1. Masking & Coping Strategies Can Hide Symptoms
Many adults with ADHD develop compensatory coping mechanisms to get by in daily life. They may create rigid structures, rely on high-pressure environments to stay focused, or overwork themselves to meet expectations. This can make their ADHD symptoms less visible—especially to therapists unfamiliar with how ADHD presents in adults.
🔹 Example: A client who struggles with time blindness might overcompensate by obsessively using planners, leading a therapist to assume their executive functioning is fine.
2. Symptoms Overlap with Anxiety & Depression
Many adults with ADHD first seek therapy for anxiety or depression, unaware that their core challenges stem from executive dysfunction. ADHD-related struggles—like forgetfulness, overwhelm, and rejection sensitivity—can look like mood disorders at first glance.
🔹 Common misinterpretations:
- Emotional dysregulation → misdiagnosed as bipolar disorder
- Inattentiveness & brain fog → mistaken for depression
- Hypervigilance & racing thoughts → assumed to be anxiety
While ADHD can co-exist with these conditions, misdiagnosing it leads to treatment that doesn’t address the root cause.
3. Gender Bias in ADHD Diagnosis
ADHD in women is severely underdiagnosed because early research focused primarily on hyperactive boys. As a result, those who present with inattentive ADHD (struggling with focus rather than externalised hyperactivity) often go unnoticed.
🔹 How this affects therapy:
- Women and with ADHD are more likely to be misdiagnosed with anxiety or depression.
- They may internalise their struggles rather than exhibit external signs of ADHD.
- Therapists unfamiliar with ADHD may focus on self-esteem issues rather than recognising neurodivergence.
How Therapy Can Help: A Neurodivergent-Affirming Approach
If ADHD is often missed, how can therapists and clients work together to ensure accurate support?
Screen for ADHD in adults – Therapists should be trained to recognise adult ADHD symptoms, even when they appear subtle.
Focus on executive functioning – Instead of only treating mood symptoms, therapy should explore struggles with task initiation, organisation, and time blindness.
Use CBT tailored for ADHD – Traditional CBT may not always work for neurodivergent individuals. Instead, ADHD-focused CBT helps with dopamine regulation, habit formation, and managing emotional intensity.
Create an affirming space – Therapy should validate the client’s experiences and help them unlearn shame and self-blame for their struggles.
Conclusion: The Need for ADHD-Informed Therapy
For too long, ADHD has been misunderstood and overlooked in therapy. Many adults seeking help are dismissed or misdiagnosed, leading to frustration and ineffective treatment. By increasing awareness and using neurodivergent-affirming therapy approaches, we can help more people get the support they truly need.
Are you looking for ADHD-informed therapy? I specialise in CBT for ADHD, autism, and neurodivergence, providing both in-person sessions in Limerick and online therapy. Get in touch today to learn how we can work together!