People sometimes expect a late diagnosis or realisation of ADHD to be the welcome end of a journey. It’s true that with this new knowledge, so many things fall into place. At last, we can explain why we are the way we are. A lifetime of confusion suddenly makes sense. Perhaps we can set aside some of the shame we’ve carried for a lifetime for what we now realise are not character flaws or moral failings but neurodivergent traits.
Yet this is rarely the whole story. Alongside relief, tricky questions can emerge about identity, relationships, missed opportunities and self-understanding. This is often where a longer and more complicated process begins.
This is particularly true if we’ve masked effectively, appearing to others to function well or even to be considered high or over-achievers. It’s also true if, upon seeking support for our struggles, we were told repeatedly either that nothing was wrong or that we should just try harder.
This post is for people whose ADHD became known to them as adults and unexpectedly found themselves grieving. This might happen before or without a formal diagnosis. Equally, you might find yourself grieving years after diagnosis. There is no timeline that determines when and what we feel.
When a late ADHD diagnosis or self-realisation rewrites your past
A late diagnosis or self-identification not only informs the present but also leads us to reassess the past.
Suddenly, episodes you’d attributed to moral failings or character defects look different: relationships in which you couldn’t show up the way you wanted to; jobs that didn’t work out or careers you didn’t even start; years of being told or internally knowing that you weren’t living up to your potential. Equally, you might have endured years of over-functioning, all your achievements gained through sheer, invisible, exhausting effort while somehow never feeling as though you were doing enough. It just doesn’t seem fair.
Speaking openly about the grief of late diagnosis is harder than it should be. Not only are the feelings themselves complex and often socially invisible, but also there is a cultural backdrop that makes it difficult to be believed in the first place. Here in the UK as elsewhere, mainstream media frequently peddles a set of interconnected narratives which frame neurodivergent diagnoses as suspect: over-diagnosed, ‘trendy’, or exploited by people who don’t really need support (Horton-Salway, 2011). In 2025, this scepticism was publicly adopted by the UK government’s Health Secretary, Wes Streeting (The Guardian, March 16, 2025), even though research has found little convincing evidence to back up the overdiagnosis claims (Cortese et al., 2026).
Conversely, more positive narratives about ADHD can similarly silence those for whom feelings of grief and anger emerge. The idea that ADHD is a ‘superpower’ if only we can learn to harness it doesn’t always feel true when we reflect on how much we have struggled over a lifetime.
High-functioning, masked, and exhausted: a particular kind of loss
One version of this that I recognise from my work as a relational integrative therapist, and elsewhere, applies to the highly-functioning, long-masked individual who got the results, built the career, maintained the relationships. These people appeared, from the outside, entirely capable, even impressive but at an immense personal cost of effort, compensation and exhaustion that scarcely anyone saw.
The concept of ‘masking’ might be relatively new to you if you have only just realised that you have ADHD. It’s the process of hiding (hence the connection with shame) or working around ADHD-related difficulties in order to meet expectations, avoid judgement, or fit in with others. Masking very commonly involves putting considerable effort into appearing organised, attentive, or in control, even when inside you feel chaotic and overwhelmed. While masking can help someone navigate daily life, and suggests how resourceful they are, it can also be absolutely exhausting, and leave them feeling unseen, misunderstood, or disconnected from their authentic self.
It’s understandable that anger might arise with the realisation that not all of that struggle need have been necessary. Such anger is legitimate. It may be directed at educational systems that failed you, at parents or other carers who just didn’t notice, at clinicians who told you either that there was nothing wrong with you or sent you away with diagnoses for other conditions such as depression or anxiety. It’s not uncommon for people to be treated unsuccessfully with medication for what became labelled as ‘treatment-resistant’ depression and anxiety. I wonder whether certain treatments didn’t work because they were treating the wrong thing! Sometimes the anger is directed inwards, at the self, judging yourself harshly and not extending to yourself the compassion or understanding you’d freely give to others.
This pattern of late recognition is especially common among women and others socialised to be quiet, compliant, and accommodating. ADHD was, for decades, understood and diagnosed largely on the basis of hyperactive boys, while the quieter, more internalised presentation common in girls and women went unnamed (Attoe and Climie, 2023). Many women I work with weren’t disruptive at school. On the contrary, they were diligent, anxious, exhausted, often achieving well academically. They were praised for trying hard, which made it easier for everyone, including themselves, to miss what was actually going on. It’s not unusual for women to first wonder about their own ADHD only after their child’s diagnosis brings the pattern into view.
The grief of paths not taken after a late ADHD diagnosis or self-identification
Alongside anger, there’s often something more elusive and harder to name. Sometimes people chastise themselves for self-pity, but I think what they’re referring to is much more complex than that. It feels like grief. When my clients explore more this feeling deeply, it shares something with the Welsh concept of hiraeth, a profound yearning for a place, time, person, or way of being that feels like home, whether lost, distant, or perhaps never fully attainable. In this context, hiraeth encapsulates the loss of an imagined life that might have been. This might include relationships that could have been otherwise, including those that didn’t survive the particular difficulties that ADHD can bring to intimacy and communication. We might think of creative or professional paths not taken, not from any lack of talent or desire, but because the combination of executive dysfunction and years of unrecognised struggle made those paths too overwhelming to pursue. And there’s also the relationship with oneself that might have been kinder and more forgiving.
These losses are real and deserve to be honoured and mourned. I think it’s important not merely to explain them away or to rush towards resolution. We’re talking about mourning for a life that was genuinely yours, that was so much harder than it needed to be, and that might in other circumstances, have gone differently.
Why strategies and coaching don’t reach grief and anger
Much of the professional support available after an adult ADHD diagnosis is, quite rightly, practical: strategies for executive function, time management, organisation. This has real value.
But it doesn’t touch what I’m describing here.
Grief doesn’t respond to strategies. Anger running decades deep doesn’t shift when you find a better system for managing your inbox. A relationship with yourself built on years of ‘why can’t I just…?’ requires more than psychoeducation to change.
In my experience, what many clients who come to therapy in the wake of a late diagnosis of or self-identification with ADHD most need is space to feel what they’re feeling without being redirected towards coping. This is in part because that would simply amount to more of the same: coping, compensating, masking is what they’ve been doing since childhood. Therapy provides a place where they can put down those burdens and begin to explore how to live authentically with their new self-understanding. It’s important to have their anger received and taken seriously rather than being processed away, to have their sadness honoured and met with compassion, and to look back on what is lost with someone beside them who isn’t hurrying them past it.
This matters especially when, as is often the case, an ADHD diagnosis is bound up with a longer history of developmental or relational trauma. ADHD and complex trauma frequently arrive together. The neurotype that was already finding the world effortful was often shaped further by early relational experiences that didn’t provide the regulation and attunement needed. Working therapeutically in this territory requires attending to both threads and how they interweave.
What ADHD-informed therapy can actually offer
Good therapy after a late ADHD diagnosis does several things, though rarely quickly. My own approach is relational integrative therapy, which means I draw on several ways of working to meet you as an individual rather than a set of symptoms or diagnosis. In practice, this is where the relational and somatic strands of my training tend to matter more than the practical ones. Grief and anger of this kind often live in the body as much as in the mind, and somatic work and EMDR can reach what talking alone sometimes can’t. Parts-based work, drawing on Internal Family Systems (IFS) and more, is often useful too, because so much of what’s being grieved belongs to a particular part of you: the part that masked, the part that achieved, the part that never quite believed it had done enough. Bringing those parts into the room, rather than trying to argue them out of existence, tends to be where the real movement occurs.
It makes room for the grief that isn’t always welcome elsewhere, whether that be with partners, friends, or colleagues who are relieved to have an explanation and expect that to be enough. It supports the retrospective reckoning, not in order to revise the past, which isn’t possible, but to come to a different and less punishing relationship with it. It attends to the particular quality of shame that comes from having believed, for years, the worst things you feared about yourself were true. Healing shame is necessarily a process that takes time. And it allows for the gradual possibility of a relationship with yourself that isn’t organised primarily around what or how you should have managed.
None of this is quick work. But it’s real, and it’s work that a diagnosis, on its own, can’t do.
If you’re somewhere in this process, not formally diagnosed, recently diagnosed, still waiting for assessment, or years on and still carrying something that hasn’t shifted, I’m happy to have an initial conversation. I offer a free 20 to 30-minute chat so you can get a sense of whether we’d be a good fit.
Garthine Walker is a UKCP-registered psychotherapist based in Cardiff, offering online therapy across the UK. She specialises in trauma, attachment wounds, neurodivergence, burnout and maladaptive daydreaming.
REFERENCES
Mary Horton-Salway (2011). ‘Repertoires of ADHD in UK Newspaper Media’, Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 15:5, 533–549. DOI: 10.1177/1363459310389626
Samuele Cortese et al., 2026. ‘ADHD (over) diagnosis: fiction, fashion and failure’. The British Journal of Psychiatry. Published online 2026:1-4. DOI:10.1192/bjp.2026.10546.
‘Wes Streeting: There is Overdiagnosis of Mental Health Conditions’, The Guardian 16 March 2025.https://www.theguardian.com/politics/2025/mar/16/wes-streeting-there-is-overdiagnosis-of-mental-health-conditions?
Darby E. Attoe and Emma A. Climie (2023). ‘Miss. Diagnosis: A Systematic Review of ADHD in Adult Women’, Journal of Attention Disorders, 27:7, 645-657. DOI: 10.1177/10870547231161533