The silent struggles of workers with ADHD

Unlike their neurotypical counterparts, workers with attention-deficit hyperactivity disorder often find themselves left behind.

When Christian got laid off in late 2022, he wasn’t surprised. The 31-year-old, based in New York City, knew he’d fallen behind on his projects as a management consultant, and underperformed with essential job duties.

“I had a tough time grappling with the sorts of executive functioning that our world operates by, like being able to set up meetings, follow through with things, focus and be detail oriented,” he says. His manager had pointed out these failings for months, which is why his termination was hardly shocking.

It’s not that he consciously slacked at work, says Christian – his ADHD got in the way. Christian has been living with the diagnosis of attention-deficit hyperactivity disorder since he was 15. It helped put a name to why he struggles with certain tasks his peers often don’t – the same things that ultimately got him sacked. And while his ADHD was mostly manageable through university, its effects ramped up when he got into the workforce. It’s held him back ever since.

Global data from 2020 estimates the rate of adult ADHD at 2.58% (yet many people remain undiagnosed, especially in minority communities). This means millions experience hurdles like Christian’s – and some don’t even know why. But even for people who do have a label for their struggles, a diagnosis isn’t necessarily a fix; many workers with ADHD experience challenges that can inhibit success. And whether they reveal their issues to managers or keep them private, the effects of ADHD follow them around in their careers, affecting their job security, career options, work relationships and even how they feel about themselves.

Yet as ADHD diagnoses tick up, so too has awareness – and this can help contextualise these workers’ struggles for both colleagues and employers, and potentially illuminate new pathways for support.

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More than ‘kids who fidget’

ADHD is not just about oft-stereotyped ‘squirmy’ kids and people who get distracted easily, says Texas-based Tracy Winter, an executive and leadership coach at Nerd Coach, who specialises in neurodiversity. Instead, ADHD is a complex neurodevelopmental disorder, which manifests in diverse symptoms and behaviours (though the word ‘disorder’ is controversial, points out Winter, who also has ADHD; she prefers to look at it as a “different kind of brain”). The ADHD brain isn’t necessarily flighty, she explains – anatomically, it structurally looks different and functions differently. 

People with ADHD each experience its effects diversely, says Henry Shelford, chairperson and co-founder of charity ADHD UK, and there’s no way to know how it’ll appear in someone’s life. Some struggle with being on time, or keep a desk that looks like something exploded, for instance; others are neat as a pin and always punctual, yet can’t stop themselves from interrupting in conversation. Some people, says Winter, only tend to do what they’re interested in – “what lights up our brains” – which causes them to de-prioritise other urgent tasks.

Its effects in the workplace can be particularly acute, where norms around behaviour and processes can drive bosses to label ADHD employees lazy, disengaged or incapable. “ADHD traits can be really badly misinterpreted,” says Shelford. “If I struggle with timeliness, you’re going to think I don’t care about my job. If I forget something, you might just conclude I’m dumb.” 

Beyond bosses’ perceptions, often, these workplace struggles can make workers with ADHD judge themselves, too, causing damaging emotional impacts.

Rebecca Phillips Epstein, a television writer and essayist who was recently diagnosed with ADHD, struggled constantly in her early career to show up to meetings prepared and on time as well as hit deadlines. The issues only compounded as she climbed the career ladder. And while she could usually manage on the fly, she says she felt terrible constantly existing on the edge of failure. 

“As I got older, the world got bigger… I started to slip, and I started to struggle,” explains Epstein, now 37. Epstein felt she “should be able to do what everyone else can do”, so she wound up “torturing” herself, balancing perfectionism with a feeling of being incapable of performing as expected. 

Christian, too, has been down on himself, despite knowing he’s neurodivergent (someone whose brain differences affect how their brain works). “There’s a whole element of shame and guilt,” he says. “[Your behaviours] start to close doors of opportunity, and then those doors are shut … When I just forget or stall something until last minute, I start to go down the spiral. ‘Why couldn't I do this? Why aren't I good enough? Why can't I do what this person could do?’”

This self-judgement is one of the problematic knock-on effects that can send people with ADHD into negative emotional states. “There can be an element of, like, ‘why bother, when I'm not going to do it right? I'm just going to get [a] negative response’, says Winter. This can trigger a common reaction of “rejection sensitivity dysphoria” , which she says “is a much deeper feeling of rejection at a critique” – one that can erode self-confidence and emotional wellbeing. And although rejection sensitivity is not unique to people with ADHD, it can be exacerbated in people with the condition.

The problem with ‘masking’

Often, people with ADHD are uneasy about asking for help, because it means announcing their diagnosis.

The stigma of ADHD is still very present – it can be viewed as a condition for children, or something that isn’t much of a challenge. “There are plenty of people still out there who don't believe in ADHD,” says Winter. This can lead to scepticism of the idea that some people’s brains function differently as a result.

Many workers instead engage in “masking” to compensate. “It’s an idea of ‘who do I need to present as to be accepted?’ … restraining oneself from a lot of natural impulses” just to fit in with colleagues, she says. Masking can be effective for a short period of time, but it is rarely sustainable and often depleting. “It’s almost like minimising your own identity to conform with social norms … It’s uncomfortable, and it’s exhausting, and if you do it enough, you can lose track of who is behind the mask.”

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For workers who do come forward about their diagnoses, however, the conversation can be risky. In some situations, asking for accommodations – like fewer meetings or different working hours – may spur bosses and colleagues to view them as difficult to work with, or not cut out for the workflow of a team.

That’s what Kim To found when she worked in finance in London in her early 20s – a position she thought of as a dream job. But, she says, “I was crying every single day.” She was so tired from masking, she became overwhelmed.

To help her succeed, she asked her boss for bits of help – an assistive app for grammar and spelling, and the ability to work from home away from distractions. But her requests were met with corporate consternation. When she tried to work around her challenges by creating her own systems, spreadsheets and schedules that other colleagues didn’t use, she says people would tell her that she was “just making excuses” for why she couldn’t perform like everyone else, or needed special treatment.

Eventually, To stopped asking for accommodations, and tried to function like her colleagues. But this didn’t work, either. “People would observe me and think ‘oh, she’s not really cut out for this industry’, she says. “It wasn’t so much the workflow. I was actually very good at the work and I liked the work. It was because I was constantly trying to conform.” She ultimately had a breakdown, and left the world of finance. During the next five years, she began and quit several more jobs, always finding herself out of place. Although she didn’t have an ADHD diagnosis at the time, she now realises her executive-function disorder was at the core of her struggles.

Even for high performers, some bosses may question the need to provide accommodations, says Winter: “If [managers] don't see where the challenges are, why would they do anything to address them?” But, in many cases, she says a worker’s strong performance may come from masking to ultimately detrimental effects. 

Forward steps

Workers with ADHD will almost always have challenges in the workplace, even if they are able to work with understanding and accommodating bosses, or get the assistive tools they request. But things may be looking up, at least in part. 

As ADHD diagnoses have increased in the past decade, Sheldon says this knowledge has enabled more people to seek help from their employers. Some managers may also be more open due to rising awareness – in some cases, as some see diagnoses within their own families, says Winter.

Plus, the pursuit of a more accommodating workplace has had an unlikely hero: Covid-19. Prior to the pandemic, working flexibly was rare, and it was difficult for all employees to make the personal adjustments that could help them succeed. Now, far more people have autonomy over how and where they do their jobs. So, as work cultures begin to become more adaptable than they once were, managers are increasingly aware workers can thrive in untraditional work cultures – something that can be particularly helpful for people with ADHD. 

Of course, educating employers and making workplaces more inclusive is important, too. Now 28, To has become a coach and speaker who works with both employees and corporations to bring awareness to the challenges and strengths of people with ADHD. She says neurodiversity training and workplace adjustments benefit everyone.

“People think accommodations need to cost a lot of money. A lot don’t cost anything at all,” she says. These adjustments can be software changes that help make screens more readable, providing quiet space where interruptions are limited or observing strict calendar or meeting boundaries to avoid unexpected disruption. To also believes employers need to stop thinking of these accommodations as favours for workers. “You’re not giving someone an unfair advantage. You’re just giving people choice. And giving people choice means better outcomes.”

In the meantime, however, workers with ADHD may be on the back foot, especially if they’re not in an environment with supportive management.

As for Christian, he’s secured a new job. But he’s fully aware he’ll be up against the same challenges he experienced in his last role. “Ultimately, we live in a world where we're judged by the things that most neurotypical people have an easy time doing, but neurodivergent [people] have a much more challenging time doing,” he says. “And that's going to be the case whether I'm in manufacturing, or coding or selling. It doesn't matter.”

Christian’s surname is being withheld for job-security concerns