After an adult ADHD diagnosis

By Tamara May

With greater awareness of ADHD in the community, more and more people are recognising the symptoms of ADHD in themselves and obtaining an adult ADHD diagnosis. But what should you do after you’ve been diagnosed? Below some important things to consider after receiving an adult ADHD diagnosis.

1. Thoroughly understand ADHD

Often people have done a lot of research (or been down an ADHD ‘rabbit hole’!) so they already know a lot about ADHD by the time they are diagnosed. Others might have waited for an assessment before doing their own research. Having a strong understanding of ADHD symptoms, how they can present in adulthood and how they can be missed in childhood, is critical. Knowing the secondary problems that can also occur, like other co-occurring mental health problems such as anxiety and depression, is also important. This can help people fully understand how ADHD influences their own life. People can then explore if they might need to make any changes in their life to reach their full potential. It can take some time and reflection to understand the full impacts of ADHD on someone’s life.

Information about ADHD can be gained by doing your own research, but make sure the information is from credible and accurate sources. People can also receive psychoeducation or information from a health professional, such as a psychologist or psychiatrist, who is experienced with ADHD.

2. Reflect on the diagnosis  

Once ADHD is confirmed many people will reflect on how the symptoms of ADHD and the secondary challenges might have impacted on their entire life from childhood onward. This can be linked with a period of grief which may include some of the usual grief stages such as depression, anger, denial, sadness, and eventual acceptance.

There may be sadness and anger about not being diagnosed in childhood and how this has impacted on a person’s life. This can include reflecting on missed opportunities for support resulting in underachievement in studies and career and misunderstandings in relationships. Many people search through their past, now understanding situations that have occurred from the context of ADHD. Previously confusing situations may make sense, particularly interpersonal misunderstandings, conflicts and ruptures.

There may be feelings of low mood or even depression around what having ADHD has meant in one’s life and what it may mean for the future. This may include coming to terms with ADHD being lifelong. Some struggle with the thought of having to rely on taking medication for the rest of their lives. There may also be denial about even having ADHD, and doubts about whether the assessment was accurate. Working through this process with a psychologist or a psychiatrist can be very helpful.

For others the ADHD diagnosis will come as a huge relief and will be almost immediately accepted. Now they can finally understand their life and why they have had a unique pattern of challenges and strengths, which may have sometimes confused them and other people. For example, ADHD can explain having variable academic achievement. Some might have performed well in some areas (e.g. History but not mathematics or vice versa) or in some testing formats but struggling with others (e.g. doing well in assignments but failing exams or vice versa). ADHD can also explain a pattern of repeating overwhelm or burn out. For example, appearing extremely organized and ‘together’ at some stages in their life but then becoming completely disorganized and unable to function at other times. ADHD can explain many unexplained challenges and there can be a great relief in finally understanding there is a cause for these occurrences.

3. Access support

Psychologists can assist with helping people understand what ADHD is, how it affects them, and help them to develop strategies to manage their ADHD symptoms including work on brining balance to their life. They can assist with the secondary impacts of ADHD; this might include an entrenched and strong negative self-view that may have arisen through having ADHD and the negative messages from others about the symptoms.

Many people also have secondary anxiety and depression which may have resulted from ADHD symptoms. For example, anxiety and fear can quickly develop around school and being tested and assessed impacting on post-secondary school studies. This can result from ADHD symptoms like not being able to follow teacher’s instructions or focus on work, procrastinating and not handing in work, being late, forgetting important things; all resulting in negative feedback and consequences and a growing fear of getting in trouble or failing.

Anxiety around social interactions can also occur from ADHD symptoms, like through having difficulties paying attention to conversations and worrying others might not think you are interested in them; forgetting birthdays or forgetting to respond to messages; impulsively blurting things out that may offend others without meaning to, and so on. This can result in hypervigilance in social situations or social anxiety like symptoms and subsequent avoidance. Unpacking how these challenges may be secondary to ADHD can be explored with a psychologist. They can help people with understanding unhelpful patterns that occur and build strategies to develop healthier coping mechanisms rather than relying on avoidance. Psychologists can help ‘shut off’ the bodies alarm system that goes off when someone sits down to attempt to study. Other secondary mental health problems, such as disordered eating and addictions, can also be treated with the help of a psychologist.

GPs and psychiatrists who have expertise in ADHD will be critical to help manage any medications or co-occurring conditions. ADHD coaches who usually have a lived experience of ADHD can assist with specific strategies to manage adult ADHD symptoms. Other health professionals that may be able to support adults with ADHD include dieticians to help manage patterns of disordered eating or assist with developing a balanced diet. Occupational therapists can help with understanding accommodations that might be needed at school/university, work or home and implement strategies and solutions to reduce the impact of ADHD symptoms. Relationship counsellors may also be needed to help work through relationship issues that are influenced by adult ADHD symptoms in one or both partners. Other health professionals that might be able to input include speech pathologists, social workers, and mental health nurses who are experienced in ADHD. Accessing ADHD consumer groups can also be a helpful way to connect with others who have gone through a similar experience.

4. Carefully contemplate who to inform.

Whether to revel your ADHD diagnosis to friends, family, school/university or employers is a complex and individual decision. This can be particularly challenging given the ADHD symptom of impulsivity where you might be at risk of blurting it out without thinking through the possible negative consequences! If you do decide to tell others it is important to be able to confidently describe and explain ADHD, as others often have very little knowledge of ADHD (refer point 1 above!). There is much stigma and ignorance about ADHD in the community so understanding the facts and being able to communicate this to others will help you to feel empowered and confident if you do decide to disclose your diagnosis to others.

Sometimes friends and family may respond with comments such as everyone has occasional trouble with concentrating/organization/planning/impulsivity/hyperactivity/ [insert symptom here], there’s nothing wrong with you. They may minimize or dismiss the persons experience, sometimes as a misdirected attempt to help the person feel better. Parents may be especially sensitive to this and feel guilty for not noticing ADHD in the person’s childhood. Being able to explain how ADHD is more than sometimes experiencing some of these problems and the significant impact it has on functioning will help you be ready to respond and explain in a calm manner to others.

If you do decide to let employers or school know, understanding what reasonable adjustments you need, and are entitled to, is also important. This can be worked through with a medical professional or allied health professional such as a GP, psychiatrist, psychologist or occupational therapist who can usually provide the necessary documentation to seek special consideration if required.