After the Relief Came the Exhaustion
When I look back at the weeks after my ADHD diagnosis, the first thing I remember is validation. Relief that the process had confirmed what I already suspected, and that I didn’t have to search for some other explanation for everything I had been learning about myself. It was the moment I could finally stop doubting. I had an answer.
What followed was exhaustion, but it wasn’t the same tiredness I had carried for years. This was the release of tension that had been building ever since that conversation in the pub where I first allowed myself to ask the question. It had built through months of late-night reading, piecing together my own self-diagnosis, and through the long process of arranging and finally undergoing the assessment itself. When the verdict came, my nervous system simply let go. I thought diagnosis would bring clarity and energy. Instead, what followed was an exhausted relief.
What came next was grief. I replayed moments from my past with a new and painful clarity. High school exams where I crammed at the last minute and managed to squeeze through, my university dissertation I couldn’t write and pushed under the door of my supervisor one minute before the deadline, relationships that fell apart, years of drinking and smoking to numb and calm myself, and an inability to manage money or think about the future. I saw how often I had struggled and felt like I needed to apologise. Knowing it wasn’t laziness or weakness didn’t stop the grief. It was grief for the life I might have lived if I had known earlier.
This crash is sometimes called the diagnosis drop, and it isn’t unusual. Research shows that autistic and ADHD adults often experience a period of exhaustion, low mood, or depression after diagnosis. One research paper concluded that “a delayed diagnosis created needless suffering and struggle” (Long & Coats, 2022). Another described diagnosis as both “a blessing and a curse”, capturing the mix of relief, validation, grief, and identity disruption that many adults feel (Gillott, Standen, & Corker, 2020). European researchers have also warned that under-recognition and lack of treatment in adults can lead to unnecessary suffering for individuals, families, and workplaces (Kooij et al., 2010).
Those feelings turned inward, but also outward. I started talking openly at work. One of my long-term habits, oversharing, actually helped me get through this stage. I spoke about what I was going through openly, in meetings and large forums, not really thinking about the impact of being so brazen. I just had a deep need to help others. That openness became the seed of something bigger. People recognised themselves in what I was saying and began coming forward. Out of that grew the neurodiversity network that I set up at work, which now has hundreds of members. At first I thought helping others was my duty, and I didn’t deserve help myself. But in creating a community, I began to see that I was allowed to be supported too. I'd not just found my tribe, but created one for many, including myself.
Medication was another turning point. Throughout the process I had always thought that I wouldn't go down the medication route. I thought it might make me lose some of my sparkiness and change me. My psychiatrist explained how it can help with so many aspects of life, and suggested I might as well try it. The tablets only last a few hours, they aren’t addictive, and if I didn’t go through titration I might have to repeat the whole diagnosis process. So I tried. The first pill of methylphenidate was like a miracle. Within twenty minutes my mind was quiet for the first time in my life. The chittering monkeys that distracted, cajoled, interrupted, and belittled me every moment of every day were gone. The silence was almost deafening. It was like going from a crowded hall full of overlapping voices to a silent library. The absence of noise was so stark that the quiet itself felt overwhelming.
That silence brought an internal peace I had never known. The anxiety I had lived with my whole life evaporated, and in its absence I realised how much pressure I had been under without ever noticing it. I had worried medication would dull me or take away my creativity, but that never happened. For weeks I thought the medication was doing nothing apart from the peace, because outwardly I still felt like me. What I hadn’t realised was that peace itself was the change. The quiet was enough.
I’ve written elsewhere about how starting ADHD medication felt like a system reboot — not a fix, but a chance to finally operate in line with how I was built. For years I had been trying to run Windows software on a Mac brain, and medication gave me the first glimpse of what it meant to use tools that fit my system. That fuller reflection is in the final piece of my ADHD Lifespan Series, which you can read here.
Over time, that inner peace began to reshape my life in small but steady ways. It wasn’t fireworks. It was more like the high jump bar had been lowered, and suddenly I could clear things that had always been out of reach. I cleared my inbox at work and kept it clear for a year. I built a way of managing tasks that finally worked, a system designed around the very gaps that ADHD had always left exposed.
Most importantly, I found I could build routines and keep them. My mornings had always been chaos. Forgetting my backpack, my lunch, my jumper, even brushing my teeth. I would leave the house three or four times before getting anywhere. With a quiet brain, I started to do things in the same order. Within a week, the habits held. I began making a healthy lunch every day, and two years later I still eat the same lunch. I started flossing, something I had never been able to do. I even had time to make a coffee and drink it before leaving the house. It was a drastic change from the whirlwind of lateness and forgetfulness that had defined me for decades.
My wife noticed the difference before I did. One day she pointed out that I had stopped leaving the cupboard doors open. At work, people remarked that I was replying to emails. These were small things, but they showed that the changes weren’t only internal. Yet even then, my instinct was not pride but suspicion. It felt like an underlining of how bad I had been. A blip that would soon end with me back where I started. That mix of progress and self-doubt was part of the drop too.
Alongside routines came bigger changes. I joined a gym and got a personal trainer. I used external motivation in ways that finally stuck. I stopped drinking every night. Alcohol had been my way of quieting my mind enough to sleep, and suddenly I didn’t need it. First I limited it to weekends, then stopped altogether. I cut out caffeine almost immediately. Before, I drank three coffees and four Diet Cokes a day. On medication, even one coffee felt like I had been up all night on Red Bull and Pro Plus. Now I might have the odd one every couple of months.
As I rebuilt, I also noticed shifts in identity. For the first time, I wasn’t just surviving on workarounds and crisis mode. I began to feel like I could choose the kind of person I wanted to be, not just fight against what I wasn’t. That shift is still ongoing and i’ll be covering that in next weeks article.
The diagnosis drop was real. At first it was collapse, grief, and the replay of old wounds. But it also gave me peace. It showed me that quiet was possible. It gave me community, healthier scaffolding, and the first stable routines of my life. I came to see that the work is not only about stopping coping strategies that no longer serve me. It is about finding new ones that do. And even now, with better habits and healthier routines, there are still days when the weight of it all returns. The difference is that I now have the awareness and tools to ride it out, instead of believing it means I’ve failed.
I sit here writing this article on a Thursday evening, after spending my spare time this week, like most weeks now, reading about psychology, coaching and neurodiversity. Just a couple of years ago I would have been two or three glasses of wine into numbing myself after a long day in work, trying to quieten my mind enough to get to sleep by 1am. When I shared a draft of this article with my mum, she said “it sounds like you’ve had a terrible life”. I really haven’t. My life has been a series of exciting adventures, some good, some not so good. I didn’t know until recently the cost that my neurodiversity was charging my mental health. It was just my “normal” to be all-in and then wiped-out. Two years on since diagnosis and every part of my life has changed for the better. I have learned that I need to look after myself, and that it’s ok to take the time to do that.
This piece has focused mainly on ADHD, as that was my first diagnosis. A year later I was also diagnosed as autistic, and in the next article I’ll be writing about what happens when lifelong masking falls away.
This article is the first in my Post-Diagnosis series. Next week I’ll be writing about my Autism diagnosis, the ways we regulate in social spaces, and how what looks like “helpfulness” is often survival. If you’d like to follow along, make sure you subscribe.
And if you’ve been through this stage yourself, I’d love to hear: what unexpected positives have you experienced since your own diagnosis? Even the small ones count. Sometimes naming the good helps us see just how far we’ve already come.
Long, N., & Coats, H. (2022). The need for earlier recognition of attention deficit hyperactivity disorder in primary care: a qualitative meta-synthesis of the experience of receiving a diagnosis of ADHD in adulthood. Family Practice, 39(6), 1144–1155. https://doi.org/10.1093/fampra/cmac038
Gillott, A., Standen, P. J., & Corker, E. (2020). Psychological impact of an adult ADHD diagnosis: A blessing and a curse. International Journal of Environmental Research and Public Health, 17(10), 3649. https://doi.org/10.3390/ijerph17103649
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559–572. https://doi.org/10.1017/S0033291718002283
Kooij, S.J., Bejerot, S., Blackwell, A. et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry, 10, 67. https://doi.org/10.1186/1471-244X-10-67
