ADHD and Mental Health: Why the Whole Person Matters

Adele Wimsett is a women's health practitioner whose work centres on ADHD, hormones and the nervous system. She was diagnosed with ADHD herself at 41. She does not carry out ADHD assessments or manage medication. Her work is helping people understand the patterns in their own wellbeing and ask better questions of the care they are offered.

We asked her about the part of ADHD that gets discussed least: what it does to mental health, and why the two are so hard to pull apart.

Why do anxiety and low mood turn up alongside ADHD so often?

I think of it as several threads woven together. ADHD can involve real difficulty regulating emotions, and research suggests some shared genetic influence with anxiety and depression.

Then there is everything else: the cumulative experience of missed deadlines, strained relationships, criticism, and trying to function in settings that were not built for your brain. That takes a toll, and the toll is not imaginary.

What we cannot do is put a reliable percentage on biology versus life experience for any individual person. It is the old nature and nurture argument and it does not resolve neatly. What I would say is that anxiety or low mood deserves attention in its own right. Understanding your ADHD does not make everything else dissolve.

What do years of not knowing do to self-esteem?

In my work I hear the same shape of story constantly: people who know exactly what they want to do and cannot reliably make it happen. After years of being called careless, disorganised, or full of potential, it is very easy to absorb those words as a verdict on your character rather than a description of a pattern.

Some people become extraordinarily good at compensating, or at masking. From the outside they look entirely capable. Inside they are exhausted and quietly terrified of dropping a ball.

There is research with women who were recognised later in life describing exactly this: the effect of delayed recognition and years of negative feedback on their sense of who they are.

"A diagnosis can bring relief and grief in the same breath. Grief does not mean you regret the person you became."

Why does a late diagnosis so often bring grief?

Because people go back and look. School reports, jobs, friendships, relationships. And they wonder how different any of it might have felt with understanding and support in place.

There is often anger too, at the sheer energy spent masking, or at years of blaming themselves for something that had a name all along. Making space to process that safely matters. It takes time, and it is not self-indulgent.

Where does executive function come into it?

ADHD is a great deal bigger than being distractible. Executive functions are what help us start something, work out what matters first, hold information in mind, switch between activities and actually finish.

So a person can care enormously about something and still not be able to begin it. That gap, between I care about this and I did it, is where shame grows. And if everybody around you assumes the difficulty is a lack of effort, you will eventually assume it too.

Practical support and a kinder explanation can interrupt that cycle. NICE guidance looks at the impact of traits on everyday functioning, not at attention alone, and I think that framing helps.

What about medication, mood and sleep?

Some people find medication gives them more space between feeling something and reacting to it, alongside the effect on attention. Others feel irritable, anxious, flat, or find their sleep suffers, particularly if a medicine or a dose does not suit them. If someone notices a change in mood, I would always encourage them to say so to the doctor who prescribes it, rather than quietly putting up with it.

Sleep is its own thread and I would ask about it early rather than leaving it to the end. Difficulties are common with ADHD but they do not look the same in everyone: some people cannot wind down, others find mornings brutal. Medication timing, stress and other sleep conditions all play in.

And poor sleep leaves anyone more emotionally raw. When someone is already working hard to regulate attention and feelings, a broken night makes anxiety, irritability and low mood a great deal louder.

What do parents of children with ADHD struggle with most?

The constant work of understanding and advocating for their child, while trying to protect the relationship with them. A parent can spend all day fielding messages from school, managing transitions and worrying about their child's confidence, and then come home to the hardest part of the day.

Plenty are navigating their own ADHD at the same time. What they need is compassion and workable support, rather than another lecture about being consistent or the offer of another parenting course.

Is enough support offered to those parents?

In my view, no. It depends far too much on where a family lives, what they can afford, and how persistently they are able to push.

NHS England's independent ADHD Taskforce called for earlier support based on a child's needs, rather than making families wait for a formal assessment first. That is the right direction. There is a long way to go.

What I would want is accessible guidance for parents, genuine support from schools, and room to talk honestly about the emotional load without it being read as complaining. Children do better when the adults around them are supported too.

The thing worth holding on to is that ADHD is rarely just about attention, and the mental health side of it is not a separate problem that happens to have turned up at the same time. Hold the two as one picture and a great deal more of it makes sense.