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A Guide to Understanding Adult ADHD
- Therapy-with-Ben
- 3 days ago
- 16 min read
Author: Therapy-with-Ben
Attention-Deficit/Hyperactivity Disorder (ADHD) isn't a character flaw or a simple lack of willpower. It's a neurodevelopmental difference, meaning the brain is genuinely wired in a way that affects how it manages focus, impulse control, and emotional regulation. It impacts millions of adults, and many have gone their whole lives without a diagnosis.
Navigating Daily Life with ADHD
Think of this guide as a compassionate starting point for understanding ADHD in adults. My aim here is to move past the old stereotypes and get to the heart of what it actually means to live with this condition day-to-day. For so many, the journey begins with nagging questions about challenges they've faced their entire lives.
Perhaps some of these feel familiar:
Constant difficulties with organisation and managing your time.
A real struggle to maintain focus, especially on the important stuff.
Emotional responses that feel incredibly intense and hard to control.
A long history of just feeling "different" but never quite knowing why.
This article is here to be a supportive resource. Whether you're thinking about seeking an assessment, you've recently been diagnosed, or you're trying to support a loved one, the goal is clarity. Understanding your unique brain wiring is the very first step toward building a life that feels more manageable and, ultimately, more fulfilling. For those looking for effective ways to handle these daily hurdles, exploring some practical strategies for focusing with ADHD can be a great help.
Why Understanding Matters
Getting an ADHD diagnosis as an adult can be an incredibly validating experience. Suddenly, there’s a framework that makes sense of past struggles, reframing them not as personal failings but as symptoms of a recognised condition. That new perspective is powerful.
Understanding ADHD allows you to stop fighting against your brain and start working with it. It’s about adapting your environment and developing strategies that align with how you naturally think and operate, rather than forcing yourself into neurotypical moulds.
This shift in mindset opens the door to self-compassion and finding support that actually works. Instead of feeling overwhelmed by daily tasks, you can start to identify the root causes of why things are so difficult.
This is often where professional support can make a huge difference. Working with a dedicated mental health counsellor can help you process what the diagnosis means for you and develop coping mechanisms that are tailored to your life. Recognising how ADHD influences you is the first real step on the journey towards not just coping, but thriving.
What It Feels Like to Have ADHD
To really get what it’s like to live with ADHD, we have to look past the common labels like "disorganised" or "easily distracted." The real story is happening inside the brain, in the way it handles information, tasks, and feelings. This control centre is powered by a set of mental skills we call executive functions.
Think of your executive functions as the chief executive of your brain, the one in charge of planning, prioritising, and getting things done. In a neurotypical brain, this CEO is usually pretty on the ball. But in an ADHD brain, the CEO is often brilliant and bursting with ideas, but is constantly being pulled in a hundred different directions at once.
This is why analogies can be so helpful. One of the most common, and for good reason, is thinking of the ADHD brain like an internet browser with countless tabs open at the same time. Each tab is a different thought, a half-finished task, or a sudden distraction, and they’re all blinking and demanding attention. It makes focusing on just one thing feel almost impossible.
The Brain's Management System
The struggle with executive functions isn't about not being smart enough or not wanting to do the work. It's a genuine neurological difference in how the brain’s management system is wired. This affects everything, from starting a simple chore like washing the dishes to tackling a complex, long-term project.
Here’s another way to picture it: imagine having the engine of a high-performance race car but with the brakes from a bicycle. You've got all this incredible power, creativity, and energy, but the system for channelling and controlling it just can't keep up. This often leads to impulsivity, a rollercoaster of focus, and that frustrating feeling of being out of control, even when you know exactly what you should be doing.
That constant internal battle isn’t a choice. It’s the result of a brain that processes motivation, reward, and focus differently, which can make even the most mundane but necessary tasks feel like climbing a mountain.
This reality shapes how someone with ADHD sees and interacts with the world, touching almost every part of their daily life.
The Three Presentations of ADHD
It’s so important to understand that ADHD doesn’t look the same for everyone. It’s a spectrum, not a neat little box. We generally talk about three main "presentations," which are really just ways of describing the most dominant traits someone might have.
Predominantly Inattentive Presentation: This is often what people used to call ADD. Someone with this presentation might struggle with organising tasks, miss important details, or find it hard to follow through on instructions. They can seem forgetful or easily sidetracked, often described as being a bit "away with the fairies" or "in their own world."
Predominantly Hyperactive-Impulsive Presentation: This is all about a feeling of restlessness you can’t switch off. It can look like fidgeting, being unable to stay seated, talking excessively, or acting on impulse without thinking through the consequences. It often feels like being driven by an internal motor that’s always running.
Combined Presentation: This is the most common presentation of all, where someone experiences a real mix of both inattentive and hyperactive-impulsive symptoms. They might find it just as hard to start a boring report for work as it is to sit still through a long meeting.
These aren't rigid categories; they’re just fluid descriptions of how ADHD can show up. Understanding these variations helps us build a more accurate and compassionate picture of the many different ways this condition can shape a person’s life.
What ADHD Actually Looks Like in Adults
When we think of ADHD, the picture that often comes to mind is a restless kid bouncing off the walls. But in adults, that’s rarely the whole story. The outward hyperactivity of childhood often turns inward, morphing into a constant, buzzing sense of unease or a mind that simply refuses to switch off.
This internal shift is a big reason why so many adults, especially women, can go their whole lives without a diagnosis. They become masters of masking their struggles, developing complex coping mechanisms just to keep up. It's utterly exhausting and can leave you wondering, "Why is this so hard for me when everyone else seems to manage?" Let me be clear: this isn't a personal failing. It's a real, recognisable sign of how your brain is wired.
Getting a precise picture of ADHD in the UK is tricky, but it's thought to affect somewhere between 3% and 4% of adults. More telling, perhaps, are surveys showing that while around 5.8% of adults in England suspect they have ADHD, only 1.8% have ever received a formal diagnosis. If you're curious about the process, you can read more about how adult ADHD is assessed in the UK.
More Than Just Focus: The Emotional Side of ADHD
One of the most significant parts of the adult ADHD experience—and one that's rarely talked about—is emotional dysregulation. This isn't just being a bit moody. It's about feeling your emotions on a completely different frequency. A small setback can feel like a world-ending disaster, while a happy moment can be almost dizzyingly intense. The brain’s regulatory challenges don’t just apply to attention; they apply to feelings, too.
This often ties into something called Rejection Sensitive Dysphoria (RSD). While it’s not an official diagnosis in itself, RSD is a very real experience for many with ADHD. It describes an almost painful emotional sensitivity to the fear of being rejected or criticised. A neutral comment from a colleague or a simple "no" from a friend can feel like a deep, personal attack, triggering a wave of intense hurt. To cope, you might find yourself becoming a people-pleaser or avoiding any situation where you might face even the slightest disapproval.
Living with this kind of emotional intensity is draining. It’s as if you’re navigating the world with a thinner layer of emotional skin, where every social interaction holds the potential for misunderstanding and pain, which can really take a toll on your relationships and self-worth.
For many, these emotional struggles are far more distressing than the better-known challenges with organisation or concentration.
The Invisible Walls of Executive Dysfunction
Alongside the emotional rollercoaster, there's the practical, day-to-day challenge of executive dysfunction. This is a broad term for the brain’s struggle with planning, organising, and actually doing the things you intend to do. It’s the source of so many classic ADHD frustrations.
To help you see how these traits can appear in daily life, I've broken down some common signs across different settings.
Common Signs of Adult ADHD Across Different Life Areas
As the table shows, these aren't isolated quirks but a pattern of challenges that can make life feel like a constant uphill battle.
A classic example of executive dysfunction is "time blindness"—a genuine difficulty with sensing the passage of time. It's not about being bad at time management; it's that your internal clock just doesn't work reliably. This is why you might always be late, consistently underestimate how long a task will take, and feel like you're forever playing catch-up.
Recognising these patterns—from the sharp sting of RSD to the quiet chaos of an untidy house—is the first, most crucial step. These aren't signs of laziness or a lack of willpower. They are symptoms of a brain that operates differently. And with the right support and understanding, they are absolutely things you can learn to manage.
Navigating the UK ADHD Diagnosis Pathway
Deciding to finally seek an assessment for ADHD can feel like standing at the bottom of a huge, confusing mountain. The whole process can stir up a lot of anxiety, but having a clear map of the journey ahead makes all the difference. Think of this as your guide to the diagnosis pathway here in the UK.
Your first port of call will usually be your GP. This is your chance to talk through the challenges you’ve been facing and explain why you think ADHD might be the reason. It’s completely normal to feel nervous about this conversation, but going in prepared can help you feel much more confident.
This chat with your doctor is the crucial first step, as it’s the gateway to getting a specialist referral. If your GP agrees your symptoms point towards ADHD and warrant a closer look, they will refer you for a formal assessment.
Understanding Your Assessment Options
Once you've got the green light for a referral, you'll find there are a few different routes you can take. It’s really important to get your head around these, because waiting times and the processes themselves can vary enormously.
The standard path is a referral to your local NHS adult ADHD service. But let's be honest, the reality for many is that these services are under immense pressure. The waiting lists can be incredibly long – we’re sometimes talking several years. That wait can be a really difficult and emotionally draining time, and it's okay to feel frustrated by it.
Waiting for an assessment can feel like being stuck in limbo. It takes real courage to ask for help, and facing a long delay can be disheartening. But remember, taking this step is a positive move towards getting the clarity and support you deserve.
Thankfully, there are other pathways. The NHS 'Right to Choose' scheme in England is a game-changer for many. It lets you ask for a referral to a qualified provider with an NHS contract, even if they aren't in your local area. This can sometimes slash your waiting time. Of course, private assessment is also an option; it's the quickest route but comes with a significant financial cost.
How to Prepare for Your ADHD Assessment
Whether you go down the NHS or private route, being prepared for your assessment is vital. This isn’t just a quick chat; the diagnostic process is thorough and aims to build a complete picture of your life, not just your current struggles. You'll almost certainly be asked for evidence of your traits going all the way back to childhood.
Here’s a practical checklist of things you can start gathering:
Old School Reports: These are gold dust. Comments from teachers about being dreamy, restless, or disruptive can be powerful evidence.
Personal Stories: Ask a parent, an older sibling, or a friend who’s known you forever if they can jot down some memories of you as a kid. What were you like? Did you struggle with things other children seemed to find easy?
Symptom Lists: Before your appointment, spend some time writing down specific, real-world examples of how your suspected ADHD traits affect your life now – at work, in your relationships, and just day-to-day.
Pre-Assessment Forms: You will almost definitely be sent questionnaires to fill out. Take your time with these. Be as honest and detailed as you possibly can.
Doing this prep work really helps the person assessing you make an accurate diagnosis. For more in-depth information, you might find external resources like this guidance on adult ADHD diagnosis helpful.
The infographic below touches on some of the core signs of adult ADHD that often come up during an assessment.
This image really highlights how the internal experiences of emotional dysregulation, a warped sense of time, and general executive dysfunction are so central to what it feels like to be an adult with ADHD.
Sadly, there's a huge gap between how many people are thought to have ADHD and how many are actually diagnosed. In the UK, while the real figure is estimated to be around 2.8% of the population, only about 0.32% of GP records actually show an ADHD diagnosis. This suggests that a staggering 1 in 9 people with the condition haven't been formally identified.
The whole diagnostic journey can feel long and isolating. Having someone to talk to while you’re in that waiting period can be a massive support. If you are looking for professional guidance as you navigate this process, you can explore how to find a therapist who understands neurodiversity to help you along the way.
Building Your ADHD Support System
Getting an ADHD diagnosis isn’t the end of the story; it’s really the beginning of a new chapter. It’s that moment you finally get to stop fighting against the current and start building a life that genuinely works with your brain's unique wiring, not against it.
A solid support system is the cornerstone of this process. It’s not about finding a single "cure," but about creating your own personal toolkit—a blend of strategies that look after both the practical and emotional sides of living with ADHD. The goal is to find a balance that empowers you to handle the challenges while playing to your strengths.
The Role of Medication in Managing ADHD
For many people, medication is a foundational piece of their ADHD management plan. Whether stimulant or non-stimulant, these medications work by helping to regulate the brain's neurotransmitter systems. This can bring about significant improvements in focus, dial down impulsivity, and quieten that inner restlessness.
Think of it like this: if your ADHD brain is an orchestra with every instrument playing its own tune, medication can act as the conductor. It doesn't change the music itself, but it helps bring all the sections into harmony, making it so much easier to think clearly and direct your attention where you want it to go.
It's important to remember that medication isn't a magic wand. What it does, and does brilliantly for many, is provide the biological support that makes other strategies, like therapy or new organisational systems, much more effective.
In the UK, prescriptions have seen a sharp rise recently, with an annual increase of 18% since 2020. Even so, it’s estimated that only 15% of adults with ADHD receive medication, which shows just how many people are managing their condition without it. To get a deeper understanding of these trends, you can read the full report from NHS England.
Therapeutic Support Tailored for the ADHD Brain
Therapy offers a vital space to unpack the emotional weight that so often comes with a lifetime of feeling different. It's about much more than just managing symptoms; it’s about healing from the years of self-criticism, anxiety, and low self-esteem that may have quietly built up over time.
Several therapeutic approaches can be particularly helpful, each offering a unique lens through which to understand yourself and develop powerful, lasting coping mechanisms.
Therapy for ADHD isn’t about fixing a deficit. It’s about building self-awareness and learning to navigate the world with a new understanding of your own mind, fostering self-compassion along the way.
Here at Therapy with Ben, we adapt established therapeutic models to meet the specific needs that come with having an ADHD brain.
Cognitive Behavioural Therapy (CBT): This is brilliant for tackling the practical, real-world challenges of ADHD. We can use CBT to spot those unhelpful thought patterns (like "I'm useless because I can't finish anything") and gently replace them with more balanced, realistic ones. It also gives us a great framework for building new habits and organisational systems that actually stick.
Psychodynamic Therapy: This approach goes a bit deeper, exploring how your past experiences have shaped your view of yourself and your emotional responses. For someone with ADHD, this can be incredibly validating. It helps you connect the dots between your neurotype and those long-standing feelings of inadequacy or anxiety.
Person-Centred Therapy: This approach puts you firmly in the driver's seat. It's built on a foundation of empathy and unconditional positive regard, creating a safe, non-judgemental space to explore what your ADHD means to you. It’s all about helping you build self-trust and reframe your story from one of struggle to one of strength.
Creating a Holistic Toolkit for Life
The most effective support is one where all the pieces work together. Medication might clear the mental fog enough for you to engage more deeply in therapy. Therapy can then give you the emotional tools to manage anxiety, while practical lifestyle changes support your overall well-being.
This is about building a life that doesn't just accommodate your ADHD, but celebrates your unique way of thinking and being. This might involve:
Lifestyle Adjustments: Prioritising sleep, getting regular exercise, and understanding how what you eat affects your focus and mood.
Environmental Design: Organising your home and workspace to minimise distractions and support your executive functions. Think visual timers or clear storage boxes.
Community and Connection: Finding others who just "get it," whether that’s through local support groups or online communities.
Creating this toolkit takes time and patience, but it's an empowering process of self-discovery. For more ideas and support on this journey, feel free to explore the articles and guides on our Therapy with Ben resources page. It's all about piecing together the support that helps you feel capable, confident, and in control of your own life.
So, What Does This All Mean for You?
If there’s one thing to take away from all this, it's a sense of empowerment. Getting an ADHD diagnosis isn’t about being slapped with a label; it’s like being handed a user manual for your own brain, finally making sense of a lifetime of experiences.
This new understanding lets you change your approach entirely. Instead of battling what you might have seen as personal flaws, you can start the much more rewarding work of collaborating with your brain's unique wiring. That's always the first, most crucial step.
The real journey with ADHD isn't about trying to become 'neurotypical'. It's about building a life that actually fits you – creating systems and surroundings that let your way of thinking shine.
Help is out there, and you absolutely don’t have to piece this all together on your own. My goal is for you to leave this guide feeling seen, understood, and ready to take your next step with confidence. A diagnosis can be the beginning of a much kinder, more effective way of living.
For anyone in Cheltenham looking for that one-to-one support to figure out what this looks like for you, I’m here to help. You can get a better feel for how I work with clients by having a look at my main page on counselling in Cheltenham.
Common Questions About Adult ADHD
When you first start exploring the world of adult ADHD, a lot of questions pop up. It’s completely normal. Let's walk through some of the most common ones that come up in my practice to clear up any confusion.
Can I Really Have ADHD If I Did Well in School?
Yes, absolutely. This is one of the biggest myths out there, and it stops so many people from seeking help. The truth is, many bright and capable people manage to get through school with undiagnosed ADHD, especially if it’s the inattentive type. They develop incredible coping strategies to keep their heads above water.
But that success often comes at a huge personal cost. It might have meant pulling all-nighters just to keep up, constant, gnawing anxiety, or a feeling of being an imposter. The real struggle often shows up later, when the rigid structure of school disappears and you’re faced with the demands of university or a career. That’s when the underlying difficulties with focus and organisation can really become overwhelming.
Isn't ADHD Just Being Overdiagnosed These Days?
It might feel that way with all the recent attention, but the data here in the UK tells a very different story. ADHD is still significantly underdiagnosed, not overdiagnosed. This is especially true for adults, women, and people from minority ethnic backgrounds who just don’t fit that outdated, hyperactive-little-boy stereotype.
There's a huge gap between the number of people thought to have ADHD and those who actually have a formal diagnosis. What we're seeing now isn't a fad; it's a long-overdue correction. Professionals and the public are finally starting to recognise the condition for what it is, allowing people to get answers they've been searching for, sometimes for their entire lives.
The recent rise in assessments isn't about over-labelling; it’s about finally catching up after decades of misunderstanding.
What’s the Difference Between ADHD Coaching and Therapy?
That's a fantastic question, because they both offer valuable support, just in different ways. Knowing which is which helps you find what you truly need.
ADHD Coaching: Think of this as practical and forward-focused. A coach is brilliant at helping you build the systems and habits you need to manage day-to-day life. They'll help with things like time management, getting organised, and actually starting tasks. It's very hands-on and action-orientated.
Therapy: This is where we go deeper. Therapy provides a safe space to explore the emotional side of living with ADHD. We can work on co-occurring anxiety or depression, process the grief and low self-esteem that comes from years of struggling, and untangle relationship difficulties. Therapy helps you understand the ‘why’ behind your feelings and behaviours.
Does Therapy Work With ADHD Medication?
Yes, without a doubt. In fact, combining therapy with medication is widely seen as the gold standard for treating adult ADHD. They work together beautifully, each supporting the other to help you build a more stable and fulfilling life.
Medication can be brilliant for improving focus and regulating your mood, which in turn creates the mental space needed to properly engage in therapy. Therapy then gives you the tools to build lasting coping skills, manage your emotions, and heal from past experiences – things that medication simply can't do on its own.
If you’re exploring what ADHD means for you and are looking for professional, compassionate support here in Cheltenham, Therapy with Ben is here to help you navigate it all. To find out more or to book an initial chat, please feel free to get in touch.
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