The Hidden Cost of Coping: When “High-Functioning” ADHD Comes at a Price
By Robert Rackley MSc MIACP
The Neurodivergent Psychotherapist | Specialist in ADHD, Autism, and Mental Health
Introduction
Many adults with ADHD have spent their lives learning how to cope — often by pushing harder, masking struggle, and keeping up appearances.
From the outside, they can seem confident, capable, and “high-functioning.”
But behind the surface success, there’s often a quieter truth: exhaustion.
At my therapy practice in Limerick, I often meet clients who have spent years running on adrenaline, fear of failure, and self-criticism. What looks like motivation is sometimes survival.
What Is “High-Cost Coping”?
“High-cost coping” is the emotional and physical toll of constantly managing ADHD in a world that misunderstands it.
It can look like:
Overcommitting to avoid letting people down
Pushing through burnout to meet deadlines
Hiding overwhelm behind a calm or capable exterior
Struggling with emotional crashes after periods of intense focus
Over time, this pattern depletes the nervous system. The body begins to run on stress hormones, and when it can’t sustain that pace, it shuts down — leaving the person feeling flat, unmotivated, or even depressed.
Why “High-Functioning” Is a Misleading Term
Calling someone with ADHD “high-functioning” can sound like praise, but it often hides distress.
It suggests that performance equals wellness — and it overlooks the energy, anxiety, and self-pressure behind the scenes.
Many of my late-diagnosed clients tell me they’ve spent decades appearing “fine” while privately battling burnout, rejection sensitivity, and shame.
They’re not thriving; they’re coping.
The Cycle of Burnout and Shame
When burnout hits, ADHD adults often blame themselves:
“I’m lazy.”
“I’ve lost my drive.”
“I just need to try harder.”
But burnout isn’t a lack of effort — it’s the body’s way of saying enough.
After years of masking and striving, the nervous system reaches its limit.
The shame that follows (“Why can’t I cope like before?”) only deepens exhaustion. Recognising this as a biological response — not a character flaw — is the first step toward recovery.
Healing from High-Cost Coping
Therapy for ADHD burnout focuses on rebuilding connection with the self, not increasing productivity.
Here are a few neurodivergent-affirming approaches that can help:
Permission to Rest – Rest isn’t failure; it’s recovery. Giving yourself permission to slow down helps restore emotional regulation and executive function.
Unmasking Safely – Reducing the pressure to perform allows authenticity and self-acceptance to grow.
Body Awareness – Learning to recognise physical cues of stress helps prevent complete shutdown.
Redefining Success – Shifting from external achievement to sustainable wellbeing reframes what progress really means.
Moving from Survival to Self-Compassion
Understanding ADHD isn’t about finding flaws — it’s about naming the invisible effort behind everyday life.
When adults begin to see that their exhaustion is rooted in biology, not weakness, something shifts.
They stop fighting themselves and start caring for themselves.
As one client said to me recently,
“I thought I was falling apart, but I was actually just tired of surviving.”
Final Thoughts
If you recognise yourself in this pattern of over-coping, know this: you’re not broken — you’re burnt out.
The goal isn’t to push harder, it’s to pause, recalibrate, and begin living with understanding rather than constant self-criticism.
Diagnosis, therapy, and education can help you move from survival mode toward something gentler and more sustainable — real wellbeing.
About the Author
Robert Rackley MSc MIACP is a neurodivergent psychotherapist based in Limerick, Ireland. He provides specialist therapy and psychoeducation for ADHD and autistic adults, alongside CPD-accredited training for mental-health professionals.
Learn more or explore his online course:
👉 Could I Have ADHD?
