Why ADHD Diagnoses and Medication Use Are Surging Among Women Over 35

The data is clear: more women are finally getting the answers they’ve been missing for decades. But what does this mean for health, stigma, and support?

For years, ADHD has been painted with a narrow brush: fidgety boys in classrooms, bouncing off walls, drawing constant attention. But that’s only part of the story. The other part—the one about girls quietly struggling, women silently sinking—is finally being recognised. And the numbers are telling.

A new study by the National Institute on Drug Abuse, published in JAMA Psychiatry, reveals a sharp rise in ADHD prescriptions among women aged 35 to 64—a group historically overlooked when it comes to neurodevelopmental diagnoses.

At the end of 2022, 1.7 million women in this age group were prescribed stimulant medications like Adderall or Ritalin. That’s up from 1.2 million in 2019—a 42% increase in just three years.

A Silent Struggle Finally Gets a Name

So what’s driving this shift?

Experts believe the surge is less about new cases and more about long-overdue recognition. Many women now in midlife were missed as children, either because their symptoms were misread as laziness or emotional instability—or simply because girls weren’t part of the ADHD conversation.

“Girls are more likely to be overlooked because the way they express ADHD isn’t likely to be captured by teachers,” explains Dr. Aaron Brinen, assistant professor of psychiatry at Vanderbilt University Medical Center. “They’re often labelled as daydreamers or anxious, rather than hyperactive.”

Brinen has known women who weren’t diagnosed until their 50s.

“It was the first time in their lives that they felt functional,” he says. “It’s a tragedy that it took so long.”

Misuse vs. Medical Need

The study also explored how stimulant medications are being used—and misused—across different age groups. Researchers found that women aged 35 to 64 were significantly less likely to misuse their medication compared to men (13.7% vs 22.0%) and younger women (13.7% vs 36.8%).

In total, just over 25% of all ADHD medication users reported misuse, and 9% met the criteria for a stimulant use disorder.

So why the lower rates among older women?

“For many, these medications aren’t about getting high—they’re about getting through the day,” says Dr. Mariely Hernandez, a clinical psychologist and postdoctoral researcher at Columbia University. “Women are more likely to use stimulants to restore a sense of normalcy, not escape from it.”

Why Now? Life, Hormones, and Mental Load

Often, symptoms of ADHD in women escalate with life demands. Parenting, career pressure, and shifting hormones can push already thin executive function past the breaking point.

“The executive function needed to manage a family may exceed their cognitive resources, especially when children are young,” Hernandez explains.

Many women are also being diagnosed at menopause, when estrogen levels drop, taking dopamine levels down with them—a key neurotransmitter tied to focus and motivation.

“Low dopamine can make everyday tasks feel impossible,” Hernandez says. “Women come in saying, ‘I can’t live like this anymore.’ That’s when the lightbulb goes on.”

A Diagnosis That Changes Lives—Too Late

For many women, finally being diagnosed with ADHD can bring relief—but also grief. Relief that there’s an explanation. Grief for the years lost to self-doubt, burnout, and misdiagnosis.

“Untreated ADHD can lead to a lifetime of feeling like a failure,” Brinen says. “These women weren’t lazy or disorganised. They were trying—really trying—and just constantly falling short.”

And once they’re finally prescribed medication that works, the idea of misusing it doesn’t even cross their minds.

“It’s not about feeling ‘better than’—it’s about feeling normal, often for the first time,” Brinen adds.

What’s Next?

This new data raises a pressing question: Why did it take so long?

Increased awareness, more access to telehealth, and a growing body of research are all helping to close the gender gap in ADHD care. But the fact remains—too many women still don’t know what they’re dealing with, and too few healthcare systems are built to notice.

If you’re struggling with chronic overwhelm, forgetfulness, or executive dysfunction, especially during major hormonal transitions like perimenopause or postpartum, you’re not alone—and you’re not broken.

You might just be missing the full picture.