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When It’s Not ADHD: Understanding Misdiagnosis and What to Watch For

ADHD can be tricky to diagnose. And sometimes, the diagnosis itself isn't the right one.

Because ADHD symptoms often overlap with other conditions, it’s not uncommon for someone to be misdiagnosed either with ADHD when they have something else, or not with ADHD when they actually do.


Misdiagnosis can delay proper support and leave people feeling confused, frustrated, or invalidated.

Here’s what we want you to know about how misdiagnosis happens, what other conditions can look like ADHD, and what to do if something about your diagnosis doesn’t sit right with you.


A person holds a pen over a clipboard in focus, another person blurred in the background on a sofa. Bright, airy room with yellow cushion.

Why ADHD Misdiagnosis Happens

ADHD is a clinical diagnosis, which means it’s based on symptoms and patient history, not a specific blood test or brain scan. Clinicians rely on interviews, questionnaires, and observation to make a determination. This subjective process can lead to misdiagnosis, especially when:

  • Symptoms are subtle or inconsistent

  • The person has other mental or physical health conditions

  • The provider isn’t well-versed in adult ADHD, especially in women or marginalized groups

Research published in BMC Psychiatry shows that ADHD is frequently underdiagnosed in women and overdiagnosed in boys. Why? Gendered expectations, internalized masking, and differences in symptom presentation all play a role (source).



Conditions That Can Look Like ADHD

Several mental and physical health conditions can mimic ADHD symptoms like distractibility, impulsivity, forgetfulness, or difficulty focusing. Sometimes, these are actually the primary concern, or they may exist alongside ADHD but need separate treatment. Here are a few common ADHD “lookalikes”:

1. Anxiety Disorders

Chronic worry, racing thoughts, and restlessness can lead to difficulty focusing and poor memory. Unlike ADHD, though, anxiety-related focus issues tend to worsen during stress and improve when calm.

2. Depression

Slowed thinking, poor concentration, fatigue, and lack of motivation are common in both depression and ADHD. The key difference is often emotional state; if mood is persistently low, depression may be the root.

3. Autism Spectrum Disorder (ASD)

There’s significant overlap between ADHD and autism. Both can involve emotional dysregulation, sensory sensitivities, and executive dysfunction. But autism often includes differences in social communication, routines, or restricted interests.

Read more from the Autism Research Institute on how ADHD and autism can co-occur or be confused (source).

4. Sleep Disorders

Poor sleep leads to cognitive fog, memory lapses, and mood swings. Sleep apnea, restless leg syndrome, or even chronic insomnia can cause daytime symptoms that resemble ADHD.

5. Thyroid Dysfunction or Hormonal Imbalances

Both hypothyroidism and hormonal shifts (like perimenopause or PCOS) can impact energy, mood, and concentration. Many women are diagnosed with ADHD after years of hormone-related misattribution.

Check out information from the Hormone Health Network for more on how hormonal health affects cognition (source).



What If I Don’t Think My Diagnosis Fits?

If your diagnosis doesn’t feel accurate, it’s okay to get curious. You’re not being “difficult” or disrespectful for questioning it. Advocating for clarity is part of owning your health journey.

Here are a few steps you can take:

  • Get a second opinion from a clinician who specializes in adult ADHD or differential diagnosis

  • Keep a symptom journal to track what shows up, when, and under what circumstances

  • Explore comorbidities and other possibilities with a trusted provider or specialist

  • Ask for updated assessments using validated screening tools like the ASRS or DIVA-5

Misdiagnosis can go both ways. Some people are told they have ADHD when it’s really anxiety. Others are told they’re just anxious when ADHD is the root. Sometimes it’s both.



How Agave Can Help

At Agave Health, our team of ADHD-informed therapists and coaches knows that no two brains are the same. We prioritize whole-person care and support you in sorting out what’s really going on — without judgment, shame, or assumptions.

Whether you're navigating a new diagnosis, questioning an old one, or trying to make sense of conflicting symptoms, we’re here to help you feel seen, heard, and supported.



Reputable Resources to Learn More

We believe in science-backed information, not one-size-fits-all answers. If you're looking to go deeper, here are some reliable places to start:



Bottom Line

It’s okay to have questions about your diagnosis. And it’s okay to seek answers that align with your lived experience. ADHD is real, but so is the reality that not every focus issue is caused by it.

You deserve care that looks at the full picture. Not just a symptom checklist.

Let’s find what fits.

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