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In this episode of Thoughts on Record, we sit down with Dr. Shirley Hershko, one of the foremost voices in the understanding of ADHD in girls and women. Her work has been central in challenging long-standing assumptions about how ADHD presents across the female lifespan—from childhood and early adulthood through motherhood, career transitions, perimenopause, and menopause.

Together, we explore why ADHD in women remains underdiagnosed, how cultural expectations shape symptom expression, and why internalizing presentations like anxiety, perfectionism, and emotional dysregulation often obscure the true clinical picture. We also discuss the impact of hormonal fluctuations, the role of trauma, and the unique diagnostic challenges clinicians face. Finally, we examine how treatment needs to be adapted to support women at different life stages, including those diagnosed later in life who are grappling with identity shifts, grief, and self-understanding.

This conversation offers clinicians, clients, and the general public a comprehensive look at the nuanced realities of ADHD in women.

Key Themes We Explore

• How ADHD in women is often misunderstood or hidden, including the influence of socialization and internalizing symptoms
• Diagnostic challenges, including confusion with anxiety, depression, trauma, and the effects of hormonal changes
• How ADHD evolves across the life span, particularly during major transitions such as parenting, career demands, perimenopause, and menopause
• Effective treatment considerations, including medication, psychotherapy, coaching, and lifestyle strategies
• Identity and emotional experiences, such as self-esteem, grief, and reinterpreting one’s life story after a late diagnosis

Dr. Shirley Hershko is an ADHD specialist, therapist, diagnostician, professor, and researcher at the Hebrew University. With more than two decades of clinical experience focused on ADHD in girls and women, she offers comprehensive diagnostics and therapy worldwide through secure digital platforms.

Dr. Hershko hosts a widely followed podcast, leads a Facebook community of 50,000 members, and is the author of the best-selling book Making Sense of ADHD. Her work centers on helping individuals with ADHD better understand their strengths, challenges, and unique neurocognitive profiles.

• Website: https://shirleyhershko.com