ADHD: Tips on Coming Out

Avoiding pitfalls of sharing an ADHD diagnosis

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One of the challenges posed by ADHD is how to discuss your condition with family and friends and how much to reveal at school or in the workplace.

ADHD manifests differently in each individual. Even if your ADHD presents strongly, it’s only one aspect of your being. Other traits, strengths, propensities, and experiences shape who you are as a person. Each coming-out audience and situation is also unique. So there’s no single best way to share the awareness of your ADHD with others.

Despite all of the possible variations, some guidelines may help you think about and craft your coming out. These suggestions are based on my three decades working with neurodivergent individuals, and in particular from helping those with ADHD, or who are LGBTQ, share sensitive parts of their identities with important people in their lives.

Even if, in ADHD fashion, you blurted out the news to everyone nearby as soon as you learned you had ADHD, you may benefit from reading these suggestions, because coming out tends to be an ongoing process.

Before we begin

Several viewers of my ADHD YouTube channel had asked for advice on coming out. When I started my response, I initially stumbled over whether one comes out “as ADHD” or “with ADHD”. I recalled a discussion ten years ago at an ADHD support group. At the time, as a psychiatrist and neuroscientist, I framed ADHD as a mental health condition that one had or didn’t have.

But several group members preferred to say they “were ADHD” rather than “had ADHD”. They saw it as an analogy to “being gay” rather than “having gay”. ADHD was simply part of their identity.

Clinicians still make an official ADHD diagnosis by determining whether an individual displays symptoms of impulsivity, hyperactivity and inattention to an extent that is unusual for their age and cultural background, and that leads to dysfunction or distress. But many researchers, clinicians, and members of the ADHD community view ADHD as a form of neurodivergence — their brains work somewhat differently, and it is primarily their executive functions — how the brain processes, organizes, and responds to information, that is different. This neurodivergent framework seems more accurate, has greater explanatory value, and is less stigmatizing than the symptom checklist definition of ADHD.

I’m aware that some individuals protest that ADHD, and virtually all of our other psychiatric labels are worthless or meaningless. If these labels don’t help you, fine, don’t use them. But thousands of studies indicate that ADHD, as currently described, defines a meaningful group of people, provides general predictions of long term outcomes, and guides targeted treatments that reduce symptoms, improve quality of life and prevent premature death.

Before coming out

Certainty. Before coming out make sure that you really have ADHD. The best way to do so is to have an assessment with a mental health professional who is familiar with the condition. Numerous on-line symptom surveys claim to identify who has ADHD, but since all of the symptoms are things everyone does some of the time, these questionnaires often fail to distinguish ADHD from other conditions or from normal behavior. At the very least, check with someone who knows you to see if their observations of your behavior align with your own perception.

For children coming out to their parents for the purpose of obtaining a formal ADHD evaluation, I suggest listing your patterns of behavior that seem to indicate that you have ADHD, and stating that you want a medical assessment to achieve greater clarity as to whether it really describes you.

Motives. Why do you want to come out? Presumably part of it is to help others understand your behaviors, and to help them understand you. Those are two different things, because although our behaviors are a reflection of who we are, they aren’t the complete story. Indeed, often coming out with ADHD is to guide others to reinterpret your behaviors in a new way. The more clearly you understand your motivation for coming out, the more likely you are to develop a plan that matches that desire.

Goals. Although motives and goals can be closely intertwined, your goal is what you are hoping to achieve. Often a goal for coming out involves some expectation that others will not only change how they see you, but how they interact with you in the future. While it is fine to have such goals, remember that you can influence, but not control what goes on inside the minds of others. You have more direct ability to shape your own thoughts, feelings, plans, and actions than to change others.

Who. Think of who you want to share your ADHD with. This is a reminder that coming out is not an all or nothing process. Often people come out first to those they expect to be most accepting. Many people come out to friends and family but, at least initially, not to bosses or co-workers.

Education. Accept that there is an element of unfairness to being different, which may include the burden of having to explain your neurodivergence to others and help them understand it. You have to become the teacher. Some of your “students” will already be well-informed, some will be teachable, and others may never care or be able to learn.

Prepare resources with accurate information about ADHD, to share with those you come out to. Depending on the audience, this can be written articles or videos. Keep them simple, and direct. Regardless of how articulate you are, new information usually takes some time to sink in. Your audience will probably want to rehash and review what you’ve told them. Having the information in a slightly different wording or voice can help reinforce the message you have delivered.

Remember that there’s a wealth of misinformation about ADHD on the internet. Your audience is likely to do their own search and may well come up with statements that are inaccurate and might undermine your coming out. In addition to some short, focused references, you may also want to suggest some more in-depth books or videos on ADHD, but don’t expect others to digest a big volume of information, particularly at the onset of their learning journey.

Individualize. I know I said this at the beginning, but it’s helpful to remind yourself that there’s no one correct way for coming out. Follow your own unique path. This is a quest, not a test. You’ll have chances to circle back and reinforce or clarify your message.

While Coming Out

Plan a time. Coming out in the midst of an argument or crisis is not ideal. You’re likely to be less able to explain yourself, the other person is less likely to be able to listen, and the entire exchange is more likely to sound like an excuse than an explanation.

When scheduling a time to talk, allow for several minutes for you to present your thoughts and feelings, as well as leaving time for questions and follow-up.

Simple. You’ve probably been thinking about ADHD longer than your audience has; if this is news to them, they probably won’t be able to process too much information at the first go around.

In particular, two ADHD tendencies might make it hard to keep it simple. Distractibility makes it easy for those with ADHD to go off track. This can be compounded by noting that either in the past or at this very moment, others aren’t following what you’re saying, which can lead to trying to backtrack, explicate, reiterate, repeat, fill-in, correct, emend or patch over what you feel you weren’t crystal clear about the first time. This, of course, tends to confuse the audience even further.

Jot down a few take-home bullet points, and try to stick with them.

Another ADHD tendency, of hyperfocusing, or going down a rabbit hole, can also contribute to providing too much information. One of my patients calls these his “dawn of time explanations”. You don’t need to include everything, particularly during an initial discussion. Just highlight a few ADHD-driven behavioral patterns that are pertinent to your interactions with this person.You don’t have to explain everything about ADHD, fascinating as it may be.

Framework As I discussed above, describing ADHD as a form of neurodiversity which affects executive functions can be a useful and powerful framework. Of course those terms themselves, depending on your audience, may need explaining.

One way to describe neurodiversity or neurodivergence is that some brains are wired differently. These differences from “typical” humans might include the size of certain brain structures, the amounts of certain neurochemicals at specific locations in the brain, or the ways brain cells use energy.

Executive functions describe how brains process, prioritize and make use of information, which can encompass directing attention, sustaining concentration, working memory, planning, initiating and completing tasks, time awareness and management, impulse control, and emotional regulation.

It can also help to mention that ADHD is characterized by fluctuations in symptoms, that part of ADHD is being consistently inconsistent, and that often for those with ADHD, actions are driven by what is interesting more than by what is important.

Personalize Pick a few ADHD-driven patterns of behavior that have led to problems for you, and phrase them as “I do these things (ramble on with my answers, stare out the window, get off track before completing my homework), which are tied to this ADHD symptom (distractibility).” because Y” Making I-statements makes your coming out personal, puts you in the position of taking responsibility. Providing examples makes ADHD concrete for your audience.

Patterns not events. You’re in a stronger position if you describe patterns rather than specific events. Saying “I’m often late for (appointments, lunches, turning in homework) because part of my ADHD is trouble with time management.” helps others to see how seemingly disconnected behaviors are actually related to an underlying cause. A specific example can also be picked apart, not least because for any specific instance other factors in addition to your ADHD contributed.

Explanation not excuse. Present your ADHD as an explanation rather than an excuse. People don’t like to hear excuses. When you clarify that your ADHD contributes to a pattern of behavior, it can actually lead to more effective measures to change these behaviors. Understanding that a behavior wasn’t simply due to “laziness”, or “willfulness”, or “resistance” or “denial” but instead flowed from your ADHD can help identify effective remedies. (Having a whiteboard near my desk helps remind me of what my tasks for today are. When you hear me going off target in conversation, it’s helpful to redirect me.)

After coming out

Resources. Make sure your audience has in hand a hardcopy or a link to a useful summary about ADHD. Two of my articles about what ADHD is and what ADHD is not may be helpful here, but CHADD, the nationwide patient and family support group for ADHD, ADDitude magazine, and the video channel How to ADHD are also good places to start.

Ongoing. Educating others about ADHD is a process, not a one and done. Almost certainly there will be aspects of ADHD, or nuances regarding your condition that you didn’t have time to describe. Don’t feel bad about not including everything; this is a quest not a test. Remember, you’ve started an important ongoing dialogue, it doesn’t matter how much you crammed into the first session.

Time. Give the other person time to reflect, come up with questions, think about what you’ve told them. People learn and process at their own rates.

Self care. Sharing something important about yourself, particularly something that differentiates you from many others, and that may have led to criticism or stigmatization in the past, is a big step. Congratulate yourself. Give yourself a reward, or at least take a break from other arduous tasks until you feel ready for them again.

Community. If you have a therapist, make use of them. In addition, friends with ADHD, or online communities can help you unpack and deal with any elation, disappointment, resentment or other feelings that might have come up from your coming out as ADHD. You’re not alone.

Certain audiences deserve special attention

Family. Coming out to family members is likely to be emotionally laden, particularly since rejection by family can feel devastating. Some families resist hearing about ADHD.

ADHD has a strong genetic component, meaning that there is a high likelihood that ADHD or strong ADHD traits run in your family member. Sometimes this can make the coming out a bonding and connecting experience. But ADHD in family members can also contribute to resistance and rejection for a number of reasons:

• obliviousness

• normalization

• individual differences

• denial

• jealousy

ADHD affects directing and sustaining attention. It’s really possible that family members with ADHD didn’t even notice your tardiness, or failing to turn in homework, or other behaviors that seem glaringly obvious to you, because they weren’t paying attention.

Even if they were aware of your ADHD-driven behaviors, they might resemble their own habits so closely that they just considered such actions to be normal. They may have minimized that there could be any negative consequences to such behavior, or dismissed this as just what one would expect to happen. Or their ADHD may manifest so differently from yours that they have trouble realizing underlying similarities.

Some people, particularly those from previous generations, spent large chunks of their life without awareness of their own ADHD. Coming out about your own ADHD may force them to confront their own ADHD. They may not be ready to look at their own ADHD, and through their own fears or other negative feelings may not be available to help with your journey of addressing your ADHD.

In particular, people whose own early years were scarred by fallout from their ADHD may — even if they love you — be jealous that you’ve figured out this challenge at an earlier point in life, or may resent that there are more resources and understanding for those with ADHD than they had available at a similar age.

ADHD is also over-represented among those who were adopted. This stems from an increased tendency that those with ADHD are more likely to become parents without being ready for it and thus put infants up for adoption, and because of possible mismatches between infants and their adoptive families. Among those who were adopted, especially those who were told that their adoptioin meant that they were specifically “chosen” or “selected,” coming out as ADHD may be particularly difficult due to fears of disappointing adoptive parents, or being viewed as being as a problem, or being defective.

School. It surprises me in this day and age, but I’ve seen numerous well meaning, otherwise capable teachers, from elementary through college level, who don’t seem to grasp that intelligence is a separate domain from ADHD — that there is a difference between what you know versus how you learn and express what you’ve learned.

Work. In the US, at the federal level as well as in most states, ADHD is recognized as a potentially disabling condition, and as such requires employers to make reasonable accommodations to help with performance. You’re usually in a stronger legal and ethical position if you have brought up your ADHD before it contributes to any impairment in your performance.

Accommodations. I think that we should be framing accommodations as efficiencies. These aren’t special perks granted to you that require a sacrifice from your teacher, manager, or workplace. These are efficiencies that are being made so that you can work more productively, and contribute to the team’s goals.

Strength Through Diversity

We’re living through a particularly strange time, when some powerful individuals feel threatened by, and deride, diversity and inclusivity. Yet the very basis of natural selection and human evolution is based on there being underlying genetic diversity, because different traits convey adaptive value in different circumstances. Some of our most compelling stories, from The Wizard of Oz to Harry Potter, highlight that having a broad range of capabilities makes groups of humans more resilient and capable. Yet we have bureaucrats who think that all soldiers need to have testosterone levels within a narrow range, or that women and other minoritized individuals can’t be effective leaders.

It’s not just that the pendulum will swing back at some point. The ignorance and spitefulness displayed by those currently overvaluing conformity consigns such views to failure. To deny or denigrate human differences makes little sense.

The communities that are strongest find ways to collaborate with even their most diverse members.

Coming out as ADHD is a step towards owning your own life, and contributing more fully to society.