Welcome to 2023

Welcome to 2023

It's a New Year! Let's see what 2023 has to bring! This is something I have been hearing and contemplating myself this month. These statements may bring up a feeling of hopefulness and/or feelings of despair and anxiety. Uncertainty about the future is something that makes us all feel uncomfortable to some degree, but at times we welcome change and new challenges. Having hope allows us to believe that things can happen, that what might be tough, challenging or mundane now may not always be the case.

the last few years we have seen much change, unexpected and expected, and yet we endure and continue. The New Year is can be like a reset, another chance to make changes, big and small, and so I say let us tell despair, anxiety and uncertainty I see you, I understand why you are there and I choose to make space for hope for good things to come.

When I work with clients struggling with uncertainty, I incorporate the following tips:

  1. Show some self-compassion - Often when we think of compassion, showing kindness and being empathic towards others tend to come to mind. Kindness and warmth are really important aspects of compassion, but compassion also encompasses strength, knowing that we have capacity to endure and be resilient. Compassion also includes wisdom and responsibility, which takes into consideration our past experiences and the learning we obtained from them, allowing us to use our knowledge and experience to prepare us for new events. These ideas come from Paul Gilbert's Compassion-Focused Therapy, which I also use with people struggling with self-criticism, shame, guilt and perfectionism.

  2. Be a Friend to Yourself (and take your own advice) - We are often better at giving others advice and shy away from taking our own. I sometimes ask my clients what they would tell a friend in this situation or ask them if a friend of theirs were having the same challenges, how they would feel towards them. This is still along the lines of showing self-compassion.

  3. Develop New Skills/Engage in New Activities - When we are struggling with uncertainty we sometimes struggle with our self-esteem and confidence. Learning a new skill or finding a new hobby can allow us to see that we capable and may provide us with a renewed sense of purpose and drive.

  4. Reflect on Past Achievements - We are all good at something, but often we forget this and I am forever pointing out to others that they are good at particular things and reminding them of past achievements. Write down what you are good at, perhaps including feedback you have received, and write down your achievements. This activity does not call for humility but is a practical and helpful way of reminding you that you are capable and that your abilities are helpful to you and others.

  5. Do not ruminate on things you cannot control - What is keeping you up at night? The mind is a wanderer by nature; however, we need to give it some focus and boundaries at times. It is important to take note of what is worrying us. Writing down our worries helps us to consider if particular worries are calling action. For instance, we have been putting off making an appointment to see our GP for a health concern which is getting worse. However, often we worry about things we cannot control, such as the actions of others or whether or not something terrible might happen.

  6. Power Map (Take control over what you can) - This refers to a visual tool used in work environments or to organise social change; however, we can use this tool for ourselves by noting down and circling our worries or challenges and then creating two columns, first column things we can control and second column thing we cannot control. The idea of this is to focus our effort on things we can control to bring about help change that may empower us.

  7. Engage in Self-Care - Do things that bring you pleasure and are rewarding. This may be a mixture of resetting and energetic activities as well as more relaxing and soothing activities. Self-care also includes all of the tips mentioned here.

  8. Seek Support from Trusted Others- Lean on those who you trust and can confide in. We all need support and advice at times.

  9. Breathe (Ground yourself) - If you find yourself feeling overwhelmed by stress, worry and uncertainty, brrrreeeeeeeethe, whilst focusing on what you can see, hear, feel, taste and smell. Do this for at least 5 minutes.

  10. Ask for Help (You are not alone) - If you are struggling with stress, anxiety and managing uncertainty, seek help. Therapy (and self-help material) can help you put these tips and more into practice.

So, I have ADHD! What now?

The road to receiving a diagnosis of any type can be anxiety-provoking for most of us and receiving a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is the same. Many adults I work with express feeling a mixture of relief, validation and empowerment. For some others, they additionally experience feelings of anti-climax and ambiguity, which can be surprising for them. It is important to know that there is no correct way to feel. Also, if you are told that you do not meet the criteria for a diagnosis of ADHD, but have traits, you may share similar feelings to those who do, but you may also be left feeling confused and disappointed.

If you have received a diagnosis of ADHD (or have many traits), here are some tips I give to and receive from my clients:

  1. You are still the same person. Of course, you know this on some level, but oftentimes there is hope that a diagnosis, particularly of a neurodevelopmental condition (a condition you are born which affects the way your brain learns and processes information) made in adulthood, may bring about a change in you. This may of course occur in time, but perhaps not immediately. For some of my clients, they begin to carefully consider who they may share the news of their diagnosis with and the impact this might have on some relationships.

  2. Learn as much as you can about ADHD. You may have already carried out lots of research on what ADHD is; however, after receiving a diagnosis, hopefully receiving a report outlining areas of strength and challenge, you may feel the need to review the literature as it pertains to you. Often learning about ourselves and our needs are closely related to the idea that knowledge is power. As you learn about your strengths (or superpowers, as some of my clients refer to their strengths as) and challenges this may provide you with a sense of agency (i.e., some control over your actions and, sometimes, unintended consequences).

  3. Learn, but pace yourself. Rome was not built in a day, right? Many of my clients have reported wanting to learn as much as possible about ADHD. This is understandable and helpful. However, be aware that you should not hyperfocus on this. As you learn about ADHD, ADHD hyperfocus refers to an intense fixation on an interest or activity for an extended period of time. Pace yourself with the learning, as you will need time to process all that you read or discuss with others. Some things you learn will absolutely fit with your experiences and you may shout “That's so me!”. However, some things may bring to mind painful and challenging experiences you have had in the past or recently whereby you may feel angry, disappointed, guilty or sad. Be compassionate towards yourself, none of us are perfect and many of us do and say things without realising the consequences, right? I have had someone close to me say that they did not realise they interrupted others often and that people found this to be rude or arrogant. We talked about it being so hard having an idea in your head and being unable to share it immediately, particularly if you are feeling emotional about whatever is being discussed.

  4. Who to tell. Information about yourself is personal and we are selective with what we choose to share with others. For some people, their family and/or partners are the first people with whom they share news of their diagnosis. However, for others, they do not feel ready to share the news with anyone straight away, feeling that they need time to process it first. Sometimes, you may feel more comfortable sharing the news with friends or trusted colleagues because they may give you the support you require. These days, many of my clients and people I know join various forums (some of which I'll list below) because they want to learn from and share with those with lived experience of ADHD. This makes good sense and I highly recommend this.

  5. Journalling. I ask many of my clients with and without a diagnosis of ADHD to journal. Sometimes this may be carried out in a natural and unstructured way as you would write in a diary, perhaps detailing your thoughts and feelings in connection to recent events. Doing this may be cathartic (i.e., bring psychological relief by openly expressing strong emotions). Sometimes, I ask people to journal in other ways. For instance, to log their daily activities so that they can see what it is they are doing daily and across the week. I then ask them to rate out of 10 the amount of pleasure and sense of achievement they got from the activities they carried out. This sometimes helps me help my clients re-jig, introduce, stop or reduce certain activities to improve mood, reduce anxiety and provide them with some agency. I also provide some of my clients with a structured template called a Thought Record to complete if they have distressing or negative thoughts about themselves. They use this record to challenge negative thoughts and find more helpful and compassionate ways of viewing themselves and/or the situations in which they find themselves.

  6. Find safe spaces and people with whom you can be yourself. We all need this, right? For some, as you get older, having gone through childhood, adolescence or perhaps early adulthood, you have learned we cannot please everyone and there are things that bring us pleasure which others (sometimes those closest to us) don't find pleasurable. I often say to people that there are some contexts we have to try and manage being in (e.g., school, college, university, work, family events etc.), which can be challenging, and there are others we can be in with little to no effort, in terms of monitoring our performance, functioning or interaction with others. As we learn to start accepting aspects of ourselves, we may begin to feel comfortable making informed choices about with whom and where we spend our time. I like to say, we have to try and get in where we fit in. This can help improve our mood, self-esteem and tune into our superpowers/strengths. Joining forums and online support groups can meet this need, particularly if meeting with others face-to-face or accessing activities is not immediately accessible. You may have also come across the term Rejection sensitive dysphoria (RSD), which refers to times when you experience severe emotional pain because of a failure or feeling rejected. RSD has been associated with ADHD and is an experience many of my clients and people I know described before I came across the term. The ideas expressed above may be helpful, at least in part, in addressing this.

  7. Self-care. This is something we all hear a lot about. Look after yourself, as this improves wellbeing. Many people I know and see in therapy say things like: “I look after myself extremely well, I eat well, exercise and meditate”, “I try and take a little time for myself as well as meet up with friends regularly”, “That sounds nice, pity I don't have time for that... too busy working and caring for others”. Self-care, for me, should incorporate biological, psychological and social components. Therefore, could include the following:
    Biological - Thinking about what we put in our bodies and what we do with them e.g., attending to our diet, exercising and being mindful about medications and substances we use and how they can impact on us physically, psychologically and socially.
    Psychological - Taking note of our strengths and qualities are important for self-care and overall wellbeing. Sometimes reading, listening to podcasts, watching inspirational/motivational videos as well as noting down affirmations and positive statements can help us with this. In addition, taking time out to do things that bring us pleasure in conjunction with having down time or alone time is important as this protects us from feeling overwhelmed and allow us to re-energise so that we can function well.
  8. Social - Spending time with our partners, family and friends is important for many reasons, but mainly because it provides us with a sense of belonging. Also, ensuring we have time outdoors so that we can interact with others is also beneficial to our health, which is something we have all learned following the pandemic where many of us worked remotely from home. Of note, many of us use social media; however, I am mindful that monitoring and/or reducing this may be important for some who spend hours on end in their “spare time” online. This is not to say social media isn't good, as it does allow us to connect with others more readily and meets our need for learning, development, entertainment and contact. However, it might be taking you away from spending time with significant others or doing a range of other activities. With all of this, self-care allows us to think, feel and function better for ourselves and others we care about and work with.

  9. Therapy and self-help material is available. For some people who have been struggling prior to receiving a diagnosis of ADHD and continue to do so, therapy is available as well as self-help resources. Some clients access therapy or counselling to help them adjust to receiving a diagnosis and use the space to think about what they have learned about ADHD and what this means for them. Others come to therapy because that are struggling with managing day-to-day due to:
    - Feeling low in mood,
    - Feeling anxious, generally and/or in social situations
    - Difficulty structuring their day, as they constantly feel overwhelmed and/or lose time to procrastination.
    - Difficulty regulating their emotions and challenges with relationships.

ADDISS: Charity providing information and resources about ADHD for parents, sufferers, teachers and health professionals.
Adders: Attention Deficit/Hyperactivity Disorder Online information service.

UK Adult ADHD Network: Professional body that aims to support practitioners in rolling out the NICE clinical guideline 72 and establish clinical services for adults in the UK.



Reddit: ADHD & ADHD Women

AADD-UK's: Peer-to-Peer Forum

PsychForums: Attention Deficit Hyperactivity Disorder forum

Publications & Books:

NICE (2018). Attention deficit hyperactivity disorder: diagnosis and management. London:

ADHD in Adults: A Psychological Guide to Practice: Susan Young and Jessica Bramham: a cognitive behavioural model of understanding ADHD - accompanied by a website.

Driven to Distraction: Ed Hallowell & John Ratey: a book written by two American psychiatrists who themselves have ADHD.

ADD and Success: Lynn Weiss: a book about successful people with ADD - “understanding and embracing your ADD character to help you to lead a more enjoyable and productive life”.

You mean I'm not Lazy, Stupid or Crazy: A Self-Help Book for Adults with Attention Deficit Disorder: Kate Kelly & Peggy Ramundo: A book by ADD adults for ADD adults, practical help and moral support to adults who are struggling to understand themselves.

How to succeed as a Hunter in a Farmer's World. Thom Hartmann - a book exploring the evolutionary theories behind ADHD and why people with ADHD feel out of place in the modern world.

Fast Minds - How to thrive if you have ADHD (or think you have): Craig Surman, Tim Bilkey Karen Weintraub.