The Effect of ADHD on Adults: Providing Support to Clients and Their Loved Ones

Editor's Note: This text-based course is an edited transcript of the webinar, The Effect of ADHD on Adults: Providing Support to Clients and Their Loved Ones, presented by Christina Marsack-Topolewski, PhD, MSW, LMSW.

Learning Outcomes

After this course, participants will be able to:

• Identify the characteristics, signs, and symptoms of ADHD in adulthood.
• Describe the multi-faceted nature of ADHD and co-occurring conditions common among adults with ADHD.
• Identify and apply practical and evidence-based strategies to support adult clients with ADHD and their loved ones.

Welcome/Today's Focus

Hello everyone! Today, we will discuss adults with ADHD and how we can best support them and their loved ones. This is often a significant factor in why they seek our help, as it’s not uncommon for a loved one, spouse, or family member to encourage them to explore what’s going on.

In my career, I’ve worked as both a special education teacher consultant and a clinical outpatient therapist. I’ve supported individuals across different stages of life, from children in K-12 settings who receive an early ADHD diagnosis and benefit from IEPs or 504 plans to adults who come in later seeking an evaluation or a formal diagnosis. For many adults, ADHD has created a ripple effect through various facets of their lives—impacting their work, relationships, and home life. Often, these individuals may not realize how significantly ADHD has been affecting them until something brings it to light, whether it’s a challenge at work, tension in a relationship, or feedback from someone close to them.

As a society, we often associate ADHD with children and adolescents, but millions of adults in the United States—and many more globally—live with ADHD. The truth is that ADHD doesn’t simply dissipate in adulthood. Many adults were either misdiagnosed or not diagnosed at all during childhood and adolescence. They may have developed their coping mechanisms to navigate school and other early life challenges, though often not without significant difficulty. When these individuals reach adulthood, they may encounter professionals—whether therapists, coaches, or evaluators—who help them identify and address what’s been underlying their experiences.

Today, we’re focusing specifically on adulthood and what we can do to support adults with ADHD. ADHD affects many areas of life, such as employment, family dynamics, and relationships, and without the right supports and tailored strategies, these areas can suffer. Our discussion will cover how ADHD presents differently in adults, how stress plays a pivotal role in its manifestation, and the complexities of the condition’s multifaceted nature. We’ll also look at evidence-based strategies and practical approaches to support adult clients and their loved ones.

It’s essential to recognize that ADHD in adulthood doesn’t exist in isolation. It impacts the individual, their relationships, and their broader environment. The ripple effects can be profound, whether it’s a couple navigating challenges, a family dealing with competing needs, or an individual striving to manage their work life. I’m excited to delve into this topic and explore ways we can help adults with ADHD find success and balance in their lives. Let’s get started.

Risks & Limitations

Regarding limitations, I want to acknowledge that this is a one-hour training, and while ADHD is a topic we could easily spend an entire day exploring, we need to remain mindful of the scope of our time together. Additionally, as clinicians, we must be aware of the limitations and boundaries within our scope of practice. Supporting clients with ADHD often benefits from a team-based approach, which might include collaboration with other practitioners, medical providers, or holistic supports. Taking this interdisciplinary perspective can be incredibly valuable for clients, allowing them to access a range of resources and perspectives that complement one another.

It’s also important to recognize that ADHD often doesn’t occur in isolation. Many clients with ADHD present with comorbid conditions, such as anxiety, depression, or learning disabilities. This has certainly been my experience, and I imagine it aligns with what many of you have seen in your own work. These co-occurring challenges can compound the effects of ADHD, so it’s critical to approach treatment holistically. Addressing the strengths, challenges, and unique needs of each client requires us to integrate evidence-based interventions that are both comprehensive and individualized.

Another consideration is the role of cultural beliefs and attitudes toward mental health conditions like ADHD. These perspectives can vary widely depending on the communities and populations we serve. Much of my consulting work has been in a highly diverse area of Michigan, where I frequently work with families to increase their understanding of ADHD and its impact. Part of this work involves reducing stigma, not just around ADHD, but also the co-occurring conditions that are often seen alongside it. Many of these conditions carry additional stigmatization, which can create barriers to accessing care or support.

As clinicians, it’s vital that we practice cultural humility and promote cultural diversity and awareness in our work. Addressing stigma requires intentionality, whether it’s through psychoeducation, fostering understanding, or creating safe spaces for clients and families to discuss these challenges. By doing so, we help create opportunities for clients to access the care they need while feeling understood and supported. These efforts are essential in ensuring that our interventions are not only effective but also culturally responsive and inclusive.

What Comes to Mind When You Think of Adults with ADHD?

When I think about adults with ADHD, a lot of themes come to mind. Disorganization is one of the key challenges, as well as difficulties with focus and memory. Many adults I’ve worked with describe a sense of being paralyzed in their lives—not knowing where to start, struggling with executive functioning skills like planning and organizing, and feeling like they’re unable to move forward. This sense of being stuck often leads to feelings of shame, guilt, and grief, especially when reflecting on how these struggles have impacted their lives over time.

Employment is often a significant pain point. Many clients come to me because ADHD has started to severely interfere with their ability to hold down a job or perform effectively at work. They may find themselves prematurely quitting or facing difficulties meeting the demands of their roles. Similarly, challenges with time management play a major role. Managing deadlines, coordinating household tasks, paying bills, and fulfilling parenting responsibilities all require a level of organization and planning that can feel overwhelming for adults with ADHD.

Another recurring theme is the challenge of motivation and task-switching. Clients often describe bouncing between tasks, becoming distracted, and struggling to follow through. The constant availability of technology can exacerbate this, with many clients recounting stories of picking up their phone for a specific reason only to find themselves derailed by social media or other distractions. These moments can create a frustrating cycle, heightening anxiety and self-criticism.

Impulse control is another topic that frequently arises in conversations. Impulsive decisions, especially related to finances, can have a ripple effect, particularly in relationships. For example, a partner may feel frustrated by unplanned purchases or difficulty sticking to a budget. In a work setting, impulsivity might mean missing out on promotions or opportunities due to impulsive actions or decisions. This can take a toll on self-esteem and contribute to the already complex emotional landscape of living with ADHD.

What stands out most is the cumulative effect of these challenges. Adults with ADHD are often navigating multiple layers of frustration, both internal and external. This makes it especially important to build strategies that are tailored to the individual. Effective supports need to be personalized, addressing not just the practical skills needed to manage daily life but also the emotional impacts like shame, self-esteem struggles, and relationship dynamics. By stepping back and recognizing the unique needs of each person, we can start to develop strategies that truly help them thrive.

Section #1: Characteristics, Signs, and Symptoms of ADHD in Adulthood

Let's first discuss the characteristics, signs, and symptoms of ADHD.

Aspects to Consider

Adults navigating life with ADHD often find their experiences uniquely challenging. Some may have made it through school or early life without significant struggles or noticeable issues, particularly if they didn’t exhibit the more overt behavioral manifestations commonly associated with ADHD. These individuals may have "flown under the radar," avoiding early diagnosis or intervention. However, the challenges can become overwhelming as they reach adulthood and face the complexities of managing multiple schedules, calendars, and competing demands. This is often compounded by the frustrations that arise within familial or relational contexts, where the ripple effects of ADHD may be felt acutely.

The adverse outcomes of unmanaged ADHD can manifest in various aspects of life. Employment difficulties, financial instability, strained relationships, and internal emotional struggles are common. Many adults with ADHD grapple with feelings of shame, embarrassment, or inadequacy when they perceive themselves as unable to meet their expectations or those of others. This internalized frustration can further erode self-esteem and exacerbate feelings of being stuck or unproductive.

Co-occurring conditions often complicate the picture. Anxiety and depression are frequent companions of ADHD in adulthood, particularly when the condition has gone unmanaged or unrecognized. These individuals may also feel regret or loss as they reflect on milestones or opportunities they missed due to their struggles. This can lead to a profound dissatisfaction with their trajectory and challenges in envisioning a way forward.

In my work with adults with ADHD, I’ve often observed how these challenges extend into their family dynamics, adding layers of tension and difficulty. Relationships can become strained as partners, parents, or children navigate the impacts of ADHD together. The frustration of unmet expectations, both personal and shared, can be palpable.

What’s critical is identifying ways to support these individuals and their families so that they can build healthier, more functional dynamics. The goal is to equip adults with ADHD with the tools and strategies to thrive while fostering understanding and collaboration within their relationships. In doing so, we can help create pathways for success and harmony, even amidst the unique challenges ADHD presents.

ADHD in Children

Adults with ADHD often find themselves grappling with challenges that can be traced back to their childhood experiences. Some individuals may have gone through school and other areas of their lives without significant behavioral manifestations, allowing them to avoid detection or diagnosis. These individuals might have only recognized their ADHD in adulthood when faced with more complex and demanding responsibilities, such as managing multiple calendars, work expectations, parenting duties, or relationship dynamics. Others may have known about their diagnosis from an early age but find that their existing strategies no longer suffice as their life circumstances and expectations evolve.

When considering ADHD in children, executive functioning delays are a significant factor. Samantha Woods, the founder of Kaizen Education Services, highlights that children with ADHD may experience a delay in executive functioning skill acquisition of up to 30% of their chronological age. This delay doesn’t vanish in adulthood—many individuals reach adulthood already behind in developing these critical skills, which can exacerbate their challenges in managing their lives.

Per the DSM-5 criteria for individuals aged 17 and older, ADHD presents with symptoms of frequent inattention, which can align with common issues like focus and organization. For a diagnosis, these symptoms must persist for at least six months in inappropriate ways for the individual’s developmental stage. Examples include careless mistakes, lack of close attention to detail, and difficulty sustaining attention on tasks. These behaviors can lead to frustration, reduced self-efficacy, and, in some cases, significant self-criticism.

Another hallmark of adult ADHD is the perception that the individual doesn’t listen when addressed directly. This might manifest as apparent daydreaming, distraction, or fidgeting during conversations, which can be frustrating for both the individual and those around them. In relationships, such behaviors often lead to complaints from partners about inattentiveness or forgetfulness. For instance, in couples counseling, I worked with a wife who described her husband’s daily forgetfulness, difficulty organizing tasks, and frequent distractions. These behaviors made her feel like she had to take on the role of “conductor” in their household, which included managing children, work, and home responsibilities. She also highlighted procrastination, noting her husband’s repeated delays in completing tasks over several years, which led to further marital tension.

Hyperactivity and impulsivity are also key components of ADHD and can persist into adulthood. While children might be unable to play quietly, adults often express these traits differently. This may include talking excessively, blurting out responses, interrupting others during conversations, or struggling to wait their turn. Some adults with ADHD have shared that others perceive them as interrupting or intruding, especially in group or conversational settings.

ADHD “grows up,” and as it does, the manifestations of hyperactivity, impulsivity, and inattention adapt to the complexities of adult life. These challenges can strain relationships, hinder productivity, and impact self-esteem. Recognizing and addressing these behaviors is critical to supporting adults with ADHD in managing their symptoms and improving their quality of life. Through tailored strategies, awareness, and support, adults with ADHD and their loved ones can navigate these challenges more effectively.

ADHD in Adults

For adults with ADHD, it’s important to recognize that this is a developmental disability. While it may not always be diagnosed in childhood or may even go undiagnosed entirely, the criteria for ADHD require symptoms to have been present before the age of twelve. This developmental origin is key, even if the diagnosis or recognition doesn’t occur until much later. Most individuals with ADHD experience a combination of inattentive and hyperactive-impulsive symptoms that affect multiple areas of their lives.

One hallmark of ADHD is that its symptoms manifest across various settings and contexts. These symptoms are not confined to just one environment, such as school or home, and individuals cannot simply “turn it on or off.” In some of my school-based work, I’ve observed children who manage to hold everything together during the school day, masking their ADHD symptoms to meet expectations. However, once they get home, the effort required to maintain that level of control can lead to emotional exhaustion, resulting in a release or unraveling. In adulthood, ADHD continues to impact different aspects of life, including social, professional, and personal settings, creating challenges that span these environments.

A key diagnostic feature of ADHD is that symptoms interfere with or reduce the quality of a person’s social, academic, or occupational activities. This can sometimes create a conundrum, particularly for individuals in the “twice-exceptional” (2e) population. Twice-exceptional individuals are those who possess very high intellectual capabilities while also living with a disability, such as ADHD. I’ve worked with many adolescents and adults in this group, and I find it fascinating to see how they navigate life. These individuals with IQs typically in the gifted range—often 130 or higher—face unique challenges because of their dual exceptionalities.

For 2e individuals, ADHD symptoms don’t disappear despite their intellectual abilities. Often, their intelligence allows them to compensate or “get by,” particularly in academic settings, where they may not struggle with the material but instead find school boring or unengaging. Their cognitive strengths can mask the challenges posed by ADHD, making it harder to identify and address their needs. This masking does not mean ADHD impacts them any less; it simply plays out differently because of their exceptional capabilities. Working with this population often involves meaningful conversations about how they view the world and navigate their unique experiences.

It’s also critical when working with adults with ADHD to ensure another mental disorder does not better account for their symptoms. This delineation is essential for accurate diagnosis and effective intervention. Co-occurring conditions, such as anxiety and depression, are common among adults with ADHD, but it’s vital to assess whether these are secondary to ADHD or independent issues requiring separate attention.

Ultimately, ADHD in adults remains a pervasive influence across multiple domains of life. Whether we’re working with individuals in the twice-exceptional population or anyone else impacted by ADHD, recognizing its developmental roots and multifaceted presentation is essential for providing the tailored support they need.

Executive Functioning

As I mentioned earlier, executive functioning is a key concept when working with individuals with ADHD, and it often plays a central role in their challenges. I like to think of executive functioning as the orchestra of the mind. It’s the cognitive system that allows us to plan, reason, organize, navigate social situations, and problem-solve effectively.

From a neurological perspective, the parts of the brain responsible for executive functioning—primarily the prefrontal cortex—are the last to develop. For typically developing individuals, this brain area doesn’t fully mature until the early twenties. In neurotypical males, this development often occurs slightly later than in females. Ideally, once this part of the brain fully functions, people can make better decisions, plan and organize more effectively, and navigate life’s challenges more easily.

For individuals with ADHD, however, executive functioning is often impaired, which leads to significant challenges. These difficulties are not limited to ADHD—they are also common in other conditions, such as autism spectrum disorder, where executive functioning deficits are prevalent. Impairments in executive functioning can manifest as trouble organizing tasks, maintaining focus, managing time, or navigating complex social and professional situations.

From a clinical standpoint, addressing executive functioning deficits is a crucial part of working with adults with ADHD. These deficits often fragment their ability to manage daily life, and our strategies must be tailored to meet these needs. For instance, interventions might focus on helping clients develop practical tools for planning and organization, strategies for improving decision-making, or techniques for navigating interpersonal dynamics more effectively.

For adults with ADHD, executive functioning challenges can impact every aspect of their lives. Understanding and targeting these deficits with individualized, aligned strategies can make a profound difference in helping them lead more organized, balanced, and successful lives. This work requires a combination of practical tools, empathy, and an awareness of the neurological realities that underlie these challenges.

Propensity of ADHD

Let’s take a moment to discuss the prevalence and presentation of ADHD in adults. Approximately 2.5% of adults are diagnosed with ADHD, though this figure can vary slightly depending on the source. More recent peer-reviewed articles suggest that the prevalence may range from 2% to 4% of the population. These numbers give us a baseline but highlight the importance of continuing research to understand better how ADHD presents across different demographics and contexts.

When it comes to risky and impulsive behaviors, research has found similarities between men and women with ADHD. However, some key differences in presentation are noteworthy. For example, a 2016 article by Dr. Cortes and colleagues observed that women with persistent ADHD were less likely to exhibit hyperactive symptoms or engage in behaviors like reckless driving compared to their male counterparts. Instead, these women were more prone to experiencing anxiety. This finding serves as a clinical red flag, emphasizing the need to assess for co-occurring conditions like anxiety and depression when working with adults—especially women—with ADHD. These overlapping conditions often complicate the diagnostic picture and can influence treatment strategies.

This insight into prevalence and gender differences sets the stage for the next part of our discussion, where we’ll delve further into how ADHD interacts with co-occurring conditions and what that means for clinical practice.

Section #2: Multi-faceted Nature of ADHD and Co-occurring Conditions Among Adults With ADHD

Today, we're going to talk about that multifaceted nature and some of the co-occurring conditions that are likely or more likely to be at play for individuals with ADHD.

Many Domains of Life Impacted

When we begin to think about the domains of life affected by ADHD, several key areas come to mind—though there are certainly more. Work is a recurring challenge for many adults with ADHD. It’s a domain where the symptoms of inattention, disorganization, or impulsivity often collide with the structured demands of employment, leading to frustrations, missed opportunities, or job instability.

Intimate relationships also frequently surface as a significant area of difficulty. Many individuals I work with express that ADHD contributes to tension and dissatisfaction in marital or romantic partnerships. The dynamics of these relationships can become strained when ADHD-related behaviors, such as forgetfulness or impulsivity, interfere with communication, trust, or shared responsibilities.

Sleep quality is another area that is profoundly impacted. Poor sleep isn’t just unpleasant; it amplifies the challenges of ADHD by exacerbating issues with executive functioning, focus, and emotional regulation. When you’re already navigating the difficulties of ADHD, adding sleep deprivation to the mix can make daily life feel nearly impossible.

Friendships can also suffer. Maintaining social connections requires planning, follow-through, and emotional presence—skills that can be inconsistent for those with ADHD. Parenting is yet another domain that often becomes a source of stress. ADHD-related struggles with organization, planning, and consistency can lead to challenges in following through with routines, managing household dynamics, or effectively meeting children’s needs.

Finances are another significant and frequently mentioned area of difficulty. This is especially relevant given the current economic landscape, where financial pressures are heightened. For adults with ADHD, managing finances can be an ongoing source of stress and tension, both within themselves and in the context of their families. Impulsive shopping, online purchases, and difficulty keeping track of budgets can result in significant financial strain. These behaviors can create guilt and frustration for the individual and strain familial relationships due to shared financial responsibilities.

These interconnected domains illustrate the breadth of ADHD’s impact on an individual’s life. Each area influences the others, often creating a compounding effect. Addressing these challenges requires a comprehensive approach that focuses on practical strategies and considers the emotional and relational toll ADHD takes. 

Example #1

I want to share a couple of examples to illustrate the challenges adults with undiagnosed ADHD can face. As I mentioned earlier, many individuals go into adulthood without a diagnosis, often because they managed to get through school without drawing significant attention to themselves. However, as the demands of adult life increase, ADHD symptoms can become more apparent, leading to struggles in various areas.

One case involved an adult male who sought counseling at the urging of his friends and family. He was experiencing significant marital challenges and difficulties maintaining steady employment. From his perspective, he was working very hard, but his inability to consistently hold down a job created strain at home. At this point, he had no formal diagnosis of ADHD.

Another example involved a young father, also undiagnosed, whose ADHD was causing tension in his marriage. This couple had a few children, and his impulsivity and financial instability increasingly burdened the wife. For instance, he would occasionally secure a job but then lose it due to impulsive decisions. In one instance, he worked at a store and decided to close early on a quiet night because no customers were coming, despite store policy requiring him to stay until the scheduled closing time. His employer reprimanded him, explaining that the hours were non-negotiable. Yet, on another night, he repeated the behavior—again closing early to join friends or because he didn’t see the point in staying. After several similar incidents, he lost his job.

This pattern left the family in a precarious financial position. The wife, frustrated and overwhelmed, found herself in a caregiver role—managing the household and their children and often stepping in to compensate for her husband’s behaviors. This dynamic created significant marital tension because of the financial stress, and the wife felt she was parenting her spouse rather than partnering with him. This imbalance understandably impacted their intimacy and the overall health of their relationship.

In counseling, the focus was on helping the couple establish clear boundaries and shared accountability. Strategies were developed for the husband to manage his impulsivity better and adhere to work expectations. Equally important was addressing the marital dynamic to ensure the wife was no longer in a caregiver role. The goal was to help them rebuild their relationship as equals, fostering a healthier and more supportive partnership.

These examples highlight how untreated or undiagnosed ADHD can ripple through different aspects of life, affecting not just the individual but also their loved ones. They underscore the importance of identifying strategies that support both the person with ADHD and their relationships, helping them create more balanced and functional dynamics.

How Does ADHD Impact Marriage and Relationships?

Adults with ADHD are more likely to experience increased relationship distress. Based on clinical examples and anecdotal reports, it’s no surprise that the symptoms of ADHD can lead to heightened tension and challenges in navigating the functionality of daily life. These challenges often stem from core ADHD symptoms like inattention, impulsivity, and emotional dysregulation, which can make communication and connection more difficult for couples.

There is also evidence suggesting that adults with ADHD may experience higher rates of breakups, promiscuity, and repeated marriages. Impulsivity and emotional dysregulation, in particular, can contribute to instability in relationships, leading to patterns of risky behaviors or difficulties maintaining long-term commitments. These behaviors can further strain relationships, creating cycles of misunderstanding and conflict.

A recent study by Dr. French and colleagues in 2024 indicated that adults with ADHD are more likely to have been divorced. This aligns with research showing that ADHD symptoms often create significant relational stress, particularly when left unaddressed. Issues such as inconsistent communication, challenges in emotional regulation, and difficulties in managing daily responsibilities can erode relationship satisfaction and contribute to separation or divorce.

Dynamics in Couples

When considering the dynamics in couples where one partner has ADHD, it’s important to examine the internal narratives and feelings that may arise, particularly for the non-ADHD partner. Many individuals I’ve worked with, whether in individual therapy or couples counseling, describe the significant frustrations expressed by their non-ADHD partner. These frustrations often stem from feeling like they carry the weight of responsibilities within the relationship. For example, they might feel responsible for coordinating household tasks, managing childcare, and ensuring everything runs smoothly. This sense of imbalance can lead to resentment, especially when there’s uncertainty about whether the ADHD partner will be able to maintain consistent employment or follow through on commitments.

From the ADHD partner’s perspective, they may struggle with guilt or a sense of inadequacy when faced with their partner’s frustration. This dynamic can create a cycle of tension within the relationship, where one partner feels overwhelmed by their perceived burden and the other feels criticized or misunderstood. These feelings and behaviors often become a central focus in therapy, as they can significantly affect the overall health of the relationship.

Medication is a topic that frequently comes up in these discussions. While many individuals with ADHD report benefits from medication, others express dissatisfaction due to side effects, the way it makes them feel, or its duration of effectiveness throughout the day. For parents with ADHD, this can be particularly challenging, as the demands of parenting often extend well beyond the medication’s effective window. Balancing these challenges while managing the daily demands of parenting and household responsibilities can feel overwhelming for both partners.

Clinically, I’ve often worked with individuals receiving weekly therapy who also consult with a PCP or psychiatrist for medication management. This team-based approach can be particularly helpful, as ADHD often requires a multifaceted support system. When medication is part of the treatment plan, it can be critical to ensure that it aligns with the individual’s daily needs and responsibilities—such as parenting long hours.

For many parents, whether or not ADHD is part of the picture, balancing the competing demands of work, family, and personal responsibilities is already a significant challenge. When ADHD is added to the mix, these challenges can intensify, requiring thoughtful strategies, collaborative efforts, and a strong support network to navigate effectively.

Parenting With ADHD

Parenting, managing children, maintaining a household, and balancing paid work outside the home are challenges that can feel overwhelming for anyone, but these demands are significantly amplified for individuals with ADHD. Many new moms or parents have said, “I just can’t keep up.” This feeling of falling behind, even in the absence of ADHD, is already a significant stressor. When you add ADHD into the mix, especially alongside potential co-occurring conditions, these challenges become even more pronounced.

For individuals with ADHD, difficulties with organization, time management, and memory can make it harder to juggle the various responsibilities of parenting and household management. Tasks that might feel manageable to others can quickly become overwhelming. This can lead to feelings of frustration, guilt, or even anger. For instance, forgetting to sign a child’s permission slip, missing an appointment, or struggling to keep up with basic household chores can create a cumulative sense of failure, even if the person is doing their best.

Frustration often becomes a common thread. Parents with ADHD might feel this frustration not only toward the tasks at hand but also toward themselves for struggling in areas where they wish they could excel. This emotional toll can spill over into relationships and family dynamics, creating a cycle of stress that affects everyone in the household. Understanding and addressing these layers is critical in supporting parents with ADHD as they navigate their unique challenges.

Tips for Moms With ADHD

Some helpful tips for moms—and certainly these can apply to fathers or caregivers—start with creating routines. Routines can be beneficial for most people, providing structure and predictability. For individuals with ADHD, they are particularly valuable in reducing overwhelm and ensuring that essential tasks are completed consistently. Establishing a routine helps set clear expectations, making it easier to navigate daily responsibilities.

Another critical aspect is focusing on problem-solving, often from a solution-focused clinical perspective. Rather than dwelling on what’s gone wrong, the goal is to identify what can be addressed or tackled in the moment. This approach encourages forward movement and reduces the tendency to linger on frustrations or mistakes. Importantly, it’s about avoiding blame, which is rarely productive and often counterproductive, especially for individuals with ADHD. Shifting the conversation to solutions can empower individuals to feel more in control and capable of managing their challenges.

I often encourage starting with smaller, more manageable problems in clinical work. Focusing on issues that can be resolved relatively easily helps build momentum and confidence. Feeling effective—whether as a therapist, a parent, or an individual seeking help—can be incredibly motivating. For clients, tackling even small challenges can create a sense of accomplishment and reinforce their ability to progress.

Equally important is fostering acceptance and self-compassion. For those with ADHD, accepting the reality of living with the condition can be a powerful step toward reducing self-criticism and blame. Self-compassion becomes an essential tool, allowing individuals to navigate their challenges with grace rather than frustration.

This message of self-compassion applies universally. Whether or not someone has ADHD, all parents—especially moms—can benefit from acknowledging the demands of their role and being kind to themselves when things don’t go as planned. Encouraging this mindset can help reduce the pressure of perfection and create space for resilience and growth.

Tips for Dads with ADHD

For dads with ADHD, symptom management skills are essential to fostering stability in their lives and relationships. A primary focus often involves identifying strategies to manage ADHD symptoms effectively, emphasizing approaches that can enhance marriage or partnership stability. One foundational strategy is utilizing structured calendars and routines, which can help mitigate the disorganization and forgetfulness often associated with ADHD.

In recent years, I’ve noticed a growing challenge: the proliferation of multiple calendars. Many individuals now juggle phone calendars, work calendars, Google calendars, paper calendars, and more. This abundance of tools, while helpful, can sometimes add to the confusion rather than reduce it. A simple yet impactful step is ensuring these calendars are synced and coordinated. Consolidating and streamlining scheduling systems can significantly improve organization and communication, especially within a household.

For instance, a shared digital calendar that partners and family members can access allows everyone to stay on the same page about appointments, events, and responsibilities. This coordination not only reduces the likelihood of missed commitments but also minimizes the stress and miscommunication that can strain relationships.

By focusing on symptom management through these practical strategies, dads with ADHD can better navigate their roles at home and work, fostering stronger partnerships and more cohesive family dynamics. These tools may seem basic, but their consistent use can improve daily functioning and relational stability.

Special Considerations for Parents with ADHD Parenting Kids with ADHD

Managing time and staying organized can be particularly challenging for individuals with ADHD. In my experience, working with people to set reminders, use timers, and build in buffers for underestimated time has been incredibly helpful. Time management is often a significant hurdle for this population, and underestimating how long tasks or commutes will take can lead to late or missing commitments altogether, which can cause a cascade of frustrations and complications.

I’ve worked extensively with parents who have ADHD and are also parenting children or adolescents with ADHD. This dynamic can be especially challenging. It’s a situation where both the parent and child are navigating similar struggles with organization, executive functioning, and time management. Supporting the parent is critical—not just to help them better manage their responsibilities but also to empower them to model and coach their child in developing their own executive functioning skills. For children and adolescents, this might include teaching time estimation, breaking tasks into smaller steps, and creating visual supports, which can also benefit the parent.

Visual supports can be powerful tools for improving organization in both parents and children. These might include visual schedules, chore charts, or color-coded systems that help everyone in the household stay on track. Referrals to external resources or support programs can also provide additional structure and coaching, reinforcing these skills sustainably for the family.

Household management and delegation can be tough for any parent, but for those with ADHD, it becomes even more complex. Questions like "Who does what?" and "When should it be done?" can quickly overwhelm if there isn’t a clear system in place. Developing structured routines for household tasks—whether it’s a rotating schedule for chores, shared digital lists, or designated responsibilities—can help reduce confusion and create more stability. These approaches ensure that the burden doesn’t fall disproportionately on one parent and promote collaboration within the family, easing stress and improving functionality.

Impact on Work Roles and Responsibilities

A newly published article from 2022 highlights an important reality: adults with ADHD are less likely to be employed. This is a significant issue, as employment provides not only financial stability but also contributes to self-esteem, daily structure, and a sense of purpose. The challenges that adults with ADHD face in maintaining steady employment often come up in clinical settings, and it’s critical to address them to support overall functionality and well-being.

There are many reasons why employment can be difficult for individuals with ADHD, both from personal observations and supported by peer-reviewed literature. This population tends to experience more frequent job changes, which can lead to increased stress over the trajectory of their careers. Without adequate supports and structures, the workplace can become a particularly challenging environment. Many jobs offer minimal on-the-job training, leaving employees to navigate their responsibilities with little guidance or support. For someone with ADHD, this lack of structure can be overwhelming, amplifying the challenges associated with organization, time management, and task prioritization.

In these situations, clinicians can work with clients to help them develop personal supports and strategies to compensate for workplace gaps. For example, creating a detailed list of responsibilities, setting up reminders and alarms, and organizing their calendar to include meetings and deadlines can be immensely helpful. These are strategies I’ve often used myself in professional settings to stay organized and on track, even without a diagnosis of ADHD. For adults with ADHD, implementing such systems can be life-changing, offering a sense of control and predictability in an otherwise overwhelming environment.

Ideally, these skills would begin developing during childhood or adolescence, but the need often persists into adulthood as the demands and expectations of work and life increase. Employment issues, coupled with challenges in family and professional life, often lead to decreased overall satisfaction. For adults with ADHD, this lack of internal satisfaction can be particularly disheartening, as it often reflects a broader struggle to meet their own and others’ expectations.

Clinicians can help individuals with ADHD navigate these challenges by focusing on strategies that build structure and reinforce confidence. Empowering clients to create systems tailored to their needs improves their employment outcomes and enhances their overall quality of life.

Employment & Education

When considering employment and education, it’s clear that adults with ADHD often experience lower rates in both areas. This is not particularly surprising based on my experience. For many individuals with ADHD, formal education is simply not an area of high interest. I’ve worked with numerous adolescents transitioning into adulthood who have expressed a strong disinterest in continuing formal education despite showing significant aptitudes in various areas.

For these individuals, it’s about finding where they best fit. Many prefer hands-on work, which is a fantastic direction to explore. Hands-on roles can align well with the strengths and preferences of individuals with ADHD, allowing them to engage actively and avoid some of the challenges they might face in more traditional academic or desk-oriented settings.

Supporting these individuals involves helping them identify career paths that capitalize on their strengths and interests, fostering a sense of accomplishment and fulfillment. For those uninterested in formal education, exploring vocational training, apprenticeships, or other experiential learning opportunities can provide meaningful alternatives that lead to success and satisfaction.

Money/Finances

Figuring out where an individual with ADHD can achieve meaningful and sustainable income is critical to supporting their financial and overall well-being. Money and finances, while not always openly discussed, are often areas of significant difficulty for adults with ADHD. In my experience, financial challenges frequently create tension within families and add stress to the lives of individuals with ADHD.

Planning, organizing, and managing finances can be particularly problematic. Adults with ADHD are more likely to miss payments or struggle to keep track of bills due to difficulties with organizational skills. Additionally, they may engage in riskier financial behaviors, making impulsive purchases or decisions that aren’t fully thought through. These habits can result in challenges such as accumulating high credit card balances, further exacerbating stress and stigma.

Providing practical strategies to help manage finances is incredibly valuable. This might include setting up automated bill payments, using budgeting apps that send reminders, or working with a financial coach who understands ADHD-related challenges. Helping individuals create a financial system tailored to their needs and abilities can significantly reduce stress and improve their financial stability.

The stigma surrounding financial struggles can often prevent individuals from seeking help, but it is key to address this openly in a supportive and nonjudgmental way. By normalizing these challenges and focusing on solutions, we can empower adults with ADHD to take control of their finances and, in turn, alleviate some of the associated familial and personal tensions.

Example #2

Another example, which echoes some of the dynamics I’ve shared previously, is the high propensity for frustration within couples where one partner has ADHD. A common theme is one partner feeling as though they’re parenting the other, taking on most responsibilities, and feeling burdened by the imbalance. This sense of inequity can lead to significant tension and dissatisfaction in the relationship.

One specific issue that frequently arises is high screen time. Often, one partner in the relationship might spend a significant amount of time on their phone, tablet, or computer, which can be especially frustrating for the other partner. This frustration is magnified when the non-ADHD partner already feels like they are compensating for a lack of follow-through or organization from their ADHD partner. This dynamic not only exacerbates feelings of inequity but can also create emotional distance and resentment in the relationship.

Co-occurring Conditions

Adding to these challenges are co-occurring conditions that frequently accompany ADHD. These can include anxiety, depression, or other mood disorders, which further complicate the relational and functional dynamics. Addressing these layered issues requires an understanding of the interplay between ADHD symptoms and any co-occurring conditions, along with strategies to improve communication, shared responsibility, and emotional connection within the relationship.

I want to highlight that anxiety is one of the most prevalent co-occurring conditions we see alongside ADHD, as well as autism spectrum disorder (ASD). This aligns with my clinical experience, and I’ve also covered this extensively in webinars focused on autism. ASD, in particular, often presents with a range of co-occurring conditions, with ADHD being one of the most common. However, individuals with ASD frequently experience other challenges, including depression, bipolar disorder, and even substance use disorders. These layered complexities require a nuanced and comprehensive approach to treatment.

A recently published 2023 study using extensive data sets underscores the significant risks associated with these co-occurring conditions. This analysis compared 14.6 million people without ADHD to over half a million individuals with ADHD. The findings revealed that adults with ADHD were five times more likely to have comorbid anxiety disorders and four and a half times more likely to have major depressive disorder. These statistics are a stark reminder of how frequently other significant mental health challenges accompany ADHD.

Clinically, this means we must address not only the core symptoms of ADHD but also the emotional regulation challenges, learning disabilities, and other explosive or reactive behaviors that can accompany these co-occurring conditions. Interventions must be multifaceted, targeting both the ADHD symptoms and the broader mental health needs of the individual to improve their overall functioning and quality of life. Understanding these risks allows us to develop more targeted and effective strategies, focusing on emotional and behavioral regulation.

Section #3: Practical and Evidence-based Strategies For Adult Clients With ADHD and Their Loved Ones

Now, let's talk about what we can do.

Patient/Family Support

One big piece that has proven incredibly effective in the families I’ve worked with is patient and family support. Families need to understand what ADHD is and how it manifests so they can better navigate the challenges it presents. This is especially important in situations where an adult comes into a clinic for an evaluation, often not knowing they have ADHD. They may have managed through their thirties or forties without a diagnosis, but their loved ones often sense something is wrong—they don’t know what it is.

This dynamic can be incredibly confusing and frustrating for families. They may see behaviors or patterns that don’t make sense to them, like an office filled with clutter—everything is there, but there’s no discernible organization. I often hear analogies from clients that resonate with this experience. One of my favorites is comparing it to a car trunk packed with thousands of items, all jumbled together without any clear system. The capacity is there, but the organization is missing.

For individuals with ADHD, this lack of structure can create a chaotic environment, both physically and mentally. And for their loved ones, witnessing this can be equally overwhelming. For example, walking into an office where papers are scattered everywhere, items are piled haphazardly, and no clear order can evoke anxiety. It’s common to hear stories about forgotten lunches unearthed weeks later amid the clutter.

Anything we can do to help support organizational strategies and create systems that bring order to this chaos can make a tremendous difference. Helping individuals with ADHD and their families better understand and address these dynamics not only reduces tension but also fosters greater empathy and collaboration within the household. It’s about finding ways to take the overwhelming and make it manageable, one bucket or trunk at a time.

Care Techniques

Care techniques for adults with ADHD often begin with building awareness. People need to understand what ADHD is, how it manifests, and how it impacts various aspects of life. This awareness extends to individuals with ADHD as well as their families, friends, and employers. Exploring treatment options with primary care providers or psychiatrists can be beneficial, particularly when it comes to considering medications, which can often help manage core symptoms. Additionally, cognitive-behavioral therapy (CBT), relaxation training, stress management techniques, and couples or family therapy can all play crucial roles in comprehensive care.

From my experience, couples therapy has been particularly helpful for many of the couples I’ve worked with. It provides a space to develop strategies for moving forward together, addressing specific challenges, and fostering a better understanding of each partner’s needs. Similarly, from a professional standpoint, job mentoring programs or workplace supports can make a significant difference. While some jobs allow individuals to "hit the ground running," adults with ADHD often benefit greatly from additional structures and supports. These can reduce stress, ease onboarding, and enhance job performance and satisfaction.

Sleep hygiene is another area that often requires attention. Many individuals with ADHD struggle with maintaining regular sleep schedules, and for some, racing thoughts in the middle of the night can further disrupt rest. Establishing consistent bedtimes and wake-up times and creating a bedtime routine can provide a helpful framework. This can include limits on digital device usage before bed—a "digital detox." While this advice is relevant for the general population, it’s especially important for adults with ADHD, who may be more prone to mindless scrolling that disrupts sleep and reduces productivity.

Exercise is another piece of the puzzle. I often hear resistance to incorporating exercise routines because of busy schedules. Some individuals have excellent routines that they would never compromise, but others feel they don’t have time. For those individuals, redirecting even a small portion of digital device time—perhaps 20 minutes a day—toward physical activity can have significant benefits. Having a clear, visual schedule for exercise can also be motivating, especially when it’s paired with practical steps like organizing workout clothes and equipment in an accessible spot to eliminate delays and excuses.

Finally, laughter and emotional connection can profoundly influence managing ADHD. These elements often carry significant weight, providing relief and improving mood while helping to build resilience against the challenges ADHD presents. Creating a balance of structure, support, and positive experiences is key to helping individuals with ADHD thrive.

Practical Solutions

I have many other practical solutions, but I want to take a moment to focus on the incredible strengths I’ve seen in the adolescents and adults with ADHD that I’ve worked with. These individuals often have unique and remarkable abilities, and I think it’s so important to emphasize how we can strengthen and augment these talents. By focusing on their strengths, we’re not just helping them utilize their abilities more effectively, but we’re also contributing to their overall self-esteem and self-efficacy.

When individuals recognize and capitalize on what they’re good at, it has a ripple effect. They begin to see their value in tangible ways, which can profoundly impact how they view themselves and approach challenges. It’s about helping them build confidence in their ability to navigate life, whether that’s in their relationships, their work, or their daily routines.

At the same time, we can’t overlook the importance of self-care and overall well-being. We often need to create tailored strategies that fit the individual’s lifestyle and preferences, ensuring that these practices feel accessible and achievable. Supporting self-care goes hand in hand with fostering strengths, as both are crucial for helping individuals with ADHD manage their challenges and thrive in their personal and professional lives.

Strategies and Supports

Structure and routine can be incredibly helpful, especially for individuals with ADHD who are managing busy lives or facing multiple demands. The question often becomes, how do we balance expectations, roles, and responsibilities? And equally important, how do we build efficiencies that make life more manageable?

One strategy I find particularly effective is the Pomodoro Technique. It’s a fantastic tool, especially for those resistant to starting a task. The concept is simple: you work for a set amount of time—usually five minutes to start—then take a short break and repeat. When introducing this to clients, I often hear, "Five minutes? I can do that." Once they start, they often find it easier to keep going, building momentum. Over time, as they grow more comfortable, the work intervals can be extended to ten, fifteen, or even twenty minutes. The key is using a timer to keep things structured and manageable. If they reach the goal and still feel productive, they can keep working, taking a break only when needed, then resetting the timer. It’s a flexible, adaptable method, and I’ve seen it work wonders with adolescents, adults, and parents seeking strategies to stay on track.

Basic reminders are another straightforward but effective tool. Let’s be honest—most of us benefit from reminders in our daily lives. Whether it’s an alarm, a phone notification, or a sticky note, these small cues can make a big difference in helping people stay organized and meet their goals.

In educational settings, reasonable accommodations can also be a game changer. Section 504 accommodations in schools and colleges, for example, can provide much-needed support. These might include extended time for tests, quiet spaces for work, or assistance with note-taking. The goal with these accommodations, as with any strategy, is to meet the individual where they are and help them build systems that work for their unique needs. These tools, combined with a focus on routine and structure, can make a profound difference in managing ADHD effectively.

Beliefs and Values

Beliefs and values play a significant role in how ADHD is understood and managed, not just by individuals but by families and society as a whole. One important dynamic to acknowledge is the presence of denial, which can often arise within families. This denial may stem from a variety of factors, including the stigma associated with ADHD or a lack of understanding about the condition. Some family members or societal influences may adopt an "if I can’t see it, it doesn’t exist" mindset, creating significant barriers to recognition and support.

Another contributing factor is the history of overdiagnosis of ADHD in certain contexts. This has led some people to dismiss legitimate concerns or downplay symptoms, perpetuating skepticism about the validity of an ADHD diagnosis. These dynamics can complicate seeking proper evaluation and care, particularly when co-occurring conditions occur. Families may struggle to differentiate between what’s attributable to ADHD and what might be a result of anxiety, depression, or other overlapping challenges.

Understanding and addressing these beliefs is crucial, as they directly impact the willingness of individuals and families to seek and accept help. Recognizing the validity of ADHD and its effects while fostering an open and informed dialogue can help overcome these barriers and create a supportive environment for those affected.

Simplify

Simplify, simplify, simplify. This mantra can be helpful, especially when working with individuals with ADHD. If you’re familiar with Marie Kondo and her approach to organizing spaces—focusing on simplifying and clearing clutter—you’ll understand how transformative it can be. Personally, I enjoy her approach, and I often think about how applicable it is when supporting individuals with ADHD.

The principle of simplifying applies not just to physical spaces but also to routines and systems. When things are simplified, they’re often easier to manage. This is true for everyone, but especially for those with ADHD, where reducing chaos can alleviate overwhelm and promote focus. For example, having an organized closet where clothes are easy to find can take one layer of stress out of the day. It’s not just about neatness; it’s about creating an environment that supports efficiency and reduces decision fatigue.

Whether it’s organizing a workspace, streamlining a daily routine, or even decluttering a mental to-do list, simplicity can be a game-changer. It’s about making life more manageable, one step at a time, and creating systems that allow people to focus on what matters.

Keep in Mind

I just want to note that we can put many supports in place to help manage and alleviate the symptoms of ADHD. This can have a positive impact not only on the individual but also on their family, coworkers, and others in their environment. There is a trickle-down effect.

Resources/Books

I have resources and podcasts available as well (in the handout).

Questions and Answers

I have noticed that my adult ADHD clients are hypersensitive to others' attitudes and behaviors towards them, which causes them to retreat physically and emotionally. Would you say that this is a trait of an adult ADHD person, and how do you develop that change?

Yes, I’ve also seen this, and it’s a great question. I think part of this hypersensitivity can come from the feeling of putting in so much effort and still perceiving or experiencing frustration from others. It’s something many of us can probably relate to in certain contexts, but for individuals with ADHD, this sensitivity may be heightened. Oftentimes, I’ve found that my clients with ADHD, or even students I’ve worked with, may inadvertently send signals to others—such as missing deadlines or underperforming in ways that others notice—that lead to frustration.

Initially, others might not vocalize their irritation, but repeated instances can escalate tensions. This is particularly evident in workplace settings or relationships, where the ADHD individual feels they’re doing their best, but others perceive a lack of effort or reliability. To address this, it’s important to build strategies that highlight their strengths, create systems to support consistency and improve self-awareness.

It’s also worth addressing how to balance the potential benefits of self-disclosure. Not every context requires full disclosure, but in some cases, gently educating colleagues or loved ones about how ADHD impacts behaviors can foster understanding and reduce frustration. This education can be done comfortably and doesn’t overexpose the individual’s challenges.

While hypersensitivity is common, building on strengths, setting clear parameters, and creating strategies to meet expectations better can help mitigate these challenges. Education—for the individual and their social or work circles—can also play a key role in improving dynamics.

I have had clients with an ADHD diagnosis who were also seeing me for substance abuse treatment. They often struggled with time management, disorganization, and bouncing between tasks socially and professionally. Many also became addicted through self-medicating with street drugs. How do you navigate this overlap?

Thank you for sharing this—it’s a very real and complex issue. Clients managing both ADHD and substance abuse face a unique set of challenges, and I appreciate the skills you’re bringing to this work, as it’s such a critical area of need.

One of the most difficult aspects is disentangling the overlapping symptoms of ADHD and substance use. For example, impulsivity, disorganization, and difficulty with self-regulation can be hallmark characteristics of both ADHD and substance use disorders, making it challenging to determine where one ends and the other begins.

With many clients, substance use may initially arise as a way of self-medicating for untreated ADHD symptoms, like restlessness, focus issues, or emotional dysregulation. However, over time, the substances themselves can compound these issues, creating a cycle that’s hard to break.

In treatment, it’s essential to approach both conditions concurrently. This often involves helping the client build sustainable routines, work on time management and organizational skills, and develop healthier coping strategies to address ADHD symptoms without turning to substances. Medication management can also play a pivotal role, especially when overseen by a skilled psychiatrist familiar with both ADHD and addiction.

Your awareness of these complexities and work in this area is valuable. Supporting clients through this dual diagnosis is challenging, but your skills and attention to both conditions can make a tremendous difference. Thank you for bringing this issue into focus.

References

Please refer to the additional handout.