The Cruelty of High-Functioning ADHD

A qualitative analysis of women who were diagnosed with ADHD as adults reveals that they spend an average of 2 to 3 years reconstructing their life and building a new identity using the correct “operating manual” for their nervous systems.

This “life reconstruction” often involves a look at the past.

Late Diagnosis: Relief and Grief

Every supposed character flaw — disorganized, forgetful, lazy, uncaring, selfish, being “too much,” being “not enough” — is reconsidered in light of the new information about our different operating system.

Every alleged failure is reframed in light of the support you didn’t receive, or the realization that you were attempting to do things in ways that were never going to work for you.

For women who have spent years bumping up against the limits of systems and frameworks not designed for them, the diagnosis can be a moment of relief. Suddenly, you have explanations — even if you don’t yet have answers.

It’s like realizing you were trying to run Apple’s native programs on a PC. Suddenly you understand why your brain kept glitching out.

But as much as this time can feel liberating, it can also be filled with grief.

Who could I have been with an earlier diagnosis? is a question that can keep many women up at night.

What would I have done differently if I only knew how to work with my nervous system?

Early Diagnosis: Masking and Shame

Early diagnosis doesn’t necessarily mitigate this grief for a life unlived.

I was diagnosed with ADHD in my late 20s, while working as a lawyer. I’m now 50. Although I’ve lived with the knowledge of my ADHD diagnosis for most of my adult life, it’s only been in the past few years that I’ve gained a more thorough understanding of all the ways it impacted my nervous system.

At the time I was diagnosed, ADHD was a stigma. In my workplace — and in my life in general — it was something I had to hide. There was no internet, no TikTok, no Instagram, no Substack conversations. In fact, there was very little in the way of research on women with ADHD.

Not only wasn’t it safe to talk about it publicly, even in private there was little support available.

My own parents were dismissive. From the outset, they dismissed the diagnosis as “clearly wrong” because I wasn’t a fidgety child and I did well in school. Of course, these things are not mutually exclusive.

The result was that, despite the assurance of a diagnosis, I continued to internalize my challenges as character flaws. I masked heavily and created my own hacks and strategies based on what worked for me. I never considered that these solutions might work for others, because I had no conversation with others like me.

I was alone in the trenches, trying to dig through tunnels holding the flashlight and the shovel at the same time.

Capacity Without Support

Meanwhile, I endured the tension of seeing my potential, my capacity, and my intelligence and yet struggling to implement my vision.

This is the cruelty of high-functioning and highly-masked ADHD: your competency becomes evidence against you.

When people around me wrote me off as “lazy,” “not trying hard enough,” or “not wanting to succeed enough,” I believed them — instead of recognizing how I was actually drowning under the weight of expectations and structures that suffocated me but didn’t support me.

The Compound Effect

The compounding effect of these beliefs over years effects its own kind of trauma: shame, grief, disparagement, disappointment, feelings of futility.

These don’t just evaporate in a world that is suddenly speaking more about ADHD. They are ingrained in our identity, and it takes a complete overhaul to rebuild a new identity and perspective.

For me, and other women who masked for years without adequate support systems, the question isn’t who would I have been with an earlier diagnosis but who could I have been (and who could I be) if I could receive the actual support I need?

Without adequate support, structures, and systems, our capacity remains latent.