Navigating ADHD Beyond Diagnosis

Receiving an ADHD diagnosis marks the initial step in your journey to address and manage ADHD symptoms that may disrupt various aspects of your life. The key to successfully navigating this journey lies in seeking appropriate medical and psychological treatment, which can pave the way for developing effective management strategies and coping mechanisms. These strategies extend beyond merely mitigating symptoms; they encompass improvements in relationships, sleep quality, self-esteem, and overall productivity, contributing to a higher quality of life.

If you’re receiving an ADHD diagnosis as an adult, it’s likely that you’ve already employed cognitive and behavioural coping strategies to lead what many might consider a “normal” life, achieving success along the way. However, this stage of life can present new challenges, such as grappling with self-esteem issues like self-loathing thoughts, feeling underachieved in life, procrastination and shame, as well as facing obstacles stemming from disorganisation, emotional dysregulations, impulsivity, and inattention. These challenges may be more pronounced compared to individuals who received timely treatments and guidance.

The typical trajectory for someone in this situation might echo the sentiment:

“Things finally made sense. Reflecting on decades of personal struggles, educational pursuits, and professional endeavours, I’ve grappled with self-criticism regarding my perceived lack of motivation and a lifetime of underachievement—all while projecting confidence to those around me. It’s been an arduous journey, a silent struggle I couldn’t openly share with others.”

What are the next steps?

Learning about ADHD is always a good starting point, as it reinforces the message that ADHD is not a character flaw and demonstrates the neurological underpinnings of daily challenges. For adults grappling with ADHD, a holistic approach combining psychotherapy and medication has shown promising results. If your ADHD leans towards the milder side, you might explore Cognitive Behavioral Therapy (CBT) or discussions with your psychologist to explore alternative therapeutic approaches, especially if there are co-existing psychological conditions.

What is Cognitive Behavioural Therapy?

CBT is well-known for treating many psychological disorders, especially depression and anxiety. CBT has been extensively tested since 1970, and more than 2000 outcome studies have demonstrated the efficacy of CBT for a wide range of psychiatric disorders, psychological problems and medical problems with psychological components. Many studies also showed that CBT effectively prevents or reduces future episodes’ severity.

CBT is goal-oriented and structured (structure is important for ADHD conditions) and aims to develop tools and strategies to reduce maladaptive behaviours and cognitive distortions. The primary role of CBT therapist is to help the client to reveal and change cognitive distortions and maladaptive behaviours while both therapist and client work together for common goals.

Individuals with ADHD often struggle with self-esteem issues due to failures, impulsive acts and unrealised intentions. CBT therapy will help them to understand the patterns in their self-criticisms, avoidance patterns, and self-defeating behaviours. Moreover, CBT sessions will also focus on changing irrational thought patterns that prevent individuals from staying on task or getting things done. For instance, for an individual with ADHD who thinks, “This has to be perfect”, “It’s no good,” or “I never do anything right,” CBT challenges the truth of those cognitions while also establishing adaptive strategies and tools to regulate emotions and deal with the stressful situations or challenges so that tasks can be completed effectively. With successful emotional regulations and increased productivity, this can progressively change individuals’ negative or unhelpful thinking patterns, possibly changing how individuals feel about themselves, their abilities, and their future and thus increasing long-term self-esteem.

A CBT therapist is like a “creative coach” who helps patients manage everyday challenges. CBT sessions are skills-based interventions that focus on identifying the situations that create challenges in a client’s day-to-day life. Sessions may help an individual deal with obligations such as paying bills or meeting deadlines, coping with emotions, and encouraging endeavours that provide personal fulfilment and well-being, such as sleep, exercise, or hobbies. Most adults with ADHD say, “I know what I need to do. I just don’t do it.” CBT focuses on adopting coping strategies and helps individuals manage negative expectations and emotions and unwinding behavioural patterns that interfere with the strategies.

In tandem with therapeutic interventions, cultivating healthy habits becomes paramount in fortifying your body against the challenges posed by ADHD. Prioritising a balanced diet and establishing a consistent sleep routine are pivotal components of these habits.

CBT intervenes to improve daily life struggles such as procrastination, time management, approaching difficult conversations, managing expectations, emotional regulations and other common difficulties, but not to treat the core symptoms of inattention, hyperactivity, and impulsivity. Thus, medication can play a important role in managing ADHD symptoms if your symptoms are moderate to severe. Engage in a conversation with a healthcare professional to gain insights into the available treatment options and determine which ones align best with your specific needs and circumstances. This collaborative approach ensures a comprehensive understanding of the available tools for effectively navigating and addressing ADHD in adults.

Navigating adulthood ADHD diagnosis requires a multifaceted approach that extends beyond symptom mitigation. Recognising the intricate correlation between psychological and neurological aspects is pivotal. The challenges faced by adults diagnosed with ADHD, including self-esteem issues and new obstacles in various life domains, underscore the need for tailored strategies. Cognitive Behavioral Therapy (CBT), a structured and goal-oriented therapeutic approach, emerges as a beacon of promise. CBT addresses not only maladaptive behaviours and cognitive distortions but also fosters emotional regulation and productivity. The journey towards self-improvement also involves cultivating healthy habits, such as maintaining a balanced diet and a consistent sleep routine. While CBT can enhance daily life functioning, medication may play an important role in managing core ADHD symptoms. By embracing a holistic and collaborative approach, individuals can equip themselves with a comprehensive toolkit for effectively navigating and addressing ADHD in adulthood.

Dr Felice Soo

Clinical Psychologist

Felice has worked as a clinical psychologist at international outpatient clinics in Shanghai (private hospitals and clinics) since 2017 with the expatriate community and local residents. She has been working with patients grappling with various medical conditions, including cancer, pain management, sleep problems and heart issues, alongside addressing a spectrum of psychological disorders, such as psychosomatic disorders, eating disorders, panic disorders, obsessive-compulsive disorders, and bipolar disorder.

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