ADHD: The Hidden Cost of Being Capable

Adam Print

Adam Print is a Personal Development Coach who helps people with identity, decision-making, clarity and communication, and specialises in helping neurodivergent people work with their own brains with confidence.

At the age of 46, I was diagnosed with ADHD. It wasn’t a surprise.

I’d spent years recognising patterns in how I think, feel and behave, and trying to understand why things can feel effortless one moment and require so much effort the next.

I’ve always found ways to make things work. But I’ve also spent an enormous amount of time managing myself ‘backstage’.

In this article, I’ll explore:

  • What ADHD really is

  • The journey I’ve been on to understand it

  • What living with it has meant for me.

I'm sharing my experience because I hope it might help others find ways to better understand themselves, help the people around them understand what they’re going through, and normalise conversations about experiences that often go unseen.

But what is ADHD?

Attention deficit isn't simply a lack of attention and hyperactivity doesn't necessarily mean someone bouncing off the walls.

Attention

Focus can be difficult to control. Sometimes it's hard to concentrate on something, while at other times attention becomes so intense that it's difficult to pull away.

Everyday functioning

Things like starting tasks, making decisions, prioritising, organising activities and judging time can be inconsistent. Something straightforward one day can feel surprisingly difficult the next.

Motivation and reward

The sense that something is important, interesting or worth doing doesn't always arrive when it's needed. It might disappear before someone acts, create a sudden impulse to act, or become so strong that it's difficult to stop.

Energy

Energy levels can be unpredictable, swinging between feeling highly energised and exhausted. It can also be difficult to recognise how much energy is left, or when it's time to rest.

Emotions

Feelings can be difficult to recognise or understand, or they can arrive with unexpected intensity. Emotional responses don't always match what someone might expect from the situation.

Thinking

Thoughts can arrive quickly, in many directions, or become intensely detailed. They don't always settle once something has been considered, leaving unfinished thoughts competing for mental space.

Senses

Sensory experiences can vary considerably. Sensations might feel overwhelming at times, while at others there can be a strong desire for particular sensory experiences.

Impulsivity

The urge to speak, react or act can arrive suddenly, sometimes before there's been time to consider the consequences. Those impulses may be expressed immediately or consciously held back.

Sleep

The body's natural sleep schedule can run later, making it difficult to fall asleep or wake at conventional times. A busy mind or a desire for uninterrupted personal time away from demands can delay bedtime.

Of all the people with ADHD I’ve met or worked with, none fit a stereotype society.

ADHD is a neurological difference affecting how we regulate far more than just attention. It shows up differently from person to person, interacting with our personalities, habits, circumstances and what we’ve learned through life, sometimes alongside other conditions such as anxiety or other forms of neurodivergence.

Here are some of the areas that can be affected:

And what could be happening in the brain?

Neurotransmitters are chemical messengers that help brain cells communicate. Two particularly important ones in ADHD are:

Dopamine

It's not simply a pleasure chemical. It helps regulate motivation, reward, interest and what deserves our attention or effort.

Think of it as a motivational thermostat: in ADHD, it can feel too cold to start or too hot to stop.

Noradrenaline

Helps regulate alertness, attention and our readiness to respond or act.

While dopamine helps signal what matters, noradrenaline helps us stay alert and ready to act on it.

Research suggests that differences in how these systems communicate and regulate signals play a part in ADHD. Signals may not arrive at the right time, may be cleared too quickly, or persist longer than needed. The result?

Inconsistency in what starts, what sticks and what stops.

Of course everyone struggles with attention, motivation, emotions or getting things done sometimes. That’s part of being human. It doesn’t mean everyone is a bit ADHD.

But just because two people experience something that looks the same doesn't mean what's happening underneath is the same. With ADHD, neurological differences can affect how often these things happen, how intensely they're experienced and how much effort they take to manage.

“But everyone’s a bit ADHD, aren’t they?”

ADHD isn’t a collection of personality quirks. It’s not about whether something happens, but how often, how consistently, and what it costs.

“What drives motivation then?

For many people, knowing something is important, rewarding or has consequences is enough to motivate action. With ADHD, that doesn’t necessarily create the motivation to act. Interest, novelty or urgency can be much stronger drivers.

Neurotypical
motivation

Importance
Rewards
Consequences

ADHD
motivation

Interest
Novelty
Urgency

For neurotypical people, importance and consequences can create a sense of urgency well before a deadline. With ADHD, the importance and consequences may be just as clear, but the urgency might not kick in until those consequences are about to become reality.

Having an ability doesn’t always mean being able to access it.

With ADHD, having the skills to do something doesn't always mean being able to access them consistently. Sometimes it comes easily; other times it takes enormous effort, even when the outcome looks the same. Much of that effort is invisible to others.

THE SAME ACTIVITY
It just works
Skills are readily available when needed.
It feels effortless.
Working hard
Considerable effort is required to access skills, without recognising the cost.
It feels relatively straightforward.
Struggling
Accessing skills requires enormous effort, and that effort is noticeable.
It feels increasingly difficult.
Stuck
Unable to access skills that are known to be there.
It can feel almost impossible.

Why didn’t I consider ADHD 20 years earlier?

Simple. Stereotypes and years of adaptation:

I assumed everybody’s brain worked like mine. Particularly as a child. You don’t have another brain to compare yours with, so your internal experience feels ‘normal’.

I can concentrate. I didn't recognise myself in the stereotype that people with ADHD can't focus. ADHD is about regulating attention, not simply lacking it.

I was compliant at school. I wasn’t a recognisably disruptive boy. I’ve since learnt that much of my hyperactivity was internal, making it harder to recognise.

I was academic. I generally found school academically straightforward, which didn't fit my understanding of ADHD. It was only as learning demands changed that some of the difficulties with attention and studying became more apparent.

I didn't consider myself particularly impulsive. That was a blind spot. I've learnt to manage it effectively that it isn't always obvious, even to me.

The two things that made it particularly difficult to recognise:

I'd become highly adapted. By adulthood, coping mechanisms, compensations and ways of managing were so embedded that they felt normal. I didn't recognise the amount of work happening underneath, and neither did anyone else.

Growing up gay. The confusion, shame, masking and sometimes denial made it difficult to recognise something else might be going on. I now realise I was double-masking. I had a very happy childhood at home. It was fun and safe, and my family did nothing but encourage and support me. The difficulties came from the society I was growing up in.

There’s growing discussion about how neurodivergence is experienced differently in LGBTQ+ populations, with multiple layers of confusion, shame and masking.

Why did I eventually end up seeking a diagnosis?

I’d been curious about neurodivergence for years, but I understood how I was wired, had found ways to manage myself and hadn’t felt the need to investigate further.

Eventually, the wildly different amounts of effort it took to achieve the same things became harder to ignore.

How
it felt
What I did
What
it cost
Outcome
Easy
Got on with it
Very little
SUCCESS
Difficult
Found ways to manage
More effort and energy
SUCCESS
Very difficult
Overcame multiple layers of difficulty
Significant effort, sometimes burnout
SUCCESS

I felt like I was spending 60% of my time trying to work myself out. Was it neurodivergence, personality, growing up gay, the way I’ve experienced the world, a drop in testosterone or lack of sleep? All of these were at play, but I needed to be sure if neurodivergence was, and how much it explained.

I felt like a high-spec computer with all the latest software, but with nowhere near enough RAM to run it.

I wanted to be sure I was choosing the right approach, so I could stop experimenting. That meant understanding why I was wired that way. And that distinction matters: why…

But does recognising something tell us what’s causing it?

Social media posts, other people’s experiences and self-assessments can help us recognise and understand ourselves. And once we start looking, we’re shown more of the same, reinforcing what we think we’re recognising. But recognising a similarity doesn’t necessarily establish what’s causing it.

I opted for an assessment covering ADHD and autism. Some of my experiences seemed consistent with accounts of people who had both: the contradictions, amplified sensory experiences, special interests that dominate, pattern-making, rigidity around expectations, contrasting social participation and communication challenges. These were the things I wanted answers to.

My psychologist recognised significant traits associated with autism, but concluded they were better explained by ADHD and the way I’d adapted to manage it. What looks like rigidity from the outside isn’t necessarily about being inflexible underneath.

Recognising our experiences in someone else’s description doesn’t necessarily mean they have the same underlying cause.

What did my assessment confirm and what did it reveal?

My consultant psychologist diagnosed me with Combined ADHD (inattention and hyperactivity), identifying lifelong developmental differences.

The psychologist identified a tendency to give things more attention than they need. My brain has plenty of processing power, but doesn’t always know when to stop using it. It drives me to over-recognise patterns and create complex systems, but is useful for creative and logical thinking, simplifying things and emotional insight.

“High capability with high cognitive load.”

My ADHD took shape within a calm, compliant demeanour. Capabilities helped compensate for aspects of it, while intensifying others. The way it evolved was complicated by the stress, vigilance and confusion of growing up gay.

He concluded that I was highly adapted and capable, but at a significant cost, which could leave me susceptible to burnout.

So how does ADHD show up for me?

Inconsistently and contradictorily!

Ask me how ADHD affects me on two different days and you might get two very different answers. That's part of what makes it difficult to explain.

I could give you examples of:

losing things ✔️ running late ✔️ talking over people ✔️ doing everything except the thing that needs doing ✔️ staying up all night to finish something ✔️ or accomplishing two weeks’ worth of work in a single afternoon ✔️

But I'm more interested in what's happening underneath those behaviours, and why they happen.

ADHD shows up differently for everyone. This is how I understand mine.

After my diagnosis, I started making sense of patterns I'd been noticing for years. I identified twelve areas where my experiences and access to my capabilities are inconsistent.

The bigger picture…

These difficulties aren't constant, and they don't happen independently. They can overlap, trigger and amplify one another, sometimes with thoughts, feelings and demands arriving at maximum volume and intensity.

Managing these inconsistencies takes considerable effort, even when it's working and nobody else can see it. And sometimes the ways I manage myself become more difficult than the things I'm trying to manage.

“We all have 24 hours in a day. But if you’re spending the equivalent of eight of those hours negotiating with yourself and consciously regulating things that don’t happen automatically, you’re effectively working with 16.”

✓ When regulation works

Effective and stabilising

Still takes energy and bandwidth.

− When regulation doesn't work, or goes too far

Can create additional difficulties and costs, leaving me more activated than before I tried to regulate myself.

✧ In either case

Much of the effort and cost is invisible to others.

How do I manage myself, and how much does that cost?

I've identified seven ways I regulate myself. They're things I need, value and naturally do, and I've come to rely on them. Each can help me manage my inconsistencies, but each can also work against me.

Completion

Closing thoughts & emotional loops

Coherence

Sense-making

Identity

Being authentic and congruent

Agency

Exercising choice and control

Interest

Engagement, curiosity and stimulation

Reasoning

Rationalising through patterns & systems

Externalising

Releasing thoughts and connecting with others

What happens when all of these things come together?

Here is an illustration of how they can interact in my everyday life:

I love the gym. I love spending time with the people I train with. It regulates me through physical exercise, social engagement and a change of environment that quietens the inner chatter. It’s the one routine I maintain consistently, and I need it. But getting there at a certain time becomes an external demand.

When I’m well regulated, I get there no problem (yes, I arrive at the last minute, sometimes after an unexpected side quest, but I do arrive on time!). But when I’m less regulated, getting there can be the hardest part of my day. I have to rip myself away from something unfinished, struggling to sequence, scrambling to find things, rushing and feeling disoriented. My mind can be racing with thoughts I can't capture on the drive there, and I arrive wired. I’m grateful that my lovely gym buddies are super tolerant, understanding and curious, so I can just exist in the way that I arrive.

How much of this do other people actually see?

How activated I am internally and how much other people see can be two very different things.

  • I can be sitting quietly, completely occupied with thoughts. If someone walks into the room, I instinctively make myself look busy.

  • Someone can approach me when my head is saturated with thoughts, and I can switch into a perfectly natural, engaged conversation. They’d have no idea how intensely activated I’d been moments earlier.

I love socialising and genuinely enjoy being around people. But when I’m activated, I may appear engaged and socially capable while feeling disoriented and not connected to what’s around me. Maintaining that appearance takes a lot energy.

Sometimes there’s little to manage. Other times, people notice me struggling to remember something, find my words or communicate clearly. And sometimes I’m highly activated but appear completely calm, or feel safe enough to let it show.

Regulated
No need to mask
Activated
but safe
Able to reveal it without masking
Activated
Masking to appear calm and capable
Overwhelmed
Masking can become exhausting or impossible

What’s changed?

One of the biggest shifts has been from asking myself, “Why can't I be consistent and perform at the level of my capability?” to asking, “I know why that happens now. What can I do about it?” 

I'm learning when to give myself some leeway and when I need to give myself a push. Recognising what activates me earlier and responding sooner also means I don't always need so much machinery to stay consistent. That understanding is helping me make more deliberate choices, with less self-criticism and inner conflict, and mask less.

One reason I wanted to understand myself better was to be able to share my lived experience more meaningfully with neurodivergent clients, and I’m now able to do that.

It's also made me clearer about what I need from people and the environments I'm in, and better at communicating those needs. It makes a real difference when people are clear about what they mean and are curious about what might be going on for me.

Self-employment suits me well, and I'm becoming more deliberate about how I organise my work and life to support one another.

For years, I've felt as though I needed to get all my ducks in a row before I could properly move forward with my life. Every time I thought I was ready, another duck wandered off. I've been reducing the everyday friction that makes managing my ADHD harder. It's freed up energy and hopefully, this time, the little buggers will stay put. But I know what to do when they don’t ◾️

Adam is always happy to hear from people who would like to continue the conversation.