Managing ADHD into Adulthood

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Managing ADHD into Adulthood

Nancy Fingerhood, LSW
Counselor, Insight Clinical Counseling and Wellness, LLC

Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder that effects the executive functioning portion of the brain (located mainly in the front part of the brain). When executive functioning is impaired, it can be difficult to prioritize and initiate tasks, sustain our attention, manage time, or regulate our emotions. When people think of ADHD, they often picture a young excessively energetic child in school unable to pay attention to the teacher and potentially even outgrow ADHD. However, research shows that ADHD symptoms persist for 60 percent of adults. In adults, the symptoms can look different from those in children, and their severity can fluctuate depending on life stressors.

The hyperactivity type of ADHD is usually not as prevalent in adults. Most adults have ADHD Inattentive type, formerly called Attention Deficit Disorder (ADD). People assume they have grown out of ADHD because they no longer seem hyperactive or impulsive, but other traits such procrastination, “zoning out,” and disorganization remain. ADHD can interfere with home life, financial management, relationships, work, and other domains.

Procrastination, a common behavior of ADHD, is often thought to stem from difficulties with organization, low motivation, and distractibility. However, an overlooked cause of procrastination is perfectionism. After years of being criticized and being told they’re not “good enough,” some people with ADHD begin to fear imperfection. A perfectionistic mindset can hinder a person from initiating a task if they believe it cannot be perfected. Putting off tasks can be a way to avoid fears of failure or rejection.

While stimulant medications like Ritalin and Adderall and non-stimulants such as Strattera can be effective, not everyone chooses to begin managing symptoms with medication. Talk therapy with a mental health professional can be an effective and goal-oriented method to address ADHD-related challenges. A therapist introduces strategies to compensate for executive function deficits and change negative thought patterns.

Strategies to assist with executive functioning include:

Keeping a calendar for appointments with specific dates in a highly visible area.
Keeping a list for tasks and crossing off a task after completing (bonus: this can supply a burst of the feel-good neurochemical, dopamine).
Breaking down tasks into smaller steps to avoid feeling overwhelmed. The feeling of being overwhelmed can lead to task paralysis.
Practicing mindfulness as stress can exacerbate ADHD symptoms.
Putting tasks into an Eisenhower Matrix, which is a decision-making framework that helps prioritize tasks.
Giving yourself a reward after completing a difficult or less-desirable task.

A mental health professional can work with clients with ADHD to explore self-judgements and personal strengths. Perfectionism creates impossible standards that can lead to burnout and anxious thoughts. A therapist can guide you to uncover the root cause of unhelpful beliefs and show how self-compassion can be an antidote to perfectionism.

A combination of education about ADHD, practical skills, and exploration of unhealthy self-dialogues can have a positive impact on ADHD symptoms. Seeing a therapist may also assist with any co-occurring conditions that emerge from the challenges of having ADHD, such as anxiety or depression. Medications are also a viable option combined with therapy. ADHD is a complex disorder that affects individuals in a unique way, and with proper guidance from a mental health professional, you can navigate life’s challenges and enhance your quality of life.

Sibley, M. H., Arnold, L. E., Swanson, J. M., Hechtman, L. T., Kennedy, T. M., … Owens, E. (2022). Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD. American Journal of Psychiatry, 179(2), 142–151. https://doi.org/10.1176/appi.ajp.2021.21010032

Movement as Medicine: How Exercise Changed My Mental Health — and Can Change Yours Too

Growing up, I didn’t call it therapy; I called it volleyball. I started playing sports in kindergarten, but, around the age of 12, volleyball became my true passion. From that point on, the court wasn’t just where I played: it was where I coped. Every teenage hardship, heartbreak, and worry was filtered through the constant drills, the competitions, and the grounding repetition of practices. Volleyball was a constant, a kind of emotional home I could return to no matter what was happening outside the gym.

Let’s Talk About Expectations

We all fall into that familiar loop:
“If only he would…”
“What if she just…”
“When will they finally…”
Or the classic: “Why can’t they just…?”
The problem with this cycle is that it keeps us stuck in disappointment. We set ourselves up with expectation, often silently, and then wonder why we feel let down when they aren’t met.