I Have Worked With ADHD for over 20 Years. I Also Have It.
By Dr Floriana | Consultant Clinical Psychologist, ADHD Coach, and late-diagnosed woman
Oasis Psychological Services Blog | 9th April 2026
I want to start somewhere personal.
I am a Consultant Clinical Psychologist. I have spent over twenty-five years working with ADHD and autism, first in the NHS and then in my own practice. I train other clinicians to assess and diagnose ADHD. I have sat with hundreds of adults, women in particular, and watched the moment something shifts in them when they finally hear a description of themselves that fits.
I am also a late-diagnosed woman with ADHD. A mother of two adolescents. A business owner. A person who will rewrite an email six times because the first five were not quite right, and then feel quietly ashamed when three days have passed and it still has not been sent. A person who can spend an entire day in a state of intense busyness and arrive at the evening with very little she can point to. A perfectionist, which sounds like a virtue until you understand the particular paralysis it can create.
I know this from the inside. And I want to write about it, not because my story is unusual, but because it is not. Because I see versions of it in my clinic every week, in women who are capable and accomplished and utterly exhausted and have no idea why.
Knowing everything there is to know about ADHD does not protect you from it. But understanding it, really understanding it, changes everything.
The Version of ADHD Nobody Told You About
For a long time, the image of ADHD was a young boy, fidgeting at the back of the classroom, unable to sit still or follow instructions. That image is not wrong exactly, but it captures perhaps the most visible and the most straightforward presentation of a condition that is, in reality, far more varied, far more subtle, and far more common in adults than anyone was acknowledging a generation ago.
The adults I see are not, for the most part, fidgeting at the back of classrooms. They are running businesses, raising children, managing teams, overachieving in careers they have built through sheer determination and an almost compulsive work ethic. They are, on the outside, doing remarkably well. On the inside, they are working twice as hard as everyone around them, wondering why it all feels so much more effortful than it seems to for other people, and quietly blaming themselves for the gap between how capable they appear and how chaotic they feel.
Does any of this sound familiar? You start the day with a clear plan and somehow, by midday, it has dissolved into a series of half-completed tasks and one very thorough reorganisation of something that did not need reorganising. You know the report needs to be done. You have known for two weeks. And yet you cannot make yourself start it until the deadline is close enough to generate the particular kind of urgency that your brain seems to need in order to function. You are not lazy. You are waiting for the panic to activate you, because nothing else quite does the job.
Or perhaps focus is not the issue at all, and it is the opposite that catches you out. You can hyperfocus for hours on something that genuinely interests you, losing track of time entirely, producing work that is excellent, only to find that the things that do not interest you remain stubbornly undone regardless of how important they are. The inconsistency is confusing to others and, often, deeply confusing to yourself.
Maybe you are a perfectionist in a way that does not feel like pride in your work, but more like an inability to let things be imperfect enough to be finished. Or perhaps the emotional weight of small things feels disproportionate, a critical comment that others have forgotten by lunchtime still replaying for you at midnight.
Why So Many Women Are Diagnosed Late
There are many reasons why ADHD in women is so frequently missed, and most of them come down to the same thing: the condition was studied predominantly in boys, the diagnostic criteria were shaped around what was most visible in boys, and the quieter, more internalised, more socially masked presentations that are more common in girls and women simply did not fit the picture that clinicians were trained to look for.
Many women with ADHD are also exceptionally good at compensating. They develop systems, they overperform, they stay up later than everyone else to get things done, they use anxiety and perfectionism as fuel. From the outside, this looks like conscientiousness. The cost of it, which is paid privately, is rarely visible.
By the time many women reach an assessment, they have often already collected other diagnoses along the way. Anxiety. Depression. Sometimes a personality disorder, or a label that feels close but not quite right. These may be real and valid in their own right. But for many women I work with, there is a sense that these explanations have not quite answered the underlying question. That something more fundamental has been missing from the picture.
For some, the recognition comes through their children. A child is assessed, and sitting in the feedback session, a parent quietly recognises herself in everything being described. For others it comes through something they read, or a conversation that finally uses language that fits. However the question arises, it deserves to be taken seriously.
What Understanding Your ADHD Actually Changes
I want to be honest about something. Knowing I have ADHD has not made the challenging parts disappear. I still have days where focus is elusive, where the to-do list feels impossible, where perfectionism slows me down in ways I can see clearly and still struggle to override. Understanding your neurology does not rewire it.
But it changes the story you tell about yourself. And that matters more than it might sound.
When you understand that the difficulty initiating tasks is not laziness but a genuine difference in how your brain produces and responds to dopamine, the self-blame starts to lose its grip. When you understand that the emotional intensity is part of the condition and not a sign that something is fundamentally wrong with you, something shifts. When you stop spending energy on wondering why you are like this, you have more available for actually working with it.
Over twenty years of clinical practice, and through my own experience, what I have found genuinely helpful is a combination of things: understanding the neuroscience well enough to stop fighting it, using ADHD coaching tools that work with rather than against how my brain actually functions, and CBT adapted specifically for ADHD to address the accumulated self-criticism that tends to build up over years of feeling like you are somehow failing at ordinary life. I also draw heavily on ACT, Acceptance and Commitment Therapy, which helps with the particular kind of psychological flexibility that ADHD can make so difficult: learning to notice your thoughts without being hijacked by them, and moving towards what actually matters to you even when your brain is pulling in seventeen directions at once. And Compassion Focused Therapy, which I come back to again and again both professionally and personally, because one of the quieter consequences of a lifetime of unrecognised ADHD is often a very harsh internal critic that takes a great deal of deliberate work to soften. Alongside all of this, learning to actively manage my executive functions and energy levels rather than pushing through regardless has made a difference I genuinely did not anticipate. None of these are magic. All of them, together, change things. I will write about each of these in more depth in future posts, because they each deserve more than a sentence.
If Any of This Sounds Like You
If you have read this far and found yourself nodding, or feeling a quiet recognition you are not quite sure what to do with, I want to say something simple: that recognition is worth paying attention to.
You do not need to have struggled visibly. You do not need to have failed. You can be over-functioning, overachieving, and managing a great deal, and still have ADHD. In fact, that description fits a significant proportion of the adults I see. The over-functioning is often the coping strategy, not evidence that everything is fine.
At Oasis, we start every adult ADHD assessment with an initial consultation, because the right first step is a conversation, not a questionnaire. I want to understand your experience before we talk about what an assessment might look like and whether it is the right direction.
This is the first in a series of weekly blogs I am writing about ADHD, autism, and neurodivergent experience, from both sides of the clinical relationship. I hope some of it is useful. I hope some of it makes you feel a little less alone in whatever you are navigating.
Dr Floriana Reinikis is a Consultant Clinical Psychologist, Accredited CBT Psychotherapist, and ADDCA-accredited ADHD Coach. She is the founder of Oasis Psychological Services and a training provider for ADHD assessment to NHS trusts across the UK. She was diagnosed with ADHD in later life.