Key takeaways
- ADHD is a neurological difference in how the brain regulates attention, not a character flaw or lack of willpower
- Many adults—especially women—are diagnosed later in life after years of being overlooked or misdiagnosed
- ADHD affects far more than focus: it impacts emotions, relationships, time management, and self-esteem
- Late diagnosis often brings both relief and grief, and these feelings can take time to process
- Counselling can help you make sense of your experience, challenge internalised shame, and find strategies that work with your brain
If you're reading this, something brought you here. Maybe a conversation struck a nerve. Maybe you saw something online that felt uncomfortably familiar. Or perhaps you've spent years quietly wondering why everything seems harder for you than for everyone else.
You might be looking for answers. You might have just received a diagnosis and feel a strange mix of relief and grief. Or maybe someone you love has ADHD, and you're trying to understand their world a little better.
Wherever you are with this, that's okay. Let's start there.
What ADHD actually is
ADHD (Attention Deficit Hyperactivity Disorder) is a neurological difference in how the brain processes dopamine and norepinephrine—chemicals that regulate attention, motivation, and what's often called "executive function." It's not a character flaw. It's not a lack of willpower. It's not the result of poor parenting or too much screen time.
The Neuroscience
The name itself is a bit misleading. ADHD isn't really a deficit of attention—it's a difficulty regulating attention. People with ADHD can often focus intensely on things that interest them (sometimes to the exclusion of everything else), while struggling to direct attention toward things that don't spark that same engagement, no matter how important they are.
ADHD also affects much more than attention. It shapes how you experience time, how you manage emotions, how you start and finish tasks, and how you move through daily life. For many people, it touches everything.
Common experiences include:
- Difficulty sustaining focus on tasks that aren't intrinsically engaging
- An ability to hyperfocus on things that capture your interest
- A complicated relationship with time—underestimating how long things take, running late despite your best efforts
- Feeling like time moves differently for you than for others
- Impulsivity in decisions, speech, or actions
- Restlessness or a constant need for stimulation
- Unreliable working memory—difficulty holding information in mind while using it
- Organisation feeling like an uphill battle
These aren't occasional difficulties everyone experiences. For people with ADHD, they're persistent patterns that have been present since childhood—even if no one recognised them at the time.
The ADHD Iceberg
Late diagnosis: why so many adults are only discovering this now
Many adults discover they have ADHD in their 30s, 40s, or later. If that's you, you're far from alone.
For decades, ADHD was understood primarily as a condition affecting hyperactive young boys. The image was a child who couldn't sit still in class, who was disruptive, who was obviously struggling. But that picture captured only one version of how ADHD can present—and it left a lot of people out.
Women and ADHD
Women and those assigned female at birth have been particularly overlooked. ADHD often looks different in women—less external hyperactivity, more internal restlessness. Less disruption in the classroom, more daydreaming. Less "behaviour problem," more "not living up to her potential."
Many women describe a lifetime of feeling somehow different without understanding why. They might have been called scatterbrained, oversensitive, or told they needed to try harder. Some developed anxiety or depression and were treated for those—sometimes correctly, since they often co-occur with ADHD, sometimes as a misdiagnosis that missed what was underneath.
Hormonal changes also play a role that's only recently being understood. Many women notice their symptoms shift across their menstrual cycle, during pregnancy, postpartum, or around perimenopause. Research shows that oestrogen affects dopamine regulation, and when oestrogen fluctuates, ADHD symptoms often fluctuate too.
High achievers who masked their struggles
If you're intelligent and determined, you may have developed sophisticated ways of coping that hid your ADHD from everyone, including yourself. You got through school. You held down jobs. From the outside, you looked fine.
But inside, you might have been working twice as hard as everyone else to achieve the same results. You might have felt constantly exhausted without knowing why. You might have experienced a persistent, nagging sense that something was wrong—that things shouldn't be this hard.
When other conditions took the spotlight
ADHD frequently occurs alongside anxiety, depression, and other conditions. Often, these more visible issues were treated while the underlying ADHD went unnoticed. Sometimes treating the anxiety or depression helped, but something still felt unaddressed. That something might have been ADHD.
What late diagnosis feels like
Receiving an ADHD diagnosis as an adult can bring up complicated feelings. There's often relief—finally, an explanation for years of struggle. A reason you're not lazy, stupid, or fundamentally broken.
But there can also be grief. For the years spent blaming yourself. For what might have been different with earlier support. For the version of your life that might have unfolded if someone had recognised this sooner.
Both of these responses make sense. They can exist at the same time. And they often take time—and sometimes support—to work through.
But what if it's not really ADHD?
If you're questioning whether your struggles are "real" or "bad enough" to count, you're in good company. Many people with ADHD spend years dismissing their own experience.
Everyone struggles with focus sometimes. I'm probably just lazy. I got through university, so it can't be that serious. Other people have it much worse.This self-doubt is so common among people with ADHD that it's almost a pattern in itself. Years of being told to try harder—and watching others apparently succeed where you struggle—can make it very hard to trust your own experience.
There's also genuine complexity here. ADHD shares features with anxiety, depression, and other conditions. They can look similar, they often occur together, and untangling them takes careful assessment. Anxiety can cause concentration problems. Depression can look like low motivation. Burnout can mimic ADHD symptoms.
If you're unsure, that's not a reason to dismiss your experience. It's a reason to take it seriously. A proper evaluation can help clarify what's going on—and what might actually help.
How ADHD shows up in daily life
ADHD affects more than the ability to concentrate. It reaches into nearly every area of life, often in ways that aren't immediately obvious.
Work and productivity
- Starting projects with genuine enthusiasm, only to find momentum evaporates before finishing
- Deadlines slipping despite good intentions
- Feeling paralysed when everything feels equally urgent
- Underperforming relative to what you know you're capable of
- Frequent job changes or roles that started well and became unbearable
- A sense of never quite finding the right fit
This isn't lack of commitment. It's often a brain that needs novelty and engagement to function well, trapped in environments that don't provide either.
Relationships
- Forgetting important dates, commitments, or conversations—not because you don't care, but because working memory is impaired
- Interrupting people or seeming not to listen when your attention has been pulled elsewhere
- Emotional reactivity that seems disproportionate from the outside
- A painful pattern of feeling like you're constantly letting people down
Daily self-care
- Struggling with eating regularly, getting enough sleep, exercising, or keeping the house in order
- Knowing what you "should" be doing but not being able to make yourself do it
- Shame spirals that make everything harder
Mental health
- Chronic low self-esteem from years of "underperforming"
- Anxiety about forgetting things, making mistakes, or being exposed as inadequate
- Depression from feeling fundamentally flawed
- Shame about struggling with things that seem easy for everyone else
These aren't separate from ADHD. They're often the downstream consequences of living with a brain that works differently in a world that wasn't designed for it.
ADHD and emotions
Emotional dysregulation is a core feature of ADHD, though it's often overlooked in favour of attention and hyperactivity symptoms.
This might show up as:
- Intense emotional reactions that feel disproportionate—even to you
- Difficulty letting go of frustration, disappointment, or anger
- Moods that seem to shift without warning
- Getting overwhelmed by feelings to the point where you can't think clearly
There's also something called rejection sensitivity—an intense, sometimes devastating response to real or perceived criticism, exclusion, or failure. It's not a formal diagnosis, but it's a pattern many people with ADHD recognise instantly. The feeling of a small slight landing like a physical blow. Spending days replaying a comment someone probably forgot five minutes after making it. Avoiding situations, opportunities, or relationships because the risk of rejection feels unbearable.
These emotional experiences aren't weakness or overreaction. They're part of how ADHD affects the brain's regulatory systems. Understanding this doesn't make the feelings less intense, but it can help make sense of them.
The weight of internalised messages
Living with undiagnosed ADHD often means absorbing messages—from teachers, parents, employers, and eventually yourself—that something is fundamentally wrong with you.
You might have been told you're lazy, when you were actually struggling with initiation and follow-through. Careless, when your working memory was overwhelmed. Too sensitive, when you were experiencing rejection sensitivity. Not trying hard enough, when you were trying harder than anyone could see.
Over time, these messages get internalised. They become your own voice. Many adults with ADHD carry deep shame about who they are, a conviction that they're somehow defective—not just struggling with specific things, but broken at a core level.
Recognising that ADHD is a neurological difference, not a character failing, can begin to shift this. But the internalised shame often doesn't disappear just because you now have a name for what's been going on. It takes time, and often support, to update the story you've been telling yourself for years.
How counselling can help
Counselling for ADHD isn't about fixing you. You're not broken. It's about making sense of your experience, healing the wounds that have accumulated, and finding ways to live that work with your brain rather than against it.
Processing the diagnosis
Whether you're newly diagnosed or have known for years, there's often a lot to work through. Relief, grief, anger, confusion—sometimes all at once. A late diagnosis in particular can bring up intense feelings about the past and what might have been different.
Having space to process this with someone who understands can make a real difference. Not to rush through the feelings, but to let them be what they are.
Rebuilding self-understanding
Much of the work involves separating who you actually are from the critical messages you've absorbed. Recognising your strengths as well as your challenges. Learning to see yourself with more accuracy and more compassion.
This isn't about dismissing the real difficulties ADHD causes. It's about no longer equating those difficulties with your worth as a person.
Working with emotions
Emotional intensity and dysregulation are part of ADHD, not separate from it. Counselling can help you develop awareness of your emotional patterns, understand your triggers, and find ways to regulate that work with your brain.
This might look different from what helps neurotypical people. That's okay. The goal is to find what actually works for you.
Addressing what often accompanies ADHD
Anxiety, depression, low self-esteem, relationship difficulties—these frequently come alongside ADHD. Sometimes they're reactions to living with unrecognised ADHD for years. Sometimes they're co-occurring conditions that need attention in their own right.
Either way, they're part of the picture. Counselling can address them together rather than in isolation.
What this looks like in practice
There's no single "ADHD therapy." What happens in sessions is shaped by what you need. It might mean exploring patterns you've noticed, making sense of past experiences through the lens of ADHD, developing strategies for managing overwhelm, or simply having a space where your experience is understood and taken seriously.
Finding your way forward
ADHD is a lifelong condition, and what helps tends to change over time. Counselling is one piece. There's also coaching for practical strategies and accountability, medication that makes a significant difference for many people, and peer support from others who genuinely understand.
The right combination is personal. It depends on your symptoms, your circumstances, your preferences, and what you've already tried. What matters is finding support that respects your experience and works with the way your brain actually functions.
A note to end on
If any of this has resonated—if you've recognised yourself or someone you love in these words—I want you to know that the way you've been struggling makes sense. You haven't been failing due to lack of effort or character. You've been navigating the world with a brain that works differently, often without support or even a name for what was happening.
That's not a small thing. And seeking to understand it better isn't either.
If you'd like a space to make sense of your experience, you don't need to have everything figured out first. Most people don't. We can start wherever you are.
About the author
Nadia Wilkinson is a BACP registered counsellor (Member No. 394901) and HCPC registered Educational Psychologist specialising in supporting adults with ADHD, autism, anxiety, and emotional wellbeing. She offers online counselling across the UK.References:
- NHS: Attention deficit hyperactivity disorder (ADHD)
- ADHD UK: Women and ADHD
- Research on oestrogen and dopamine: Shanmugan & Epperson (2014), "Estrogen and the prefrontal cortex" — published in Hormones and Behavior