Navigating late ADHD: A neurodivergent therapist's journey

Being diagnosed with ADHD in my mid-forties has been a life-changing experience. It has given me clarity, self-understanding, and a newfound sense of compassion for myself and for others who have spent years struggling without knowing why. Although there has been grief for the years of unnecessary hardship, my diagnosis has also brought relief. It has allowed me to make sense of my past, to recognise my strengths, and to embrace the ways my mind works rather than constantly trying to fit into a mould that was never made for me.

Growing up without answers

Growing up in Pakistan, I never had the words to describe what I was experiencing. I was expected to be responsible, diligent, and hardworking, with no room for forgetfulness, difficulty following instructions, or struggling to retain information. The pressure to do well in school was immense, and struggling with subjects like maths only made things more challenging. The effort required to stay on top of my studies was exhausting, and despite trying my best, I always felt like I was falling behind.

There were clear gender differences in how struggles were perceived. The expectations placed on me meant I had to work twice as hard to meet the standards set for me. There was little room for exploration or alternative learning styles, and as I progressed in my education, the gap between my efforts and my results became wider. By the time I reached university, I was overwhelmed. Completing assignments, keeping up with coursework, and trying to meet deadlines required an incredible amount of effort. At the time, I didn’t understand why everything felt so difficult for me when others seemed to manage just fine.

The emotional toll of masking and keeping up

But my challenges were not limited to academics. Maintaining friendships and relationships was difficult when I forgot to check in, missed important details, or acted impulsively. Family expectations added another layer of pressure. Keeping up with extended family, remembering to call relatives, and staying connected in the way that was expected always felt overwhelming.

It’s not that I don’t care – I care deeply. But the simple act of picking up the phone and making a call, especially to relatives abroad, feels like an impossible task. There’s no clear reason why – it’s just difficult.

I tell myself I’ll do it later. I make mental notes, even draft messages in my head. But then time passes, weeks slip away, and suddenly it’s too late. Too late to check in after someone has been discharged from the hospital. Too late to send congratulations for a wedding or a birth. Too late to offer condolences after a loss. And then the guilt sets in, heavy and suffocating.

I know how it looks from the outside – like I don’t care, like I’m too busy, too detached. But inside, I feel paralysed. The weight of having to keep up with it all, the expectation to always be present in the way others are, feels overwhelming. It’s not just about remembering to call – it’s about the emotional and mental energy required to initiate that connection, to hold a conversation, to stay engaged in the ways that are expected.

It’s a constant cycle – realising I’ve fallen behind, feeling guilty, promising myself I’ll do better, and then struggling to follow through. And while I’ve learned to be more compassionate with myself, this is one area where the self-judgement lingers.

The impact of late perimenopause on ADHD

In my mid-forties, just as I was beginning to understand my ADHD, perimenopause entered the picture – and everything became even harder. What I hadn’t realised before was how much fluctuating hormones impact ADHD symptoms. As oestrogen levels drop, dopamine levels – already lower in ADHD brains – also decline, making symptoms worse.

My ability to concentrate, retain information, and manage emotions became even more unpredictable. Forgetfulness increased, brain fog became a regular occurrence, and my already limited energy felt even more depleted. It was as if the challenges I had unknowingly managed my whole life had suddenly intensified.

For years, I had blamed myself for struggling with focus, memory, and organisation. Now, I understood that these difficulties weren’t just part of my ADHD but were being exacerbated by perimenopause. It was a frustrating realisation, but also a validating one. I wasn’t failing – I was simply dealing with an added layer of complexity that I hadn’t been aware of.

Discovering my path as a therapist

Despite these difficulties, I found my way into psychotherapy. Becoming a therapist was one of the most meaningful decisions of my life. My personal struggles gave me a deep sense of empathy for others, allowing me to connect with my clients in a way that felt natural. However, my undiagnosed ADHD still presented challenges. Managing paperwork, appointments, and session notes required significant effort. The mental load of organising my work was exhausting, and I often felt like I was running on an endless loop of catching up. But even with these struggles, I found immense fulfilment in my work.

Then came my diagnosis. Suddenly, everything made sense. The years of struggling, the feelings of inadequacy, the exhaustion of masking – it all had an explanation. ADHD was not a failure of character or a lack of discipline. It was simply the way my brain worked. And with this understanding came an incredible sense of relief.

How therapy and coaching can help people with ADHD

One of the most important realisations I’ve had since my diagnosis is how much the right support can help people with ADHD build resilience and recognise their strengths.

Therapy, coaching, and structured guidance can be incredibly effective in helping individuals navigate their challenges, develop self-awareness, and implement practical strategies to improve their quality of life.

• ADHD coaching can be invaluable in helping individuals create structure, set realistic goals, and build habits that work with their brains rather than against them. It provides a space to explore difficulties with organisation, time management, and focus, offering tailored strategies to manage everyday life.
• Therapy can help individuals with ADHD process the emotional toll of years of self-doubt, masking, and feeling different. It allows people to work through past experiences that may be impacting their present challenges, build self-compassion, and develop tools for emotional regulation.
• Self-compassion practices and mindfulness can also play a significant role in supporting neurodivergent individuals. Learning to accept oneself, rather than constantly striving to "fix" perceived shortcomings, can lead to a more fulfilling and balanced life.

For many adults diagnosed later in life, finding the right support makes all the difference. Therapy and coaching help shift the focus from “fixing” oneself to embracing neurodivergence and working with, rather than against, the brain’s unique strengths.

Moving forward with a new perspective

Living in the UK, I have had access to a level of awareness and support that I may not have received elsewhere. While the diagnostic process for ADHD, especially in women, is still evolving, the recognition and accommodations available have made a significant difference. I am still absorbing the process of my diagnosis and considering medication, trying to determine what support will work best for me. Knowing that I have options is reassuring, but I am also taking my time to process this new understanding of myself before making any decisions.

But the most significant change has been in how I view myself. Instead of constantly pushing against my natural tendencies, I am learning to work with them. I am embracing my strengths – the deep focus and empathy I bring to my work – rather than only seeing the challenges.

For those who are newly diagnosed or suspect they may have ADHD, know that support is available. Therapy, coaching, and self-compassion practices can help you understand yourself better, develop strategies that work for you, and build a life that aligns with your strengths. The journey may not be easy, but with the right tools and support, it can be transformative.

This is not just a new chapter – it’s a new way of living. One where I embrace who I am, work with my strengths and help others do the same. My ADHD is not a limitation; it is a part of me, and for the first time, I am learning to see it as a gift.