How Coping With An Adult ADHD Diagnosis Mirrors Stages of Grief
If you’re coping with a new adult ADHD Diagnosis, you may be grieving.
Before we begin, let’s review the Stages of Grief and their origin. A Swiss psychiatrist, Elizabeth Kübler-Ross first introduced her five-stage grief model in her book On Death and Dying. Kübler-Ross’ Model was developed while working with terminally ill patients. Kübler-Ross notes that these stages are not linear and some people may not experience any of them. However, these five stages of grief are the most commonly observed experienced by the grieving population.
FIRST THINGS FIRST
If you’re already an adult before you’re diagnosed with ADHD, take some time to let the dust settle. Although a diagnosis can be helpful and informative, you will do well to take your time as you move through the coping process.
First, it’s important to accept that grieving is a unique and personal process, and it is NOT a one-size-fits-all. In a recent conversation with a past client, she reminded me of the metaphor I had shared with her during Her life transition: “Sometimes, you don’t need to do anything, just be stuck in the goo for awhile – there’s learning there.” And this is the case with a new diagnosis as well.
No one person copes with a new adult ADHD diagnosis the same way. In fact, people pass through different stages and can even loop back to one they already “experienced.” In order to make sense of your new ADHD diagnosis, it’s helpful to review the stages of grief. This helps to normalize and make safe the difficult, sometimes uncomfortable behaviors.
For instance, some people jump right into action to seek their new path to wellness, while others may go through an extended period of isolation, for months to years after the initial diagnosis is confirmed.
What feels abnormal and possibly uncomfortable can, in fact, be considered perfectly healthy when coping with a new adult ADHD diagnosis when you connect the dots with the Stages of Grief.
Stage 1. DISBELIEF & DENIAL
The initial reaction to a new adult ADHD diagnosis is typically disbelief. This can include a feeling of shock. Learning that life-long behaviors and idiosyncrasies are actually symptomatic of this condition can create numbness and flood you with doubt. Disbelief is actually a form of emotional protection and can last for weeks. The time necessary to go move from shock, disbelief, and denial can extend for a very long time. In my practice, I often engage with clients decades after a diagnosis has been medically confirmed. Denial is a type of self-preservation much like a shock.
Denial helps shelter you from feeling the eventual pain of loss associated with your definition of self, and the narrative of your past self. Maybe you’re not lazy, unmotivated, and stupid after all. When you’re in denial, your mind goes into a state of avoidance to side-step pain and real-life consequences. For instance, many diagnosed people may deny that a diagnosis makes any difference, and as a result, try to keep up in a neurotypical world for a long time.
Disbelief and denial can be long-term phases for some. The process is unique to each individual. Denial can be reframed as the stubbornness of the human spirit. The sheer weight of constantly trying to measure up to a neurotypical standard can be exhausting. So, disbelief and denial can seriously affect you and delay your ability to get the help, support and resources that are critical to your success.
Avoidance is common at this stage
Another grieving model known as the 6 R’s was developed by Dr. Rando. His theory of the grieving process focuses 3 grieving phases: avoidance, confrontation, and accommodation. Rando uses the term mourning as an active process requiring 6 distinct tasks to actively deal with feelings and move towards healing.
When coping with your new adult ADHD diagnosis the avoidance phase is when you may be unable or unwilling to fully understand what has happened. Though you might understand the fact that you have this condition, a part of you can still not accept this as reality.
According to Rando, the Avoidance Phase has one task (the first R) Recognize the loss of the pre-diagnosis you, and accepting it and making peace with it..
Stage 2. ANGER
While coping with your new adult ADHD diagnosis, there may be a desire to lash out. You may subtly shift from feeling flat to over-reacting to raging. And, since emotional dysregulation is a hallmark symptom of ADHD, it can feel very powerful to hang out with anger for a while. This phase may strain your relationships. Because of this, it’s imperative to develop coping strategies to release extreme emotions in a healthy manner. Failing to do so may permanently damage ties you have with friends, family, or coworkers. Feeling helpless, lashing out, or placing undue blame on your parents, partner, boss, work culture, or family of origin is part of the passage to acceptance and building your new way forward.
Confrontation is common at this stage
Anger is a reaction that can help you process and embrace all the complex, powerful emotions you may be feeling. It also means acknowledging something known as ‘secondary losses’. For example, you may have thoughts of what you could have been ‘you’ if you had only known about your ADHD diagnosis sooner. These are known as secondary losses for which you may grieve.
So, reacting is Dr. Rando’s 2nd action. Allowing yourself time to REACT to your diagnosis is critical to you moving through the next phases.
As powerful as anger may feel, underneath it may lie some scary emotions such as guilt and shame. As you venture into the full realization of diagnosis numbness may evolve into the true emotional pain and suffering of seeing your past differently. Although some people mask this stage with alcohol or drugs, it only makes things worse in the long run.
Stage 3. BARGAINING
This is better understood as a phase of negotiation. And this occurs when you need an emotional release from stages 1 and 2. This phase involves wrestling with this condition, negotiating, and making sense of it all. This phase often catapults you into trying to live as ‘neuro-normal’ or neurotypical. Many clients come to coaching depleted and exhausted. They claim they’ve been wearing a mask (of sorts), just trying to keep up with expectations, despite this diagnosis.
I often work with the fallout when ADHD adult clients try to pass as neurotypical for extended periods of time. Many people falsely believe they can, if they were able to work harder, effort more, be more ‘productive’, or squeeze another drop out of their brains every minute, then they will magically be more able to cope. However, at some point, you realize that this condition isn’t going to go away. There’s no secret formula, no sneaky all-encompassing app, and no magic medication that will invoke necessary changes ahead. Instead, you’ll endeavor upon your own journey of awareness and self-discovery. You’ll need to discover your own unique solutions that support you to thrive moment by moment in your life. You’ll experiment with ways to pause, notice, and shift your thoughts, behavior, beliefs, resources, habits, boundaries, needs, and agreements.
Recollecting your past self is a necessary action
Recollect and re-experience is Dr. Rando’s third action to take. Recollecting means remembering the ‘you’ prior to diagnosis, the good and bad. These memories and narratives will become important as you create your path forward and hone your moment awareness skills.
Stage 4. DEPRESSION
If you’ve never experienced depression before, you may have a hard time with this stage of coping with an ADHD Adult diagnosis. Full-on depression can be all-encompassing, and while it may seem extreme, there are some close emotional cousins of depression: helplessness, hopelessness, and sadness. Recognize that all are perfectly healthy emotions as you cope with your adult ADHD diagnosis and grieve your pre-diagnosis self.
Guilt and shame often accompany this phase. You may experience a constant internal voice questioning “what might have been.” Or, you may mourne missed opportunities. You may regret never taking that risk, or ending that relationship. During this phase, you may revisit burned bridges or blown-up opportunities from your past. Conversely, you may be aware that undiagnosed ADHD had you taking way too many risks, and instead, be grateful you’ve survived this long!
It’s important to take stock here. You need to experience the full depth of your many emotions when going through this stage. After all the energy expelled and mental anguish of the other stages, depression provides time to go inside yourself to reflect and recover. Taking ample time for yourself to isolate, and cocoon will make it easier to re-enter the world when you are ready.
In this phase, it’s best to avoid people who encourage you to “snap out of it.” You’ll also do well to avoid those who’d ‘love wash’ you and those who will want you to minimize the collateral damage of your diagnosis. But, I’ll caution you to beware of the wolf in sheep’s clothing… You need to feel this. It creates an ending, and this alone is a very important step of closure, necessary for you to move forward.
It’s important to note that many people (especially women) are misdiagnosed and treated for depression way before they’re screened and confirmed with ADHD. So sometimes an adequate and accurate ADHD diagnosis ‘explains so much…’ and those who’ve been misdiagnosed all these years with either depression or anxiety often move through an accelerated grieving process. In some ways, their new adult ADHD diagnosis helps them to feel right-sized and normalized. Therefore they happily move into acceptance and begin resourcing their lives accordingly.
Instead of controlling your emotions, let yourself feel the despair and emptiness – just as you let yourself feel the other stages. When you lean into this phase, you’ll discover a significant period of reflection and recuperation.
Letting go is a necessary action
During this phase, Dr. Rando says you’ll need to take step 4 as you let go and relinquish attachments to the past self. This may sound harsh at first, but ‘relinquishing old attachments’ does not necessarily mean moving on or forgetting your past experiences. It’s a long and very gradual process where you slowly begin to process the impact of your diagnosis and make peace with your past self.
Stage 5. ACCEPTANCE
When you reach the next stage of coping with your adult ADHD diagnosis, depression and other extreme feelings begin to fade away. Many clients stop measuring their lives in terms of self-loathing, sluggishness, and negative symptoms, and notice instead, a general sense of more ease and less pain. Accepting your adult ADHD diagnosis means you can move powerfully toward your new post-diagnosis normal. While we cannot guarantee ultimate happiness, coaching can help you move consciously forward.
An adequate adult ADHD diagnosis will help you to move on and work towards a feeling of normality. After working with a coach, clients rarely feel the same way they did prior to a diagnosis again. Acceptance occurs when you stop looking backward and focus on your future.
The fifth R is to Readjust
Acceptance means you’re moving toward the accommodation phase according to Dr. Rando which means it is all about finding meaning in life again. This doesn’t mean you won’t still have feelings of sadness or longing, but you will be able to have moments of happiness again.
Readjusting can mean becoming more comfortable with your new self, but also accepting who you are now and how you may have changed from who you were prior to diagnosis. You will be feeling more able to cope with day-to-day life within this new phase. And, with support, you can work toward your new normal. That may mean restructuring your personal and work systems, discerning between what is important, limiting exposure to toxic people and relationships, creating plans to address personal, financial, and long-postponed problems, developing strategies for procrastination, avoidance, and distraction. You may even reprioritize and make time for new projects, passions, relationships, a side-hustle or resurrecting hobbies.
Stage 6. DEVELOPING YOUR WAY FORWARD
Although this is not a classic ‘step’ in the grieving process you need to develop your unique way of living so you can thrive. This stage is also seen in the sixth action to take which is reinvesting your emotional energy. Another way to describe this is to take steps to enjoy your life again. This is all about allowing yourself to care about new things and even enjoy your new diagnosis.
During this stage of coping with an adult ADHD diagnosis, some people shift careers, while others deepen their ties to things that matter most. Ideally, your new way forward will help you become more self-aware, trust yourself more deeply, and reclaim your agency. Ideally, you’ll feel more empowered to weigh out your choices, employ your skills and come to trust yourself. Eventually, you’ll fully embrace this diagnosis, and see both the costs and shortcomings as well as your strengths and gifts.
To build a life in which you can thrive, you need to tap into your own judgment. You need to experience contrast, conflict, and difference in order to know what you don’t want. Trust is what brings everything together. This is when you realize and recognize who you are (warts and all) throughout your entire being. Unfortunately, there are no straight, linear steps nor any particular order to this process. Coaching can help you find core realizations and bring your awareness to them in order to pave the way to a more comfortable, integrated path.
An adult ADHD diagnosis can help you get real and create conditions for you to thrive. An ADHD Coach can be a neutral third party to help you cope with your adult ADHD diagnosis. We can work through your grief, emotions, and the ensuing fallout that comes with re-mapping a life. An ADHD Coach can help you express the complex web of feelings you experience and provide helpful tools for dealing with them. And if you are looking for an ADHD Coach, book a complimentary Discovery Call to learn more.