7 Secret Struggles of High-Functioning ADHD

In the past few years, there has been an increased awareness and buzz about Attention Deficit Hyperactivity Disorder (ADHD). As of 2025, it is estimated that 6% of the adult population in the United States has a current diagnosis of ADHD, and of that number, only a third are receiving treatment or therapy.

People with ADHD often struggle with inattention, hyperactivity, or impulsivity (or all three), and it can cause impairment at school, at home, or their work. For some, they have become so efficient at managing their ADHD symptoms that they have what is known as high-functioning ADHD. On the outside, they seem to have everything under control, while on the inside, they face unique secret struggles that cause them to feel exhausted, alone, and helpless.

High Functioning ADHD

High-functioning ADHD is not an official medical diagnosis or a different subtype of ADHD, but it is instead a way to describe how certain people manage their ADHD symptoms.

Someone who has high-functioning ADHD will still experience many of the symptoms that come with having ADHD, such as inattention, hyperactivity, time blindness, distractibility, procrastination, or restlessness. These aspects of ADHD can be crippling and detrimental, but some have learned how to mask, cope, or work around these issues so efficiently that no one knows of their private struggles.

Many people with high-functioning ADHD have become adept at masking their ADHD. They have learned to manage their struggles to such an extent that no one around would even suspect they had ADHD. Outwardly, they may seem calm, focused, punctual, and reliable, while inside, they are exhausted from holding it all together to appear unfazed.

Eventually, because they are having to focus on completing tasks in the same way as a neurotypical person would, this can lead to regular burnout because they are having to exert twice the effort of everyone else.

Seven Struggles of High-Functioning ADHD

While everyone diagnosed with ADHD faces certain struggles, many struggles are unique to people with high-functioning ADHD. Sometimes, the first step to learning healthier coping mechanisms is to acknowledge where you are not coping.

Here are the most common ways that people with high-functioning ADHD struggle to cope:

Identity Confusion

Most people with high-functioning ADHD do not “feel” as if they have ADHD. They often learn in school that they must not do certain things, such as become distracted. Likewise, they know they must do more of what feels unnatural to them, such as maintaining their enthusiasm even when their focus has been lost.

On the other hand, some individuals with high-functioning ADHD never get diagnosed with ADHD because they have learned to mask their symptoms so well. They feel different from others because they struggle with basic things like punctuality. No one else would notice their struggles because on the surface, they seem to be coping just fine. It’s frustrating to feel as if you don’t fit in while everyone is telling you that you’re fine.

Imposter Syndrome

It is common for those with high-functioning ADHD to feel like they might become exposed at some point. People around them might see that they complete tasks on time, produce a high standard of work consistently, or “lock in” as they work. What they miss is the enormous effort that it takes to achieve any of these things as an individual with ADHD, even as a high-functioning one.

It is completely normal for people with ADHD to feel inadequate and undeserving of praise, while also fearing that their mask might slip and expose their true struggles. Dealing with impostor syndrome is a common but secret struggle of being someone with high-functioning ADHD.

Emotional Dysregulation

Emotional dysregulation is the difficulty in managing or expressing one’s emotions appropriately, and is often a symptom of ADHD. For the high-functioning, it can be a more intense experience. They may have frequent mood swings, angry outbursts, or emotional episodes that feel disproportionate to the situation.

Individuals with high-functioning ADHD are aware of this quality about themselves, and they might attempt to repress, stifle, or delay their responses as best they can until they are in a safe place to let it all out. This can cause a host of issues, from physical symptoms like high blood pressure and migraines, to suppressing their emotions.

Inconsistencies

The tendency of high-functioning people with ADHD to mask their issues often results in inconsistencies. They might have spent the day communicating wonderfully at work, but they give their partners the silent treatment when they get home.

They might have met all of their professional deadlines, but haven’t replied to a text from a friend for months. They likely feel ashamed and confused about their behavior, without understanding why they act this way. They can’t explain their behavior.

Overcompensation and Perfectionism

People with ADHD do not function the same way as neurotypical people without having to put in a lot of extra effort. This causes them to overcompensate and to become perfectionistic in their approach to life, whether it’s professional, personal, or spiritual. The combination of perfectionism and high-functioning ADHD often results in anxiety, exhaustion, and, in some cases, depression and feelings of hopelessness.

Isolation and Loneliness

Although ADHD diagnoses are becoming more common, people with ADHD still feel alone in their struggles, and they might even struggle to understand themselves, which is a unique kind of isolation. This kind of loneliness has a deeper impact on people with high-functioning ADHD because few people understand the struggles of a neurodevelopmental disorder like ADHD.

Needs Versus Wants

It can be incredibly difficult to release yourself from the pressure to be high-functioning. These are learned habits and developed abilities that have taken decades to finely tune. They have served you in some capacity, or else you wouldn’t still be doing them.

You might need to start prioritizing your needs above your wants, though. Maybe you want to be seen as competent, average, or unremarkable, but what you need is to be seen, understood, and supported for who you are deep down. Though you have done so well to get to where you are, now you need acceptance, grace, and help in the areas where you can’t manage.

Finally, it is important to remember that while you may have an ADHD diagnosis, it does not define who you are as a person. ADHD is a medical diagnosis that describes one facet of who you are. We are not defined by our health, but by our identity in Christ.

Next Steps

ADHD is treatable. It can be treated with psychotropic medications (along with therapy) that help improve concentration, hyperactivity, and restlessness. You are not alone. There are counselors, therapists, and support groups waiting to walk alongside you and help you. If you would like to be connected with a counselor, please contact our office today. Make an appointment to start on your path of relief, understanding, and freedom.