written by William Pellegrini

Therapy is difficult. That might be the most important lesson I have learned in my time as a

professional mental health counselor. I can see the stress and anxiety written on the faces of

every new client as they begin to tell me what has been making their lives so difficult. I want

them to believe that everything is going to work out and that we will find an answer. However,

it takes time for them to discover this for themselves. This is an especially hard realization for

those that have been suffering with ADHD and never knew this was the condition that has been

agitating them for so long. They come to therapy, summoning as much hope as they can muster

and await some sort of clarity that might give them an idea of how they can manage their lives

and maybe even get a diagnosis that makes sense and has some path to recovery. It’s when

they get that diagnosis that the real journey begins.

I do need to set the record straight; I do not diagnose people with ADHD. I specialize in its

treatment, but I don’t have a PsyD or a PhD, so ADHD is one diagnosis I cannot give. However,

that does not stop me from going over every symptom they experience as a basis to refer them

to a psychiatrist for diagnosis. It’s when they finally receive the diagnosis that I see a pattern

begin. I call it the Phases of ADHD Realization.

When a client comes back with a diagnosis, almost every one of them reacts in the same way.

This is a major life event and it sets them on a path that I recognize and have identified as the

following.

First is Phase One: Excitement/Relief. Both of these words are an understatement. I have

witnessed people expressing themselves in a range that goes from absolute relief to outright

ecstasy. What’s more, they almost all say the same thing. “I had no idea ADHD affected so

much of my life!”

Their reactions are not unusual. The majority of people who have ADHD actually have very little

education on just how deeply the condition affects their daily lives. Most people have a cursory

knowledge of the disorder, but typically apply some form of pop psychology to treat their

symptoms and over-generalize them. This becomes a problem because they overlook so much

of how their executive functions are affected. Additionally, many people who do not

understand, believe or accept the diagnosis for whatever reasons will judge those who have

been diagnosed. So, these poor souls simply avoid the topic for fear it will only create more

criticism in their lives. They already have enough. This newfound delight is a welcome repose

from the ignorance they have suffered. Unfortunately, it is also rather short lived. This leads

them into Phase #2.

The next Phase is Investigation. They finally have an answer as to what is going on and where

their lives have been distorted from the norm. Now, they need to know more about this

unwelcome distortion of their brains so they can learn how to negotiate life under the ruleset

they should have been following all along. However, what usually happens is that they find a

group or congregation of fellow neuro-divergent with whom they share stories, experiences,

and information. While this is healthy and positive, learning new and information and

education involving the details of the disorder are neglected in lieu of comradery and

connecting with peers that actually understand. It is necessary to find a sense of community,

but it is also essential to further understand the disorder and its impact on life. This phase like

the first one is also rather short lived and leads rapidly to Phase #3.

The third Phase is Frustration. Many of my clients find themselves spending the most time in

this phase. Those that come into therapy already armed with an ADHD diagnosis have likely

been in this Phase for quite some time. When they are finally able to articulate their frustration,

the number one statement I hear is, “I don’t know how to make this stop.” Clients who have

recently been diagnosed usually are able to manage this stage productively and rapidly. The

issue all individuals with a diagnosis have to face is that the disorder is permanent, ongoing,

and relentless. I realize how daunting that might sound, but the reality of ADHD can be harsh. It

is a hereditary physical malady that pervasively invades each aspect of a person’s life

throughout their lifetime. The element about this disorder that causes the most frustration for

those afflicted and undereducated is that there is no escape, no breaks, no cure. When this

realization hits, the results can be exhaustingly clear. This disorder is never going to stop

distracting and misdirecting their minds and lives. They find themselves feeling hopeless and

helpless. This is where co-occurring disorders such as depression and anxiety begin to play their

roles. They become misguided in their beliefs about the future they face and tend to believe

those that know less than they do. Luckily, these beliefs are not difficult to refute with the right

guidance and education. Once they find themselves on a path to awareness and management,

they enter the next Phase.

After learning all they have regarding their disorder, the neuro-divergent now finds themselves

in Phase #4, acceptance. Now, it will be important to understand this period is difficult to

recognize and can typically be the final destination for most. At this point, the individual has

discovered an issue that has plagued them most of their days. They come to realize that the

disorder is the reason for a great number of impediments they currently suffer, have discovered

a group of people that understand their anguish, discovered a larger group of people that do

not accept their disorder as a reason for their struggles, and recognized that this issue is never

going to stop nor go away. However, they have now learned more about how it is affecting

them and that there are methods, medicinal and otherwise, in which they can manage and

even overcome some aspects of the disorder. By now, they have accepted the disorder and its

effects on them. They also have come to terms with the fact that not everyone is going to

understand what they are suffering. What’s more, some of those have a negative opinion about

them as a person as though they actually personify the disorder. The important take away from

all of this is that they do not take it personally. They have dropped their expectations of the

general public and accepted that most people will not get it. Therefore, they have found a

semblance of peace about their ADHD and no longer judge themselves based on outside

opinions.

This is commonly the point in which the growth and progress stops for most neuro-divergent.

From here, they have created patterns, habits, and processes that assist them in managing the

symptoms they once found unbearably oppressive. They have found a way to let go of their

inner turmoil and find acceptance where it is available. However, some of them become so

involved in the forward motion of the disorder they find themselves becoming advocates. They

speak out in defense and understanding, looking to motivate and inspire others to understand

themselves the same way. These are the one’s that find themselves moving to the final stage,

Phase 5.

This Phase is the application stage. They not only understand their disorder, they have

exhaustively researched it, identified areas that were once completely misunderstood or even

overlooked, and take steps to apply that education in their lives. Their motives are to use their

disorder in ways that can actually help them instead of always looking at it as a hinderance that

must be endured. They find the areas where their disorder is actually a strength and then utilize

it accordingly. Basically, they develop their superpower. What is even more impressive is that

these champions of the ADHD look to empower those they know suffer in silence. They give

them a voice, a direction, and hope. All in all, their true motivation is to let others know they

are not alone. They bring them something that becomes all to rare in the lives of those

diagnosed with ADHD, they give them a friend.