How to Manage Your ADHD as an Adult

What to do if you're "naturally" inattentive

Photo by Lena Kudryavtseva on Unsplash

On a rainy day last fall, I joined the professional organizer Nicole Anzia in her client Diana’s bedroom, where we surveyed The Pile. It consisted, at that moment, of a red blazer, a blue bra, and half a dozen professional work tops.

Diana, a 50-year-old consultant with a warm smile and big glasses, feels like she has too many clothes for her space: Just two small dressers for what looked like a GAP’s worth of shirts, most of which she gets secondhand and through trunk shows.

Nicole and her partner, Christina, were there to cull them, which is a common request from their clients. People mostly wore athleisure during the pandemic, and now all their old Ann Taylor is too small and too 2019.

The day I came over, Diana had just returned from traveling, and she hadn’t yet unpacked. The suitcase from her trip to Dallas was on the floor. The suitcase from her trip to Paris was in her office. Clothes heaped on the bed, a chair, and a bench at the foot of her bed.

Nicole and Christina took turns holding up sweaters and blouses for the vote of Diana, who would issue a “keep” or “toss” for each one. There were a lot of sentimental t-shirts: One with her sorority letters; a shirt devoted to the Icelandic rock band the Sugarcubes. These mostly survived. Tossed were a pair of pink pants that didn’t fit right. Kept were some denim overalls, a swimsuit cover-up, and a corset from Anthropologie.

When the organizers came to a large, boxy striped shirt, Diana vacillated. Christina and Nicole recommended tossing it, with the logic that it would swallow her slim figure. Diana agreed reluctantly. Within a couple of hours, it looked like the home of someone who didn’t need a professional organizer.

Diana thinks she might have a mild form of ADHD. Leaving on time can be challenging, so she sets alarms for her doctors’ appointments and meetings. She’s not interested in doing things that aren’t novel, so when clothes get dumped on the bed, they tend to stay there.

ADHD may seem like a permanent, incurable condition. But it’s associated with the personality trait conscientiousness (specifically, low levels of it). And as I write in my forthcoming book, conscientiousness can change over time and with interventions. By using some of these conscientiousness-building tools, people with ADHD can learn to manage their condition. Maybe not “cure” it entirely, but at least make it fit into their lives. The kind of work Nicole was doing with Diana—helping her sort through her belongings; drawing her attention to what she truly needs or wants—can help. This type of personality change is unique because it requires tweaking your immediate environment, rather than something about yourself.

ADHD often shows up first in preschool, as abnormal hyperactivity. It lends extra rocket boosters to a cohort that already struggles with the zoomies. When kids start school, ADHD can turn into inattention—zoning out and procrastinating. It can also reveal itself in interpersonal problems: People with ADHD might talk too loudly and too long, change the subject, or miss the point of a conversation because they weren’t really listening. Some adults with ADHD might have flashes of anger and irritability; they struggle to regulate emotions as much as attention.

Because ADHD is partly genetic, many kids with ADHD have parents who have it, too, which tends to compound the problem. Parents with ADHD are often disorganized, which can exacerbate the ADHD symptoms of their children, since there’s no one at home keeping everything on track.

But only about 60 percent of kids with ADHD grow up to meet the criteria for the disorder in adulthood. In other words, some people have a way of changing, or at least managing, their own ADHD. And it’s largely by crafting their environments to fit their attention span.

In college, many people major in something they’re naturally interested in, or they at least find ways, through reminders and alarms, of managing their attention. Some wind up in active jobs that require, rather than repress, their tireless natures. “I worked with a family where the dad was an outdoor engineer,” says Michelle Martel, a psychologist at the University of Kentucky, “and he was like, ‘well, I used to have problems sitting in a desk. But now that I'm running around on my site all day, it's fine.’”

Most research suggests that ADHD can be treated with medications, but behavioral therapy can also be really helpful. People with ADHD tend to be more sensitive to rewards, so much of the treatment involves dispensing, say, M&Ms and TV minutes for sentences written or PowerPoint slides created. Martel, who primarily works with kids who have ADHD, will show her patients how to organize their backpacks, to set rewards for completing homework, or to break tasks into smaller chunks. Adults can benefit from this kind of organizational-skills training, too.

Often, what people who struggle with ADHD or low conscientiousness need is not to simply “try harder,” but to change their environment, as Angela Duckworth, the author of Grit, told me. Instead of berating yourself for being disorganized or inattentive, you need to structure your environment so that it’s easier for you to be organized and attentive. Personality change can come from within, but it can also come from pomodoro timers. If you keep getting distracted by your phone, Duckworth says, “put your cell phone in a locked drawer and give somebody else the key … believe me, you'll pay attention more, and not because you're trying harder, but because you changed your situation.” Or, if you’re disorganized, hire a professional organizer.