helping others learn from their lived experiences.
Author Contributions
All the authors contributed to conceptualization of the study, data college, data analysis and manuscript writing.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Disclosure Statement
The authors declare that no funding was received for the research, authorship, and/or publication of this article. Informed consent was obtained from all participants involved in the study. This study is not a clinical trial and therefore does not have a trial registration number. No specific grant number was associated with the funding of this research. The study was conducted in accordance with ethical guidelines for research involving human participants. The authors declare no conflicts of interest related to this study. The manuscript has not been previously published or submitted elsewhere. No supplementary material is available. The qualitative data generated and analyzed during this study, including interview transcripts, are not publicly available due to ethical considerations and confidentiality agreements with participants. However, the data may be accessed upon reasonable request by contacting the corresponding author, provided appropriate ethical approvals and data use agreements are in place.