The Interplay of ADHD, Urgency, and Anxiety in Women

For many with ADHD, the relationship between their neurodivergence and anxiety is complex and often misunderstood. According to a recent survey, women with ADHD are significantly more likely to experience anxiety disorders compared to their neurotypical counterparts.

Understanding the Urgency-Anxiety Cycle

Women with ADHD often experience "urgency-driven anxiety." This manifests in two primary ways:

• Task Paralysis: Despite feeling intense urgency about completing tasks, many find themselves unable to start, leading to increased anxiety
• Last-Minute Rush: the ADHD brain may require the natural dopamine boost from urgent deadlines to engage with tasks In a brain that has a dysfunctional dopamine system the rush of procrastinating helps us focus.

The Female ADHD Experience

According to the Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) organization, women with ADHD often face unique challenges:

• Later diagnosis than male counterparts (average 12 years later)
• Higher rates of internalized symptoms
• Greater likelihood of developing compensatory strategies
• Increased masking of symptoms in social situations

Hormonal Influences

Hormonal fluctuations can also significantly impact both ADHD symptoms and anxiety levels in women, particularly during:

• Menstrual cycle phases
• Pregnancy
• Postpartum period
• Perimenopause and menopause

Treatment Considerations

• Medication (when appropriate)
• Regular therapy sessions
• Lifestyle modifications
• Support group participation

Gendered Expectations

Remember when women's work was a full-time job? Well, instead of becoming shared labor, it became the invisible overtime that no one pays you for, thanks you for, or notices unless it's not done. "Will you quit nagging me?" and "MOM! Where are my soccer cleats?!" Layer in these gendered expectations and invisible household management on a brain that struggles with executive functioning, and it makes total sense you are anxious, irritable, and overstimulated.

What Do We Do About It?

While what works for each person is different there are some broader themes that may be helpful.

Here are actionable strategies to help manage these interconnected challenges:

1. Create External Structure

• Time blocking: Designate specific times for tasks to reduce decision fatigue
• Timed reminders: calendars or digital tools to externalize memory demands, sticky notes sound great until you’ve been staring at a sea of them for weeks with no idea when it’s due or which to do first. Ask Siri to remind you in an hour, a day, at a location to do the task you needed to remember
• Body doubling: Work alongside someone else (in person or virtually) to increase accountability and motivation

2. Practice Self-Compassion

• Recognize neurological differences: Understand that your brain processes differently, not deficiently
• Challenge perfectionism: Set realistic expectations, perfectionism is a rachet wrench that only tightens until the bolt snaps.
• Celebrate small wins: Acknowledge progress, no matter how incremental

3. Address Gender Expectations

• Delegate responsibilities: Create clear systems for sharing household management, I love the card deck from Fair Play. Books I’m also loving in this vein Fed Up by Gemma Hartley, How Not to Hate Your Husband After Kids by Jancee Dunn, and of course Fair Play by Eve Rodsky
• Set boundaries: No is a full sentence. Your tasks your to manage and your partner’s, children’s, or coworker’s are theirs.
• Make invisible work visible: Document and communicate the mental load you carry. Try it, just for a week see all of what you do, decide what’s worth it, what’s getting outsourced, and where are your time sucks.

4. Develop Sustainable Coping Mechanisms

• Snowball your tasks: Stop trying to find the right task to start when facing task-paralysis and pick one, let the inertia of crossing something off your list roll into more things even if it’s not the right order.
• Use the 5-minute rule: Commit to just five minutes of a dreaded task, after that you can quit if you want, I promise.
• Don’t Put it Down Put it Away: Seems silly, but it works. The counter top is where things go to die [collect dust].

5. Seek Professional Support

• ADHD-informed therapy: Work with clinicians who understand the unique challenges of ADHD in women
• Medication evaluation: Discuss whether medication might help improve executive functioning and reduce anxiety
• Hormonal assessment: Track symptom changes throughout your cycle to identify patterns

Remember that implementation will look different for everyone. Start with one or two strategies that resonate most with you rather than trying to change everything at once. Progress isn't linear, and what works may evolve over time as your needs change.

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