Just Diagnosed: Next Steps

“If Only I’d Known This 20 Years Ago”

Regret and resentment are common among adults diagnosed with ADHD after a lifetime of learning challenges, self-esteem struggles, and harsh criticism. Working through complex emotions is Step One. Then, follow these steps to decide on the best treatment plan and secure the support you need.

The difficulty of a late ADHD diagnosis

“Doctors used to be taught that ADHD affects only children,” explains Lenard Adler, M.D., director of the adult ADHD program at New York University. “But now we know that, although hyperactivity may wane, ADHD symptoms such as inattention and impulsivity continue into adulthood.”

The condition is still widely underdiagnosed in the general population. Experts estimate that about 80 percent of adults with ADHD — roughly 5 million — haven’t been officially diagnosed and are going untreated. Most undiagnosed adults know that they have more difficulties than others with organization, focus, and productivity than peers or colleagues, so the diagnosis rarely comes as a complete surprise.

From the moment you start to think you might have ADHD — or even after you get a formal diagnosis — it’s common to think, “Now what do I do?” Follow these steps to work through your emotions, assemble your team, and get the treatment you need.

Step One: Honor Your Feelings

Your immediate reaction to the news of an ADHD diagnosis may be relief — now you know why you are the way you are. But it may well be regret for past struggles and for what might have been, or fear that ADHD treatment will take away your creativity and change who you are.

You may also have difficulty accepting the diagnosis itself. “Even though my diagnosis made sense, I just couldn’t or didn’t want to believe it,” says one woman who was diagnosed in her forties.

Understand that your feelings about the diagnosis, whether positive or negative, or mixed, are natural. Realizing you have something to feel sad about, or work on, or capitalize on and preserve will help you take action.

Step Two: Decide on Treatment

Deciding to move forward with treatment — particularly medication — is a big step, and just the beginning of a new course you’ll be carving out for your life. Remember that bringing about major change takes time.

Even under the care of an experienced physician, it may take weeks or even months to find a medication and dosage that work best for you. The effectiveness of ADHD medications varies with each individual, so finding the right one will involve trial and error with different doses and, possibly, different medications.

Once you and your doctor have gotten the medication right, the results can be dramatic. “The first day was like, who pulled up the shades?” recalls one woman who started a stimulant medication after much deliberation. “Already, I’m much more organized and on top of things. I can remember what time I told my teenagers to be home.”

Step Three: Change Your Behavior

Studies show that ADHD in adults is treated most successfully with a combination of medication and behavior therapy. Medication can help with focus, but it’s up to you to take advantage of this newfound clarity of mind to develop strategies that will help your life flow more smoothly.

The coping systems that may have gotten you this far — relying on last-minute bursts of energy and adrenaline or putting in twice as much work behind that scenes to complete projects — are hard to sustain when family and work responsibilities begin to mount up.

“External” organization systems — checklists, planners, smartphones, beeping watches or alarms — become a way of life for many with ADHD. Many newly diagnosed adults work with experienced psychologists, psychiatrists, and ADHD coaches to learn other ADHD-friendly behavioral, time management, and organizational strategies.

Step Four: Seek Support

Effective treatment of adult ADHD rarely comes from a single doctor writing out a prescription. Your treatment “team” may eventually include a psychiatrist or other M.D., a psychologist or therapist, an ADHD coach, and a professional organizer.

Don’t underestimate the importance of emotional support. Understanding spouses, children, relatives, and friends can be a great help. Newly diagnosed adults may want to reevaluate and diversify their support systems, however, so that they don’t rely too heavily on any one person.

Now matter how understanding friends and family are, you may also find that you need to connect with others who grapple with ADHD, who don’t need you to explain what you’re going through. Attending meetings of your local chapter of CHADD, a nonprofit advocacy and education organization, can provide this kind of been-there-done-that support. Or seek support virtually — in this day and age, online communities are often easier to find (and attend) than IRL support groups!

1 comment

  1. I have a wonderful friend who is very organized, including making and meeting long-term goals. She seems to have endless energy, and is happy most of the time. She also likes to send me lengthy emails listing all her accomplishments. I’ve gotten used to it, and I think there’s something in her that needs attention. But when I’m feeling down on myself, I can also feel very resentful towards her!

    It seems like life in general is a struggle for me. And as I’ve gotten older, I find myself getting tired much more easily. When I was young, I could drive myself into exhaustion. Now exhaustion seems to take over before I can even get going. I do have another close friend who definitely suffers from ADD, and even though I don’t wish this on anyone, there’s something helpful about having a friend who knows how I feel and being able to laugh and encourage one another through some of our frustrations.

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