October is considered ADHD Awareness Month. In recent years, ADHD has received increasing attention as more people discuss their experiences online via social media and as more people have been able to access testing, obtain a diagnosis, and receive treatment. However, especially for people who receive the diagnosis later in life, the experience can be complicated, involving relief and empowerment as well as grief, shame, and confusion. 

If you’ve been feeling like you haven’t lived up to your full potential, embarrassed by your limitations, or feeling like you’re mourning a life you could have had with an earlier diagnosis or better accommodations, you’re not alone. These are common experiences for people with late diagnoses of ADHD, and they’re common experiences for anyone coming to terms with a new diagnosis or a new understanding of themselves. 

Therapy with trained psychologists, like those on the team at Aviva Psychology Services, can provide a supportive environment to develop self-compassion, to challenge internalized ableism, and to receive evidence-based therapy that has been proven to help effectively manage ADHD symptoms.

What is ADHD? 

The recent cultural surge of attention on the topic of ADHD has increased awareness and acceptance of ADHD, but has unfortunately also resulted in a surge of misinformation. Most of this misinformation isn’t intentional, but it can still be confusing and harmful. 

For clarity, let’s start by identifying what ADHD actually is. A diagnosis of ADHD requires all of the following:

• At least 6 symptoms of inattention and/or at least 6 symptoms of hyperactivity-impulsivity 
• Symptoms that interfere with daily life or development 
• Symptoms that were present prior to age 12
• Symptoms that are present across two or more settings (like work, school, or socially)

The specific symptoms of inattention that are currently recognized as ADHD symptoms are:

• Failing to give close attention to details or making careless mistakes
• Difficulty sustaining attention in tasks 
• Often seeming not to listen when spoken to directly 
• Often does not follow through on instructions and failed to finish work, chores, or duties 
• Often has difficulty organizing tasks and activities 
• Often avoids, dislikes, reluctant to engage in tasks that require sustained mental effort 
• Often loses things necessary for tasks or activities 
• Is often easily distracted by extraneous stimuli 
• Is often forgetful in daily activities 

The specific symptoms of hyperactivity-impulsivity that are currently recognized as ADHD symptoms are:

• Often fidgets with or taps hands or feet or squirms in seat
• Often leaves seat in situations when remaining seated is expected
• Feeling restless, or running or climbing in situations in which is it inappropriate
• Often unable to play or engage in leisure activities quietly
• Often on the go, acting as if driven by motor, or unable to be comfortable being still 
• Often talks excessively 
• Often blurts out an answer before a question is completed 
• Often has difficulty waiting to take a turn appropriately 
• Often interrupts or intrudes on others 

It is important to note that just because someone has one or even several of these symptoms doesn’t necessarily mean that the individual is experiencing ADHD. For example, difficulty concentrating and difficulty starting tasks are both common symptoms of depression. The diagnosis of PTSD includes symptoms like difficulty focusing, difficulty with memory, and restlessness. Anxiety routinely results in people talking excessively or failing to follow through on tasks.

Accurately interpreting symptoms and which diagnoses they "come from" is a complex process called differential diagnosis. This process requires thoughtful consideration of a person’s entire context, including their medical, psychological, relational, cultural, and trauma history. It also requires the use of evidence-based assessment and testing methodologies to help clarify symptom causes and to reduce biases in interpretation of data. This process is what professional diagnostic evaluation offers that self-diagnosis cannot.

It is also important to recognize that psychological science, including research about and best practices for evaluating and diagnosing ADHD is ongoing, imperfect, influenced by culture and politics. The diagnosis of ADHD will likely evolve over time as research continues, and in the future it may incorporate many of the emerging ideas and theories that are currently popular in contexts like social media. However, it is also likely that science will eventually debunk many of these ideas.

The Mixed Emotions of an ADHD Diagnosis 

People diagnosed with ADHD, especially those diagnosed later in life, often find the diagnosis brings extremely mixed emotions. In some ways, a diagnosis can be deeply validating. Finally, an explanation for your experiences, struggles, and skills! Finally, being seen more accurately by others! Finally, having a diagnosis that opens the doors to treatment like medications and therapy! 

However, for many people, the diagnosis also involves complicated, more unpleasant emotional experiences. Here are some common challenges:

ADHD and Grief

For those diagnosed later in life, there is sometimes a period of grieving for lost time, a life that could have been different or easier with an earlier diagnosis, or for our past self who struggled without access to necessary information and support. Grief is a complex human experience, and you can read more in this Aviva article about grief, which includes discussion of complex, non-traditional types of grief. 

ADHD and Ableism

Ableism, or negative beliefs or behaviors toward those with disabilities like ADHD, can be experienced both externally and internally. External ableism can look like being judged, mocked, or discriminated against for your ADHD symptoms. Internalized ableism can look like negative beliefs about yourself, such as believing that your diagnosis means you are stupid, lazy, or rude. Ableism is complex and harmful, and you can read more about ableism in this Aviva article about Disability Pride Month.

ADHD and Shame

In large part due to the ableism in the world, many people with ADHD experience intense shame about their limitations or diagnosis. Many people judge themselves harshly and experience decreased confidence, self-esteem, and hope after receiving a diagnosis—even if they initially hoped for the diagnosis.

ADHD and Overwhelm

A new diagnosis is confusing. After all, it’s a major shift in how you think about yourself, and there’s so much to learn about ADHD, your rights as a person with a disability, how to ask for accommodations for ADHD, and more. Feeling confused, overwhelmed, or stressed is common and can co-exist with other emotions, like relief or hope. 

What’s the Best Treatment for Adults with ADHD? 

Determining the best treatment for ADHD involves considering both research evidence and the unique needs, goals, preferences, and abilities of each individual who seeks ADHD treatment. There’s no “one size fits all” answer, but there are clear indications from scientific research about what works best for the most people. 

Broadly speaking, there are three recommendations for adults with ADHD, and research suggests that for many people, the most effective approach is a combination of all three:

Comprehensive Assessment for ADHD

Evidence-based, thorough assessment is often the first step in getting clarity about what diagnoses are present and developing a good treatment plan for ADHD. While expensive and time consuming, comprehensive assessment allows for deeper understanding of your unique symptoms, needs, limitations, and strengths. This doesn’t just help with getting a diagnosis; it also helps identify what types of treatment will suit you best.

Medication Management for ADHD

Medications, often stimulants like Adderall, are commonly used to treat ADHD and are widely considered the gold standard treatment. While helpful for many people with ADHD, medications are not accessible or desirable to all people with an ADHD diagnosis, and they aren't required to seek other types of treatment, such as therapy.

Evidence-Based Therapy for ADHD

As a supplement to medication or an alternative, there are multiple forms of evidenced-based therapy that can be helpful for ADHD. Forms of therapy that can be helpful include:

• Disability-Affirmative Therapy (D-AT): an empowering approach to therapy that can help people with ADHD challenge ableism and embrace themselves and their diagnosis fully. This approach can be applied to other specific forms of therapy, such as CBT and ACT.
  
  
• Cognitive Behavioral Therapy (CBT): a structured, practical type of therapy teaches specific, evidence-based skills for managing ADHD. Examples of skills taught in CBT for ADHD are time management, emotion regulation, and organizational approaches.
  
  
• Acceptance and Commitment Therapy (ACT): a mindfulness-based and values-focused style of therapy that teaches mindfulness and radical acceptance to help people with ADHD live values-consistent and meaningful life. In ACT, an important concept is living out your vaues without waiting to “fix” symptoms, thoughts, or emotions. 

Getting Started in Therapy for ADHD 

Living with ADHD can be exhausting, expensive, and overwhelming on its own, even if you were diagnosed as a child. For people diagnosed with ADHD later in life, adjusting to a new diagnosis can be even more complicated and include experiences like grief about not having the diagnosis and associated benefits and support earlier in life.

At Aviva Psychology Services, therapy for ADHD can address all those experiences and more. All therapy at Aviva is evidence-based, trauma-informed, and tailored to each unique client’s needs, preferences, goals, abilities, and readiness. Psychologists at Aviva are trained to help you develop a customized treatment plan that allows you to learn skills you need to manage ADHD and the insights to challenge experiences like internalized ableism, shame, and grief. 

You can get connected with a psychologist who has expertise and experience in working with clients who have ADHD by filling out the Request an Appointment form.

Selected References and Recommended Reading 

1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
   
   
2. UC Davis Health. (2025). Evidence Based Treatment of ADHD | UC Davis MIND Institute. Health.Ucdavis.Edu. https://health.ucdavis.edu/mind-institute/resources/understanding-adhd/adhd-treatment 
   
   
3. Reeves G, Schweitzer J. Pharmacological management of attention-deficit hyperactivity disorder. Expert Opin Pharmacother. 2004 Jun;5(6):1313-20. doi: 10.1517/14656566.5.6.1313. PMID: 15163276. 
   
   
4. Wakelin C, Willemse M, Munnik E. A review of recent treatments for adults living with attention-deficit/hyperactivity disorder. S Afr J Psychiatr. 2023 Dec 5;29:2152. doi: 10.4102/sajpsychiatry.v29i0.2152. PMID: 38126038; PMCID: PMC10730462.