ADHD: The Long Term Consequences of Being Undiagnosed

Srinivas Rao
12 min readNov 8, 2022
Photo by Gigi on Unsplash

An early ADHD diagnosis can be transformative , while a late one can have a detrimental impact on someone’s life.

Prior to entering high school, Jesse Patel, the founder of Workflowy had been kicked out of multiple schools. His father had the foresight to recognize that his son might have ADHD and asked if he wanted to take medication for it. Despite his early struggles, Jess graduated from Stanford with degrees in mechanical engineering and product design.

For people who are diagnosed later in life, it’s a different story. They may have spent years feeling out of place or struggling to understand themselves, without realizing that they have a condition that could explain their experiences.

Early Warning Signs of ADHD

Photographer: Muhammad Daudy | Source: Unsplash

I wasn’t diagnosed with ADHD until age 28, despite lifelong signs.

Losing Things

My parents stopped buying me watches in 2nd grade, I’ve lost 6 cell phones in a year, and there have been days when I’ve torn apart my house looking for my keys only to discover they’re in my pocket. It’s moments like that that make you feel like you’re showing early signs of Alzheimer’s.

“When you’ve ADHD, less stuff is better. Clutter is a distraction waiting to happen,” says Peter Shankman in his book Faster Than Normal.

For this reason, I don’t put down my Apple Watch until it’s completely dead, and I try to own as little as possible.

Forgetting Things

Because my brain is faster than normal, I forget …

To Put the damn cap on the toothpaste (sorry mom, I’m trying)

To close doors to closets, cars, patios, etc

Turn off the lights (Yes, Dad, I know it’s not Diwali)

Put things back where they belong

Reading street signs. The San Francisco Parking and Traffic Department should erect a statue in my honor for giving them so much money in my early 20s. If they don’t, one day I’ll buy the peeing boy of Brussels from the Skymall catalog, have it engraved, and put it in front of DPT.

The list goes on and on. My mother and close friends describe me as a tornado. After my visits, they always find things I’ve left behind.

The solution: have the closet of a serial killer or a minimalist. You could easily mistake one for the other when you see how little is in my closet.

When you have ADHD, you forget about these things because your brain works too fast and you don’t give a damn about them. What most people think is important, you think is pointless.

Talking too Much

Photographer: Timothy Dykes | Source: Unsplash

This is the greatest irony of all. I make my living listening to people. But in a social situation, I can’t shut up.

When my female podcast listeners ask me out on a date, they’re stunned by their friends’ feedback: He’s not listening.

  • What most of these people don’t know is that I listen to and remember EVERYTHING in great detail.
  • Some of my friends say that my memory of their stories is better than their own

Talking less and listening more in social situations is something I’ll work on for the rest of my life.

What It’s Like Inside My ADHD Brain

Photographer: Milad Fakurian | Source: Unsplash

“If you were to climb up into our head you’d find ideas firing around like kernels in a popcorn machine: ideas coming rat-a-tat fast, and on no discernable schedule. Ideas come in spontaneous, erratic bursts. And because we can’t turn this particular popcorn machine off, we are often unable to stop the idea generation at night; our minds never seem to rest” says Ned Halowell in his book ADHD 2.0.

This is one of the many ways mem helps me deal with ADHD. It’s become an essential part of my work because

  • You can capture ideas as they emerge
  • Bidirectional links help you trace the thought process that sparked an idea.
  • You can follow your curiosity wherever it leads without interrupting your workflow

When I talked with Andrew Bustamante about how to develop a CIA agent’s people-reading skills, he said the following.

  • When you talk, you talk, and then you break off your own sentences to ask new questions. You jump around on your own questions, not just on my answers, but in your own dialogue, your own monologue. This is a strong indication that your brain is working faster than your mouth, which tells me that you’re thinking very conceptually. You’re trying to turn these complex concepts into something that can be communicated verbally. That’s an ADHD trait.

Until you’re diagnosed with ADHD, you think you’re a loser who can’t get your shit together. So does everyone else.

The Unfortunate Consequences of Being Diagnosed with ADHD later in life

Photographer: lucas Favre | Source: Unsplash

Before being diagnosed, people with ADHD are considered lazy, unmotivated, and uninterested in taking control of their destinies. Unfortunately, their grades in school, their relationships, and their performance at work only reinforce this perception.

My fourth grade teacher expressed concern to my parents that I might have a learning disability because I was failing reading. However, my parents, being Indian, were skeptical of this diagnosis. They attributed my difficulties to a subpar teacher, rather than any inherent issue on my part.

Despite these early struggles, I managed to make it through high school with grades that were good enough to earn me admission to UC Berkeley. Unfortunately, my academic struggles resurfaced in college, and things quickly went downhill from there.

  • No matter how hard I tried, my grades did not improve and I graduated from college with a grade point average of 2.97
  • By the time I was 30, I had been fired from so many jobs that my resume looked like a rap sheet of all the places I had sat in corporate America.
  • I could never finish anything I started: hobbies, classes, books, etc. False starts defined my life.

People with ADHD experience “biographical illumination,” as

discussed on Unmistakable Creative.

There are some sorts of diagnoses, especially like terminal illness, where it marks a separation from the time before the diagnosis to after the diagnosis. And there’s a disruption in your sense of identity. With autism and with some other conditions as it gives you an opportunity to shine a new light on the whole rest of your life.

Like many people, when I was finally diagnosed with ADHD, I felt relieved because it helped me make sense of how my life had turned out.

When I was finally diagnosed with ADHD, like many people, I felt relieved because it helped me make sense of how my life had turned out.

The Blessing and Curse of ADHD

Photographer: Mohamed Nohassi | Source: UnsplashPhotographer: Zac Durant | Source: UnsplashPhotographer: Zac Durant | Source: UnsplashPhotographer: Zac Durant | Source: UnsplashPhotographer: Zac Durant | Source: UnsplashPhotographer: Zac Durant | Source: Unsplash

It helps to think of ADHD as a complex set of contradictory or paradoxical tendencies: a lack of focus combined with an ability to superfocus; a lack of direction combined with highly directed entrepreneurialism; a tendency to procrastinate combined with a knack for getting a week’s worth of work done in two hours; impulsive, wrongheaded decision making combined with inventive, out-of-the-blue problem solving; interpersonal cluelessness combined with uncanny intuition and empathy; the list goes on. — Ned Hallowell, ADHD 2.0

ADHD is a blessing and a curse. Every negative aspect of ADHD has a positive counterpart.

  • You can’t sit at a desk, but you can build a business and hire other people who sit at a desk.
  • If you’re not doing anything interesting, it feels impossible. And when you do, you can make the impossible possible.
  • Because your brain is what Ned Hallowell calls the ADHD popcorn machine. You never have a shortage of creative ideas. But you also constantly face the risk that following parallel paths will impede your progress in one direction

ADHD is a gift in some contexts and a curse in others.

The Emotional Sensitivity Paradox of ADHD

Photographer: Tengyart | Source: Unsplash

One odd thing about ADHD is that you have a higher level of rejection sensitivity than someone who is neurotypical.

  • They fall hard, fall fast, and are notorious for confusing infatuation with love.
  • When someone criticizes or ridicules you, their words carry weight. But those words are much harder when you have ADHD.

The paradox is that you are also insensitive, unfiltered, and unable to sugarcoat anything.

  • If you have a problem, I already have a solution in hand before you finish telling me about the problem. But, I tune out the second you start sharing your emotional issues, I tune out.
  • When people ask for feedback on something, you tell them if you think it sucks. You’re unaware of the fact that it might hurt their feelings.

​But if you talk to my closest friends, they’ll tell you I am as loyal as they come. So I guess ADHD makes me a loyal friend that is an acquired taste, but you also might initially hate it.

The Cognitive Paradox of ADHD

Photographer: Ryan Gagnon | Source: Unsplash

The same characteristics that make people with ADHD professionally useless also make them successful.

When people with ADHD don’t give a damn about something, they can’t focus, engage, or control their impulses. But when they do, it leads to hyperfocus, obsessive commitment, and a relentless propensity to act.


People with ADHD brains have a higher tendency to flow states. Because our attention span is short, we need to take advantage of intense moments of concentration to get things done. As a result, we can get more done in an hour than someone with a neurotypical brain can in a week.

The same “weakness” that got me fired from every job allowed me to finish a 45,000-word manuscript in 6 months.

But hyperfocus also makes you impatient, reckless, and somewhat unbearable. My family got on my case because I would not answer calls or respond to text messages for hours. I had to set them up as exceptions when I activated focus mode on my phone.

I often joke that one of two things would happen if I ever returned to the corporate world: I’d get fired on day one for not being able to accept the status quo. Or I would get promoted for being more efficient than the average employee.

Obsessive Commitment

If boredom is a kryptonite for the ADHD brain, engagement is a superpower that leads to obsessive commitment.

When my 7th-grade band director told me I would make the all-state band, I was obsessed with proving him right.

  • I practiced so much that I drove my family members crazy because the tuba is not a quiet instrument that most sane people would willingly listen to.
  • I would wake up at 6 a.m. and practice in our minivan because we lived in a two-bedroom apartment.

Like Hyperfocus, this is another trait that can make us unbearable. When we are obsessed, it’s all we think about or talk about. Just ask anyone who met me when I first started surfing.

Bias Towards Action

Photographer: Jakob Owens | Source: UnsplashPhotographer: Brett Jordan | Source: Unsplash

It would be an understatement to say that someone with ADHD has a strong propensity for action. Speed as a habit is the default mode and “hit them whenever you can” is the mantra of someone with ADHD.

Because people with ADHD have a Ferrari brain with bicycle brakes, The Rapid Idea Execution Framework is something you’ll see in almost all of my work. If I have an idea in the morning, by the end of the day I have started working on it or even finished it.

I finished the first version of Unmistakable Creative an hour after Sid Savara sent me an email suggesting I turn my interview series into a separate website from my blog.

But a strong inclination to act can bite you in the butt.

  • Neurotypical people know the power of moderation. People with ADHD have addictive personalities. When I told my roommates I had limits, they both replied, “We have never seen them before.”
  • You push people to their limits. When someone I work with tells me they need a week to get something done, my first question is, “Why can you not do it in a day?”

The short-term consequences of undiagnosed ADHD are mainly annoying other people in your life. Because they can not comprehend your actions, they think you are absent-minded.

Our ADHD drives us crazy, too! Always remember that on those rare occasions when ADHD gets the best of us, it makes us even more insane than it does you. Thanks, but we already feel like crap for our mistake. You don’t have to remind us. -Peter Shankman

But the long-term consequences of undiagnosed ADHD can be detrimental to your life and career.

The Impact of Match Quality on Performance

Photographer: Nicolas Hoizey | Source: UnsplashPhotographer: Nicolas Hoizey | Source: Unsplash

The match between a person’s gifts, talents, and strengths and their work affects everyone’s performance. But for someone with ADHD, it’s the difference between peak performance and unemployment.

  • Shackling an employee with ADHD to a desk is tantamount to putting them in jail. It’s one of the worst things you can do to them.
  • Long meetings and company outings where you force a person with ADHD to sit in a hotel ballroom are a form of information torture.

However, the main cause of poor performance at work by people with ADHD is that they have the wrong job. Unfortunately, the standard approach of most managers is to put underperforming employees on performance improvement plans.

Performance Improvement Plans are Pointless

Performance improvement plans are a joke. They’re insurance against employment discrimination and litigation. And for certain people, they are not so-subtle signals that it might be time to look for a new job. -Dan Pink, The Unmistakable Creative Podcast

Performance improvement plans do more to prevent wrongful termination lawsuits than they do to improve performance. It’s impossible to improve performance in any organization if you mismatch someone’s talent and environment. The first question an organization should ask about an underperforming employee is whether or not they are in the right role, to begin with.

Performance Skyrockets When You Match Talent With Environment

If you can find a perfect match, that is, a match between your personality, your upbringing, your culture, your values, your goals, your skills, and your strengths, and if you apply the tools of excellence, you can be world-class. -Steven Kotler, The Unmistakable Creative Podcast

What Steven Kotler says is even more true for people with ADHD. Despite all the challenges it brings to the lives of people with ADHD, many people with ADHD have achieved exceptional performance in their fields.

“Among us are self-made millionaires and billionaires, Pulitzer and Nobel Prize winners, Academy, Tony, Emmy, and Grammy award winners, high-profile trial lawyers, brain surgeons, commodity exchange traders, and investment bankers. And we are often entrepreneurs,” says Nad Halowell

ADHD can be a superpower for creative people. People with ADHD use divergent thinking, noticing connections that others do not see and making observations that someone with a neurotypical brain would tune out. This allows them to create at the speed of thought

If you put a person with ADHD in the right place, hiring them will be the best decision you’ve ever made.


The long-term consequences of being undiagnosed with ADHD can be significant. For many people, it can mean years of struggling in school, work, and relationships. It can also lead to a sense of frustration and confusion, as they don’t understand why they can’t seem to get their lives together.

But once someone is diagnosed with ADHD, they can begin to make sense of their struggles and take steps to manage their symptoms. They can learn to work with their strengths and weaknesses and find ways to thrive in spite of their challenges.

For some, this might mean finding a job that allows them to work in short bursts of intense focus, or one that doesn’t require them to sit at a desk all day. For others, it might mean developing routines and habits that help them stay organized and on track. Ultimately, understanding and managing ADHD can be the key to unlocking a person’s full potential.

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Srinivas Rao

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