The Effect of ADHD on Adults: Providing Support to Clients and Their Loved Ones

Editor's Note: This text-based course is an edited transcript of the webinar, The Effect of ADHD on Adults: Providing Support to Clients and Their Loved Ones, presented by Christina Marsack-Topolewski, PhD, MSW, LMSW.
Learning OutcomesAfter this course, participants will be able to:
Identify the characteristics, signs, and symptoms of ADHD in adulthood.Describe the multi-faceted nature of ADHD and co-occurring conditions common among adults with ADHD.Identify and apply practical and evidence-based strategies to support adult clients with ADHD and their loved ones.Welcome/Today's FocusHello everyone! Today, we will discuss adults with ADHD and how we can best support them and their loved ones. This is often a significant factor in why they seek our help, as it’s not uncommon for a loved one, spouse, or family member to encourage them to explore what’s going on.
In my career, I’ve worked as both a special education teacher consultant and a clinical outpatient therapist. I’ve supported individuals across different stages of life, from children in K-12 settings who receive an early ADHD diagnosis and benefit from IEPs or 504 plans to adults who come in later seeking an evaluation or a formal diagnosis. For many adults, ADHD has created a ripple effect through various facets of their lives—impacting their work, relationships, and home life. Often, these individuals may not realize how significantly ADHD has been affecting them until something brings it to light, whether it’s a challenge at work, tension in a relationship, or feedback from someone close to them.
As a society, we often associate ADHD with children and adolescents, but millions of adults in the United States—and many more globally—live with ADHD. The truth is that ADHD doesn’t simply dissipate in adulthood. Many adults were either misdiagnosed or not diagnosed at all during childhood and adolescence. They may have developed their coping mechanisms to navigate school and other early life challenges, though often not without significant difficulty. When these individuals reach adulthood, they may encounter professionals—whether therapists, coaches, or evaluators—who help them identify and address what’s been underlying their experiences.
Today, we’re focusing specifically on adulthood and what we can do to support adults with ADHD. ADHD affects many areas of life, such as employment, family dynamics, and relationships, and without the right supports and tailored strategies, these areas can suffer. Our discussion will cover how ADHD presents differently in adults, how stress plays a pivotal role in its manifestation, and the complexities of the condition’s multifaceted nature. We’ll also look at evidence-based strategies and practical approaches to support adult clients and their loved ones.
It’s essential to recognize that ADHD in adulthood doesn’t exist in isolation. It impacts the individual, their relationships, and their broader environment. The ripple effects can be profound, whether it’s a couple navigating challenges, a family dealing with competing needs, or an individual striving to manage their work life. I’m excited to delve into this topic and explore ways we can help adults with ADHD find success and balance in their lives. Let’s get started.
Risks & LimitationsRegarding limitations, I want to acknowledge that this is a one-hour training, and while ADHD is a topic we could easily spend an entire day exploring, we need to remain mindful of the scope of our time together. Additionally, as clinicians, we must be aware of the limitations and boundaries within our scope of practice. Supporting clients with ADHD often benefits from a team-based approach, which might include collaboration with other practitioners, medical providers, or holistic supports. Taking this interdisciplinary perspective can be incredibly valuable for clients, allowing them to access a range of resources and perspectives that complement one another.
It’s also important to recognize that ADHD often doesn’t occur in isolation. Many clients with ADHD present with comorbid conditions, such as anxiety, depression, or learning disabilities. This has certainly been my experience, and I imagine it aligns with what many of you have seen in your own work. These co-occurring challenges can compound the effects of ADHD, so it’s critical to approach treatment holistically. Addressing the strengths, challenges, and unique needs of each client requires us to integrate evidence-based interventions that are both comprehensive and individualized.
Another consideration is the role of cultural beliefs and attitudes toward mental health conditions like ADHD. These perspectives can vary widely depending on the communities and populations we serve. Much of my consulting work has been in a highly diverse area of Michigan, where I frequently work with families to increase their understanding of ADHD and its impact. Part of this work involves reducing stigma, not just around ADHD, but also the co-occurring conditions that are often seen alongside it. Many of these conditions carry additional stigmatization, which can create barriers to accessing care or support.
As clinicians, it’s vital that we practice cultural humility and promote cultural diversity and awareness in our work. Addressing stigma requires intentionality, whether it’s through psychoeducation, fostering understanding, or creating safe spaces for clients and families to discuss these challenges. By doing so, we help create opportunities for clients to access the care they need while feeling understood and supported. These efforts are essential in ensuring that our interventions are not only effective but also culturally responsive and inclusive.
What Comes to Mind When You Think of Adults with ADHD?When I think about adults with ADHD, a lot of themes come to mind. Disorganization is one of the key challenges, as well as difficulties with focus and memory. Many adults I’ve worked with describe a sense of being paralyzed in their lives—not knowing where to start, struggling with executive functioning skills like planning and organizing, and feeling like they’re unable to move forward. This sense of being stuck often leads to feelings of shame, guilt, and grief, especially when reflecting on how these struggles have impacted their lives over time.
Employment is often a significant pain point. Many clients come to me because ADHD has started to severely interfere with their ability to hold down a job or perform effectively at work. They may find themselves prematurely quitting or facing difficulties meeting the demands of their roles. Similarly, challenges with time management play a major role. Managing deadlines, coordinating household tasks, paying bills, and fulfilling parenting responsibilities all require a level of organization and planning that can feel overwhelming for adults with ADHD.
Another recurring theme is the challenge of motivation and task-switching. Clients often describe bouncing between tasks, becoming distracted, and struggling to follow through. The constant availability of technology can exacerbate this, with many clients recounting stories of picking up their phone for a specific reason only to find themselves derailed by social media or other distractions. These moments can create a frustrating cycle, heightening anxiety and self-criticism.
Impulse control is another topic that frequently arises in conversations. Impulsive decisions, especially related to finances, can have a ripple effect, particularly in relationships. For example, a partner may feel frustrated by unplanned purchases or difficulty sticking to a budget. In a work setting, impulsivity might mean missing out on promotions or opportunities due to impulsive actions or decisions. This can take a toll on self-esteem and contribute to the already complex emotional landscape of living with ADHD.
What stands out most is the cumulative effect of these challenges. Adults with ADHD are often navigating multiple layers of frustration, both internal and external. This makes it especially important to build strategies that are tailored to the individual. Effective supports need to be personalized, addressing not just the practical skills needed to manage daily life but also the emotional impacts like shame, self-esteem struggles, and relationship dynamics. By stepping back and recognizing the unique needs of each person, we can start to develop strategies that truly help them thrive.
Section #1: Characteristics, Signs, and Symptoms of ADHD in AdulthoodLet's first discuss the characteristics, signs, and symptoms of ADHD.
Aspects to ConsiderAdults navigating life with ADHD often find their experiences uniquely challenging. Some may have made it through school or early life without significant struggles or noticeable issues, particularly if they didn’t exhibit the more overt behavioral manifestations commonly associated with ADHD. These individuals may have "flown under the radar," avoiding early diagnosis or intervention. However, the challenges can become overwhelming as they reach adulthood and face the complexities of managing multiple schedules, calendars, and competing demands. This is often compounded by the frustrations that arise within familial or relational contexts, where the ripple effects of ADHD may be felt acutely.
The adverse outcomes of unmanaged ADHD can manifest in various aspects of life. Employment difficulties, financial instability, strained relationships, and internal emotional struggles are common. Many adults with ADHD grapple with feelings of shame, embarrassment, or inadequacy when they perceive themselves as unable to meet their expectations or those of others. This internalized frustration can further erode self-esteem and exacerbate feelings of being stuck or unproductive.
Co-occurring conditions often complicate the picture. Anxiety and depression are frequent companions of ADHD in adulthood, particularly when the condition has gone unmanaged or unrecognized. These individuals may also feel regret or loss as they reflect on milestones or opportunities they missed due to their struggles. This can lead to...