ADHD Counselling

What is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder and is neuro-developmental condition affecting the brain. It starts in childhood, but some individuals are diagnosed in adulthood. Common symptoms are difficulties with concentration and motivation, emotional dysregulation as well as hyperactivity and impulsivity.

There are three types of ADHD of mainly hyperactive, mainly inattentive and combined. ADHD is a hidden disability; this means you cannotsee if someone is an ADHD individual. ADHD can affect an individual’s life in many ways and often impacts mental health.

What are the causes of ADHD?

Whilst in recent years, ADHD had been more researched due to increasing awareness and diagnosis in children and adults, the exact cause is still not fully known and understood. It is considered that several factors might contribute like genetics as ADHD seems to run in families, meaning that if you have ADHD parents and/or siblings, you are more likely to be ADHD yourself.

Research discovered brain difference between the ADHD and neurotypical brain, for example neurotransmitters not functioning properly, resulting in a chemical imbalance connected to the dopamine levels.

What are the symptoms of ADHD?

ADHD is a spectrum and presentation can vary and change depending on the different times of the day, situations and settings and event throughout life. It can affect the four categories below, but an individual might be alright and managing sensory stimulation but find executive functioning more challenging.

Executive functioning

• Organisation, management
• Time blindness
• Motivation
• Memory, forgetfulness, loosing things
• Making careless mistakes and being easily distracted 

Hyperactivity and impulsiveness

• Restless, difficulties to switch off and relax
• Impatience, easily frustrated, boredom
• Talkative, interrupting others, difficult to take turns and queue, seem argumentative
• Acting quickly without thinking, seem chaotic

Emotional regulation

• Hypersensitivity (hypersensitivity dysphoria), sensitive to criticism
• Shame and feeling judged
• Often and quickly dysregulated, seem drama and attention seeking
• Aggression and rage (towards others and self), no emotional brakes

Sensory integration

• Over or under-stimulation
• Need for stimulation (dopamine hit) 

Are ADHD individuals likely to have other conditions?

More than two-thirds of ADHD individuals have a co-existing condition. When you have ADHD, you are more likely to have another neurodivergent condition, for example 1 in 2 ADHD individuals also have dyslexia.

Examples of co-occurring conditions

• Dyspraxia, dyscalculia and dyslexia, Tourettes
• Obsessive Compulsive Disorder (OCD)
• Eating Disorders
• Anxiety & Depression
• Insomnia
• Chronic Fatigue (ME)
• Hypermobility and Ehlers-Danlos syndrome
• Digestion Problems & IBS
• Epilepsy
• Phobias
• Anger
• Post Traumatic Stress Disorder (PTSD)
• Rejection sensitivity dysphoria
• Pathological Demand Avoidance
• Trauma
• Addiction

Reading this list, enforces the magnitude of challenges an ADHD individual can face and must manage in daily life.

What treatment and support are there for ADHD?

There are various types of ADHD medication designed to help with the symptoms of the condition, to regulate the imbalances in the brain. Research has shown a high rate of success and effectiveness of ADHD medication of more of 80%. It is not a cure but can help with focus, concentration and impulsivity for example. Like any other medication, it has its side effects like loss of appetite and sleeplessness. Medication can be described to individuals who have an official diagnosis by trained professionals like psychiatrists. It should be titrated to ensure the individual is taking the right type and dose for the best effect and should be regularly reviewed.

ADHD is categorised as disability and long-term health issue under the Equality Act 2010. This means that employers and education providers are required by law to make reasonable adjustments to ensure that employees, applicants and students are not disadvantaged, for example through adjusting the working/ learning environment, changes in working/learning/recruitment patterns and processes, provision of additional or specialised support.

You also might be able apply for some financial support depending on the severity of your condition like PIP (Personal IndependenceAllowance) or ESA (Employment and Support Allowance). The government programme of Access to Work also supports individuals with physical and mental health condition to take up and stay in employment.

Some individuals find specific ADHD coaching and mentoring beneficial or seek help through online information, support groups and specialist ADHD organisations. In general psycho education, for the individual and people around them leads to better understanding and adjustment of the environment to enable the ADHD individual to thrive and reach their full potential.

How can counselling help with ADHD?

From my experience, often my ADHD clients start sessions in a state of heightened anxiety, low mood and feeling bad about themselves, carrying shame at not being able to function ‘like an adult’ and guilt of being perceived as rude or aggressive in their relationships. Overwhelmed by life, feeling different, not fitting in and an absolute failure.

I believe ADHD counselling encompasses different stages of exploration, understanding, acceptance and choice. For me it doesn’t matter if a client has an official diagnosis or is self-identifying as ADHD.

In therapy, the client is offered a space to reflect and communicate what is going on for them and how specifically their ADHD affects them. For this, developing a trusting and safe therapeutic relationship with me is essential. Where my clients feel not judged or criticized but accepted and embraced as who they are and who they want to become. This means that they can come as they are, if they want to move around in the room because they find it difficult to sit still or like to fidget that is alright. Some ADHD clients will talk endlessly and they want a space where they are not cut off or censored or they might want me to help them focus and concentrate. I am led by their pace and way of communicating. There are no expectations in fitting into neurotypical structures and I work from an integrative approach to adapt my counselling support to what my clients need, might it be CBT, trauma work or creative therapy. Sometimes, it is necessary to support my client first to feel more stable, for example to develop some strategies to manage their anxiety and mood enough to be able to work on a deeper level.

I really want to understand their world and with that believe they will start to understand themselves better. My clients regularly say they have chosen me as their counsellor because they want someone who has knowledge of ADHD and ‘gets it’.

ADHD individuals often have low self-esteem and confidence, not surprising as they experienced of not fitting in and being wrong. Relational trauma, bullying and abuse are sadly not uncommon for this client group, linking back for the necessity of a safe relationship with me.

I work from a strengths approach, in not only focussing on the challenges but also recognising where the individual succeeds and even excels in; they are often creative, courageous and resilient individuals who are energetic, charismatic with high conversational skills, emotional intelligence and in general good fun to be around. Another element is psycho education around the different aspects of ADHD like sensory issues and interoception or hyperfocus.

In understanding themselves better and feeling accepted in who there are in all its facets, gives the way to decide which changes they want to make in their lives. This stage is often accompanied by sadness, hurt and anger at the losses and discriminations they endured, especially when working with adults who had an ADHD diagnosis later in life. They might discover things they like or even love about themselves, things that are right in their lives and they want to keep or are able to accept. There probably will be areas or issues they want to change and here the counselling can offer the opportunity to explore the benefits of developing strategies and using aids to help with management and organisation or exploration how communication with family members might be adapted.

If you are struggling and are diagnosed/identify as ADHD, please reach out for support. All our counsellors are trained in ADHD and neurodivergent sensitive. We are here for you.