← Back to Mental Health
06 · Mental Health

When 'Anxiety' Isn't the Whole Story

Women's mental health is sometimes both over-labelled and under-supported at once — a physical cause missed behind an 'anxiety' label, or a real condition like adult ADHD overlooked for decades.

May 20266 min readClinician-reviewed

Mental health deserves the same careful assessment as any other aspect of health — and that includes checking what might lie beneath the symptoms. Fatigue, palpitations, poor concentration, and low mood are sometimes attributed to anxiety when a physical contributor — thyroid disease, low iron or B12, or perimenopause — is actually driving them. Treating the underlying cause, alongside appropriate emotional support, often makes the biggest difference.

Attention deficit hyperactivity disorder (ADHD) is a striking example of under-recognition in women. Historically diagnosed in boys, it frequently presents in women as inattention, overwhelm, disorganisation, and internal restlessness rather than obvious hyperactivity — and is often masked for years, surfacing as anxiety. Many women are diagnosed only in their thirties, forties, or beyond, often around hormonal transitions.

Perinatal depression and anxiety — during pregnancy and after birth — are also commonly under-reported, dismissed as 'baby blues' when they persist well beyond the first couple of weeks. All of these are treatable. Recognising them is the first, and often hardest, step.

Symptoms worth paying attention to
  • 01Lifelong overwhelm, forgetfulness, or restlessness, often masked
  • 02Low mood or anxiety that persists beyond two weeks after birth
  • 03Physical symptoms labelled 'anxiety' without other causes being explored
  • 04Mood changes that worsen around the cycle or in perimenopause
When to speak to a healthcare professional

If anxiety or low mood is not improving, ask whether physical contributors have been checked. If lifelong patterns of overwhelm and inattention sound familiar, it is reasonable to ask about an ADHD assessment.

Sources · Peer-reviewed: female adult ADHD review (PMC 2024) · NICE NG87 — ADHD · NICE CG192 — Antenatal & postnatal mental health