You might leave an ADHD assessment at 50 and spend the drive home thinking about something a teacher said when you were twelve. Or about the job you left because you couldn’t keep up with the paperwork, even though you were good at the work itself. You finally have an explanation that makes sense, and now you’re looking back at years of trying to figure out why certain things felt so hard.
Then you get home, and the bills still need to be paid. You still have to remember to call the dentist. What are you supposed to do with this new information on a regular Tuesday?
You can feel relieved and still wish someone had noticed sooner
In a study that interviewed 21 adults diagnosed with ADHD in adulthood, participants described gaining a better understanding of themselves and their histories. Some also talked about sadness or anger over the years they’d spent without an explanation or support. The interviews were about adult diagnosis more broadly, and they give words to feelings that can come up when you find out later in life (Hansson Halleröd et al., 2015).
At 50, you might think about the help you could have used in school, the arguments you kept having about chores, or how much of your evenings you spent catching up after work. You might also wonder how you managed to do as much as you did. Both are worth sitting with. You’re allowed to be glad you know now and sad that it took this long.
Take stock of what already helps
Maybe you’ve been putting your keys in the same bowl for twenty years. Maybe you do your best work when someone else is quietly working nearby. Maybe the only way an appointment makes it onto your calendar is if you enter it while you’re still on the phone.
Those are things you’ve learned about how you work. Before you buy another planner, it may be worth asking what’s already helping and where you’re still spending more energy than you want to.
Researchers reviewing ADHD care for adults 50 and older have argued that therapy should account for what’s happening at this stage of life, including changes in work, health, and relationships (Torgersen et al., 2016). That might mean looking at how your routines change when you leave a job that gave your day structure, or how you’ll keep track of your own appointments while helping a parent manage theirs.
Start with one part of your week
Pick a moment that keeps giving you trouble. Maybe you remember the bills when you’re lying in bed, when you have the least energy to deal with them. Instead of setting a goal to “get organized,” you could try keeping the bills in one visible spot and opening them while you have coffee on Saturday. If that falls apart, look at where it fell apart. Did the reminder go off while you were out? Did opening the bill turn into a search for a password? That gives you something specific to work with.
You might also pick a moment when you’re especially hard on yourself. If you miss an appointment and immediately think, I can’t be trusted with anything, try describing what happened in plain terms. I wrote it down on the back of an envelope and never put it on the calendar. You can take responsibility for missing the appointment and give yourself a fairer account of how it happened.
What can counseling help with after an ADHD diagnosis?
You can bring both the practical stuff and the feelings about finding out late. In one session, we might talk about how to make the end of your workday less frantic. In another, we might spend time with a memory that has been bothering you since the assessment. You may also want to talk about what to tell a partner, or how to ask for help with something you’ve been quietly managing for years.
If you’re looking for a place to start, think of one thing you’d like to be easier by this time next week. That’s enough to bring to a first conversation. At Small Works Counseling, I work with adults who are figuring out what a late ADHD diagnosis means for them and what kind of support would fit the life they already have.
References
Hansson Halleröd, S. L., Anckarsäter, H., Råstam, M., & Hansson Scherman, M. (2015). Experienced consequences of being diagnosed with ADHD as an adult – A qualitative study. BMC Psychiatry, 15, Article 31. https://doi.org/10.1186/s12888-015-0410-4
Torgersen, T., Gjervan, B., Lensing, M. B., & Rasmussen, K. (2016). Optimal management of ADHD in older adults. Neuropsychiatric Disease and Treatment, 12, 79–87. https://doi.org/10.2147/NDT.S59271
