Understanding the meaning of a possible or confirmed ADHD diagnosis among apparently well-functioning women: a qualitative interview study

Adult women with ADHD are often diagnosed later in life which may impact overall well-being. Among women diagnosed in adulthood, symptoms are often internalized, and impairment may be hidden or compensated, while high levels of psychosocial functioning according to conventional social indicators may be maintained. Little research has explored what an ADHD diagnosis means for these apparently well-functioning women. In this qualitative study, semi-structured interviews were conducted with six adult women who self-identified as having ADHD and appear well-functioning according to conventional social indicators. Data were analysed using reflexive thematic analysis following Braun and Clarke. Six adult women aged 25-36 years were included; only three had a formal diagnosis while three did not. All participants were employed full-time and had completed higher education. Six themes were identified; “Why do I have to struggle?”, “Feeling miserable”, “ADHD as part of self-identity”, “Taking the blame away”, “Curiosity and scepticism regarding medication”, and “Lower the bar, and life gets better.” Overall, participants expressed subjective struggles despite high external levels of social functioning, including self-blame and low self-esteem. An ADHD diagnosis was perceived as providing validation, explanation and identity formation, although initially associated with illness and pharmacological treatment. These findings suggest that engagement with the ADHD diagnostic process among apparently well-functioning women is complex, involving need for explanation, validation, and identity negotiation. Recognition of this complexity may contribute to improved communication and understanding in clinical practice.