SPECIALIST THERAPY ● LONDON & ONLINE
Therapy for ADHD in London.
For adults who are tired of being misunderstood: You're not lazy. You're not broken. You're not too much.
You have a brain that works differently... And for most of your life, no one told you that.
Neuro-affirming ADHD therapy in Fitzrovia, Central London and online. From a therapist with real firsthand understanding of what living with ADHD involves, not just clinical knowledge of it.
Last updated: May 2026
OVERVIEW
ADHD Therapy Sessions in Fitzrovia & Online
What is ADHD in Adults?
Attention Deficit Hyperactivity Disorder is a neurodevelopmental condition that affects how the brain regulates attention, impulse control, and activity levels. In adults, ADHD rarely looks like the hyperactive child bouncing off classroom walls. It looks like someone who is highly intelligent but can't finish things. Someone who can focus for six hours on something fascinating and can't write a single email they're not interested in. Someone who is always late despite genuinely trying not to be.
ADHD is not a character flaw. It is not laziness. It is not an excuse. It is a neurological difference, consistent, measurable, and well-evidenced in decades of research, that affects roughly 3-4% of UK adults, the majority of whom have never received a diagnosis.
For many adults, the recognition of ADHD comes late, in their thirties, forties, or beyond, often triggered by a child's diagnosis, a burnout crisis, or simply a growing sense that no matter how hard they try, they keep running into the same walls.
"I spent years thinking I was a clever person who couldn't get their act together. The diagnosis didn't change what I was struggling with. It changed what I thought it meant about me."
The goal of ADHD therapy is not to make you function like someone without ADHD. It's to help you understand how your brain actually works, and build a life that fits it.
KEY DISTINCTION
It's not about attention
ADHD is better understood as a disorder of attention regulation, not attention capacity. People with ADHD can attend, often with extraordinary intensity, but they cannot reliably direct that attention on demand. Interest, urgency, novelty, and emotional significance regulate attention instead of intention and importance.
COMMON MISCONCEPTION
But I can focus when I want to
The ability to hyperfocus is one of the most common reasons adults miss their ADHD diagnosis. "How can I have ADHD if I can read for four hours?" Because ADHD affects the consistency and controllability of attention, not its existence. The capacity is there. The on-demand control often isn't.
Types of ADHD in adults
The DSM-5 describes three presentations of ADHD. These are not fixed categories, a person can move between presentations across their lifetime, and most adults show features of more than one. What matters clinically is not the label, but the specific pattern of difficulties you experience.
PRESENTATION 1
Predominantly Inattentive
Formerly called ADD. Difficulty sustaining attention, following through on tasks, organising, remembering details. Often missed, particularly in women and high achievers, because it presents as daydreaming, forgetfulness, or "not trying hard enough" rather than disruptive behaviour. The absence of hyperactivity makes it invisible to others, and often to the person themselves.
PRESENTATION 2
Predominantly Hyperactive-Impulsive
Restlessness, difficulty sitting still, talking excessively, acting before thinking, and interrupting others. In adults, hyperactivity often becomes internal, a racing mind, an inability to relax, a constant low-level restlessness that never quite switches off. Impulsivity shows up in decisions, spending, relationships, and risk-taking.
PRESENTATION 3
Combined Presentation
This is the most commonly diagnosed presentation in adults - significant symptoms of both inattention and hyperactivity-impulsivity. This is not "worse" than other presentations; it simply means the ADHD affects a wider range of functioning. Many people who are diagnosed as inattentive in childhood are rediagnosed as combined as an adult, as patterns become clearer over time.
Signs and Symptoms of Adult ADHD
Clinical checklists capture symptoms. They don't always capture the experience of living with them every day. These are the patterns that bring adults to therapy, often for the first time, having spent years not knowing there was a name for any of this.
Time Blindness
Time doesn't feel linear. There is now, and there is not now. Deadlines feel abstract until they are suddenly, catastrophically real. Being late is not disrespect, it is a neurological experience of time that works differently.
The shame-procrastination loop
The task feels too big. The shame of potentially failing is worse than not starting. Not starting creates more shame. More shame makes starting feel even harder. This is not laziness, it is a well-documented ADHD shame spiral.
Hyperfocus
The ability to focus so intensely on something interesting that hours disappear. Can be a strength and a source of great achievement, and simultaneously a reason the diagnosis gets missed ("but you can focus when you want to").
Working memory difficulties
Forgetting what you came into a room for. Losing a thought mid-sentence. Missing important details in conversations even when you were paying attention. This is not stupidity, it is a fundamental feature of how ADHD affects the brain's holding and processing capacity.
Rejection Sensitive Dysphoria (RSD)
Intense, overwhelming emotional pain in response to perceived criticism, failure, or rejection. Can arrive in seconds and feel physically painful. Often the most impairing aspect of ADHD for adults, and one of the least discussed.
Emotional dysregulation
Big feelings that arrive quickly and intensely. Frustration, excitement, grief, all amplified. The ADHD brain's regulatory systems don't modulate emotional responses as effectively, meaning feelings can feel overwhelming even in ordinary situations.
ADHD masking
The enormous effort of appearing neurotypical, organised, attentive, on time. Common in people who succeeded academically or professionally. The performance is exhausting and unsustainable, often ending in burnout that looks like depression.
Relational impact
Forgotten commitments, misread social cues, impulsive words, difficulty following conversations in groups. Partners and friends can experience this as indifference, when in fact the person with ADHD cares deeply, their brain just processes social information differently.
The Neuroscience of ADHD in Adults
Understanding the neuroscience doesn't make ADHD easier. But it does something important: it removes the moral weight. When you understand that the difficulties you experience are rooted in measurable neurological differences, it becomes harder to blame yourself for them.
DOPAMINE & NORADRENALINE
The neurotransmitter picture
ADHD is associated with differences in the functioning of dopamine and noradrenaline systems in the brain. Dopamine plays a central role in motivation, reward, and the experience of interest. In ADHD brains, dopamine signalling is dysregulated, meaning the brain doesn't release or respond to dopamine in quite the same way in response to low-stimulation tasks. This is why tasks that feel dull or unimportant are genuinely, neurologically harder to sustain attention on, and why urgency, novelty, and high interest can temporarily override the deficit. The ADHD brain is not broken; it has a different reward threshold.
EXECUTIVE FUNCTION
The CEO that doesn't always show up to work
Executive functions are the brain's management system, planning, prioritising, initiating tasks, holding information in working memory, regulating impulses, and monitoring progress. Research consistently shows that ADHD involves differences in the prefrontal cortex, the region most responsible for executive function. This explains why someone with ADHD can know exactly what they need to do and still be unable to start. It is not a knowledge problem; it is an activation problem. The understanding is there. The neurological bridge to action is not always reliable.
THE DEFAULT MODE NETWORK
Why the ADHD mind is always elsewhere
The Default Mode Network (DMN) is the brain's "resting state", the network that activates during daydreaming, mind-wandering, and self-referential thought. In neurotypical brains, the DMN deactivates when focused attention is required. In ADHD brains, research suggests this suppression is less efficient, meaning the mind-wandering network and the task-focused network compete with each other more. The result is the experience of a mind that keeps wandering, that keeps pulling away from what you are trying to focus on, not out of choice but out of neurological architecture.
EMOTIONAL REGULATION
Why feelings hit harder
The same neural circuits involved in attention regulation, particularly the prefrontal cortex and the amygdala, are also involved in emotional regulation. ADHD affects both. This is why emotional dysregulation is now considered a core feature of ADHD rather than a complication. The amygdala, the brain's threat detection system, is less effectively modulated by the prefrontal cortex in ADHD, meaning emotional responses arrive faster, feel more intense, and take longer to settle. Rejection Sensitive Dysphoria is the extreme end of this spectrum.
ADHD is not a willpower problem. It is not a motivation problem. It is a difference in how certain neural circuits in the brain regulate attention, impulse, and emotion. It is as neurological as dyslexia, and as real as gravity.
ADHD, anxiety, and depression, what's the difference?
ADHD, anxiety, and depression share a significant amount of overlapping territory, which is one of the main reasons adult ADHD goes undiagnosed for so long. Difficulty concentrating, sleep problems, low motivation, emotional dysregulation, withdrawal from things you used to enjoy, all of these can point to any of the three. Without someone looking carefully at the full picture, it is easy to treat the wrong thing.
The key clinical distinction is this: ADHD symptoms are persistent, pervasive, and traceable to childhood. They are present across contexts, at work, in relationships, at home, not just during periods of stress or low mood. Anxiety and depression tend to be more episodic, waxing and waning in response to life circumstances, even when they are severe or long-standing.
The more important clinical reality, however, is that most adults who come to therapy with ADHD are not choosing between these diagnoses. They are living with more than one simultaneously. Research suggests that around 50% of adults with ADHD also have an anxiety disorder, and roughly 30% experience depression.
These are not separate problems that happen to coexist, they are often deeply interconnected, each feeding the other. The shame-procrastination loop fuels low mood. The emotional intensity of ADHD produces chronic anxiety. The masking required to function in a neurotypical world is exhausting in ways that look, and feel, exactly like depression.
This is why an integrative approach matters. Treating anxiety or depression without understanding the ADHD underneath it rarely produces lasting change. The work needs to hold all of it at once.
Who Comes to ADHD Therapy?
Adults come to ADHD therapy from many different starting points. You don't need a formal diagnosis to begin, and you don't need to have everything figured out.
Here are some of the people I work with.
Recently diagnosed and trying to make sense of it
You have a diagnosis, finally, and you feel a mixture of relief, grief, and anger. You're looking back at your whole life through a new lens and you don't quite know what to do with what you're seeing. Therapy can hold all of it.
Suspected ADHD but not yet diagnosed
You've read enough, recognised enough, to think ADHD might be relevant to your experience, but you don't have a formal diagnosis. You don't need one to start therapy. We can work with what you're experiencing regardless of where you are in the diagnostic process.
Carrying years of shame
You were told you weren't trying hard enough. That you were bright but lazy. That you just needed to apply yourself. You internalised all of it. Therapy can start to unravel what you were told about yourself and what was actually just ADHD.
Successful on the outside, exhausted on the inside
You've achieved things. You've kept it together. But the effort of doing so, the masking, the compensating, the constant performance of neurotypicality, has worn you down. You are in or approaching burnout, and you can't keep going the way you have been.
Struggling in relationships or at work
The ADHD affects how you show up for people you care about, forgotten commitments, emotional intensity, impulsive words. Or work has become untenable. Therapy can address both the ADHD patterns and the relational or professional fallout from them.
In recovery or managing co-occurring conditions
ADHD frequently co-occurs with anxiety, depression, eating disorders, and addiction. Many people self-medicated for years without knowing why. Therapy that understands ADHD as a root system can change what treatment looks like for co-occurring conditions.
How Therapy for ADHD Works
Therapy for ADHD is not coaching. It goes further than strategies and productivity systems, though those have their place. Therapy addresses the emotional, relational, and identity dimensions of ADHD that no app or planner will ever touch.
Processing the past
Years of being told the wrong story about yourself leave marks. Low self-esteem, perfectionism as armour, chronic self-criticism, shame about ordinary ADHD experiences, therapy creates the space to examine those narratives and begin to loosen their hold.
Emotion regulation skills
DBT is particularly well-suited to ADHD because it offers a concrete set of skills for managing the emotional intensity that often accompanies it, distress tolerance, emotion regulation, interpersonal effectiveness. These are practised, not just talked about.
Relational repair and patterns
ADHD affects relationships in specific, often painful ways. Therapy explores how ADHD shows up in your closest relationships, what patterns have developed as a result, and how to communicate about your neurology in ways that don't leave you feeling permanently at fault.
Understanding your neurology
Psychoeducation, understanding what ADHD actually is and why you experience what you do, is often itself therapeutic. When you understand the shame-procrastination loop neurologically, it changes your relationship to it. Knowledge creates distance from self-blame.
Working with the shame cycle
Addressing procrastination and avoidance without touching the shame underneath them doesn't work. Therapy goes to the root, exploring where the shame came from, what it's protecting, and how to interrupt the cycle at its source rather than managing its symptoms.
Building a life that fits
Practical strategies, structures, environments, routines, that align with how you actually work, not with how a neurotypical productivity system expects you to work. The goal is congruence: a life that works with your neurology, not against it.
Some of the approaches I draw on
Dialectical Behaviour Therapy (DBT)
CBT adapted for ADHD
Internal Family Systems (IFS)
Psychoeducation
Psychodynamic therapy
Somatic awareness
Attachment-based therapy
Strengths-based approaches
Therapist for ADHD in London, Matthew Frener
Matthew Frener, MSc, Clin. Dip, UKCP Reg, BACP (Snr Accred), SNPCS (Accred)
Integrative Psychotherapist & DBT Therapist · he/him
I work with adults who are tired of explaining themselves to other people, to previous therapists, and to themselves. People who are self-aware, who can often name their patterns, trace them back, and yet find the same dynamics returning.
At the heart of how I work is the therapeutic relationship: a connection built on trust, understanding, and mutual respect. I believe the self is formed in relationship, and that relationship is also where change becomes possible. Not through technique alone, but through what happens between us in the room.
My approach is integrative, drawing on relational and attachment-based theory, psychodynamic thinking, DBT, CBT, IFS, and somatic approaches, shaped by clinical experience across residential treatment, outpatient services, and private practice. I don't apply a single model to every person. I work with what you bring, at your pace, attending to the whole of your experience: cognitive, emotional, somatic, relational.
I do not consider myself a therapist who is a neutral blank screen. I bring warmth, directness, and a willingness to say difficult things carefully, and a genuine belief that the people who end up in my consulting room are not broken. They have simply never had the right kind of support. Therapy works best when you don't have to perform wellness to receive it.
UKCP Registered · Registered Member MBACP (Senior Accred) · Senior Accredited Registrant SNCPS (Accred) · Addictions Professional AP
PRACTICAL INFORMATION
Fees & Getting Started ADHD Therapy
Sessions are offered on a sliding scale of £100 to £120 per 50 minutes. A limited number of concessionary spaces are available for NHS workers and those on a low income. I currently accept AXA, Aviva, WPA, Cigna, and Vitality insurance.
Sessions take place in person at my consulting room in Fitzrovia, Central London, or online via secure video. We meet weekly for 50 minutes.
One important note: I provide therapy for ADHD, not diagnostic assessments. If you are seeking a formal diagnosis, I can point you towards appropriate services. Therapy can begin, and be highly beneficial, before or without a formal diagnosis.
For full details on fees, payment, cancellation, location, and how to get started, visit the Practical Information page.
FURTHER READING
From the journal
