10 Things About ADHD I Wish I Knew Before My Diagnosis

When I first decided to pursue an ADHD diagnosis, I called a psychiatrist in my insurance network to make an appointment. Before he even scheduled me for a consultation, he ran through an unofficial screening right there on the phone.

He asked about my level of education. I told him I had my doctorate. He asked about my profession. I told him I was a professor. He asked if I was married. I said yes.

After all three answers, he laughed and said, “There’s no way you have ADHD.”

He actually laughed out loud.

That moment — that laugh — was my very first introduction to what it’s like to be an adult woman seeking an ADHD diagnosis and accommodations. And ten years later, I have a lot I wish I could tell that version of myself.

That’s what this episode (and post) is all about.

Listen to the episode above or stream it on your favorite podcasting app. Prefer to read? No problem! Keep scrolling for the full blog post.

Want to learn more about navigating the complexity of an ADHD brain? Check out this post on 3 key lessons from an ADHD diagnosis.

Episode 348: 10 Things About ADHD I Wish I Knew Before My Diagnosis (Transcript)

Why I Wrote a Letter to My Newly Diagnosed Self

If you’re on my email list, The Awesome Edit, you know that last week was my birthday. And around my birthday, I tend to do quite a bit of reflecting. This year, the reflection kept circling back to one thing: it has now been ten years since my ADHD diagnosis.

I’ve been thinking about that phone call with the psychologist, the injustice I felt, and honestly? I’m proud of that past version of me for standing firm in her experience when this perceived “authority figure” literally laughed at her. She was busy being awesome.

Last week, in episode 347, we explored why time management is not the most important piece when it comes to getting things done with an ADHD brain — at least not in a sustainable way. This week, I want to build on that and take it further. Because as I sat with all of these reflections around the 10-year anniversary of my diagnosis, I realized I had so much more I wanted to say to that version of me in 2016.

So today, I’m writing a letter to my newly diagnosed self. I’m sharing ten things I wish I could go back and tell her — the things I wish someone had told me when I was just starting this journey.

Whether you were diagnosed ten years ago, ten months ago, or you’re still figuring things out, I think many of these messages are ones we all need to hear at different points along the way.

Some of what I’m sharing is more tactical — the brain science and executive function pieces that would have saved me years of confusion and self-blame. And some of it goes deeper, into the identity and self-concept shifts that changed everything.

Here are the ten things I’d tell myself ten years ago.

Lesson 1: It Makes Sense Why You Keep Falling Asleep…Your Brain Is Understimulated

The first thing I’d tell that version of me from ten years ago is this: the reason you fall asleep every single time you try to read an academic article, drive long distances, or sit through anything that doesn’t have a clear narrative pulling you in is not because you aren’t getting enough sleep.

Your brain is understimulated.

I can’t tell you how many times I shamed myself for this. I would think, “I need to go to bed earlier. I need more discipline. I need to try harder to pay attention.” It didn’t matter what time of day it was. I could have just woken up. I could have had three cups of coffee followed by a Diet Mountain Dew — which was practically its own food group for me at that point. And I would still fall asleep the moment I opened some dense academic reading that didn’t grab me.

The truth is, it was a stimulation problem. My brain literally did not have enough stimulation to stay awake. And once I understood that, I could finally stop blaming myself for something that was never a character flaw in the first place.

If you relate to this, if you’ve been telling yourself that you just need to “try harder” to stay engaged, I want to offer that it might not be about effort at all. It might be about how your brain is wired. And that distinction matters, because one path leads to shame and the other leads to actual solutions.

Lesson 2: Meds Will Help, but Pills Don’t Teach Skills

The second thing I’d tell myself is about medication. And I want to be clear: medication has been incredibly helpful for me. I am so grateful for my prescription, especially because I know not all bodies respond to medication in the same way. That’s why it’s so important to find a supportive doctor who will iterate with you to discover the right balance. I take meds myself, and I am not anti-medication in any way.

Here’s what happened, though. When I got my diagnosis, I was essentially handed a prescription and a “good luck.” That was it. No guidance on building skills, no conversation about how ADHD actually shows up in daily life, no coaching, no next steps beyond the pill.

So I took my meds and expected them to fix things. And in some ways, they did help. But what I found was that without the skills piece — without learning how to work with my ADHD brain — the medication mostly made me really, really good at focusing on whatever was already in front of me. Which, more often than not in 2016, was a Pinterest rabbit hole.

What I wish someone had told me is that the meds are a powerful tool in the toolbox, but not an all-in-one solution. At least not for me. I also needed to build my skills around intentional focus, supporting transitions, emotional regulation, working memory — all of these areas where our brains need extra scaffolding.

Medication can help quiet some of the noise. It can make it easier to access the strategies. But it can’t teach you the strategies. That’s where the real work comes in. And I don’t say “work” to make it sound heavy. I actually find it really empowering. Because once you start learning how your brain operates and what it actually needs, you get to build a toolkit that’s genuinely yours. And that changes everything.

Lesson 3: Cognitive Flexibility Is Going to Explain a Lot

If I could go back and tell myself one thing that would have immediately lowered my frustration levels and negative self-talk by about 50%, it would be this: you struggle with cognitive flexibility, and that is completely normal for an ADHD brain.

You know that feeling when plans change and it completely throws you? Or when someone interrupts you while you’re in the middle of something and you get so irritated, even when you know intellectually that it’s not a big deal? Or when you’re deep in hyperfocus and someone asks you to shift to something else and your whole system kind of revolts?

That’s cognitive flexibility — or rather, our inflexibility. It’s our brain’s ability (or struggle) to shift between tasks, adjust to new information, and transition from one thing to the next. And for some ADHD brains and AuDHD brains, this is genuinely hard.

I spent so many years thinking I was just inflexible as a person. That I was being difficult or rigid or dramatic when things didn’t go according to plan. But that’s not what was happening. My brain was working overtime just to make the shift, and I didn’t have the tools or the understanding to support myself through it.

Here’s what I’d tell past me: give yourself more transition time. Build in buffers. When you can, make the plans yourself so you’re not sitting in waiting mode (which is its own special kind of torture). And when plans do inevitably change, give yourself space to actually process the shift. You deserve that space. It’s not being dramatic — it’s honoring how your brain works.

Ten years later, it’s still hard sometimes. But it is so much better. And most of that progress came from simply understanding what was happening and giving myself permission to need a minute to make the shift.

Lesson 4: Needing Notes Is Not a Sign of Low Intelligence. It’s a Working Memory Thing

This one is really personal for me, and I want to take a minute with it because I think it might resonate with a lot of you.

For years, I was deeply ashamed that I couldn’t do what I saw my colleagues do — just stand up and lecture brilliantly off the top of their heads, pontificating in grand lecture halls without a single note in front of them.

I couldn’t do that. If I tried, I would lose my words entirely, forget key points, go completely off track. So I wrote out my lectures. Every one of them. Detailed notes, bullet points, the whole thing. And I was so embarrassed about it.

What I didn’t understand at the time was that this had nothing to do with intelligence and everything to do with working memory. Working memory is essentially your brain’s ability to hold information in mind while you’re using it. And for ADHD brains, that capacity is often more limited. The knowledge is there — our brains just have a harder time accessing and holding onto it in real time.

Once I understood that, everything shifted. I stopped fighting the notes and started leaning into them. And you know what? My lectures were actually better because of them. They were clearer, more organized, more actionable. My students got a more focused experience.

I want to pull back the curtain for a second, too, because if anyone is listening to this podcast thinking, “Well, she can just talk through all of these ideas off the top of her head” — that’s not what’s happening. For nearly every one of my episodes, I write the whole thing out. I have a literal teleprompter that I use.

The real transformation came when I stopped telling myself I should be able to do it like everyone else. When I dropped that story, I was able to do it my way — and actually enjoy the process. Whatever your version of “using notes” is — checklists at work, embracing your chronotype, setting elaborate reminders on your phone, alarms for everything — let it be okay. Let it be more than okay. Let it be a powerful way you understand and support yourself.

Lesson 5: It Makes Sense Why You’re So Exhausted You’re Masking Constantly

Speaking of being tired all the time… past me, I need you to hear this: the reason you are so completely drained at the end of every day, especially after long days at the office, teaching, and being around colleagues, is because you are constantly masking.

Your approach to learning, communicating, processing, and people-ing generally is so different from how most of the people around you at the university operate. And you spend all of this energy trying to match their pace, their style, their way of doing things. You’re performing “normal” all day long, and it is exhausting.

Here’s the part that might sting a little: they’re not your people. Not all of them, anyway. And that’s okay. You don’t have to force it quite so much. You don’t have to work so hard to fit into a space that wasn’t designed for how your brain works.

I also want to say — and this is important — it changes. It genuinely gets better. Not because the masking magically disappears overnight, but because over time, you start to recognize when you’re doing it. You start to find spaces and people where you don’t have to perform. You build a life and a business where you can actually show up as yourself. And the difference in your energy when that starts to happen is remarkable.

So if you’re in that season right now where you come home and just collapse, where you feel like you’ve been running a marathon just from being around people all day — it makes complete sense. That exhaustion is real. And it won’t always feel this heavy.

Lesson 6: Some People Will Doubt Your Diagnosis. Trust Yourself Anyway

That psychologist who laughed at me on the phone? He wasn’t the last person to react that way. Over the years, I’ve had colleagues, acquaintances, and even people I’d consider friends who, in one way or another, communicated that they didn’t quite buy it. They’d say things like, “But you’ve done so much,” or “You don’t seem like you have ADHD,” or, “Isn’t everyone a little ADHD these days?”

For a while, that really got to me. Because here’s the thing about high-achieving adults with ADHD: we’ve spent our entire lives building systems and strategies to hold it together. We’ve learned to mask so well that from the outside, it doesn’t look like anything is off. So when someone says, “You don’t seem like you have ADHD,” what they’re really saying is, “Your mask is working.”

But your experience is what matters. What you’re living with every single day — the internal chaos, the exhaustion, the constant effort it takes to do things that seem effortless for other people — that’s real. And no one else gets to decide whether your experience is valid.

Past me, here’s what I’d say: some people are going to doubt this, and it makes sense. You don’t fit the stereotypical mold. You’re not the school-age little boy who can’t sit still. Your ADHD doesn’t look the way most people expect it to look. And that’s okay. You don’t need their understanding to trust your own experience. Let their doubt be about them and their limited understanding of ADHD — not about your reality.

If you want to explore this topic further, this post on accepting your ADHD diagnosis dives deep into the process.

Lesson 7: That Shame Spiral Has a Name: It’s Called Rejection Sensitivity

Number seven. Past me, I need to tell you about something called rejection sensitivity, because it’s going to explain so much of what you’re going through right now.

At this point in my life, I had submitted my book manuscript to a university press. It went through single-blind peer review, which meant the reviewers knew exactly who I was, but I had no idea who they were. (Already feels like a cruel setup.)

I got feedback from two reviewers. Reader A gave thoughtful, constructive comments — the kind of feedback that actually helps you make the work better. Reader B? Reader B made it personal. They poked at insecurities. They essentially wanted me to write a different book.

And I couldn’t touch those revisions for over a year. Every time I even thought about opening that document, my whole body tightened up and I just… couldn’t.

That wasn’t procrastination in the way I thought it was. Reader B’s feedback landed right on my deepest insecurities, and my brain turned it into a shame spiral that kept me frozen for twelve months.

This is rejection sensitivity. Many ADHD brains experience emotional responses to perceived and actual criticism or rejection in a really big way. We feel it so intensely in our bodies. And sometimes our brain amplifies something that wasn’t even intended as criticism, but we still feel it that way. Either way, the emotional response is very real and very intense.

Naming this pattern won’t make it disappear. But understanding what’s happening can help you notice when you’re in it. And when we start noticing and naming it, that’s when we can bring in supports to move through it instead of staying stuck.

Lesson 8: 31 Years of Patterns Won’t Change in 31 Days. Give Yourself a Minute

Here’s something your brain is going to offer you over and over in the coming years: “I know what to do, I’m just not doing it.”

That thought is going to feel so heavy. And every time it shows up, it’s going to bring a suitcase full of shame with it.

So I want to lovingly offer this: give yourself a minute.

You’ve been doing things this way — trying to force your ADHD brain into a neurotypical way of operating — for 31 years. Expecting a massive transformation in 31 days? That’s just not realistic. You get to take more than a month to figure this out.

Change will feel slow, especially when you’re in the messy middle of it. Your brain will absolutely want to rush through this part. It’s going to tell you that you’re not making progress, that you’re falling behind, that everyone else has this figured out.

But I’m here from ten years in the future to tell you: one year from now, five years from now, ten years from now, you’re going to look back and see so much transformation. Some of that will be in the more traditional areas — following through on the things you want to do, building systems that actually work for your brain. But even more than that, you’re going to see shifts in how you relate to yourself, how you talk to yourself, and how you feel about yourself. You’re going to begin accepting and actually loving yourself exactly where you are.

And here’s the part that won’t make sense right now: it was when you started accepting and loving yourself that the biggest shifts happened. The doing didn’t come first. The being did.

Lesson 9: Self-Acceptance Is Where the Real Transformation Begins

Building on that: number nine is the piece that ties it all together, and it’s the thing I wish I could somehow make past me truly believe on day one.

Once you can genuinely accept and appreciate yourself for where you are, what you’re doing, and who you are — that is when you see the greatest leaps. In your abilities, in your progress on goals, in your sense of confidence overall.

I know this might sound counterintuitive. I know your brain right now is convinced that the path forward is to push harder, be more disciplined, fix the things about you that are “wrong.” And I get why it feels that way. You’ve been told your whole life, in one way or another, that you need to shape up.

But what actually happened over the next 10 years — and what I see with my clients over and over — is that the striving and the self-criticism kept us stuck. The more we beat ourselves up for not being “better,” the more frozen we became. It was only when we started getting curious instead of critical, and when we started meeting ourselves with genuine compassion and understanding — even in small amounts — that things genuinely started to move.

And the bonus on top? It makes this whole experience so much more fun. Building a life that works for your brain from a place of acceptance rather than punishment is a completely different experience. And you deserve that.

If this piece resonates with you, I encourage you to explore how to find acceptance of your ADHD diagnosis — it’s a topic I’ve spent a lot of time on, and it might be exactly the next step your brain needs.

Lesson 10: Your Emotions Are Not Too Much. Please Hear Me on This

Last one. And I saved this for the end intentionally, because I think it might be the most important thing I could say to that version of myself.

Please hear me: your emotions are not too much.

You feel so many big feelings, and that’s okay. It’s actually quite beautiful, despite being told otherwise for so long by so many different people.

Here’s what’s happening: ADHD brains struggle with emotional regulation. We feel emotions so intensely in our bodies, and they can wash over us in a way that feels completely overwhelming. So yes, you feel huge waves of disappointment, frustration, and shame. Those feelings come on fast and they hit hard.

But here’s the part people forget to mention: that same intensity means you also get to feel enormous joy and excitement and gratitude. It’s both. It’s always both. And the key to working with your emotions (something that will take time, and that’s okay) is learning how to allow all of it — the big hard feelings and the big beautiful ones.

You don’t have to make yourself small. You don’t have to smash down your feelings and lock them away. Your feelings are valid and real. They belong. And they make up a key part of who you are.

Take up more space. Let yourself feel.

Quick Recap: 10 ADHD Diagnosis Lessons from 10 Years

1. It makes sense why you keep falling asleep. Your brain is understimulated.
2. Meds are a powerful tool, but pills don’t teach skills.
3. Cognitive flexibility is a thing, and it explains so much.
4. Needing notes is about working memory, not intelligence.
5. You’re exhausted because you’re masking, and it gets better.
6. Some people will doubt your diagnosis. Trust yourself.
7. That shame spiral has a name: rejection sensitivity.
8. 31 years of patterns won’t change in 31 days. Give yourself a minute.
9. Self-acceptance is where the real transformation starts.
10. Your emotions are not too much. Take up space and let yourself feel.

---

Your Turn: What Would You Tell Your Past Self?

I think there’s something really powerful about taking a moment to reflect on what you would tell a past version of yourself — whether it’s earlier in your ADHD journey, or a harder season in your life. Maybe it has nothing to do with ADHD. That’s okay too.

This kind of reflection matters. Not only because it helps us recognize the growth we’ve had and the shifts we’ve made, but because these ADHD diagnosis lessons carry forward. They prepare us for new growth edges, new challenges. And they remind us that we can do hard things. We already have.

I would love to hear from you. What would you add to this list? What would you tell your past self? You can leave it in the YouTube comments, the Spotify comments, or send me an email at paula at imbusybeingawesome.com I’d genuinely love to hear about it.

And if you know someone who might be wrestling with their ADHD journey right now, or someone you think might connect with this episode, would you be a rockstar and share it with them? Sometimes that small gesture of letting someone else know you’re thinking of them can mean more than we realize.

---

Ready to Take the Next Step?

If you’re ready to take these concepts and apply them to your life — if you’re ready to learn how to support your ADHD in a way that works for you — I invite you to check out today’s show notes where you can learn more about how we can work together through We’re Busy Being Awesome small group coaching and one-on-one coaching.

And if you want to discover the unique way overwhelm presents for your brain, the obstacles that pattern creates, and powerful steps to shift from overwhelm into action, be sure to take my free quiz and discover your overwhelm type today.

Until next time, keep being awesome. I’ll talk with you soon.

---

Frequently Asked Questions About ADHD Diagnosis Lessons

What are the most common things people wish they knew after an ADHD diagnosis?

Many adults with a late ADHD diagnosis wish they had understood concepts like understimulation, working memory, cognitive flexibility, masking, and rejection sensitivity much earlier. These executive function challenges explain so many of the daily struggles that are often misattributed to laziness or lack of effort. Understanding that these are brain-based, not character-based, is one of the most transformative ADHD diagnosis lessons.

Why do high-achieving women often get dismissed when seeking an ADHD diagnosis?

High-achieving women with ADHD have typically spent years building systems and strategies to compensate for executive function challenges. This masking can make it appear, from the outside, that everything is fine. Because ADHD has historically been associated with hyperactive boys, many healthcare providers still overlook the inattentive presentation that’s more common in women — leading to delayed or dismissed diagnoses.

How long does it take to adjust after an ADHD diagnosis?

There’s no set timeline. Many people go through stages similar to grief — including denial, frustration, and eventually acceptance. As I share in this post, I spent 31 years operating without understanding my brain, so expecting everything to shift in 31 days wasn’t realistic. The adjustment is ongoing, and self-compassion is one of the most important tools throughout the process.

What does rejection sensitivity look like with ADHD?

Rejection sensitivity (sometimes called RSD) involves an intense emotional response to perceived or actual criticism or rejection. For ADHD brains, this can look like freezing on a project after receiving harsh feedback, avoiding situations where rejection is possible, or spiraling into shame after a minor interaction that felt critical. The emotional response is very real and very physical — it’s not something you can simply “think” your way out of.

Can you manage ADHD without medication?

Many people manage ADHD through a combination of strategies including coaching, therapy, skill-building, environmental supports, and lifestyle adjustments. Others find that medication in combination with these supports works best. There’s no one-size-fits-all approach. The key ADHD diagnosis lesson here is that medication alone — without skill-building — often isn’t enough. And skill-building without understanding how your brain works can feel like swimming upstream.

Resources From This Episode:

• Learn about Rejection Sensitivity Here
• Learn about ADHD Masking Here
• Learn about Working Memory Here
• Learn How to Deal with ADHD Boredom and Understimulation

More ADHD Resources:

• Discover my favorite ADHD resources
• Learn my Top 10 Tips to Work With Your ADHD Brain
• Access the I’m Busy Being Awesome Planning System
• Get the I’m Busy Being Awesome Podcast Roadmap
• Free course: ADHD Routine Revamp

Leave IBBA A Rating & Review!

If you enjoy the podcast, would you be a rockstar and leave a review? Doing so helps others find the show and spreads these tools to even more people.

1. Go to Apple Podcasts
2. Click on the I’m Busy Being Awesome podcast
3. Scroll down to the bottom of the page, where you see the reviews.
4. Simply tap five stars; that’s it!
5. Bonus points if you’re willing to leave a few sentences sharing what you enjoy about the podcast or a key takeaway from the episode you just heard. Thanks, friend!