My mom has ADHD. I have long suspected I have some qualities that point to the same diagnosis. We have had a weekly phone date for the last 20 years, and we laugh, tell stories, and sometimes argue, but the real hallmark is that neither of us can stay on any one point for long without a swift right turn into something that distracts one of us. Often, for my mom, it's her email or a bird in her yard. For me, it is my own wandering thoughts of various worries I try not to ruminate on.
When I started my career, I worked in the Accessibility Office at Laguardia Community College. The majority of students I worked with had ADHD and struggled with many symptoms, making it nearly impossible to succeed in school. My job as their counselor and advisor was to help them learn techniques for managing inattention, impulsivity, disorganization, poor time management, difficulty focusing, forgetfulness, restlessness, and trouble managing multiple tasks at once, such as writing a paper in English while studying for a Math test.
Since high school, I have struggled with a lot of the symptoms listed above. I taught myself in college how to manage them. With my newly minted research skills from grad school, I couldn’t wait to find the current papers on how to help adults struggling with this. I didn’t realize back then what I learned would help me throughout my career, not just with people with ADHD, but with people with other issues that come up in therapy, such as depression, anxiety, freelance workers trying to manage a new way of scheduling and working, and people moving through life transitions. All of these struggles often lead to many of the symptoms associated with ADHD.
What does working with someone with ADHD look like in therapy? As always, we begin with cultivating a trusting relationship. Then we work to understand the patient’s specific struggles. Is low self-worth holding them back? Do they have difficulty staying focused on a specific task? Time Blindness? Often, it’s a combination of many symptoms that get in the way of someone with ADHD feeling productive and intentional in their life. From gaining knowledge about the major problems arising, we move on to understanding the reasons for these behaviors, both attached to ADHD and any other extenuating factors (trauma, attachment issues, etc). Finally, we act, deliberately changing some behaviors to learn what will and won’t work through psychodynamic and somatic practices.
Everyone’s therapy journey looks a little different, even if the diagnosis is the same. Some techniques I use to help someone improve their quality of life while living with ADHD are as follows:
Understand Patterns: Traits like procrastination, avoidance, and inconsistency are not random. They often serve a purpose. They may protect you from feelings like shame, failure, overwhelm, or internalized pressure. By understanding why you resist, you gain more choice in how you respond.
Body Awareness: Your ability to focus and follow through is deeply connected to your body. States like anxiety, shutdown, or restlessness aren’t just mental—they are physiological. Learning to notice and regulate these states makes structure and consistency more accessible.
Increasing Tolerance for Frustration and Discomfort: Changing the ways we think and move through the world is incredibly difficult. Many people avoid frustration and discomfort because they feel they cannot tolerate those feelings, as if they will be crushed by their weight. We work towards accepting these feelings through journaling and talking through why they feel so hard to sit with. As someone becomes more comfortable having all their feelings, they feel less resistant to trying new things that could bring formerly difficult feelings to the surface.
Creating external structures that actually work with your brain, not against it: Learning about oneself in therapy allows the patient and therapist to work together to find the right tools to move forward in a new way. For some, it's color-coded calendars, setting timers for tasks, or anchor points in their day. Others need visible systems and reset rituals.
There are many interventions for working with your own ADHD and working with someone with ADHD; the key is paying attention to what works and what doesn’t, and moving in flow together through the frustration towards solutions. The goal is not to quickly fix difficult behaviors but to make lasting change.