When ADHD Hides Behind the Mask of Bipolar: The Misdiagnosis Many Women Face
For countless women, the road to self-understanding is a winding one — filled with confusion, self-doubt, and years of wondering “Why can’t I seem to get it right?”
One of the most painful detours on this journey is the misdiagnosis of ADHD as Bipolar Disorder.
Both can involve emotional highs and lows, impulsivity, and racing thoughts — but beneath the surface, their roots and rhythms are profoundly different.
Why So Many Women Are Misdiagnosed
For decades, ADHD was viewed through a male-centric lens. Diagnostic criteria were built around how symptoms appear in young boys — restless, hyperactive, disruptive.
Women’s experiences, however, often look very different.
Instead of external chaos, women tend to internalise their struggles. Their ADHD might look like:
Emotional hypersensitivity and overwhelm
Chronic exhaustion from masking or over-functioning
Perfectionism and people-pleasing
Quiet daydreaming or mental restlessness
These subtler signs are easily mistaken for mood instability — particularly Bipolar II Disorder, where energy and mood fluctuate between lows and highs.
The Overlap — and the Crucial Differences
Both ADHD and Bipolar can share features like:
Impulsivity
Racing thoughts
Restlessness
Poor sleep
Mood swings
But the timing and triggers reveal the truth.
ADHD emotions can be triggered by internal aspects of low self-worth, people pleasing needs, or unmet needs; or external circumstances — a stressful day, sensory overload, or rejection.
Bipolar mood episodes are cyclical and sustained, lasting days or weeks, and often arise without any clear external cause.
A woman with ADHD might have bursts of motivation and creativity (hyperfocus), followed by mental fatigue — not because of mania and depression, but the hormonal fluctuations of menstration and the energy cost of living in constant overdrive.
Hormones: The Missing Link in Women’s ADHD
Hormones are often the hidden variable in women’s ADHD presentation.
Estrogen boosts dopamine and serotonin — chemicals vital for focus, motivation, and mood regulation.
Progesterone, which rises after ovulation, tends to lower dopamine and heighten emotional sensitivity.
As estrogen fluctuates across the menstrual cycle — and especially during premenstrual, postpartum, or perimenopausal phases — ADHD symptoms can worsen.
Mood instability, irritability, and exhaustion peak, mirroring bipolar cycling — yet they’re neurochemical fluctuations, not psychiatric episodes.
When hormonal interplay is unaccounted for, it can lead to a misread cyclical ADHD dysregulation as Bipolar Disorder. The result? Years of misdirected treatment, medication side effects, and self-blame.
The Emotional Unravelling — and Rebuilding
Receiving an ADHD diagnosis after years of being told you’re “bipolar” can be a profoundly emotional experience.
It’s often accompanied by two parallel emotions:
Grief — for the lost years of misunderstanding, the ineffective treatments, and the quiet shame of thinking you were broken.
Relief — the deep exhale that comes when the puzzle pieces finally fit.
This new understanding allows women to reclaim their story.
Their mood swings are no longer evidence of instability — but of a sensitive, responsive brain doing its best to regulate itself in a world that wasn’t built for it.
Finding Freedom in the Right Diagnosis
Getting the right diagnosis doesn’t just change treatment — it transforms identity.
It allows women to:
Access effective support (stimulant or non-stimulant medications, executive-function coaching, and ADHD-informed therapy).
Replace shame with self-compassion.
Rebuild trust in their own emotions and experiences.
For many, it’s the first time they can finally say:
“This is me. It all makes sense now.”
From confusion to clarity
At Holistic Haven Counselling, I often walk alongside women navigating this very transition — from confusion to clarity, from self-doubt to self-acceptance.
Through a trauma-informed, neurodivergent-affirming, and integrative approach, we unpack the layers of misdiagnosis, burnout, and emotional fatigue to help women rebuild their sense of self.
Because when you finally find a diagnosis that fits —
You’re not discovering what’s wrong with you.
You’re discovering what’s been true all along.