Attention Deficit Hyperactivity Disorder (ADHD) can mean people find it hard to concentrate or regulate their emotions, can be hyperactive or behave impulsively – but it can also affect people’s lives in so many other ways too.

There’s no one-size-fits all experience of ADHD, or how it impacts people’s mental health.

Years of being judged and misunderstood, the exhaustion of masking symptoms, the challenges of fitting into a neurotypical world, the impact on relationships and working life are just a few of these other challenges ADHDers may face. These experiences can also have a devastating impact on people’s mental health and wellbeing.

More than one in three adults who screened positive for ADHD were also identified as having a common mental health condition, such as depression or anxiety, according to an NHS survey.

In 2024 our Mindometer survey found that three quarters of therapists reported a rise in clients seeking therapy for ADHD-related issues in the previous year.

Therapy is not about ‘solving’ ADHD, but about helping people understand their diagnosis, address the challenges they face, and live in a way that feels true to themselves.

We asked some of our members, who work with ADHDers or have ADHD themselves, to explain what counselling and psychotherapy can offer people with this condition.

Feeling heard and accepted

For many ADHD adults, they may have been misunderstood, judged and had their needs dismissed by those who don’t understand the difficulties they’ve faced.

But therapy offers a place to be heard and accepted.

Alistair Newton, an accredited BACP member, says the therapist has an opportunity to show what’s described as ‘unconditional positive regard’ – which is accepting and valuing you.

He adds: “The therapeutic relationship might be what heals: it’s a space for you to understand who you are and come to an acceptance of who you are.”

BACP-registered therapist Kesley Cage adds: “For ADHDers, therapy is a space where they can be themselves and process more naturally, without being held to neurotypical standards.

“The acceptance and understanding ADHDers experience in therapy is something they may then internalise, so they can trust themselves more in day-to-day life.”

Building tools for emotional regulation and resilience

Emotional regulation differences associated with ADHD can include feeling things very deeply and intensely, rejection sensitivity, taking time to come out of a deep feeling, and tendencies to ruminate, says Laura Bradshaw.

BACP-registered therapist Laura adds that many people “cite these differences as one of the most difficult aspects of having an ADHD brain.” 

She adds: “ADHDers often report a chronic state of hyperarousal, their nervous systems stuck in fight or flight.

“Therapy can help equip you with tools to regulate your nervous system and to learn to self-soothe. 

“This often begins with building awareness with clients of when they need that regulation: noticing and naming what they are feeling, when they are feeling it. We can then build on that awareness with practical strategies they can employ to tend to those feelings and that state of hyperarousal.”

These strategies can include cognitive reframing exercises, breathing and grounding exercises, and somatic exercises to regulate the nervous system.

Working through shame and quietening the inner critic 

“Many ADHDers will report a lifetime of feeling different, misunderstood and criticised for their differences,” explains Laura.  

“This often means that, by adulthood, ADHDers will have developed a deep sense of shame around their differences, rather than seeing them neutrally as just that, different.

“They now too judge themselves as they have been judged by others. This can lead to various damaging behavioural tendencies such as perfectionism, people-pleasing, and ignoring the body’s need to rest, resulting in cycles of recurrent burnout.”

Laura adds: “Therapy can serve as a space to bring awareness to the impact of those shaming, early experiences, and to help you unlearn that shame by working on cultivating a more compassionate relationship with yourself, bringing in curiosity around your own needs, where shame would previously have had you disregard them.”

Coping with a late diagnosis

For some people, a late diagnosis can be a relief as you finally understand why you are the way you are, says Kesley.

But it can also bring grief for having lived for so long without understanding or support. Often by the time an adult receives a late diagnosis, the harm has already been done.

Alistair says: “Those diagnosed in later life may have a sense of bereavement for the life they might have had if they had known why they were acting the way that they were (and were treated appropriately).”

And Kesley adds: “A late diagnosis can come with a lot of grief and frustration about the past, and a feeling that there are still mountains to climb.

“A therapist will accompany you to acknowledge and honour the grief, and support you to transition to a more you-shaped life.”

Processing masking, overwhelm and burnout

Masking is where people learn to hide, disguise or suppress their natural behaviours, as they feel they’re not acceptable to people around them. But this can be exhausting, overwhelming and can contribute to burnout.

Alistair says ADHDers may be “unaware of why they need an unusual amount of recovery time.”

Therapy gives them time and space to understand and process this – to have their experiences heard.

He says therapy can create a calm space where the therapist listens to the client, recognises their difficult experiences and “allows them to gain insights into how they are and how they want to be.”

Learning how to make sense of your whole world

ADHD people may also experience a range of other difficulties or conditions. It often doesn’t happen in isolation.

Alistair says: “People may also be struggling with other problems such as screen addiction, binge drinking, risk-taking behaviour.

A therapist may ask you to describe every part of your life to get a thorough understanding of what’s going on for you and what therapy can support you with.

This isn’t about diagnosing you or offering an interpretation. It’s about noticing your whole world, says Alistair.

“This is an opportunity for you to be normalised, to understand yourself, and to accept who you are.”

Therapy can help you learn how to make sense of your world and to have compassion for yourself. 

Understanding the conflicting needs of Autism and ADHD

Kesley says that for people with autism and ADHD (often known as AuDHD) – things can seem contradictory due to conflicting needs.

For example, “A need for fizzy and vibrant sociability might conflict with a deep need for calm and gentleness. This can feel like loneliness and understimulation, yet result in exhaustion after socialising,” he says.

“AuDHDers may feel like two sides of themselves are battling and behaving at odds with one another, which can be confusing for them and their loved ones. These are some of the unique problems for autistic ADHDers that require understanding through an AuDHD lens, not just an ADHD lens alone.

“Good therapy can help autistic ADHDers understand their conflicting needs, and find ways to bring them into balance.”

Having a space to process and organise thoughts

Many ADHDers seek counselling as a space to process and organise their thoughts, which can be overwhelming at times, says Kesley.

“Therapy offers you the space to externalise those challenging thoughts and emotions, and start to find how everything connects, and how to move forwards without getting lost in spirals. It’s natural to go round in circles a bit sometimes, but counselling helps you explore the next right step for you. 

“Every ADHDer has different strengths and values. A therapeutic relationship can provide a space to reflect on and explore these strengths and values, and how to apply them in your life.”

Kesley concludes: “Therapy can help you explore the right way forward in the life you’re living. Everyone needs extra support sometimes.”