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“After the Diagnosis: The 5 Phases of ADHD ‘Realization’”

“It’s when these clients finally receive their diagnosis that the real journey begins – and a pattern emerges. I call it the five phases of ADHD realization.“

By William Pellegrini, M.S., APCC Updated on March 31, 2022
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Therapy is difficult. That may be the most important lesson I have learned in my time as a professional mental health counselor.

I see the stress and anxiety marked so clearly on the face of every new client I meet as they tell me what’s making life so difficult. I want them to believe that everything is going to work out and that we will find an answer. But my assurances are only minimally helpful; they need time to discover these truths for themselves.

The path of discovery and recovery is especially hard for those who have been suffering with undiagnosed ADHD — those adults who learn at a later age that ADHD is what has been agitating them for so long.

These individuals often come to therapy, summoning as much hope as they can muster, in an effort to gain some sort of clarity about why their lives are so difficult. They want to know how they can change, and if their problems are really, truly explained by a condition.

It’s when they finally receive their diagnosis that the real journey begins – and a pattern emerges. I call it the five phases of ADHD realization.

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Diagnosed with ADHD: The Phases

Though I specialize in the treatment of ADHD, I cannot diagnose this condition. That said, I absolutely do analyze every symptom my clients experience and refer them to psychiatrists for diagnosis.

When a client comes back to me with an ADHD diagnosis, they almost always follow this discrete series of stages.

Phase One: Excitement/Relief. I have witnessed every emotion from exhausted relief to outright ecstasy at this stage. What’s more, almost all clients say the same thing: “I had no idea ADHD affected so much of my life!”

Most people have a cursory knowledge of the disorder, and they typically view symptoms through the lens of pop-psychology, completely overlooking core aspects of ADHD like executive dysfunction.

[Read: Your After-Diagnosis Survival Guide]

Additionally, many recently diagnosed individuals choose to keep the diagnosis to themselves. They avoid the topic, fearing that others in their circle who do not accept or believe the diagnosis will judge and criticize them.

While the newly diagnosed revel in the news, this phase is rather short-lived.

Phase Two: Investigation. With basic explanations for their lifelong difficulties, the newly diagnosed want to know more. They want to understand their brains so that they can learn how to navigate life using some set of the rules they believe they should have been following all along.

In search of more answers, the newly diagnosed eventually find a group or congregation of fellow neuro-divergent folks with whom they share stories, experiences, and information. While joining a community is a healthy and positive step, the details of the disorder are often neglected in these settings in lieu of camaraderie. This phase, too, is short-lived and leads rapidly to the next.

Phase Three: Frustration. All diagnosed individuals eventually come face-to-face with the stark realization that ADHD is permanent, chronic, and relentless. There is no escape, no break, and no cure.

I realize how daunting that might sound, but that’s the harsh reality of the condition. ADHD is hereditary and, especially if left untreated, pervasively invades just about every aspect of a person’s life.

This truth is sobering. The diagnosed individual realizes that ADHD is never going to stop distracting and misdirecting their minds and lives. They might find themselves feeling hopeless and helpless.

This is where co-occurring disorders like anxiety or depressive disorders come into focus and complicate the person’s life.

My newly diagnosed clients are usually able to manage this stage productively and rapidly; this is not always true for clients with long-standing ADHD diagnoses. The number one statement I hear from them is, “I don’t know how to make this stop.” They are often misguided in their beliefs about their futures. Fortunately, these beliefs are not difficult to refute with the right guidance and education.

Once they eventually find themselves on a path to awareness and management, they enter the next phase.

Phase Four: Acceptance. This phase is the most difficult to recognize. It is also the final destination for most individuals with ADHD post-diagnosis.

By this stage, the individual has accepted ADHD and how it uniquely manifests for them. They know that there are methods — medicinal and otherwise — to manage and even overcome some aspects of the disorder. They have created patterns, habits, and processes that assist them in managing the symptoms they once found unbearably oppressive. They have found a way to let go of their inner turmoil and find acceptance.

They have also come to terms with the fact that not everyone is going to understand or believe what they are going through – and they do not take it personally. They have dropped their expectations and have found a semblance of peace about their diagnosis. They no longer judge themselves based on others’ opinions.

This is commonly where growth and progress stop for most of my clients. Some of them, however, want to do more, and find themselves becoming advocates. They speak out in defense and in hopes of educating others about ADHD. They look to motivate and inspire others with ADHD to better understand themselves. These are the ones who find themselves in the next stage.

Phase Five: Application. Individuals in this stage view ADHD as a condition that can help them, instead of a hindrance that must be endured.

Beyond simply understanding ADHD, individuals who have reached this stage have exhaustively researched the condition and identified all its positive attributes. They have taken steps to apply that education in their lives and use their strengths accordingly.

Even more impressive, these champions of ADHD look to empower those who are suffering in silence. They want to give them a voice, a direction, and hope. All in all, their true motivation is to let others struggling with ADHD know that they are not alone.

They strive to become that rare person for someone diagnosed with ADHD: a true, fully accepting friend.

Diagnosed with ADHD: Next Steps

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