Blog posts by our team

How ADHD Shows Up in Your Relationships

A lot of people understand ADHD as a focus problem. You can't stay on task. You lose things. You start projects and don't finish them. And while all of that is real, it tells an incomplete story — because ADHD doesn't stay in the realm of productivity. It follows you into your relationships, and that's often where it does the most damage.

What the person with ADHD experiences

ADHD affects the brain's ability to regulate attention, emotion, and time — and all three of those things are foundational to relationships.

When you have ADHD, you're not inconsistent because you don't care. You're inconsistent because your brain struggles to maintain the same level of engagement with things that don't generate immediate stimulation. You can be completely absorbed in a conversation one day and genuinely struggle to track it the next. You forget the thing your partner mentioned because it didn't get encoded the way it would for someone with a neurotypical brain — not because it didn't matter.

Time blindness is another one that hits relationships hard. It's not that you disrespect someone's time when you're late or lose track of it. Your brain genuinely experiences time differently, and the gap between intention and follow-through is often invisible to you until the damage is already done.

And then there's emotional dysregulation — one of the most undertalked aspects of ADHD. Rejection sensitive dysphoria, big emotional reactions that seem disproportionate, difficulty cooling down after conflict — these are neurological, not character flaws. But they don't always look that way to the people on the receiving end.

What the people around you experience

From the outside, ADHD in a relationship can feel like being prioritized inconsistently. Your partner sees you spend three hours hyperfocused on something that interests you and then forget the thing they asked you about twice. It reads as a choice. It reads as them not mattering enough.

Over time, partners of people with ADHD can start to feel more like managers than equals — tracking, reminding, following up, and quietly absorbing the emotional labor of maintaining the relationship's infrastructure. This breeds resentment that's hard to articulate because the person with ADHD isn't trying to create it.

The shame spiral that makes everything worse

Here's what I see a lot in the room: someone with ADHD who already knows they let people down. They've heard it their whole lives — from teachers, from parents, from partners. They've internalized it as a character statement rather than a neurological one. And that shame makes them avoidant, defensive, or paralyzed in exactly the moments where the relationship needs them to show up.

The shame doesn't make the ADHD better. It makes it harder to work with.

What actually helps

Understanding the neurology is the starting point — not as an excuse but as a framework for addressing the real problem rather than the symptom. A lot of relationship conflict around ADHD dissolves when both people understand what's actually happening and stop assigning intention where there isn't any.

From there it's about building systems that compensate for where the brain falls short, communicating about needs directly rather than waiting for one person to notice them, and doing the deeper work of separating who you are from what your brain does.

ADHD is workable. In yourself, and in your relationships. But it usually takes more than trying harder.

If this is something you're navigating — whether you're the one with ADHD or the one in a relationship with someone who has it — I'd be glad to talk.

Joseph Grimsley M.S

What High-Functioning Anxiety Actually Looks Like

When most people picture anxiety, they picture someone who looks anxious. Cancelled plans. Panic attacks. Visibly struggling. But some of the most anxious people in any room are also the most put-together — the ones who respond to emails immediately, never miss a deadline, and somehow always know what to say.

This is what high-functioning anxiety looks like. And because it doesn't look like the clinical picture most people have in their heads, it often goes unrecognized for years.

The surface vs. what's underneath

High-functioning anxiety isn't a clinical diagnosis — it's a pattern. On the outside, it tends to produce people who are reliable, driven, and high-achieving. On the inside, it feels like your brain never fully powers down. The productivity isn't coming from enthusiasm. It's coming from the fear of what happens if you stop.

• Some things that often get missed as anxiety:

• Overthinking decisions long after they've already been made

• Difficulty relaxing without feeling guilty or restless

• People-pleasing and difficulty saying no, even when you're already overwhelmed

• Running through worst-case scenarios as a form of "preparation"

• Irritability that seems to come out of nowhere

• Physical tension — jaw clenching, tight shoulders, headaches — that you've just normalized

• Lying awake replaying conversations or rehearsing ones that haven't happened yet

• A constant low hum of "I should be doing more"

None of these alone signals anxiety. Together, they paint a picture of a nervous system that's working overtime.

Why it stays hidden

The tricky thing about high-functioning anxiety is that the coping mechanisms look like virtues. Being prepared, being responsible, working hard — these are things that get praised. So the person experiencing it often doesn't think of themselves as anxious. They think of themselves as a high achiever who just happens to worry a lot.

And because things are still getting done, there's rarely an external reason to stop and ask if something's wrong.

But functioning isn't the same as feeling fine. You can be managing everything on your list and still feel exhausted, disconnected, and like you're running on fumes that are running out.

When it's worth paying attention to

If your drive comes primarily from fear of failure rather than genuine motivation — if rest feels dangerous rather than earned — if you're constantly bracing for something to go wrong even when things are going well — that's worth looking at.

Anxiety that keeps you productive can still quietly dismantle your relationships, your health, and your ability to enjoy the life you're working so hard to build.

Therapy won't make you less driven. It'll help you figure out whether you actually want what you're chasing, and whether you can want it without the cost you're currently paying to get it.

If any of this sounds familiar, feel free to reach out.

Joseph Grimsley M.S

How to Know When It Might Be Time to Start Therapy

You don’t need to be in crisis to benefit from therapy. Sometimes, it’s simply about having a supportive space to grow, heal, and better understand yourself. You might consider starting therapy if:

Emotional & Mental Health

☐ You feel overwhelmed, anxious, or stuck more often than not

☐ Your inner critic feels loud or hard to escape

☐ You’re struggling with low mood, motivation, or burnout

☐ You feel disconnected from yourself or your emotions

Daily Life & Stress

☐ Stress is interfering with your sleep, work, school, or relationships

☐ You’re having trouble managing responsibilities or transitions

☐ Small things feel like they take a lot of energy

Relationships & Identity

☐ You’re navigating relationship challenges or recurring conflict

☐ You’re exploring your identity, values, or sense of self

☐ You want to feel more confident setting boundaries

Personal Growth

☐ You want to better understand patterns in your thoughts or behaviors

☐ You’re ready to heal from past experiences, even if they feel “small”

☐ You want support becoming the version of yourself that feels most authentic

Gentle Reminder:

If you checked even one of these, therapy could be a supportive next step. You deserve care, understanding, and a space just for you. Therapy isn’t a last resort. It’s a space for understanding yourself, learning new tools, and creating a life that feels more grounded, aligned, and sustainable. You don’t need to have the right words. You don’t need a diagnosis.

You just need a desire for something to feel different.

Perfectionism vs Health Striving

Many people assume perfectionism is just “caring a lot” or “having high standards.” In reality, perfectionism and healthy striving may look similar on the surface, but they feel very different on the inside.

Understanding the difference can be a powerful step toward more sustainable motivation, self-compassion, and emotional well-being.

What Perfectionism Often Looks Like

Perfectionism is driven by fear: fear of failure, judgment, disappointment, or not being “enough.” Perfectionism often promises success or safety, but instead leads to burnout, anxiety, shame, and disconnection from yourself.

You might notice perfectionism when:

☐ Your self-worth feels tied to achievement, productivity, or appearance

☐ Mistakes feel intolerable or deeply personal

☐ You procrastinate because starting feels overwhelming

☐ You struggle to feel proud of your efforts, even when things go well

☐ Rest feels earned, not necessary

☐ You constantly move the goalpost for what’s “good enough”

☐ You’re motivated more by avoiding failure than pursuing growth

What Healthy Striving Looks Like

Healthy striving is driven by values, curiosity, and self-respect; not fear. Healthy striving allows room for ambition and humanity.

You may be engaging in healthy striving when:

☐ You set goals that are flexible and realistic

☐ Mistakes are uncomfortable but seen as part of learning

☐ Your worth feels separate from outcomes

☐ You can pause, adjust, or rest without guilt

☐ Effort matters more than flawless results

☐ You can celebrate progress, not just achievements

☐ Motivation comes from growth, meaning, or alignment

Why does this matter?

When motivation is rooted in fear, the nervous system stays in a constant state of pressure. Over time, this can affect mental health, relationships, creativity, and physical well-being. Learning to shift from perfectionism to healthy striving isn’t about lowering standards; it’s about changing the cost of meeting them.

The Power of Private-Pay

Private health insurance may be the default in the United States, but does it work? Does it help you? Does it have your needs in mind?  The short answer is kind-of, and sometimes not at all. Ultimately, insurance companies exist to make a profit, and they make money by charging you more than you get, on average.

Here's a quick list of the most useful benefits of private pay mental healthcare instead of health insurance:

• Privacy: Insurance requires a diagnosis on day 1. That means that we are required to provide them with your personal and private information, personal health information (PHI), and a mental disorder which fits your symptoms based on very little conversation. A one hour session really flies by during counseling -- often for our client's, too! I generally advise against needless diagnosis for multiple reasons, which I will get into in more detail below, but the biggest reason is that this becomes part of your permanent health record and can limit you from certain careers and can be used against you in court.

• Freedom: Choose who you want to see, and how long or often you want to see them. No visitation limits or referral requirements.

• Better Care: Insurance companies require that providers use 'cost-efficient' treatment plans and techniques. This means that many individuals with their own unique issues get funneled into the same treatment style. This goes completely against contemporary therapy philosophy. To quote Irvin Yalom, "The therapist must strive to create a new therapy for each client."

• Stability: With private pay, your insurance company will never send you a retroactive bill. You won't have to worry about copys vs coinsurance, or maximum out of pocket vs deductible. In short, way less crazy-making. 

Diagnoses: The pros and cons of labeling unique experiences

Many people come in wanting a diagnosis. This is understandable. It's what I wanted when I first came to therapy as well. I think I wanted to know that my situation was not normal. I also wanted to know which kind of not-normal it was. Like many others, I thought a label would help me fix my problems. Looking back, I was lucky enough to go to a good therapist who danced around the question artfully when I asked, "Do I fall into anything diagnosable?" She responded by telling me that what I was dealing with could be overcome with the right tools and the right way of thinking. The way out was through.

This is not to say that diagnoses aren't useful. The DSM is built upon categorizing people's symptoms into labels and categories based on similar experiences, and it is -- sometimes -- a profoundly useful instrument of the trade. It is also constantly being worked on and compared to the ICD, which offers a slightly different view on many symptoms. The DSM has yet to include C-PTSD and is currently undergoing a revision to its section on personality disorders, which will likely have huge implications for American psychotherapy and mental health care. 

A diagnosis can help understand what else a clinician should examine, and how to treat particular issues. Scientific research would not be possible without the concept of diagnosis. At the same time, a diagnosis doesn't mean that you have every symptom. It doesn't connote a life-long affliction. It really doesn't mean that anything about your life is different than before you were diagnosed.

Language is imperfect. This is one of my favorite -isms. I use idioms and metaphor often, partly because they help simplify complex ideas and partly because they can mean many different things. In this case, what I mean is that we think more creatively about something before we have a word for it. The word itself constrains our thought process, which can make it more efficient, but also can lead us astray from the reality of the situation. Sometimes this can lead to us moving faster in an incorrect direction.

Disclaimer:

This blog is for informational and educational purposes and is not a substitute for mental health therapy services. Reading this blog does not establish a therapist-client relationship. If you're in need of mental health services, please reach out to a licensed mental health professional.  If you are experiencing a mental health crisis or an emergency please call 911.