Adult ADHD in Men: Expert Strategies to Manage Your Diagnosis

A month ago, I got on a Zoom with Alex Campbell, a writer and ADHD coach, to talk all things attention deficit hyperactivity disorder. At the time, Campbell, a Brit, was over in London, on holiday from New Zealand where he lives. He seemed frazzled, and it probably wasn’t just the jet lag. His kindergarten-aged daughter kept running into the room as we spoke, wanting his attention. To my understanding, it seemed the perfect personification of ADHD — a task interrupted by uncontrolled distractions.

But Campbell challenged that, explaining that ADHD isn’t just about being distracted. The condition also describes a great deal of focus in unexpected directions.

“An ADHD brain is wired for interest, not for importance,” he explains. For most of us, things like work deadlines or knowing where we left our house keys register as something we need to focus on. “[But] not in my brain,” says Campbell. “I’ve got to be interested in the thing for it to feel important to me.” That’s useful for the CEO firing off a thousand emails at three in the morning. Less so for the employee who just needs to shower and get to work on time, yet can’t seem to manage it.

Campbell’s explanation of ADHD felt so timely that I asked if he’d speak to me again, and this time from his home in New Zealand. But first, some ground rules. “I’m not comfortable with the phrase ‘suffering from ADHD,’” Campbell emailed me when I got in touch to ask him to contribute to this piece. “It’s a lot more nuanced than that.”

He’s right. As an ICF-accredited ADHD coach and the author of the book ADHD…Now What?, Campbell works with men struggling with ADHD almost every day. They’re often in middle age (or approaching it), and are just coming to terms with their ADHD, a condition that has been widely under-diagnosed, despite the fact that men are more likely to be diagnosed with ADHD than women in the U.S. According to data from the National Comorbidity Survey Replication (NCS-R), 5.4% of American men aged 18 to 44 — approximately 8,856,000 guys — are diagnosed with it, compared to 3.2% of women in the same age bracket.

Campbell says that men who grew up with undiagnosed ADHD likely developed a feeling that something was “off,” without really knowing what it was. This can lead to internalized feelings, and greater levels of anxiety. “I call it survival mode,” Campbell says. “You end up surviving on a diet of anxiety and urgency as your way of getting by.”

Friends of mine have been diagnosed as late as their 40s. Telling me about their diagnosis, it seemed to me like something had been unlocked in them. Universally, their diagnosis seemed to be a gift, although one tied up in painful emotional ribbons and a sense of mourning over what could have been, had they only known earlier. Campbell describes a late-life diagnosis of ADHD not as an excuse, but an “explanation.” For many men, it can be the key to understanding their past, and the beginnings of a way forward. If you’ve recently received your own diagnosis, here are Campbell’s suggestions for making your life easier.

Understand It

“A lot of the narrative around ADHD is that we have to deal with it, as opposed to understanding that it’s simply a difference,” says Campbell. “Historically, there’s been a lack of awareness from people like parents and teachers, so when someone in their 30s, 40s or 50s is getting a diagnosis, we need to remember that this is a privilege. And then the next thing is to really understand how ADHD looks for you. It won’t necessarily look like what you see on TikTok.”

The takeaway? Do your research. “Read books, get an ADHD coach, go online, and figure out what support looks like for you. And don’t dismiss the first bit of information that you don’t relate to; it’s a spectrum.”

It can also helps to tap into the broader community. “It’s about not going it alone. Lots of marginalized communities have found healing by finding people who feel the same way that they do,” he says. “It’s exactly the same in the neurodivergent community.”

These Pain Experts Will Help You “Futureproof” Your Body

Myo’s applying the dentist model to mobility. We paid them a memorable visit.

“When you realize ‘Oh my god, this is me,’ you do want to talk about it,” Campbell says. But those first conversations with friends and family can be difficult, especially if you feel like they’ve reacted poorly to your behaviors pre-diagnosis.

“We’re very aware of the stigma,” Campbell says. “And look at what’s going on at the moment. It’s a scary time to admit that you hold any form of marginalization. The question I would ask is: What is my why for sharing this? How do I feel about sharing it with this specific person or people? When we talk about ADHD, we begin to normalize the experience of being neurodivergent, but it might help initially to share it with the people you know are going to be immediately supportive.”

Consider Therapy and Coaching

For someone with underlying mental health issues wrapped up in their ADHD, Campbell says seeing a mental health professional can be useful. But he’s quick to point out that ADHD is not a mental health condition, and that a coach — someone who can help you learn how to express yourself — may be the stronger option.

“A really good question that will tell you a lot about a therapist is, ‘How do you understand ADHD?’ and ‘Are you neuro-inclusive?’” says Campbell. “If the therapist says, ‘Well, I think ADHD is often a result of trauma,’ run a mile.”

A coach is can be more practical. “What a good ADHD coach does is help you understand your identity, with models and tools that help you understand your experience,” Campbell says. “You get clarity on you in your context, and from that clarity you start to develop your own strategies.”

Campbell says counseling gave him language for the good parts of ADHD as well as the not so good. “I’m way more ‘boundaried,’ I’m calmer. I feel more connected to myself, and more confident.”

Explore Medication

If there’s a common theme in Campbell’s advice, it’s about figuring out what works for you. Medication is no different. “I don’t take a side with medication,” he says. “I know that for some people, it genuinely doesn’t work, and there could be lots of other co-occurring medical conditions that may have a bearing on that. I personally do take medication, but not all the time.”

Campbell says that medication can be a “really helpful combination” with a good coach, along with a medical expert, helping you navigate what pills and what dosage, if any, can give you the results you want.

Accept It

“Part of it is accepting that there’s nothing to be ‘fixed’,” says Campbell. “It’s about accepting that you’re on a journey that is ongoing and you’re going to be continually figuring this shit out.”

It isn’t an impossible task. After years of working on himself, Campbell has arrived at a place where he knows what he needs. And you can get there too. He told me a story of his daughter being trapped in an indoor playground. You know how it goes: kids screaming, lots of awkward small talk from sidelined parents. It’s overwhelming for anyone. It was too much for Campbell. He told his partner to help their daughter, then asked another parent to help his partner on the way outside. A few quiet moments later, and he was back and able to help. Knowing he needed this took years of work.

“I don’t need hours and hours alone,” he says. “If I could just go outside and accept ‘That was a lot,’ that gets me back online, and I can then go back in and be the dad I need to be. There’s no shame in that.”