Can I Have ADHD at 45? 

Many women in their 40s  are concerned that they have ADHD.  They notice it is harder to keep track of things, remember names, and stay organized.   Perhaps this is you.  Is it difficult to “think clearly”?  There are multiple explanations for this.  ADHD is just one of them. 

woman sitting in front of the laptop computer in shallow photo. She is overwhelmed and confused.  She wonders if she has  adult ADHD?
Photo by Alexander Dummer on

Possible Reasons You Are Having Trouble Thinking.


   Approximately  23% of women suffer with anxiety.    Anxiety is a sense of unease or restlessness.  It does not always feel like “worry”.  In fact, many women who have anxiety don’t actually realize it.  They may obsess over small things, feel a need to control situations, or avoid new things. Women with anxiety will often jump to the worst case scenario first.   This can be useful in some situations.  If we did not have  any anxiety, we would not make safe choices.  However in overdrive, it can prevent you from experiencing life fully.  An unknown feature of anxiety is poor concentration. 

Anxiety can cause poor memory because you are unable to focus on the present. Therefore you are not absorbing the information to begin with. Your head is somewhere else, typically in the worst case scenario. 


Like anxiety, depression can also cause cognitive issues.  Depressed women may not always feel “sad”.  In fact, you may feel  anhedonic, or simply put “meh” .  You’re not unhappy but you are not experiencing any enjoyment in anything.  That favorite show is no longer so funny.  The morning coffee, while energizing, is no longer pleasurable. 

Depression can also cause poor concentration which then leads to poor memory.  It can also cause indecision. Lack of motivation is also a symptom of depression.  Women often confuse this with ADHD.  


Who is not stressed.  According to the Global Women’s Health  Index, 41% of women worldwide report high stress. Stress can make you feel like your mind is in a million places.  Its like having 20 tabs on your laptop up and you are constantly switching from one to another, not really absorbing any one thing. This can make one feel like they have ADHD. 


Perimenopause is the 10 year transition period to menopause.  It can start in your early 40’s.  During this period, estrogen levels fluctuate wildly and unpredictably,  Overall, they lower.  The problem with this is that estrogen is thought to help your brain function optimally.  Estrogen helps protect neurons.  These are the cells in your brain that fire together to help form thoughts, memories, and words. 

woman wearing blue shawl lapel suit jacket. She is super confident because her adult ADHD is treated.
Photo by Moose Photos on

But what if it really is ADHD?  

It absolutely can be.  Many women go their whole lives undiagnosed.  However, the key is you must have had symptoms in childhood.  Adult ADHD does not  develop in adulthood.  It starts in childhood and symptoms will wax and wane throughout adulthood.  Women tend to have more inattentive symptoms.  These include not paying attention in class or conversations, having difficulty starting work or attending to details,  and having difficulty sequencing tasks. Again, this all must start in childhood.    

Women who had ADHD as children may be able to function well as adults for long periods of time.  However, when more demands are put on them, they reach a tipping point. All of a sudden, the symptoms reemerge. 

What can I do for adult ADHD? 

First and foremost, get a proper diagnosis.  As written above, it may not actually be ADHD.  Treating it as ADHD will not actually help you in the long run. Plus, stimulants can make anxiety worse if that is the real cause.  It is best to see a Psychiatrist, Psychiatric Nurse Practitioner, or a Psychologist to get a proper diagnosis. 

If it is ADHD, there are many resources.  I recommend this book a lot to my clients.  You can also see an executive functioning coach.  Lastly, there are several medications that can help.  Wellbutrin and Strattera are non-stimulants that can help.  Vyvanse, Adderall, and Concerta are stimulants that are often used. 

What if it is not adult ADHD? 

The reason it is so important to get a proper diagnosis is to get the correct treatment. 

If it is anxiety or depression, therapy and/or medication can help a lot!  So can basic lifestyle management.  Say no more often and set boundaries.  Your kids do not need to do three activities each.  You may have to set more realistic expectations with your boss, too.  

These interventions will help with stress, obviously, as well. 

Exercise and a nutritious  diet are big helps as well.  Even a brisk 20 minute daily walk can improve cognition.  Processed foods are known to cause inflammation which may hinder proper brain function.  Stick to whole foods.  Limit alcohol and recreational drugs.  Marijuana, although sometimes can help people with ADHD, can also cause a loss of motivation and concentration in others.  

Lastly, if it is perimenopause, see your midwife or gynecologist.  Hormone Replacement Therapy can help a lot and is now considered safe for most women. 

If you are experiencing these symptoms and looking for help, call or email us today. Nurtured Well, LLC is dedicated to helping women live their best lives at all ages. 

About the Author

Sharon P.  FIsher is board certified as both an Adult and Psychiatric Nurse Practitioner. Her team serves women throughout Maryland on-line and in-person in Towson, MD.

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