Why So Many High-Performing Women Start Doubting Themselves at Work

The hidden impact of perimenopause, ADHD traits, and self-limiting beliefs in the workplace

Key Takeaways

• Many high-performing women experience self-doubt despite consistently delivering exceptional results.
• ADHD traits and perimenopause can significantly impact confidence, emotional regulation, working memory, and self-belief.
• Self-limiting beliefs often show up as perfectionism, procrastination, overworking, people-pleasing, and difficulty delegating.
• Research suggests women are more likely to underestimate their abilities and delay applying for opportunities unless they feel fully qualified.
• Confidence is not the absence of self-doubt; it is the willingness to take action despite it.
• Small shifts in awareness and behaviour can have a significant impact on workplace confidence and wellbeing.

A Common Thread

A common thread often emerges across almost every coaching conversation I have with my high performing female clients. 

Not burnout.

Not workload.

Not time management.

Self-doubt.

Specifically, the quiet, persistent inner dialogue that tells highly capable women they aren't quite good enough.

One client, a senior leader in her late 40s, described herself as "not that smart."

This surprised me.

She's articulate, strategic, emotionally intelligent, and has a rare ability to build high-performing teams. Her people trust her. Her peers respect her. She consistently delivers results.

Yet her internal story does not reflect any of that.

Another client is an accomplished events specialist who has represented Australia in competitive sailing.

She manages complex projects, coordinates multiple stakeholders, and thrives under pressure.

Yet she was struggling to complete a report.

Not because she couldn't do it.

Because perfectionism, fear of disappointing others, and the belief that she should be doing better had paralysed her.

Different women.

Different industries.

Different challenges.

But the same underlying belief:

"I'm not enough."

And increasingly, I'm seeing this pattern emerge among women navigating the intersection of leadership, ADHD traits, perimenopause, and high-performance workplaces.

The Confidence Gap Nobody Talks About

What's fascinating is that self-doubt often has very little to do with competence.

In fact, many of the women experiencing the highest levels of self-doubt are exceptionally capable.

Research has consistently shown that women are more likely to underestimate their abilities and less likely to put themselves forward for opportunities unless they believe they meet almost all of the criteria.

One of the most widely cited examples comes from research discussed in The Confidence Code, which found that women often wait until they feel 100% ready before applying for opportunities, while men are more likely to apply when they meet only some of the requirements.

This creates an interesting paradox.

The more responsibility women take on, the more visible they become.

The more visible they become, the more vulnerable they feel to judgement.

The more successful they become, the more pressure they often place on themselves.

And for many women in their 40s and 50s, another layer is added to the equation.

Perimenopause.

When Perimenopause Starts Messing With Your Confidence

Perimenopause is often discussed in terms of hot flushes, sleep disruption, and hormonal changes.

Far less attention is given to its impact on workplace confidence.

Many women report experiencing:

• Brain fog

• Memory lapses

• Difficulty concentrating

• Increased emotional sensitivity

• Reduced confidence

• Challenges with decision-making

According to the Fawcett Society, the UK's leading charity campaigning for gender equality and women's rights, one in ten women have left their jobs due to menopause symptoms, while many others reported feeling less confident and less able to perform at work.

The Australasian Menopause Society also highlights that cognitive symptoms such as forgetfulness, reduced concentration, and mental fatigue are common experiences during perimenopause.

For women who have built careers on being capable, organised, and reliable, these changes can feel deeply unsettling.

Tasks that once felt effortless suddenly require more effort.

Meetings become harder to navigate.

Words don't come as easily.

Energy becomes less predictable.

Many women begin questioning themselves.

Not because they are less capable.

Because the way they access their capability has changed.

The ADHD Factor

For women with ADHD, or identify with ADHD traits, this experience can be even more complex.

Many ADHD women reach mid-career having spent decades compensating for challenges with attention, organisation, working memory, emotional regulation, and time management.

They've developed systems.

Created workarounds.

Built careers.

Raised families.

Led teams.

Yet many have also spent years hearing messages such as:

• You're too much.

• You're too emotional.

• You're disorganised.

• You're inconsistent.

• You're not applying yourself.

Over time, these messages become internalised.

And internalised messages become beliefs.

The irony is that many ADHD women possess extraordinary workplace strengths.

Including:

• Curiosity

• Creativity

• Strategic thinking

• Innovation

• Problem-solving

• Relationship building

• Big-picture thinking

Yet because ADHD has historically been under-recognised in women, many continue to focus on their perceived shortcomings rather than their strengths.

Then when perimenopause begins affecting cognition and emotional regulation, the self-doubt often intensifies.

The coping strategies that once worked no longer work in quite the same way.

And suddenly the inner critic has more evidence to work with.

The Workplace Cost of Self-Limiting Beliefs

Most organisations don't see self-limiting beliefs.

They see the behaviours they create.

Women who:

• Overwork

• Overprepare

• Avoid visibility

• Struggle to delegate

• Say yes too often

• Underestimate their contributions

• Delay decisions

• Miss opportunities

From the outside, these behaviours can look like commitment.

On the inside, they often feel exhausting.

Gallup's latest workplace research found that employee stress remains at record levels globally, while engagement remains stubbornly low.

When talented women stop backing themselves, organisations lose leadership capability, innovation, confidence, and diverse perspectives.

The cost isn't just personal.

It's organisational.

Three Steps to Interrupt the "Not Good Enough" Story

The good news?

Self-limiting beliefs can be challenged.

Not overnight.

But through awareness and practice.

Step 1: Name the Story

The next time you find yourself procrastinating, overthinking, overworking, or avoiding something important, ask:

What story am I telling myself right now?

Is it:

• I'm not smart enough?

• I'm going to get it wrong?

• I'll let people down?

• Everyone else is coping better than me?

Naming the story reduces its power.

Instead of:

"I'm not good enough."

Try:

"I'm noticing the thought that I'm not good enough."

That small shift creates distance between you and the story.

Step 2: Gather the Evidence

Ask yourself:

What would a neutral observer see?

List three pieces of evidence that challenge the belief.

Facts are often far more reliable than fear.

When self-doubt shows up, your brain starts looking for proof that it is right.

Your job is to intentionally look for proof that it isn't.

Step 3: Act Before You Feel Ready

Confidence rarely comes first.

Action does.

Choose one small action.

Send the email.

Submit the report.

Delegate the task.

Apply for the role.

Share the idea.

Progress creates evidence.

Evidence builds confidence.

A Different Question

One question I often leave clients with is this:

What would you do if you trusted yourself just 10% more?

Not completely.

Just 10%.

Would you speak up?

Delegate more?

Apply for the role?

Set a boundary?

Ask for support?

Sometimes that small shift is enough to create meaningful momentum.

Final Thoughts

The women I coach are some of the most capable people I know.

They lead teams.

Build businesses.

Raise families.

Navigate ADHD.

Support others.

Create extraordinary results.

Yet many still carry the belief that they are somehow not enough.

If that's you, I want you to know this:

The story in your head is not always the truth.

And sometimes the most powerful thing you can do is stop treating self-doubt as a fact and start seeing it for what it is:

A story that deserves to be questioned.

Download the Free "Not Good Enough" Toolkit 

If this resonates, I've created a free one-page toolkit for high-performing women navigating self-doubt, perfectionism, ADHD traits, and workplace pressure.

Inside you'll find:

✓ The 3-step reset process

✓ Reflection prompts

✓ A practical delegation template

✓ Scripts for perfectionism, people-pleasing, overwhelm, and imposter syndrome

Because confidence isn't about eliminating doubt.

It's about learning not to let it drive.

Frequently Asked Questions

Why do high-performing women struggle with self-doubt?

Many high-performing women hold themselves to exceptionally high standards. Combined with workplace pressure, perfectionism, societal expectations, ADHD traits, and life transitions such as perimenopause, self-doubt can emerge even when performance remains strong.

How does perimenopause affect confidence at work?

Perimenopause can impact concentration, working memory, emotional regulation, sleep quality, and energy levels. These changes can affect workplace confidence and lead women to question their capability, even when their skills and experience remain unchanged.

Is there a link between ADHD and low self-esteem?

Yes. Many women with ADHD spend years masking challenges, overcompensating, and receiving messages that they are disorganised or inconsistent. Over time, these experiences can contribute to self-limiting beliefs and reduced self-confidence.

What are common signs of self-limiting beliefs in the workplace?

Common signs include perfectionism, procrastination, over-preparing, difficulty delegating, people-pleasing, avoiding visibility, overworking, and reluctance to apply for new opportunities.

How can women challenge self-limiting beliefs?

Start by identifying the story you are telling yourself, gathering evidence that challenges that belief, and taking small actions before you feel completely ready.

References

Australasian Menopause Society. (2024). Menopause and cognitive symptoms in the workplace.

Fawcett Society. (2022). Menopause and the Workplace Report.

Gallup. (2024). State of the Global Workplace Report.

Kay, K., & Shipman, C. (2014). The Confidence Code. Harper Business.

Nussbaum, N. L. (2012). ADHD and female-specific concerns: A review of the literature and clinical implications. Journal of Attention Disorders.

World Health Organization. (2023). Mental Health at Work.

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). ADHD in Women Resource Centre.

Australasian ADHD Professionals Association (AADPA). Australian Evidence-Based Clinical Practice Guideline for ADHD.