ADHD · Adults · Telehealth Therapy
ADHD therapy that addresses what's actually happening.
Not a list of productivity tips. Not a focus on time management. Therapy for the emotional dysregulation, the shame, the rejection sensitivity, and the patterns that have been building for years built around how the ADHD brain actually works.
What ADHD actually looks like in adults.
Adult ADHD rarely looks like the version most people picture. It's not primarily about focus. It's the gap between knowing what you need to do and being able to make yourself do it. The emotional intensity that seems disproportionate and takes longer to recover from than it should. The sensitivity to criticism or perceived rejection that can derail a day completely. The chronic undercurrent of feeling like you're failing at things that seem effortless for everyone around you.
It's starting things with genuine momentum and watching them get abandoned when the novelty fades. It's the mental tab overload twenty things running at once with no clear off switch. It's being really good at some thing the hyperfocus, the creative thinking, the ability to work under pressure while struggling significantly with things that require sustained, uninteresting effort.
Both of those things are real. Neither cancels out the other. ADHD is not a personality flaw and it is not a deficit of character. It is a neurological difference that has meaningful, documented effects on how the brain manages attention, emotion, and behavior.
The emotional layer nobody talks about.
Emotional dysregulation is one of the most impairing features of ADHD in adults and one of the least discussed. Emotions arrive faster, feel more intense, and take longer to regulate than for people without ADHD. This is not a sensitivity problem. It is a neurological feature of ADHD that has to do with how the brain processes and regulates emotional response.
Rejection Sensitive Dysphoria — RSD — is a specific form of emotional dysregulation in ADHD involving an intense and often immediate emotional response to real or perceived rejection, failure, or criticism. It can look like depression, anxiety, or extreme sensitivity. It's common in ADHD, rarely identified correctly, and significantly impacts relationships, work, and self-perception.
ADHD also accumulates a specific kind of shame built from years of trying hard, falling short of expectations that seemed reasonable, and not having a framework for why. That shame becomes its own layer on top of the ADHD, and therapy that doesn't address it directly produces limited change.
Late diagnosis and what it brings with it.
A significant and growing number of adults receive an ADHD diagnosis in their 30s, 40s, or beyond often after years of misdiagnosis as anxiety, depression, or personality disorder. For women particularly, ADHD has been systematically underidentified because the clinical presentation often looks different than the hyperactive, disruptive version that shaped diagnostic criteria.
Late diagnosis brings relief finally an explanation and grief, for the years spent thinking you were failing at things that were actually harder for you than for other people. It brings a complete rereading of personal history: the jobs that didn't work out, the relationships that strained under patterns you couldn't name, the gap between your potential and your performance that nobody could account for.
That reckoning deserves real support. Not just strategies for managing ADHD going forward, but space to process what it means to understand your past through a new lens.
ADHD and food.
One of the most common and least addressed presentations in adults with ADHD is a complicated relationship with food. The neuroscience is straightforward: the same executive function networks that regulate attention also regulate hunger cues and fullness signals. For many adults with ADHD this manifests as forgetting to eat during the day, then eating past full in the evening. Or eating for stimulation when the nervous system is understimulated food as a dopamine source. Or a restrict-and-binge pattern that no amount of discipline or meal planning has changed.
This is not a willpower problem. It is a regulation problem, and it responds to being treated that way. Approaching it as a food issue or a discipline issue consistently makes it worse because the intervention doesn't address the mechanism.
How ADHD therapy works here.
Therapy for ADHD at this practice is not structured around productivity and time management, though practical skills are part of the work when they're relevant. It's structured around what's actually creating the most impairment which for most adults with ADHD is the emotional layer, the shame, and the specific patterns that ADHD has created in their relationships, work, and relationship with food.
The modalities I draw on are CBT and DBT skills adapted for how the ADHD brain actually processes information and implements change. The pacing and structure of sessions account for ADHD rather than working against it. Between-session work is realistic, specific, and designed to fit how your brain functions not how it's supposed to function.
If you're working with a prescriber on medication, I coordinate with them when it's useful. For most adults with ADHD, medication and therapy together produce meaningfully better outcomes than either alone.
Common questions about ADHD therapy.
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A: Medication addresses the neurological component of ADHD — the bandwidth, the regulation, the noise. It does not address the emotional patterns, the shame, or the relational impact that have built up over years. Most adults with ADHD who are on medication find that therapy moves differently with that foundation but that there's still a meaningful layer of work that medication doesn't touch. Therapy is also useful without medication for adults who choose not to medicate or who are in the process of figuring that out.
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A: Yes. Many adults come in with a strong suspicion but no formal evaluation. I don't diagnose ADHD — that requires a separate neuropsychological or psychiatric evaluation but I can assess your presentation thoroughly and help you understand whether pursuing a formal evaluation makes sense. If the presentation is consistent with ADHD and that's what we're working with clinically, we proceed accordingly. A formal diagnosis is not required to begin therapy.
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A: In meaningful ways, yes. Therapy that doesn't account for ADHD often inadvertently works against it — assuming levels of working memory, follow-through, and emotional regulation that ADHD specifically impairs. Effective ADHD therapy is structured, direct, and designed around realistic implementation rather than insight alone. Sessions are paced for how the ADHD brain engages, and between-session work is concrete and specific rather than open-ended.
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A: Yes. Late-diagnosed women are a significant part of my caseload. The ADHD presentation in women frequently differs from the hyperactive, disruptive version that has dominated clinical training — which is why misdiagnosis and delayed diagnosis are so common. The grief, the rereading of personal history, and the specific ways ADHD has shown up in relationships and self-perception are all part of the work I do regularly.
ADHD is not a character flaw. It's a starting point.
If you've been managing ADHD or suspected ADHD without the right support, or if therapy has focused on the wrong things, a consultation is the right next step. It's free, brief, and the place where we figure out whether this is a fit.
Virtual · Licensed in CO · ID · SC · Currently accepting new clients