This is one of the most common questions I hear — and it makes sense, because the two conditions overlap significantly in how they feel. Both can involve constant worry, difficulty focusing, overwhelm, and emotional exhaustion.   The key difference is often in the root cause. Anxiety tends to center on fear of future events or outcomes. ADHD is neurological — it's about how the brain regulates attention, impulse, and emotion. Many women have both, and addressing only one often leaves the other unresolved.  If you've been treated for anxiety but still feel like something isn't quite adding up, it's worth exploring ADHD with a specialist. I offer a free phone consultation to talk through your experience and see if therapy might help.

ADHD affects more than just focus—it shapes how you think, feel, and move through the world. Common symptoms include trouble concentrating, difficulty starting or finishing tasks, forgetfulness, and feeling easily distracted. Many adults also experience racing thoughts, restlessness, or a tendency to lose track of time. For women, ADHD often appears as disorganization, emotional overwhelm, or perfectionism rather than hyperactivity. You might seem “put together” on the outside while feeling chaotic or exhausted inside. If you recognize these patterns, therapy can help you understand your unique ADHD profile and develop strategies that work with your brain—not against it.

A: Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are terms often used interchangeably, but there are important distinctions. ADD is an outdated term that was previously used to describe individuals who have difficulty focusing but do not exhibit hyperactive behaviors. Today, the condition is recognized under the umbrella term ADHD, which stands for Attention Deficit Hyperactivity Disorder. ADHD is the official medical term and it encompasses three subtypes: Predominantly Inattentive Presentation (what used to be known as ADD), Predominantly Hyperactive-Impulsive Presentation, and Combined Presentation. At Carole Goguen, PsyD, we provide specialized therapy for women dealing with ADHD, anxiety, and trauma, offering sessions as late as 10 pm to accommodate your busy lifestyle. If you suspect you might be dealing with ADHD, we can help you navigate your symptoms and improve your quality of life.

Most of what's been written and researched about ADHD was based on studies of boys and men. The hyperactive, impulsive presentation is more common in males. Women with ADHD are more often inattentive — internally restless, distractible, and prone to emotional overwhelm rather than visible hyperactivity.   Women also tend to develop masking behaviors early: working harder to compensate, appearing organized on the outside while feeling chaotic inside, or channeling restlessness into people-pleasing and perfectionism. This makes ADHD harder to spot — and easier to misdiagnose as anxiety or depression.   A specialist who works specifically with women understands these patterns. That's exactly what I focus on.

A general therapist can provide real support — but ADHD requires specific expertise that general training often doesn't cover. An ADHD specialist understands the neuroscience behind attention dysregulation, knows how ADHD interacts with anxiety, trauma, and hormones in women, and uses targeted approaches rather than generic talk therapy.   Many women I work with have seen general therapists before coming to me. They often describe feeling like the sessions were helpful but incomplete — like the therapist understood their feelings but not their brain.   As a Certified ADHD Specialist with 25+ years of experience, I offer targeted ADHD treatment combined with evidence-based therapy for the anxiety and trauma that so often travel alongside it.

Absolutely — in fact, many women who receive a late ADHD diagnosis find therapy especially valuable. There's often a complex mix of emotions: relief at finally understanding why things were so hard, grief for the years spent struggling without support, and sometimes anger at having been missed for so long.   Therapy can help you process all of that, while also building practical strategies that work for your brain and your life as it is now. It's never too late to understand yourself better — and to stop working so hard against your own neurology.

No. Many clients come to me wondering whether they have ADHD — they haven't been formally diagnosed, but something about the description resonates. That's a completely valid starting point.   If a formal assessment is something you want, I can discuss referral options during our work together. But therapy can begin — and be very effective — without a formal diagnosis in hand. What matters most is understanding your experience and building strategies that help.

Because many of my clients are holding their lives together all day — working, managing families, masking their ADHD — and a 10 am or 2 pm therapy slot just doesn't fit. The name Night Owl Psychotherapy isn't accidental: a lot of women with ADHD find that their minds are sharper and more settled in the evenings, and that's when they actually have space to do meaningful work.   I offer appointments as late as 10 pm, fully online throughout California. You shouldn't have to choose between therapy and the rest of your life.