ADHD in High-Functioning Adults: When “Coping” Still Feels Like Struggling

(And why it’s often missed in women and global majority clients)

If you’ve found yourself thinking, “I can’t have ADHD — I’m doing well on paper,” you’re not alone.

Many adults who seek an ADHD assessment are capable, successful, and outwardly organised. They’re professionals with busy diaries, high standards, and a track record of achievement. From the outside, they might look like they’re thriving.

But internally, life can feel like constant effort — a cycle of overwhelm, procrastination, last-minute pressure, and exhaustion. Some people describe it as living in “hard mode,” even though others don’t see the struggle.

This is one of the reasons adult ADHD is often missed, delayed, or misunderstood — especially for women and for people from global majority backgrounds.

What ADHD actually is (and what it isn’t)

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that affects attention regulation, impulse control, and executive functioning. Executive functioning refers to the mental skills we rely on to:

• plan and prioritise

• organise and manage time

• start tasks and follow through

• regulate emotion and attention

• shift focus and adapt to change

ADHD isn’t about being unintelligent or “not trying hard enough.” In fact, many people with ADHD are highly intelligent — and have spent years working extremely hard to compensate. The difficulty is that ADHD affects consistency and sustainability. You might be able to perform well, but it comes at a cost.

The hidden reality of “high-functioning” ADHD

A lot of adults with ADHD have built their lives around coping strategies. These strategies can be effective — until they aren’t.

You might recognise patterns like:

• doing your best work under pressure, then crashing afterwards

• feeling paralysed by small tasks (emails, forms, admin)

• starting with enthusiasm, then struggling to maintain momentum

• being capable at work but overwhelmed at home

• losing time, forgetting things, or feeling constantly behind

• needing intense structure to function — and still feeling like it’s not enough

• feeling guilty because “other people make this look easy”

Sometimes ADHD doesn’t stop you from succeeding — it just makes success more draining than it needs to be.

And when life demands increase (more responsibility at work, parenting, relationship stress, health changes), the coping strategies that used to work can fall apart. That’s often when people seek help — not because they’ve suddenly become “worse,” but because they can no longer keep carrying the load alone.

ADHD can look different in women

Many women reach adulthood without being recognised. This is partly because ADHD has historically been framed around external hyperactivity — the disruptive, restless presentation that tends to be noticed in childhood.

But ADHD in women can be more internalised.

It may look like:

• mental restlessness and constant overthinking

• difficulty concentrating in meetings or conversations

• feeling emotionally flooded or easily overwhelmed

• chronic disorganisation despite being “responsible”

• perfectionism and over-preparing to avoid mistakes

• people-pleasing and fear of being seen as incapable

• intense self-criticism and shame

• burnout that builds quietly over time

Some women are first identified during periods of major change — starting university, getting a promotion, becoming a parent, or during hormonal transitions like perimenopause. When the demands increase, the cost of coping becomes more visible.

Masking and compensation: why ADHD is missed

Many adults with ADHD become experts in coping. They don’t necessarily feel okay — but they look like they are.

Masking and compensation can include:

• overworking to make up for lost time

• relying on anxiety, adrenaline, or urgency to function

• using perfectionism as a protective strategy

• appearing calm while feeling restless inside

• copying other people’s systems and routines (without them sticking)

• avoiding tasks until the pressure becomes unbearable

• “performing competence” while privately struggling

These strategies can hide ADHD from employers, teachers, and even from loved ones. They can also hide it from you. Many people only realise how hard they’ve been working when they begin to ask: “Is this level of effort normal?”

ADHD in clients from ethnically diverse communities: the context matters

For global majority clients, ADHD can be missed or misunderstood for additional reasons — many of which have nothing to do with symptoms and everything to do with context.

You may have experienced:

• pressure to achieve and be “twice as good” to be taken seriously

• fear of being judged, stereotyped, or dismissed

• cultural stigma around mental health or neurodevelopmental differences

• an emphasis on endurance and responsibility rather than support

• being labelled “lazy” or “undisciplined” instead of being understood

• masking and code-switching in professional spaces to stay safe

It’s also common for global majority clients to carry multiple roles — professional, family responsibilities, community expectations — while having less space to fail or ask for help.

This is why culturally responsive assessment matters. ADHD doesn’t exist in a vacuum: stress, trauma, workplace dynamics, discrimination, and survival strategies can shape how ADHD presents and how it’s managed.

A good assessment holds the whole picture — not just the checklist.

ADHD, anxiety, and burnout: the overlap

Many adults come seeking an ADHD assessment because they’ve been treated for anxiety, depression, or burnout — but something still feels unresolved.

This makes sense. ADHD often leads to secondary emotional impacts, such as:

• chronic stress from feeling behind

• anxiety from trying not to drop balls

• low mood from repeated self-criticism

• exhaustion from constant compensating

• shame from not meeting your own expectations

It’s not unusual for people with ADHD to present with anxiety first — especially when they’ve relied on anxiety to stay motivated and organised. That’s why a careful assessment includes screening for common co-occurring difficulties and looking at how symptoms have developed over time.

So… how do you know if it’s ADHD?

here isn’t one sign that confirms ADHD on its own. The most useful questions are:

• Have these patterns been present for a long time, even if they were hidden?

• Do they show up across more than one setting (work, home, relationships)?

• Do they create functional impact — not just “being forgetful,” but real consequences?

• Are you relying on effort, pressure, or perfectionism to keep things together?

• Does coping feel unsustainable?

Many people don’t need “more discipline.” They need clarity, understanding, and the right support.

What an ADHD assessment can offer

A high-quality ADHD assessment isn’t just about diagnosis. It can offer:

• validation that your experience has a name

• a clearer understanding of your strengths and difficulties

• insight into patterns you’ve blamed yourself for

• a framework to reduce burnout and build sustainable strategies

• recommendations for work, study, and daily life

• support for next steps, whether that’s therapy, coaching, or medical care

Most importantly, it can shift the narrative from “What’s wrong with me?” to “What’s been happening, and what do I need?”

If this resonates

If you’ve spent years coping quietly — achieving, managing, and holding it together — while privately struggling, you deserve support that reflects the reality of your experience.

ADHD can be missed when you’re bright, capable, and “doing fine.” But your internal experience matters.

If you’re considering an ADHD assessment, you’re welcome to reach out or book. Clarity can be the start of a kinder, more sustainable way of living and working.