High-Performing Adults with ADHD: How to Manage ADHD at Work

How to Manage ADHD at Work: 7 Proven Strategies That Can Support Your Professional Success

A 42-year-old executive in New York City came to see me several months after being promoted to lead a large division of a global healthcare company. She was now managing more than 150 employees, traveling regularly for work, and trying to stay engaged with her spouse and two middle-school-aged children. Even though she didn’t realize it, she was struggling to manage ADHD at work.

Although outwardly successful, she was quietly struggling with the day-to-day challenges of leadership, deadlines, and communication—especially when it came to how to manage ADHD at work while leading a team and balancing home life. Deadlines were piling up. She spent hours rewriting emails. She constantly felt behind, disorganized, and mentally overloaded. The promotion had pushed her beyond what she could compensate for with late nights and adrenaline.

What she didn’t realize at the time was that she had lived her entire life with undiagnosed ADHD.

Her symptoms didn’t start with the promotion—they began in early childhood. Teachers often described her as intelligent but unfocused. She excelled in subjects like history and foreign language that captured her interest but struggled in more structured or repetitive classes. Her grades in math and science were often in the low-average range. Starting in first grade, her teachers raised concerns about daydreaming, incomplete work, and difficulty following instructions. They recommended an evaluation for ADHD or a learning disability. While her mother was open to pursuing this, her father strongly opposed any formal assessment, and she was never evaluated.

In college, the lack of external structure made things worse. She frequently missed deadlines, procrastinated on long papers, and avoided classes that lacked clear expectations. She sought help at student health and was diagnosed with anxiety and depression. Over two years, she tried multiple medications and therapy approaches—but nothing helped. Feeling discouraged, she eventually stopped all treatment.

When we met years later, she shared how exhausting it felt to constantly juggle details, manage communication, and complete high-stakes projects. After a comprehensive psychiatric evaluation, including validated diagnostic tools, we confirmed a diagnosis of ADHD, predominantly inattentive presentation, with symptoms going back to early childhood and impacting multiple areas of her life.

In our first three sessions, we developed a working list of “success strategies” tailored to her strengths and challenges. I encouraged her to write these strategies by hand—because research shows that handwriting engages executive function systems in the brain and improves memory, planning, and problem-solving. Over time, we built on this list, adjusting and refining it as she gained confidence and momentum.

1. Create an Organizational System

To reduce overwhelm, we created a streamlined organizational system that worked across her digital and paper environments. She organized her work into weekly dashboards that grouped tasks by project and clearly labeled deadlines. She created consistent folder naming systems and reviewed her dashboard each Sunday evening to prepare for the week ahead. This allowed her to focus on priorities and freed up mental space previously spent tracking unfinished tasks.

2. Break Down Tasks into Smaller Steps

She often avoided starting large projects because they felt amorphous or overwhelming. By learning to break tasks down into clear, specific steps, she was able to approach each one more systematically. She set realistic deadlines for each subtask and scheduled check-ins with herself to track progress. This approach transformed her relationship with large assignments—from avoidance to execution.

3. Use Checklists and Templates

To increase consistency and reduce rework, she developed customized checklists for recurring responsibilities like staff onboarding and presentation prep. She also created templates for status reports and internal updates. These tools helped her save time and avoid errors. More importantly, they removed the need to re-invent a format every time, freeing her to focus on content and decision-making.

4. Time Blocking to Protect Focus

Many of the high-performing professionals I work with come to me unsure of how to manage ADHD at work in a sustainable way. Tools like time blocking, weekly planning, and accountability partnerships provide structure and reduce decision fatigue—key to showing up consistently in demanding roles.

We incorporated time blocking into her weekly planning. She identified the times of day when her energy and attention were at their best and scheduled “deep work” blocks during those periods. During these sessions, she turned off notifications, closed unrelated tabs, and focused on one task at a time. After each session, she gave herself a short, planned break to recharge. Over time, these blocks became her most productive hours of the week.

5. Accountability and Activity Partners

One of the most impactful additions to her routine was working with both an accountability partner and an activity partner. She chose a trusted colleague to check in with at the beginning and end of each week. They exchanged updates on goals and progress, which added structure and motivation. She also began co-working once a week with a friend—either in person or virtually—during which they worked on separate tasks in parallel. Having someone else present helped her stay focused and minimized avoidance, particularly for administrative work. Many of my patients use these partnerships to provide external support and follow-through in a non-judgmental, consistent way.

6. Handwriting and End-of-Day Reviews – How to Manage ADHD at Work

Each evening, she used a small notebook to reflect on her day. She reviewed what she had completed, listed what still needed attention, and wrote down one goal for the next day. Writing by hand activated areas of the brain involved in planning and memory and helped her mentally close out the workday. This practice also built self-awareness and served as a low-stress way to stay aligned with her longer-term goals.

7. Overcoming Procrastination with Practical Tools

She had a long-standing habit of waiting until the last minute to start major projects. To counter this, she began using “10-minute launches,” committing to work on a task for just 10 minutes to bypass the mental resistance of starting. She used Google strategically to research how others had tackled similar challenges, helping her generate ideas when she felt stuck. Templates and rough drafts gave her a starting point and removed the pressure of perfection. When she caught herself overthinking, she reminded herself that “done is better than perfect,” a phrase that became one of her personal productivity mantras.

Once the diagnosis was made, we discussed treatment options in detail, including the possibility of starting cognitive behavioral therapy (CBT), medication, or a combination of both. I explained the potential benefits and limitations of each approach. After reviewing the options, we collaboratively decided to begin with CBT strategies alone for five to six sessions. There are many personal and clinical factors that go into this type of decision, which we discussed thoroughly in our sessions. As it turned out, she made such significant progress in her role and with the strategies we implemented that we extended treatment for another eight months without introducing medication. We agreed to keep the option open and revisit it as needed.

Ultimately, she continued with monthly sessions for nearly a year. These appointments helped reinforce her strategies, provided accountability, and allowed us to adjust her tools as new challenges arose. By the time we tapered down treatment, she had created a strong set of systems that supported her leadership, organization, and long-term success.

If you’re a high-performing adult who feels like success takes more effort than it should, or if you’ve long struggled with organization, focus, or follow-through, it’s worth considering whether undiagnosed ADHD could be a factor. With the right strategies and support, it’s absolutely possible to thrive—without the constant stress of holding it all together.

To learn more or to schedule a consultation, visit www.scottshapiromd.com or contact me at 212-631-8010.

*Disclaimer: This article contains composite case material. None of the details reflect an actual person. These examples are used for educational purposes only to illustrate common patterns and strategies in the treatment of adults with ADHD.