Adults with ADHD: Evidence-Based Neuro-affirming Strategies

Some facts about ADHD

The Neurodiversity Paradigm and Adult ADHD

The neurodiversity paradigm views conditions like Attention-Deficit/Hyperactivity Disorder (ADHD) as valuable variations in human cognition, not as inherent flaws or pathologies. This framework shifts the therapeutic goal from "normalisation" to empowerment, adaptation, and skill development, which can significantly reduce the internalised shame that many neurodivergent individuals experience. It promotes building on an individual's unique strengths and talents, fostering a supportive environment that values their distinct way of thinking, while also acknowleding the struggles which accompany neurodivergence.     

Gender-Specific Manifestations of Adult ADHD

Emerging research and anecdotal evidence indicate that while ADHD symptoms may present with similar severity across genders, there are subtle differences that are crucial for tailoring effective interventions. For example, women with ADHD are often diagnosed significantly later than men, with mean ages of diagnosis ranging from 16.3 to 28.6 years for females compared to 11.2 to 22.7 years for males. This is partly due to a historical bias in diagnostic tools, which were largely developed with a male-centric understanding of the disorder.   

Differences in functional impairment have also been identified. Research shows that men with ADHD are more likely to report significant impairment in work performance, while women tend to experience greater difficulties in their social and interpersonal relationships. Furthermore, women with ADHD may face an increased psychological burden due to societal gender roles and hormonal fluctuations, which can contribute to a greater tendency toward self-doubt, perfectionism, self-blame, and self-harm.   

These differences highlight that a one-size-fits-all approach is insufficient. Interventions must be individualised, focusing on strategies for task management for men and addressing emotional regulation and self-compassion for women.   

Table 1: Gender-Specific Patterns in Adult ADHD

Characteristic	General Research & Common Lived Experience	Specific Gender Patterns Identified in Research
Symptom Presentation	Similar severity and type of symptoms.	Women may present with more inattentive symptoms, while men may present with more hyperactive/impulsive symptoms, leading to under-diagnosis in women.
Age of Diagnosis	ADHD is often a lifelong condition with symptoms present from childhood.	Women are diagnosed later, on average between 16.3 and 28.6 years, compared to men who are diagnosed between 11.2 and 22.7 years.
Functional Impairment	Greatest impairments occur in work performance and interpersonal relationships.	Men report greater impairment in work performance. Women report greater impairment in social relationships and self-esteem.
Psychological Burden	Common comorbidities include depression, anxiety, and substance use.	Women are more likely to experience low self-esteem, perfectionism, and self-blame due to internalised symptoms and societal pressure. They are also more susceptible to self-harm and suicidal ideation.

Some strategies for ADHD

The Power of Movement and Physical Activity

Physical activity is a powerful neuro-enhancement strategy for adults with ADHD. Exercise increases the production of neurotransmitters like dopamine and norepinephrine, which are key to attention and focus and are the same chemicals targeted by stimulant medication. This helps reduce symptoms such as distractibility and hyperactivity and can significantly improve inhibitory control, a hallmark of executive dysfunction in ADHD.   

Both acute and long-term exercise have been shown to positively affect inhibitory control. Physical activity also enhances neuroplasticity, which helps the brain develop new pathways to manage executive functions. Furthermore, exercise helps manage common co-occurring conditions such as anxiety and depression. Aerobic activities and strength training are particularly beneficial, while mindful movement like yoga can improve emotional regulation. For individuals with ADHD who struggle with motivation, the key is to make exercise enjoyable and start with small, achievable goals.   

Externalising Executive Functions: Organisation and Time Management

Challenges with executive functions are central to living with ADHD. A core strategy to manage these challenges is to externalise these functions by moving them from an unreliable internal mind to a dependable external system. This reduces mental stress and combats forgetfulness.   

Effective strategies include:

• Time Blocking: Allocating specific blocks of time for various tasks.   

  
  

• Visual Aids: Using calendars, planners, and colour-coding to make schedules and tasks tangible.   

  
  

• "Chunking": Breaking down large, overwhelming tasks into smaller, manageable steps to improve task initiation and overcome procrastination.   

  
  

While many digital interventions show potential for improving executive function, a systematic review notes that the overall evidence is "inconclusive due to low evidence quality" and that these tools may carry risks like video game addiction. A balanced approach that prioritises simple, low-tech strategies, customised to the individual's needs, is often most effective.   

Structured Productivity: The Pomodoro Technique and Body Doubling

The Pomodoro Technique and body doubling are two strategies that provide external structure and motivation to help with task initiation and sustained focus.   

• Pomodoro Technique: This method breaks work into short, focused intervals (traditionally 25 minutes) with short breaks. This aligns with the ADHD brain's preference for working in short bursts and helps to combat "time blindness" by making the passage of time tangible.   

  
  

• Body Doubling: This involves working alongside another person, either in person or virtually. The presence of this "body double" serves as an external anchor that can help with task initiation and maintaining focus by providing accountability and a model of calm concentration. While one source cites a study finding improved focus in 95.7% of participants, another states that formal research to prove its effectiveness is lacking, highlighting the gap between anecdotal and formal evidence.   

  
  

Both methods work by providing psychological and social scaffolding that compensates for executive function deficits.   

Leveraging Intense Interests: The Power of Hyperfocus

A neuroaffirming approach reframes intense interests and hyperfocus as unique cognitive strengths to be leveraged. Hyperfocus is a state of deep, intense concentration on a rewarding task, which is thought to be the flip side of the same neurobiological mechanism that causes distractibility: a deficiency of dopamine. The ADHD brain will fiercely cling to activities that provide instant feedback and a surge of dopamine.   

When channelled effectively, hyperfocus can lead to tremendous advantages, such as enhanced productivity, rapid skill acquisition, and high-quality work. However, it is a double-edged sword. Unrestrained, it can lead to the neglect of essential responsibilities, burnout, and strained relationships. The therapeutic goal is to provide strategies for channelling this intense focus towards productive and valued goals.   

Therapy - Community Support Groups or Individual Therapy

A comprehensive approach to ADHD includes understanding the nuances of the diagnoses, what it means for you, and how it plays out in others. Seeking therapy can allow a safe and reflective space for you to understand your needs, foster reflection, and ultimately work on self-compassion. Further to this, ADHD is often accompanied by other emotional difficulties such as anxiety. Therapy can help with the co-occurring difficulties.

Support groups serve as a vital component by providing a space for shared experience, mutual psychoeducation, and the reduction of internalised shame and isolation. A support group acts as a form of social scaffolding, externalising emotional regulation and providing a non-judgemental framework. The Australian ADHD Guideline explicitly recommends support groups as part of a comprehensive treatment plan, acknowledging their role in improving quality of life and facilitating a sense of belonging.   

Table 2: Adult Strategies at a Glance

Strategyf	Primary Function	Strength & Nature of Evidence
Movement & Exercise	Improves inhibitory control; boosts dopamine and norepinephrine; manages comorbidities.	Strong. Acute and chronic exercise show positive effects on inhibitory control. Evidence for improving mood and managing comorbidities is well-established.
Externalisation	Compensates for working memory deficits; reduces mental stress; improves organisation.	Established. The principle is well-supported and widely used in clinical practice.
Pomodoro Technique	Combats "time blindness"; improves task initiation; provides structured focus.	Promising/Anecdotal. Aligns with ADHD brain function. Widely recommended by clinicians, though large-scale research on its specific efficacy for ADHD is limited.
Body Doubling	Provides external anchor for focus; boosts motivation; reduces procrastination.	Mixed/Contradictory. Some studies and widespread anecdotal reports show significant benefits , while other sources state formal research to prove effectiveness is lacking.
Intense Interests	Channels hyperfocus for productivity and skill acquisition.	Conceptual/Contextual. Reframes a symptom as a strength. The neurobiological mechanism is understood , and anecdotal evidence of its power is extensive.
Support Groups and/or therapy	Provides psychoeducation, a safe space for reflection, community, and social scaffolding; reduces shame.	Recommended. The Australian ADHD Guideline explicitly recommends support groups as a component of multimodal care.    evidence for individual therapy is very strong.

A comprehensive approach to managing ADHD is multimodal and grounded in a neuroaffirming framework. This perspective reframes ADHD as a natural variation, with the therapeutic objective shifting from normalisation to empowerment and skill-building.

Hopefully you are able to benefit from one or more of these strategies. We are biased, but at Jigsaw Psychology & Assessment, we highly recommend seeking individual therapy on top of utilising these strategies, especially if there are co-occurring difficulties and a lot of stress. Contact Us if you wish to discuss some options.