A look at “Women, ADHD and the missing years” by Rachael Martin (2026)
Picture a woman in her late forties who has spent decades holding it all together: job, family, ageing parents, a calendar like a game of Tetris. Then perimenopause arrives and the whole thing topples over. For a growing number of women, this is the moment they first discover they have ADHD. This feature in Therapy Today, the magazine of the British Association for Counselling and Psychotherapy, explores why, and what therapists need to know.
What it covers
This isn’t a research study but an investigative feature. It weaves together interviews with GPs, psychologists, therapists and coaches, women’s stories, and the author’s own experience of being diagnosed with autism and ADHD in midlife.
The key threads:
- Girls were missed. ADHD was long seen as a boys’ condition. Many girls, especially bright ones, internalised their restlessness and masked their struggles.
- Hormones matter. Falling oestrogen in perimenopause may make ADHD traits harder to manage. Practitioners describe women arriving in complete burnout after years of treatment-resistant anxiety and depression. The article cites estimates that up to 47% of women with ADHD experience PMDD, a severe form of premenstrual distress, and that rates of postnatal depression are three to four times higher.
- Access is unequal. NHS waiting lists can run to years, pushing many towards private assessment. But conversations about ADHD tend to centre middle-class, white women, leaving others without a voice.
- Therapy is often the lifeline. Therapists can’t diagnose, but they can offer a validating space to explore what a diagnosis means, untangle decades of masking and shame, and adapt how they work. For example, asking someone to “sit with their feelings” can be hard if they struggle to sense or name their internal states.
It also explores the overlap with autism (sometimes called “AuDHD”), which can feel like having membership of two clubs while not fully fitting into either.
A grain of glitter ✨
This is a warm, well-researched and genuinely useful piece, especially for therapists. But it’s journalism, not science, and should be read as such.
Much of it rests on interviews and personal stories, which are powerful but can’t tell us how typical those experiences are. Some of the hormone-related ideas, such as falling oestrogen affecting dopamine, are presented with confidence. Yet as the article itself admits, the research is “in relative infancy”. Headline figures like the 47% PMDD estimate come from a young and still-developing research area, so they’re best treated as early indications rather than settled facts.
It’s also framed entirely around cisgender women. Trans men, nonbinary people and others who experience periods, perimenopause or menopause aren’t mentioned, yet they may face many of the same challenges, often with even less recognition.
Why this matters
If you’re in midlife and recognising yourself in this, you’re not alone, and you’re not “just stressed” or “just menopausal”. It may be both, it may be neither, but it deserves proper curiosity. Good therapy can help you make sense of the past, protect yourself in the present and decide what, if anything, a diagnosis means for you.
Some unicorns don’t discover their horn until midlife. It was there all along; it just took a hormonal plot twist to notice it.