Ever feel like your mind is quietly racing behind a calm facade? You might blame stress or anxiety. But for many women and teen girls, this internal discomfort could be ADHD — especially if it looks different than what people usually expect.

Putting yourself in their shoes
Inside, ADHD in females often means chronic self-doubt, mental chatter, and emotional overwhelm. They may feel pulled in a hundred directions at once—trying to stay organized, keep up socially, and not make mistakes. Outwardly, they might seem calm, polite, and even high-achieving. That’s because many learn to hide, or mask, their struggles rather than let them show.

What others might notice

• Frequent forgetfulness, missed appointments, or lost items

• Long pauses before responding, or nervous fidgeting

• Avoidance of demanding tasks, despite knowing them well

• Quiet perfectionism, flawlessly covering up lapses to avoid judgment.

Why ADHD in females is often mistaken for anxiety
Both ADHD (especially inattentive type) and anxiety can make concentration feel impossible. Anxiety tends to come with excessive worry, fear of what might go wrong, and physical symptoms like racing heart or panic. ADHD often shows up as scattered attention, disorganization, and internal restlessness. When a young woman says, “I can’t focus, I’m always anxious,” it may actually be ADHD masking as worry.

One helpful view is to consider why focus breaks down. If it's tied to fear or what-ifs, anxiety is likely at play. If it happens even when the task matters, or even when excitement is high, that might point toward ADHD, especially hyperfocus or internal restlessness.

Using an ACT (Acceptance and Commitment Therapy) lens, we might say: anxious thoughts feel too big and overwhelming; ADHD thoughts feel too scattered and urgent. Recognizing the shape of your mind is the first step to choosing the right support.

Even high-functioning women and teen girls benefit from understanding their inner experience—whether it stems from anxiety, ADHD, or both. You’re not lazy or overly emotional. Understanding and help make a difference. If you’re curious whether this applies to you, a short self-check conversation Rick-Smith.com could bring clarity.

Thanks to Dr Neff for the helpful poster below.