For many teenage girls, school is a place to discover who they are and how they fit in. But for girls with ADHD, that journey often involves masking their true selves to meet expectations—leaving them emotionally drained and questioning their identity.
A new study by Jan Grimell, Maja Ericson, and Matilda A. Frick, published in Frontiers in Psychology (2025), explores how adolescent girls with ADHD navigate identity development while managing social norms, school pressures, and the effects of medication.
The researchers found that girls with ADHD often feel compelled to suppress their authentic behaviors and emotions in order to appear more socially acceptable. This constant self-monitoring, particularly in school settings, was described as exhausting and emotionally taxing.
ADHD is a common neurodevelopmental condition affecting attention, impulse control, and activity levels.
Although boys are more frequently diagnosed in childhood, recent data from Sweden show that ADHD is now slightly more prevalent among young adult women.
Girls, however, often remain underdiagnosed and understudied, partly because their symptoms tend to be less overt and more internalized than those of boys. This delay in recognition can create complex identity issues, especially during adolescence.
To examine these experiences, the researchers conducted in-depth interviews with ten girls aged 15 to 18 in the greater Stockholm area. All had been diagnosed with ADHD and were attending upper secondary school.
The interviews were analyzed using thematic and abductive methods, drawing on theories of identity by sociologists George Herbert Mead and Erving Goffman.
The participants described a recurring tension between how they naturally behaved and how they felt expected to behave—what the researchers refer to as the conflict between the “I” (the spontaneous self) and the “Me” (the internalized societal expectations).
School, in particular, emerged as a central site of this identity struggle.
The girls reported feeling pressure to be quiet, focused, and socially competent—traits that conflicted with their ADHD symptoms.
To meet these expectations, they frequently engaged in what the researchers termed “social camouflaging”—modifying their behavior, mimicking peers, and suppressing impulses to avoid being labeled as disruptive or different.
Many said this masking behavior left them drained by the end of the school day, often resulting in physical and emotional fatigue.
Some described collapsing at home after school, needing hours to decompress.
Although adjusting to social norms is common during adolescence, the study suggests that for girls with ADHD, this process is intensified and more burdensome due to the continuous effort to regulate behaviors that are core to their neurological profile.
Medication was another significant factor in the identity work described by the participants. While stimulant medication helped some girls improve focus and academic performance, several felt that it changed who they were.
One participant noted that her teachers appreciated the calm version of her on medication, while her friends missed her spontaneous and humorous personality. This raised questions about authenticity—whether success in school was worth feeling like a different person.
The study also highlighted the role of stereotypes.
Several girls reported feeling alienated by the public image of ADHD as a “boy problem” characterized by aggressive or hyperactive behavior.
Because they didn’t fit that mold, some initially questioned whether they had ADHD at all. Others felt that their symptoms—such as emotional intensity or forgetfulness—were misinterpreted as personal failings rather than part of their condition.
Despite these challenges, some participants found ways to integrate their ADHD into their identity in a positive way.
A few described learning to embrace their impulsivity as a strength in social situations, reframing traits once seen as problematic into assets. However, this acceptance often came only after years of internal conflict and negative feedback from adults and peers.
The findings underscore how social environments—particularly schools—can shape not only educational outcomes but also psychological development.
For girls with ADHD, school was often the setting where their symptoms were first flagged and their diagnosis initiated. Yet it was also a place where they felt most pressured to conform.
The authors argue that rather than focusing solely on medical interventions, schools should consider structural changes such as smaller class sizes and more individualized support to create inclusive environments where students can succeed without compromising their sense of self.
These insights are especially relevant given the rising number of ADHD diagnoses in Sweden and elsewhere. The study suggests that this trend may not reflect a sudden increase in the condition itself but rather growing awareness and changing social expectations, particularly in academic settings.
While the study is limited by its small sample size and qualitative design, it offers a rare look into how adolescent girls with ADHD perceive themselves and navigate daily life. Further research could explore how these identity struggles evolve over time or differ by gender.
Ultimately, the research highlights a complex interplay between diagnosis, school culture, and personal identity.
For girls with ADHD, the challenge is not just managing symptoms—but also being seen, accepted, and allowed to be themselves.
Citation
Grimell, J., Ericson, M., & Frick, M. A. (2025). Identity work among girls with ADHD: Struggling with Me and I, impression management, and social camouflaging in school. Frontiers in Psychology, 16, 1591135. https://doi.org/10.3389/fpsyg.2025.1591135
