Newly Diagnosed With Adult ADHD? Here’s What’s Next.
Episode Summary:
A late ADHD diagnosis can bring two truths at once: relief and grief. Relief because there is finally language for what has been happening. Grief because you can see the years you spent muscling through.
This episode walks through what to do next. You will hear why it was often missed, how to pursue a solid evaluation if you only have a preliminary one, and how to map your wiring at work and at home so you can choose support that fits.
We also look at treatment in context. Medication and therapy can help, and most adults still need a second track, learning the executive function skills they want and adjusting environments so those skills can stick.
You will leave with a clearer picture of your options, a steadier frame for the relief and grief you may feel, and a simple way to start without trying to overhaul your life overnight.
What You’ll Learn About ADHD and Self-Esteem:
- Why ADHD is sometimes missed until adulthood.
- How to seek an evaluation for adult ADHD from the right specialist.
- What kind of ADHD treatments are available for adults.
- How body and brain basics (exercise, nutrition, etc.) set the conditions for focus and regulation for ADHD adults.
- Ways you can adjust your environment so it is a better fit for you after your ADHD diagnosis.
Transcript:
(00:02):
If you are a late-diagnosed adult with ADHD or maybe have a preliminary diagnosis from your primary care doctor or therapist, I’m guessing you’ve been on one crazy ride, and now you’re just trying to figure out what comes next.
You’ve tuned into Reimagining Productivity with ADHD, a podcast for ADHD adults like you who want to learn how to adopt the best strategies, tools, and skills to be able to get your essential work done in a way that works with the way your brain is wired.
I’m Marla Cummins, an ADHD and executive function coach, and I’m glad you decided to join me today on this journey toward finding your way to doing what matters most to you without trying to do it like everyone else. First, so that we’re on the same page, a late ADHD diagnosis means that you are diagnosed as an adult rather than as a child.
(01:01):
I’m sure that part is obvious to you, but the other key is that the symptoms must have been present before the age of 12. And though this podcast episode is intended for those who already have a diagnosis or a preliminary diagnosis, I still thought it would be helpful to review best practices around getting an evaluation, because getting one can be a little tricky sometimes. I know some listeners may have received their diagnosis and evaluation from their primary care doctor, who can also certainly prescribe ADHD meds.
And while I’m sure your primary care Dr. may have seen their fair share of people with ADHD, diagnosing mental health conditions is probably just not their area of expertise. But having a conversation with your doctor, who may be able to give a preliminary diagnosis, and then asking them for a referral to a qualified mental health specialist can be a great way to start down this path.
(02:07): Who should diagnose adult ADHD?
And if you’re able to get a comprehensive neuropsych evaluation by a psychologist, I think that’s often the best bet. But I also know that taking this route can be beyond the reach for some, as sometimes it’s not covered by insurance, can be expensive, and can take a long time to get an appointment.
So the next best option is to see a psychiatrist or a psychiatric nurse practitioner. Whoever you decide to see, you’ll want to make sure that, at minimum, they screen for other coexisting conditions such as depression, anxiety, sleep disorders, because sometimes, or actually quite frequently, it’s difficult to tease these apart, and they can co-occur with ADHD.
I’m sure you have lots of questions related to your new diagnosis of ADHD. One is, how did this get missed when I was a kid or perhaps even a young adult in college? That is, how did none of the adults in my life pick up on this?
(03:15):
Because, of course, you needed to rely on the adults in your life, usually parents and teachers, to recognize that there’s something problematic first that needs to be addressed, and then to determine what steps to take. And there are many reasons adults, and yourself included, don’t get diagnosed earlier.
One that is particularly true for women who are later diagnosed as inattentive is that they just fell under the radar, often because they did well in school and didn’t have behavior problems. So even if they were struggling a bit, they seemed to be getting by.
In addition, research shows that systemic racism, cultural stigma, and unequal access to care can contribute to later diagnosis, particularly for people of color, and can also limit appropriate care into adulthood. Even when evaluations do happen, studies have found that white children with similar symptoms are more likely to receive an ADHD or adjustment disorder diagnosis, while children of color are more likely to receive oppositional defiant disorder or other behavioral labels.
(04:33):
And then there are times when parents, even when teachers may bring problems to their attention, don’t want to stigmatize their child by getting an ADHD diagnosis, so they just avoid it. And then other times, being a parent myself, I know that sometimes parents are just doing the best they can and may not have the information they need to consider that an evaluation might be helpful.
Other parents may just see the inconsistent problematic behavior, but then attribute it to their child not trying hard enough, and for others, they were able to get by because perhaps their symptoms were milder and they were able to mask and then have the structure afforded at home and in school to support them.
It’s always interesting to hear people’s stories about their perspective on why their parents, teachers, or other adults in their life didn’t recognize that they might need to be evaluated when they were kids.
(05:42):
I don’t think my parents knew much about ADHD when I was young, even though, interestingly enough, they were both teachers. So whenever I had challenges, even though I did well in school, my parents decided it was the environment or the teacher, and I just kept bumping along.
The relevant point is that once you recognize the factors that may have contributed to not being diagnosed early, you can start to shift your story from blaming yourself to understanding that it just wasn’t your fault—that whoever the adults were in your life, they just missed it for whatever reason.
Whatever the reason for you not getting diagnosed earlier, there are many reasons that you and other adults seek out an evaluation later in life. One that I sometimes hear from clients is that their child was diagnosed, and then it might become a light bulb moment for them and their partner as they learn more about ADHD symptoms and think, “Oh my God, that’s me.”
(06:47): Why Do Adults Seek An Evaluation For ADHD?
Others seek out an evaluation when they’re challenged by a transition that they’re going through. It could be as early as college, grad school, becoming a parent, entering the workforce, or maybe transitioning to a new job, sometimes being promoted.
For others, it’s just getting older and deciding I don’t want to keep on pushing myself to the limits anymore. Whatever the case for you, the compensating strategies or masking that you and others have used prior to your transition just stop working.
And I know it can be really disorienting, but you just keep on pedaling until maybe, perhaps, you fell off the bike and you lie there thinking, I can’t or don’t want to do this anymore.
(07:37):
For others, it’s their partner who is carrying too much of the weight and finally puts their foot down and says, you know what? I don’t want to do it like this anymore. You’ve got to figure this out.
I got my diagnosis after teaching for a few years and feeling absolutely paralyzed by the amount of work I needed to do, especially the administrative work. I still have this vision of piles of paper on my dining room table. I’m not sure if that’s accurate, but that’s an image that has stayed with me.
So what prompted you to get evaluated or become curious as to whether you have ADHD or not? Getting a late ADHD diagnosis is just the beginning of your journey to understanding your past and being able to chart a new path forward. And there’s no one right way to proceed. What you do next really just depends on what you need right now and what goals you want to pursue.
(08:39):
Depending on your nature, you may be tempted to charge ahead and try to figure things out as quickly as possible, and that makes sense to me. After all, you’ve spent enough time not knowing why things are so challenging, and now maybe you’re feeling like you don’t want to waste any more time.
But while you’re trying to figure out what comes next, it’s also essential to give yourself time and grace before setting your GPS on the future, because I’m guessing you have a lot to unpack and process about the challenges you’ve had and the choices you may have made and how they may have been related to your ADHD.
So give yourself time to do this emotional work. And if you’re feeling a sense of regret, grief, or maybe even frustration over your past when you were not yet diagnosed, that’s also really normal. You may be mourning the time you think you lost due to your struggles, and the life maybe you imagined you could have had if you had known earlier.
(09:49): Grief and Regret After A Late ADHD Diagnosis
Maybe it’s about missed academic or career opportunities. It could also be about coming to understand why various relationships maybe have been strained for so long. Or it could be about all the time and energy you spent just trying to fit in and not being able to offer yourself the self-compassion that you’ve needed all this time.
As you sit with all of this, remind yourself again that you did the best you could. And if you think it might be helpful, reach out for support. If you’re not already working with a therapist, you may choose to do so now. And if it doesn’t feel like your current therapist is a good fit for you any longer—which happens—you may decide to seek out another.
One type of therapy often recommended for ADHD adults is cognitive behavioral therapy, which can help you change negative thought patterns and thereby help you also change your feelings and behaviors.
(10:55): What Is The Best Therapy For ADHD Adults?
Another beneficial therapy for ADHD adults is dialectical behavioral therapy, which focuses on managing intense emotions and is particularly recommended if you struggle with emotional dysregulation. In addition to therapy, you may also find it helpful to be in a support group of other ADHD adults, whether in person or virtual.
This can help you connect with others so you don’t feel so isolated and alone. Through connection and perhaps professional support, you’ll also hopefully be able to let go of maybe some of the shame that many late-diagnosed adults with ADHD carry around with them.
And other than therapy, you may or may not decide to take medication right away to treat your ADHD. And, no doubt, ADHD meds can form the cornerstone of an effective treatment plan for many.
But it’s also essential to understand that the efficacy of medication varies from person to person, and it may take time to find the right medication and dosage while working with your prescriber. Also, using medication alone may not help.
(12:18): Is Medication The Best Treatment For Adult ADHD?
Sure, it can help improve your focus and attention, but you still have to have the skills to decide what to focus on, right? Likewise, medication can help reduce your impulsivity, but you also need strategies and skills to do this.
There’s more that I can say about this, but I think you get the idea—that is, medication can help you slow down and focus, but it just won’t teach you the skills that you need, such as how to become better organized, make decisions that work for you, execute effectively, or, again, heal from a lifetime of undiagnosed ADHD.
That is, medication can certainly help many, but it’s definitely not a turnkey solution. And in addition to deciding on medication, one of the first critical steps is to really understand your ADHD brain wiring and how it’s currently affecting your life. That is, how does it play out for you at work and at home?
(13:27):
Because, again, I know you have a lot of questions about this, some of which are: How come I lock in when something is urgent but stall when it isn’t? Or why do I become dysregulated so easily, especially when something is frustrating?
Another question I hear from people is, what’s going on when I’m trying to have a conversation and I struggle to listen and process? Or why do transitions and context switches throw me off so much? And then another question is, I’ll make a plan and then not follow through—what’s that about?
Anyway, once you understand better how your ADHD works, you’ll be in a much better position to answer these questions and other questions that I’m sure you have, and then take the next step, which is to decide what will help you upgrade your executive function skills.
Because, unlike many neurotypical people who were able to absorb executive function skills almost like by osmosis along the way, and then practice them to make them stick, that’s not how it probably happened for you.
(14:48):
And it’s not that you missed the memo—it’s just that school and work teach content, not the how, not the executive function skills, not so much anyway. So now, with support, you’ll likely need to upgrade your skills in areas such as planning, task management, and, again, how to execute.
And you may do this with the support of others in your circles who perhaps have stronger executive function skills than you do, or you may decide at some point to work with an ADHD coach to provide you with the extra support in learning about your ADHD, also helping you identify what it is that you need to function better in the various domains where you struggle, and then work with you to upgrade your skills in these areas.
Beyond therapy, medication, and coaching, many complementary treatments can help you work with your ADHD, and I think these are often overlooked.
(15:53): What Are The Best Treatments For Adult ADHD?
Think of it this way: your executive functions are compromised because of your ADHD. You also know that you could steady that ground that also shapes energy, attention, and regulation by, for example, getting sufficient sleep, connecting with a support system, eating nutritious food, drinking enough water, exercising, and perhaps practicing mindfulness, among other things.
I’m definitely not asking you to try to do all of this at once, but just to consider these options as levers that you can choose if you want. But it’s not just about you making changes to work with your ADHD.
It may also be about changing your environment to be a better fit for you, because part of the reason you have these challenges now is perhaps because your environments aren’t a good fit for you. So if you lived on a deserted island, you might not need to learn all of these skills, right?
(17:10):
But you don’t, at least I don’t think you do. So as you think about your environment, are there ways that you want to pivot? Maybe your home life with your partner needs a bit of, well, reworking—that might range from changing responsibilities to getting help from a group such as the ones offered through Melissa Orlov’s ADHD and Marriage.
Or maybe now that you’re beginning to understand what’s behind some of your challenges at work, you might decide, I don’t want to swim against the current as much as I have been. And then you might try to find not a new career necessarily, but a job that feels like a better fit for you.
Or maybe you’ve developed a community or circle of friends that just don’t work for you anymore because maybe it was based on you masking. And so now, perhaps you’re wondering, what might happen if I drop the mask?
(18:12): Should I Disclose That I Have Adult ADHD?
Maybe my social circles also need a little bit of remixing. What environments are you in right now that you’re considering might not be a great fit? I know there’s a lot to consider, and all of this will take time.
So, again, please do give yourself the grace and space to let this unfold in time without rushing. And the last consideration I’m sure you’re thinking about is, who do I want to tell?
If you’re wondering whether to disclose at work or not, I encourage you to listen to the interview I had with Kate Broeking, a neurodivergent HR expert. I’ve included a link to this episode with the show notes on my website.
And as to whether you disclose to anyone else, I think that really depends on, one, your comfort level. There’s no right or wrong answer, and I would just encourage you to think about what you’re hoping to get out of telling each person.
(19:17):
So, again, as we’re closing for today, remember that your ADHD diagnosis was missed for reasons that weren’t your fault, but now it’s up to you to figure out how to move forward at your pace and with the support that you need.
So that’s it for now. If this episode landed for you, please do share it with someone you think might also benefit from hearing this.
And if you have a moment to leave a rating and a review, that will help others discover the show and learn more about thriving with their ADHD. Please do that, and thanks for listening.
Until next time, this has been Reimagining Productivity with ADHD and Marla Cummins, reminding you that your ADHD doesn’t define you, but how you work with it can shape what’s possible.
Newly Diagnosed ADHD Adults Resources:
- Learn how to plan better with my Free Guide: 6 Common Planning Mistakes Adults with ADHD Make.
- If you are wondering what kind of professional support you need, check out, How Do I Know if I Need a Therapist or an ADHD Coach?
- If you are trying to decide whether to disclose your ADHD at work, listen to this interview with a neurodivergent AR expert: Can You Get ADHD Support at Work Without Disclosing?
