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Adult ADHD: Late Diagnosis

Updated: Mar 11

You have probably been told that for a diagnosis of ADHD to be made, symptoms must have been present from early childhood. However, not all ADHD adults will have shown obvious symptoms in early life. When most people hear ADHD, they think of the hyperactive version.


Addressing ADHD in Therapy

Many individuals come to therapy confused, lost, and distressed due to symptoms of ADHD. Unsure of where and when it started, or why suddenly they can't seem to function at the level they desire. It feels as though, despite all their best efforts, they cannot seem to "get it together"--which then leads to symptoms of depression and anxiety. Folks also come to therapy because of how symptoms are impacting their relationships. There is also often time shame associated with roles and expectations as a partner, partner, or functional person in society.


*Scroll down to see common indicators of Adult ADHD.


DSM-5

ADHD treatment is as comprehensive and individualized as the diagnosis and its impairments. We will understand the diagnosis and its impact for what it is: neurology rahter than character based. As we work to correct maladaptive habits, we will build self-esteem and self-efficacy by identifying the right tools, skills, supports, and environments for your particular strenghts.


In the DSM-5, the diagnosis criteria for ADHD is either (1) symptoms of hyperactivity-impulsivity or (2) symptoms of inattention.


What can ADHD look like in adulthood?

  1. Intense pressure of meaning-making on things that happen, and what it will mean about future events as a reflection of them as a person.

  2. Executive functioning deficits that cascade into a multitude of troubles.

  3. Occupational Functioning

  4. Daily Life

  5. Psychological

    1. Self-image

    2. Self-efficacy

    3. Defense mechanisms like procasination or apathy

  6. Social Skills & Relationships

    1. tactfulness and ability to adjust behavior to appropriate situation

    2. moderating expressions of strong emotions & controlling nonverbal displays

    3. ADHD adults are twice as likely to seperate/divorce and report less marital satisfaction

    4. parenting



A late diagnosis of ADHD in adults often happens because symptoms can be masked, misunderstood, or attributed to other causes. Here are some of the biggest indicators that someone may have undiagnosed ADHD:


1. Chronic Procrastination & Time Management Issues

  • Constantly putting off tasks, even important ones.

  • Difficulty starting or finishing projects.

  • Frequently missing deadlines or appointments.

  • Relying on last-minute pressure to complete tasks.


2. Executive Dysfunction

  • Difficulty organizing tasks and prioritizing.

  • Struggles with breaking down large projects into smaller steps.

  • Trouble following multi-step instructions or remembering details.

  • Often losing or misplacing important items (keys, wallet, phone).


3. Emotional Dysregulation

  • Intense emotional reactions that seem disproportionate to the situation.

  • Frequent mood swings or feeling overwhelmed by emotions.

  • Difficulty handling criticism or rejection (Rejection Sensitivity Dysphoria - RSD).

  • Impatience or frustration in daily interactions.


4. Hyperfocus vs. Distractibility

  • Inability to focus on boring or repetitive tasks but extreme focus on interesting ones.

  • Losing track of time while working on something engaging.

  • Difficulty shifting attention between tasks when required.

  • Struggling to listen during conversations, zoning out, or interrupting others.


5. Impulsivity

  • Speaking without thinking or interrupting in conversations.

  • Making impulsive decisions (spending, quitting jobs, relationships).

  • Struggling with self-control in emotional or financial situations.

  • Engaging in risky behaviors without fully considering consequences.


6. Relationship & Social Struggles

  • Difficulty maintaining friendships or romantic relationships due to inconsistency.

  • Feeling misunderstood or like an “outsider.”

  • Forgetting important dates, commitments, or plans.

  • Difficulty reading social cues or oversharing personal information.


7. Sleep Problems & Fatigue

  • Difficulty falling asleep despite exhaustion (racing thoughts).

  • Inconsistent sleep patterns, staying up too late, or waking up frequently.

  • Feeling perpetually tired despite getting enough sleep.

  • Relying on caffeine or stimulants to stay functional.


8. Masking & Coping Strategies

  • Developing routines, lists, and alarms to compensate for forgetfulness.

  • Overworking or perfectionism to hide difficulties.

  • Relying on adrenaline (last-minute pressure) to complete tasks.

  • Feeling exhausted from constantly trying to "keep up" with others.


9. Coexisting Conditions

  • Anxiety or depression (often misdiagnosed instead of ADHD).

  • Struggles with self-esteem and feeling like a failure despite efforts.

  • History of misdiagnoses (bipolar disorder, borderline personality disorder, etc.).

  • Addictive behaviors (social media, gaming, shopping, substance use).


Why ADHD Gets Diagnosed Late

  • Many adults assume their struggles are due to personality flaws, laziness, or stress.

  • Symptoms may be dismissed as anxiety, depression, or lack of discipline.

  • High-functioning individuals might develop coping mechanisms that delay diagnosis.

  • Societal expectations, especially for women, can lead to masking ADHD traits.


If You Suspect Late-Diagnosis ADHD

If these signs resonate with you, seeking an evaluation from a medical professional can provide clarity and potential treatment options. Therapy, medication, and lifestyle changes can significantly improve daily functioning and well-being.


 
 
 

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