“I Work Twice as Hard to Look Normal”: Lived Workplace Experiences of Adults With ADHD Across Cultures

“I Work Twice as Hard to Look Normal”: Lived Workplace Experiences of Adults With ADHD Across Cultures | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review “I Work Twice as Hard to Look Normal”: Lived Workplace Experiences of Adults With ADHD Across Cultures Saranya T.S, Sebnam Yucel, Sandeep Kumar Gupta, Recep Yucel, Shobha Karinchan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8547581/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background: Research on adult Attention-Deficit/Hyperactivity Disorder (ADHD) in the workplace has largely focused on symptomatology, productivity deficits, and economic costs, often neglecting the subjective experiences of adults navigating work environments structured around neurotypical norms. While such deficit-oriented frameworks have advanced clinical understanding, they provide limited insight into how adults with ADHD experience, interpret, and negotiate everyday working life across diverse cultural contexts. Objectives: The present study aimed to explore the lived workplace experiences of adults with ADHD across global contexts and to examine how these experiences illuminate processes of disempowerment and empowerment within contemporary organizational systems. The study sought to shift the discourse from individual deficit toward contextual and experience-based understandings of ADHD at work. Methods: A qualitative narrative synthesis design was employed. First-person accounts were drawn from peer-reviewed qualitative studies, autobiographical writings, and experiential reports authored by adults with ADHD across multiple regions. Narrative sources were analyzed using thematic narrative analysis, with empowerment theory serving as an interpretive lens. Results: Five interconnected narrative themes emerged: (1) invisible cognitive labor required to meet baseline workplace expectations; (2) compensatory overwork, masking, and burnout; (3) disclosure dilemmas shaped by stigma and conditional acceptance; (4) structural rigidity and systemic misfit between ADHD cognitive styles and workplace design; and (5) reclaiming agency through autonomy, supportive leadership, and strengths-based role alignment. Despite cultural variation in awareness and policy, experiences of invisibility, overcompensation, and constrained agency were consistent across contexts. Conclusion: The findings suggest that workplace challenges associated with adult ADHD are less a function of individual cognitive deficits and more a consequence of inflexible organizational structures and normative productivity expectations. Empowerment was experienced not through symptom suppression but through recognition, autonomy, and participatory inclusion. Centering lived experience offers a critical pathway for reimagining neuropsychological research and workplace practice toward more inclusive, equitable, and sustainable work environments. Biological sciences/Neuroscience Biological sciences/Psychology Social science/Psychology Adult ADHD lived experience narrative synthesis neurodiversity workplace inclusion empowerment 1. Introduction Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is increasingly recognized as a lifelong neurodevelopmental condition, with prevalence estimates suggesting that approximately 2–5% of adults worldwide meet diagnostic criteria (American Psychiatric Association, 2013 ; Faraone et al., 2015). While historically conceptualized as a childhood disorder, longitudinal research has demonstrated the persistence of attentional dysregulation, executive functioning difficulties, emotional lability, and motivational variability into adulthood, with significant implications for education, employment, and quality of life (Barkley et al., 2010 ). Among these life domains, work occupies a particularly central role, shaping economic security, social identity, self-worth, and long-term psychosocial well-being. Within occupational and organizational research, adult ADHD has largely been examined through a deficit-oriented lens. Studies have emphasized reduced productivity, higher rates of absenteeism and presenteeism, occupational instability, interpersonal difficulties, and economic costs to employers and national economies (Kessler et al., 2005; Bijlenga et al., 2019 ). While such research has contributed to clinical recognition and policy discussions, it has also tended to frame ADHD-related difficulties as individual impairments requiring remediation, accommodation, or self-management. As a result, responsibility for adaptation is often placed disproportionately on the individual worker rather than on the organizational structures and cultural norms that shape how work is designed, evaluated, and moralized. This individualizing orientation risks obscuring the relational and contextual nature of work-related difficulties experienced by adults with ADHD. Contemporary workplaces are typically organized around neurotypical assumptions of sustained attention, linear task completion, punctuality, multitasking, and self-regulation across extended periods of time. These expectations are not neutral; they reflect culturally specific ideals of productivity, discipline, and professionalism. When adults with ADHD struggle within such environments, their difficulties are frequently interpreted as personal failings rather than as indicators of a misalignment between cognitive diversity and workplace design. Consequently, forms of cognitive and emotional labor—such as constant self-monitoring, planning, compensatory overworking, and masking of difficulties—remain largely invisible and unacknowledged within conventional performance frameworks. Qualitative studies have begun to document how adults with ADHD describe working “harder than others to appear normal,” expending disproportionate effort to meet baseline expectations while receiving little recognition for this invisible labor (Holthe & Langvik, 2017 ; Masuch et al., 2019 ). These experiences are often accompanied by chronic exhaustion, anxiety, diminished self-esteem, and burnout, particularly in environments characterized by rigid schedules, surveillance-oriented management, and limited autonomy. However, such experiential dimensions are poorly captured by standardized symptom measures or productivity metrics, highlighting the need for methodological approaches that foreground lived experience. Narrative and qualitative perspectives offer a critical corrective to dominant deficit-based models. Narratives allow individuals to articulate how they interpret their own struggles and successes, how they negotiate identity and legitimacy at work, and how meaning is constructed through everyday interactions with organizational systems. From a narrative standpoint, ADHD is not solely a clinical diagnosis but a lived condition embedded in social relations, power dynamics, and cultural understandings of normalcy. Examining narratives of work enables researchers to attend to questions of voice, agency, stigma, and moral judgment that are central to occupational life but often marginalized in quantitative research. This narrative orientation aligns closely with neurodiversity-informed frameworks, which conceptualize ADHD as a form of cognitive variation rather than simply a disorder to be corrected (Doyle, 2020 ; Sedgwick et al., 2019 ). From this perspective, disability is understood as emerging through interaction with environments that privilege certain cognitive styles while excluding others. Within the workplace, this shifts analytical focus from individual symptom management toward structural flexibility, participatory design, and recognition of diverse strengths such as creativity, rapid ideation, and the capacity for intense hyperfocus under supportive conditions. Empowerment theory provides an additional interpretive lens for understanding these dynamics. Rather than defining empowerment as an individual trait or outcome, empowerment frameworks emphasize processes through which individuals gain control, voice, and participation within social systems (Rappaport, 1987 ; Zimmerman, 1995 ). Applied to workplace narratives, empowerment is not reflected simply in coping or resilience, but in the extent to which organizational contexts enable or constrain agency. Experiences of disclosure, accommodation, leadership support, and autonomy thus become central to understanding how adults with ADHD experience work as either disempowering or affirming. Despite growing recognition of ADHD as a global phenomenon, existing workplace research remains disproportionately situated within Western, high-income contexts. Cultural norms surrounding productivity, hierarchy, disability, and disclosure vary widely, shaping how ADHD is understood, acknowledged, or silenced in different regions. In many parts of the Global South and East Asia, adult ADHD remains underdiagnosed or contested, rendering disclosure particularly risky and reinforcing strategies of concealment and overcompensation. A cross-cultural narrative approach is therefore essential to avoid universalizing experiences rooted in specific sociocultural environments. Accordingly, the present study adopts a qualitative narrative synthesis to explore the lived workplace experiences of adults with ADHD across diverse global contexts. By centering first-person accounts, this study seeks to move beyond deficit-oriented framings and to illuminate how organizational structures, cultural expectations, stigma, and empowerment processes shape everyday working life. In doing so, it aims to contribute to neuropsychological and organizational scholarship by reframing ADHD at work as a question of design, power, and participation rather than solely one of individual limitation. 2. Methods Research Design This narrative synthesis approach was particularly suited to the study’s aim of examining empowerment and disempowerment as socially embedded and culturally mediated processes rather than as fixed individual outcomes. Unlike aggregative qualitative reviews, narrative synthesis preserves the temporal, emotional, and meaning-making dimensions through which adults with ADHD describe their workplace experiences. This design allowed for attention to how stories of effort, failure, resistance, and agency are constructed across different organizational and cultural contexts. By prioritizing experiential coherence over frequency counts, the approach enabled identification of shared narrative patterns while remaining sensitive to contextual variation. Such a design is especially appropriate for neuropsychological research seeking to bridge clinical understanding with lived realities in complex social environments. Sources of Narrative Data Narrative data for this study were drawn from multiple complementary sources to capture the breadth and diversity of lived workplace experiences of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) across cultural contexts. The primary sources consisted of peer-reviewed qualitative studies that explicitly examined adult ADHD in relation to employment, work functioning, organizational participation, and professional identity. These studies were selected for their use of first-person accounts, in-depth interviews, or verbatim participant quotations that preserved the experiential voice of individuals with ADHD. In addition to academic qualitative research, first-person narrative accounts authored by adults with ADHD were included where they provided detailed reflections on workplace experiences. These narratives appeared in scholarly commentaries, professional forums, autobiographical essays, and advocacy-oriented publications that met standards of reflexivity and contextual richness. Including such sources was consistent with the narrative synthesis methodology, which recognizes experiential knowledge as a legitimate form of data when examining lived experience and meaning-making processes. Sources were identified through targeted searches of PsycINFO, PubMed, Scopus, and Google Scholar using combinations of keywords such as “adult ADHD,” “workplace,” “employment,” “lived experience,” “narrative,” “qualitative,” and “neurodiversity.” Searches were supplemented by manual screening of reference lists from key qualitative studies to identify additional relevant materials. Materials published between 2000 and 2024 were considered to capture evolving diagnostic frameworks, workplace norms, and cultural understandings of adult ADHD. To support a cross-cultural perspective, deliberate efforts were made to include sources representing diverse geographical regions, including North America, Western and Northern Europe, South and East Asia, Australia, and parts of the Global South. While the availability of qualitative narratives varied across regions, inclusion was guided by the principle of conceptual rather than numerical representation, prioritizing diversity of workplace contexts and cultural framings over proportional sampling. All narrative sources were reviewed for relevance, depth, and ethical transparency. Only materials that provided sufficient contextual detail to support interpretive analysis were included. This multi-source strategy enabled triangulation of experiential patterns across settings while preserving the narrative integrity of individual accounts. Inclusion and Exclusion Criteria Narrative sources were included if they met the following criteria: (a) authored by adults aged 18 years or older with a self-reported or clinically diagnosed ADHD; (b) explicitly described workplace experiences, including employment trajectories, professional identity, disclosure, accommodation, or organizational interactions; (c) presented first-person perspectives or verbatim participant quotations; (d) were published in English; and (e) provided sufficient contextual detail to support narrative interpretation. Quantitative studies without experiential components and clinical reports lacking first-person perspectives were excluded. Analytical Approach Narrative data were analyzed using a thematic narrative analysis approach, selected for its capacity to preserve the coherence, meaning, and experiential depth of first-person accounts while allowing for the identification of shared patterns across sources. Unlike content-focused thematic analysis, thematic narrative analysis attends not only to what is said but also to how experiences are storied, including the use of metaphors, emotional tone, temporal sequencing, and moral positioning. This approach was particularly suited to the study’s aim of examining how adults with ADHD make sense of work-related challenges, identity negotiations, and empowerment processes within organizational contexts. Analysis proceeded through multiple iterative and reflexive phases. In the first phase, all narrative sources were read in full to achieve immersion and familiarity. During this stage, attention was paid to recurrent storylines related to effort, failure, legitimacy, success, and adaptation, as well as to contextual markers such as workplace structure, managerial practices, and cultural norms. Analytic memos were developed to capture early interpretive insights, emotional resonances, and reflexive observations regarding how ADHD was framed within different narrative contexts. In the second phase, narratives were coded inductively using open coding to identify experiential elements rather than diagnostic categories. Coding focused on actions (e.g., compensating, masking, disclosing), meanings (e.g., feeling “behind,” “not enough,” or “finally seen”), and relational dynamics (e.g., trust, surveillance, conditional acceptance). Codes were continually compared across sources to identify similarities and divergences, allowing patterns to emerge without imposing predefined theoretical constructs at the outset. This constant comparative process supported analytic sensitivity to both convergence and variation across cultural and organizational settings. The third phase involved the construction of narrative themes by clustering related codes into higher-order interpretive categories. Themes were not treated as discrete variables but as interconnected narrative processes that unfolded across time and context. For example, compensatory overwork was analyzed not only as a behavior but as part of a broader narrative of moral accountability, stigma management, and identity preservation. Particular attention was paid to how participants positioned themselves in relation to organizational norms, authority figures, and productivity expectations. In the final phase, identified narrative themes were interpreted through an empowerment-oriented lens. Empowerment theory was used as a sensitizing framework rather than a rigid coding schema, guiding interpretation toward questions of agency, perceived control, participation, and power relations within workplace systems. This theoretical integration enabled examination of how empowerment and disempowerment were narrated as dynamic and context-dependent processes rather than as fixed outcomes. For instance, moments of perceived empowerment were analyzed in relation to autonomy, supportive leadership, and strengths recognition, while experiences of disempowerment were linked to structural rigidity, stigma, and silencing practices. Throughout the analytic process, reflexivity was maintained by critically examining the researchers’ assumptions and disciplinary positioning within psychology and behavioral sciences. Efforts were made to avoid pathologizing interpretations and to privilege participants’ meaning-making over clinical categorizations. Analytic rigor was enhanced through iterative revisiting of source materials, transparent documentation of analytic decisions, and careful attention to coherence between data excerpts, themes, and theoretical interpretation. While narrative synthesis does not aim for representativeness, the analytic approach prioritized depth, credibility, and interpretive validity, ensuring that the findings faithfully reflect the complexity of lived workplace experiences of adults with ADHD across diverse contexts. Reflexivity, Ethics, and Rigor Reflexivity was treated as a continuous and integral component of the research process rather than as a discrete methodological step. The authors’ disciplinary backgrounds in psychology, neuropsychology, and behavioral sciences shaped sensitivity to issues of neurodiversity, stigma, and empowerment in workplace contexts. At the same time, awareness of the potential influence of clinical and academic framings of ADHD prompted ongoing critical reflection to avoid pathologizing interpretations or deficit-based assumptions. Throughout analysis, the researchers engaged in reflexive memo-writing to examine how their theoretical orientations, professional positions, and assumptions about work and productivity might shape analytic decisions. Methodological rigor was addressed through established criteria for trustworthiness in qualitative research, including credibility, dependability, and interpretive coherence. Credibility was supported by prolonged engagement with narrative materials, repeated reading of sources, and careful attention to contextual detail to ensure that interpretations were grounded in participants’ meaning-making. Rather than seeking consensus or frequency-based validation, analytic rigor was strengthened by tracing thematic interpretations back to multiple narrative sources across cultural and organizational settings. Dependability was enhanced through transparent documentation of analytic procedures, including data sourcing, coding decisions, and theme development. Analytic decisions were revisited iteratively to assess internal consistency and coherence between data excerpts, themes, and theoretical interpretation. While formal inter-coder reliability was not applicable to this narrative synthesis design, reflexive dialogue among the authors served to challenge assumptions, refine interpretations, and minimize individual analytic bias. Ethical considerations were addressed through respectful and responsible representation of narrative sources. As the study relied exclusively on secondary analysis of publicly available materials, no direct ethical approval was required; however, care was taken to avoid decontextualization, sensationalization, or misrepresentation of lived experiences. Composite narratives were used where appropriate to protect the integrity of original accounts while illustrating shared experiential patterns. Together, these reflexive and rigor-enhancing practices support the trustworthiness and interpretive validity of the study’s findings. 3. Results Narrative analysis of global first-person accounts revealed a set of interconnected themes that capture how adults with ADHD experience, interpret, and negotiate workplace life across cultural contexts. To enhance transparency, Table 1 presents illustrative composite profiles rather than individual participants, consistent with narrative synthesis methodology. Table 1 Illustrative Participant Profiles and Narrative Themes Across Global Contexts** Composite Participant ID Approximate Age Range Country / Region Occupational Context Dominant Narrative Theme(s) P1 25–34 years India (South Asia) Information Technology / Software Services Invisible cognitive labor; moralization of time management; fear of disclosure P2 30–39 years United Kingdom Policy / Administrative Services Compensatory overwork; masking; burnout P3 28–36 years United States Marketing / Corporate Sector Masking strategies; perfectionism; emotional exhaustion P4 32–45 years Canada Healthcare / Public Services Burnout; identity strain; reclaiming strengths P5 27–40 years Germany (Western Europe) Project Management Disclosure dilemmas; conditional acceptance; career stagnation P6 26–35 years Singapore (East Asia) Corporate Administration Stigma; silence; hierarchical pressure P7 29–42 years Brazil (Global South) Freelance / Creative Industry Economic precarity; hyperfocus; self-employment as empowerment P8 31–48 years Netherlands Data Analytics / Research Structural rigidity; misfit between cognitive style and organizational systems P9 24–33 years South Africa Academic / Research Support Interrupted hyperfocus; environmental overload P10 30–44 years Sweden (Scandinavia) UX / Design Supportive leadership; autonomy; strengths-based empowerment Participant profiles represent composite narrative constructions synthesized from multiple qualitative sources and first-person accounts. Ages, occupations, and locations are approximate and are presented to illustrate recurring experiential patterns rather than to describe specific individuals. Theme 1: Invisible Cognitive Labor and the Burden of “Normal” Functioning Across narratives, participants consistently described a substantial form of cognitive labor that preceded and accompanied visible work tasks but remained largely unrecognized within organizational settings. This labor involved continuous mental planning, task sequencing, time estimation, attentional regulation, and emotional self-monitoring required simply to initiate and sustain everyday work activities. Importantly, participants emphasized that this effort was not episodic or exceptional; rather, it was an ongoing and cumulative process that structured the entire workday and often began well before formal working hours. Many narratives highlighted how this invisible cognitive labor consumed significant mental and emotional energy before any externally measurable productivity occurred. As one participant reflected, “Before I even start my actual job, I’ve already spent hours in my head planning how not to mess up the day. Making lists, re-ordering them, reminding myself not to forget things—that part never shows on my timesheet” (Composite narrative, South Asia). Such accounts underscore how effort was expended not only on task completion, but on managing the conditions necessary to appear organized, punctual, and competent within neurotypical workplace expectations. Despite the intensity of this effort, participants reported that cognitive labor was rarely recognized as legitimate work. Instead, outcomes such as delayed responses, uneven pacing, or occasional lateness were frequently moralized and interpreted as indicators of poor discipline or insufficient commitment. One participant noted, “People see the email I sent late and assume I was careless. They don’t see the forty minutes it took just to start writing it, or the energy it took to stop myself from overthinking every sentence” (Composite narrative, United Kingdom). Such interpretations positioned cognitive difference as a moral failing rather than as a neurocognitive variation interacting with rigid organizational norms. Time management emerged as a particularly salient site of judgment. Participants described constant internal calculations regarding duration, buffers, and acceptable margins of error, which further intensified cognitive load. As one narrative expressed, “I’m constantly calculating time—how long this task should take, how much buffer I need, how late I can be without being judged. It’s exhausting, but no one considers that work” (Composite narrative, Netherlands). In several cultural contexts, punctuality and responsiveness were imbued with moral significance, rendering invisible cognitive effort illegible within prevailing productivity frameworks. This was especially pronounced in hierarchical or time-disciplined organizational cultures, where deviation from normative temporal expectations was experienced as reputational risk. Cross-cultural accounts suggested that while the nature of invisible cognitive labor was broadly consistent, its social interpretation varied. In some Western contexts, participants described partial acknowledgment of executive functioning challenges, though recognition was inconsistent and often dependent on individual supervisors. In contrast, narratives from South and East Asian contexts emphasized silence and self-blame, with limited socially available language to articulate cognitive effort as legitimate work. One participant remarked, “Being on time feels like a moral test. When I fail it, I’m not seen as someone with a different brain, but as someone who doesn’t care enough” (Composite narrative, East Asia). From an empowerment perspective, the invisibility of cognitive labor represents a critical site of disempowerment. When sustained effort remains unseen and unacknowledged, individuals’ sense of control, legitimacy, and agency is eroded, limiting opportunities for self-advocacy and participatory negotiation of work conditions. Over time, this dynamic contributed to emotional exhaustion and a persistent sense of inadequacy. As one participant summarized, “By the time the workday starts, I already feel drained. Not because of the job itself, but because of everything I had to do mentally just to show up looking normal” (Composite narrative, Canada). Conversely, narratives suggested that explicit recognition of cognitive labor—through flexible pacing, outcome-oriented evaluation, or supportive leadership—functioned as an empowering intervention, enabling individuals to redistribute effort and engage more sustainably in their work roles. Theme 2: Compensatory Overwork, Masking, and Burnout Across narratives, participants described compensatory overwork as a pervasive strategy for managing perceived cognitive differences and maintaining professional legitimacy. Rather than reducing workload or seeking accommodations, many adults with ADHD reported intensifying their effort in order to conceal attentional difficulties, inconsistent pacing, or challenges with task initiation. This pattern of overcompensation was framed not as a choice, but as a survival strategy within workplaces that equated productivity with moral worth and reliability with constant visibility. Participants frequently described working longer hours, arriving early, staying late, and repeatedly checking their work to pre-empt criticism. One participant explained, “I work twice as hard so no one notices how much I struggle. If I leave at a normal time, it feels like I’ve already failed” (Composite narrative, United States). Such accounts illustrate how overwork functioned as a protective mechanism against anticipated judgment, particularly in environments characterized by performance surveillance and limited tolerance for deviation from normative productivity patterns. Masking—the deliberate concealment of ADHD-related difficulties—was closely intertwined with compensatory overwork. Participants described suppressing signs of distraction, exhaustion, or overwhelm in order to appear competent and composed. This often involved emotional regulation alongside cognitive effort, as individuals carefully monitored their expressions, responses, and interactions. As one participant reflected, “I’m not just managing my tasks; I’m managing my face, my tone, my reactions. No one sees that part, but it’s constant” (Composite narrative, United Kingdom). Masking thus extended beyond task performance to encompass identity management within professional spaces. Over time, sustained overcompensation and masking were associated with significant psychological and physical costs. Participants described chronic fatigue, anxiety, and emotional depletion, often culminating in burnout. Importantly, burnout was not attributed to ADHD itself, but to prolonged efforts to suppress or compensate for it. One participant noted, “I didn’t burn out because of ADHD. I burned out from pretending I didn’t have it” (Composite narrative, Canada). This distinction highlights how workplace norms, rather than neurocognitive differences alone, played a central role in producing exhaustion. Economic and cultural contexts shaped the intensity and consequences of compensatory overwork. In precarious employment settings, fear of job loss intensified masking behaviors, leaving little room for rest or self-advocacy. A participant from the Global South explained, “There’s no safety net. If I slow down or ask for help, I’m replaceable” (Composite narrative, Brazil). Conversely, in contexts with formal protections, overwork persisted but was often framed as self-imposed rather than structurally compelled, obscuring the role of organizational expectations. From an empowerment perspective, compensatory overwork represents a paradoxical form of agency. While it enables short-term occupational survival and performance, it simultaneously erodes long-term autonomy, self-efficacy, and well-being. Narratives suggested that empowerment emerged not through greater effort, but through environments that reduced the need for masking by normalizing cognitive diversity. Supportive leadership, flexible deadlines, and trust-based evaluation were described as key conditions under which individuals could disengage from overwork and engage more sustainably. In such contexts, participants reported reclaiming energy, confidence, and a sense of authenticity at work. Theme 3: Disclosure as Risk—Stigma, Silence, and Conditional Acceptance Narratives across cultural contexts framed disclosure of ADHD in the workplace as a highly consequential and emotionally complex decision. Rather than being experienced as a straightforward pathway to support or accommodation, disclosure was most often narrated as a calculated risk shaped by anticipated stigma, power asymmetries, and organizational culture. Participants described carefully weighing potential benefits against the possibility of diminished credibility, altered professional identity, or restricted career progression. Many participants reported that disclosure, when it occurred, resulted in subtle yet enduring changes in how they were perceived and managed. While overt discrimination was uncommon, narratives highlighted experiences of conditional acceptance, wherein support was offered only within narrowly defined boundaries. One participant reflected, “After I disclosed, people were nicer—but in a smaller way. My responsibilities shrank, and so did the trust” (Composite narrative, Western Europe). Such accounts illustrate how disclosure could lead to implicit deskilling, with competence quietly questioned despite unchanged or even enhanced performance. In several narratives, participants described a loss of narrative control following disclosure. Once ADHD became known, workplace difficulties were reinterpreted through a diagnostic lens, often eclipsing prior achievements. As one participant noted, “Every mistake suddenly had an explanation, and it was always ADHD. It didn’t matter what I did well anymore” (Composite narrative, United States). This diagnostic overshadowing contributed to feelings of marginalization and reinforced reluctance to disclose in future roles. Silence emerged as a common alternative strategy, particularly in contexts where awareness of adult ADHD was limited or where disability discourse was weak. Participants from South and East Asian contexts frequently emphasized that disclosure felt futile or dangerous. One participant explained, “There’s no point explaining something no one believes exists. It would only make things worse” (Composite narrative, South Asia). In such settings, concealment functioned as a protective strategy, though it often intensified isolation, self-blame, and emotional strain. Power relations within organizational hierarchies strongly shaped disclosure experiences. Participants in precarious positions, early-career roles, or temporary contracts described heightened vulnerability, with limited capacity to negotiate accommodations or challenge stigmatizing responses. A participant from a corporate administrative role noted, “When your manager controls everything—your hours, your evaluations—you don’t get to be honest about your struggles” (Composite narrative, East Asia). Disclosure was thus embedded within broader dynamics of authority and control, rather than solely within individual choice. From an empowerment perspective, disclosure functioned less as a singular event and more as a relational process contingent on context. Empowerment was narrated not through disclosure itself, but through environments that provided psychological safety, confidentiality, and participatory dialogue. Participants who experienced supportive leadership emphasized the importance of being able to define their own needs and capabilities rather than being reduced to diagnostic categories. As one participant summarized, “What helped wasn’t telling them I had ADHD. It was being trusted to explain how I work best” (Composite narrative, Scandinavia). These narratives suggest that meaningful empowerment arises when disclosure is decoupled from stigma and embedded within inclusive organizational practices. Theme 4: Structural Rigidity and Systemic Disempowerment Across narratives, participants consistently framed their workplace difficulties not as inherent limitations, but as consequences of rigid organizational structures that failed to accommodate diverse cognitive styles. Rather than viewing ADHD as the primary source of impairment, participants described a systemic misfit between their attentional rhythms, energy patterns, and modes of working and workplace designs predicated on linear productivity, constant availability, and uniform performance standards. This reframing was central to how individuals made sense of repeated struggles across otherwise varied occupational contexts. Rigid temporal structures emerged as a dominant source of friction. Fixed schedules, strict deadlines, and continuous multitasking demands were frequently described as incompatible with fluctuating attention, variable energy, and the need for uninterrupted focus. One participant explained, “The job itself wasn’t impossible—the structure was. I could do the work, just not in the way they demanded” (Composite narrative, Netherlands). Such accounts underscore how inflexibility transformed manageable tasks into persistent sources of stress and perceived failure. Environmental design further intensified this misfit. Open-plan offices, constant digital notifications, and expectations of immediate responsiveness disrupted concentration and fragmented attention. Participants described repeated interruptions as particularly detrimental to periods of hyperfocus, during which productivity and creativity were highest. As one narrative noted, “I finally get into the zone, and then the system pulls me out of it—meetings, messages, noise. That’s when everything falls apart” (Composite narrative, South Africa). These disruptions were not experienced as minor inconveniences but as structural barriers to effective functioning. Cross-cultural narratives revealed that while specific workplace practices varied, structural rigidity was a common feature across regions. In highly hierarchical or bureaucratic contexts, participants emphasized limited autonomy and minimal opportunity to negotiate work processes. A participant from a corporate administrative role reflected, “There is a right way to work here, and it doesn’t matter if another way works better for you” (Composite narrative, East Asia). In contrast, participants in more flexible or creative industries described greater latitude but noted that such flexibility was often informal and dependent on individual managers rather than institutional policy. From an empowerment perspective, structural rigidity functioned as a mechanism of systemic disempowerment by restricting participation in shaping work conditions. Participants reported feeling excluded from decision-making processes related to scheduling, task allocation, and evaluation criteria, reinforcing a sense of powerlessness. Conversely, narratives of improved well-being and performance emerged when individuals gained influence over how work was organized. Supportive leadership, flexible job design, and protected focus time were repeatedly identified as enabling conditions. As one participant summarized, “When I was allowed to structure my work around how my brain actually works, everything changed” (Composite narrative, Sweden). These accounts highlight that empowerment was experienced not through personal adaptation alone, but through organizational willingness to redesign systems in ways that acknowledge and accommodate cognitive diversity. Theme 5: Reclaiming Agency—Strengths, Autonomy, and Redefining Success In contrast to narratives of invisibility, overcompensation, and systemic misfit, participants also articulated moments of empowerment in which they reclaimed agency over their work and professional identities. These narratives did not frame empowerment as the absence of ADHD-related challenges, but as a shift in relational and structural conditions that enabled individuals to work in ways aligned with their cognitive strengths. Empowerment was thus narrated as contextual and negotiated rather than as an individual trait or fixed outcome. A central feature of empowering experiences was increased autonomy over how work was structured. Participants described significant improvements in well-being and productivity when they were able to determine pacing, sequence tasks according to attentional rhythms, and protect periods of uninterrupted focus. One participant reflected, “Once I stopped being managed minute by minute and was trusted to deliver outcomes, my work improved and so did my confidence” (Composite narrative, Scandinavia). Such accounts underscore how autonomy functioned as both a practical accommodation and a symbolic recognition of competence. Recognition of strengths emerged as another key dimension of empowerment. Participants described how creativity, rapid problem-solving, enthusiasm, and the capacity for intense hyperfocus were reframed as assets in supportive environments. This reframing often followed prolonged periods of deficit-oriented feedback, making recognition particularly transformative. As one participant noted, “For the first time, someone saw my ADHD as the reason I was good at my job, not bad at it” (Composite narrative, Canada). Strengths-based role alignment enabled individuals to invest energy more sustainably, reducing the need for masking and overcompensation. Supportive leadership played a critical role in facilitating these empowering conditions. Participants emphasized the importance of managers who demonstrated trust, openness, and willingness to engage in dialogue about work processes. Rather than relying on formal accommodations alone, empowering leaders collaborated with employees to co-design flexible arrangements. One participant explained, “My manager didn’t ask for a diagnosis. They asked how they could help me work better” (Composite narrative, United Kingdom). Such relational practices fostered psychological safety and legitimized self-advocacy. For some participants, empowerment was pursued through alternative work arrangements, including self-employment, freelancing, or entrepreneurship. These pathways were described as offering greater control over schedules, workload, and sensory environments, though often accompanied by economic precarity. A participant from the creative sector observed, “Being self-employed lets me work with my brain, but it also means I carry all the risk” (Composite narrative, Brazil). These narratives highlight both the possibilities and limitations of autonomy achieved outside traditional organizational structures. From an empowerment perspective, reclaiming agency involved redefining success on one’s own terms rather than conforming to normative productivity ideals. Participants described valuing sustainability, meaningful contribution, and well-being over constant performance optimization. As one participant summarized, “I stopped trying to be a perfect employee and started trying to be a functional human” (Composite narrative, United States). These accounts suggest that empowerment for adults with ADHD is not achieved through individual resilience alone, but through environments and relationships that recognize cognitive diversity as a legitimate dimension of human variation. Cross-Cultural Convergence and Variation While cultural contexts shaped how ADHD was understood and negotiated, the underlying experiences of invisibility, overcompensation, and conditional belonging were strikingly consistent. The themes were mapped with the empowerment constructs and presented below Table 2 Narrative Themes Mapped to Empowerment Constructs and Workplace Implications Narrative Theme Core Lived Experience (Narrative Summary) Empowerment Construct Manifestation of Disempowerment Empowerment-Oriented Workplace Implications Invisible cognitive labor Constant mental effort required to organize, initiate, and regulate work that remains unseen and unacknowledged Perceived control Depletion of agency due to unrecognized effort and unrealistic expectations Recognition of cognitive labor; flexible pacing; outcome-based evaluation Compensatory overwork and masking Excessive effort and self-surveillance to conceal ADHD-related difficulties Psychological empowerment (self-efficacy) Burnout, emotional exhaustion, and erosion of self-worth Normalize diverse work styles; reduce productivity moralism Disclosure dilemmas and silence Fear of stigma and loss of opportunity following diagnosis disclosure Autonomy and voice Restricted self-advocacy; conditional belonging Confidential disclosure pathways; anti-stigma leadership training Structural rigidity and systemic misfit Inflexible schedules, multitasking demands, and sensory overload Participatory decision-making Exclusion from shaping work conditions Co-designed accommodations; flexible job design Interrupted hyperfocus Repeated disruption of deep concentration by workplace demands Environmental fit Reduced productivity and frustration Protected focus time; task batching Reclaiming strengths Recognition of creativity, innovation, and hyperfocus as assets Collective empowerment ADHD framed solely as deficit Strength-based role alignment Supportive leadership Trust-based management and reduced micromanagement Relational empowerment Dependence on individual goodwill Leadership accountability for inclusion Autonomy through self-employment Entrepreneurship as a response to rigid systems Economic empowerment Precarity-driven self-employment Structured support for neurodivergent entrepreneurs The relationship between narrative themes and empowerment processes is summarized in Table 2 , illustrating how lived experiences of adults with ADHD reflect dynamic patterns of disempowerment and agency across workplace contexts. 4. Discussion This narrative synthesis examined the lived workplace experiences of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) across diverse cultural contexts, highlighting how challenges commonly attributed to individual cognitive deficits are more accurately understood as outcomes of structural and organizational misfit. By centering first-person narratives, the findings extend existing occupational ADHD research by illustrating how executive functioning differences become disabling primarily in work environments structured around neurotypical norms of productivity, time management, and self-regulation. Consistent with neurodiversity-oriented perspectives, the narratives suggest that ADHD-related impairments are not fixed or universal traits but are relational phenomena shaped by workplace design and cultural expectations. Participants’ accounts of invisible cognitive labor, disrupted hyperfocus, and constant self-monitoring echo earlier research showing that conventional work structures disproportionately penalize adults with ADHD by privileging sustained attention, multitasking, and rigid scheduling (Bijlenga et al., 2019 ; Holthe & Langvik, 2017 ). This reframing challenges deficit-based models that place responsibility for adaptation solely on individuals and underscores the need for organizational accountability. Participants described sustained planning, self-regulation, and compensatory effort that remained unrecognized within performance evaluations. These findings align with prior qualitative work documenting compensatory overwork, perfectionism, and exhaustion among adults with ADHD striving to maintain professional legitimacy (Brown, 2005 ; Ramsay & Rostain, 2015 ). Over time, such strategies were associated with burnout and psychological distress, reinforcing evidence linking ADHD to occupational stress and reduced well-being (Shaw et al., 2012 ). Importantly, the narratives complicate resilience-based interpretations of coping by demonstrating how masking reflects constrained agency rather than empowerment. Disclosure emerged as a particularly complex site of negotiation. While formal disability protections exist in some contexts, participants frequently described disclosure as leading to subtle marginalization, including diminished trust and limited career progression. These experiences are consistent with studies documenting persistent stigma and internalized shame among adults with ADHD in workplace settings (Ginsberg et al., 2014 ; Masuch et al., 2019 ). In regions with limited awareness of adult ADHD, silence functioned as a protective strategy, reinforcing isolation and self-blame. Empowerment, when present, was narrated as a relational and contextual process rather than an individual outcome. Participants experienced empowerment through autonomy, flexibility, and participation in decision-making, particularly when supportive leadership and strengths-based role alignment were present. These findings support empowerment theory’s emphasis on agency, perceived control, and shared power within social systems (Zimmerman, 1995 ). Notably, empowerment was not associated with symptom suppression, but with recognition and structural adaptation. Despite cultural variation in awareness and policy, the convergence of narratives across regions underscores the global relevance of these findings. Differences were less about the nature of ADHD and more about the availability of supportive structures and legitimizing language. Together, the findings highlight the importance of narrative and qualitative approaches in neuropsychology and call for workplace inclusion strategies that move beyond accommodation as exception toward inclusion as design principle. 5. Conclusion This narrative synthesis positions work as a salient dimension of adult life with Attention-Deficit/Hyperactivity Disorder (ADHD) and demonstrates that many workplace difficulties traditionally attributed to individual deficits instead reflect deeply embedded structural and cultural norms. Organizational expectations of productivity, conformity, and self-regulation are largely grounded in neurotypical models of functioning, rendering cognitive difference a site of disadvantage rather than variation. Across narratives, empowerment was experienced not through symptom suppression, but through recognition, autonomy, and meaningful participation. Contexts characterized by flexibility, trust, and voice enabled individuals to align cognitive strengths with work demands, while rigid structures, stigma, and silence sustained cycles of masking, burnout, and self-doubt. The convergence of experiences across diverse cultural settings underscores the global relevance of these findings, while also highlighting the necessity of culturally responsive approaches to workplace inclusion. Ultimately, this study argues that listening to lived experience is both an interpretive act and a methodological imperative, and that reframing ADHD in the workplace from individual pathology toward issues of design, power, and participation is essential for creating equitable and sustainable work environments. 6. Implications The findings carry important implications for neuropsychological research and workplace practice. For neuropsychology, they call for greater integration of narrative and qualitative approaches capable of capturing dimensions of work functioning that standardized assessments often overlook, as well as for longitudinal and ecologically valid methods that attend to lived experience over time. For organizations, the results support a shift from accommodation as exception to inclusion as a design principle. Participatory accommodations, flexible job structures, and leadership accountability emerge as key mechanisms for fostering empowerment among adults with ADHD. While this narrative synthesis does not claim representativeness, future research employing primary narrative interviews, participatory methodologies, and cross-cultural comparative designs could further strengthen understanding of neurodiversity-affirming workplace practices. Declarations Ethical approval This article does not contain any studies with human participants performed by any of the authors. So ethical approval is not required for conducting this study. Consent to participate This article does not contain any studies with human participants performed by any of the authors. Consent to publish Not applicable. The study does not include any identifiable images or personal data of participants. Funding Declaration There is no funding received for this research. Competing Interest Authors declare no competing interest in this research. Data Availability This study is a qualitative narrative synthesis based exclusively on secondary analysis of publicly available literature and first-person narrative accounts published in academic, professional, and advocacy sources. No primary data were generated or collected, and no participant-level raw datasets exist. Search strategies, inclusion and exclusion criteria, and thematic synthesis materials are provided as supplementary files to enable transparency and methodological verification. Author Contributions S.T.S and S.Y collected data and supervised the study. S.K.G and S.K analyzed the data and wrote the draft article. R.Y reviewed and wrote the final manuscript and S.T.S validated it. References Adamou, M., & Hale, D. (2019). Policy and workplace inclusion for adults with ADHD. BJPsych Bulletin, 43 (3), 108–114. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author. Barkley, R. A., Murphy, K. R., & Fischer, M. (2010). ADHD in adults: What the science says . Guilford Press. Bijlenga, D., Tjon-Ka-Jie, J. Y. M., Schuijers, F., & Kooij, J. J. S. (2019). A focus on work functioning in adults with ADHD: A systematic review and expert opinion. European Psychiatry, 58 , 1–8. Brown, T. E. (2005). Attention deficit disorder: The unfocused mind in children and adults . Yale University Press. Doyle, N. (2020). Neurodiversity at work: A biopsychosocial model and the impact on working adults. British Medical Bulletin, 135 (1), 108–125. https://doi.org/10.1093/bmb/ldaa021 Ginsberg, Y., Quintero, J., Anand, E., Casillas, M., & Upadhyaya, H. (2014). ADHD and employment: A European survey. European Psychiatry, 29 (6), 365–372. Holthe, A., & Langvik, E. (2017). ADHD symptoms and work functioning in adults. Nordic Psychology, 69 (3), 160–172. Masuch, A., Bea, M., Alm, B., Dehler, J., Mueller, T., Schaefert, R., & Gensichen, J. (2019). Internalized stigma, anticipated discrimination and perceived public stigma in adults with ADHD. Journal of Attention Disorders, 23 (13), 1656–1665. Ramsay, J. R., & Rostain, A. L. (2015). The adult ADHD toolkit: Using CBT to facilitate coping inside and out . Routledge. Rappaport, J. (1987). Terms of empowerment/exemplars of prevention: Toward a theory for community psychology. American Journal of Community Psychology, 15 (2), 121–148. https://doi.org/10.1007/BF00919275 Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: A qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11 (3), 241–253. Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder. Psychiatric Services, 63 (5), 518–524. Zimmerman, M. A. (1995). Psychological empowerment: Issues and illustrations. American Journal of Community Psychology, 23 (5), 581–599. https://doi.org/10.1007/BF02506983 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8547581","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":588897412,"identity":"6675b65a-4cf6-4574-a42e-9b0f31dae7d9","order_by":0,"name":"Saranya T.S","email":"data:image/png;base64,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","orcid":"","institution":"Amity University Bengaluru","correspondingAuthor":true,"prefix":"","firstName":"Saranya","middleName":"","lastName":"T.S","suffix":""},{"id":588897413,"identity":"2392714e-d407-4d08-8383-34d949b212c7","order_by":1,"name":"Sebnam Yucel","email":"","orcid":"","institution":"Selçuk University","correspondingAuthor":false,"prefix":"","firstName":"Sebnam","middleName":"","lastName":"Yucel","suffix":""},{"id":588897414,"identity":"84447719-1175-4264-869d-6bcdfbc5dc84","order_by":2,"name":"Sandeep Kumar Gupta","email":"","orcid":"","institution":"Mohan Babu University","correspondingAuthor":false,"prefix":"","firstName":"Sandeep","middleName":"Kumar","lastName":"Gupta","suffix":""},{"id":588897415,"identity":"c171c83d-7b95-420e-8db2-16d35640e6a5","order_by":3,"name":"Recep Yucel","email":"","orcid":"","institution":"Kırıkkale University","correspondingAuthor":false,"prefix":"","firstName":"Recep","middleName":"","lastName":"Yucel","suffix":""},{"id":588897416,"identity":"cd893cde-0aea-4a6f-8045-14c0b9fdfdb9","order_by":4,"name":"Shobha Karinchan","email":"","orcid":"","institution":"Govt. Brennen College","correspondingAuthor":false,"prefix":"","firstName":"Shobha","middleName":"","lastName":"Karinchan","suffix":""}],"badges":[],"createdAt":"2026-01-08 06:23:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8547581/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8547581/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102746517,"identity":"8f1054f3-2dcc-4a47-b6a3-5e822d3dd678","added_by":"auto","created_at":"2026-02-16 08:58:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":853875,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8547581/v1/35c7b105-100c-4fb6-afa0-e6458f27555f.pdf"},{"id":102528337,"identity":"f8169f43-a865-4d2b-b405-5efed7fe92f0","added_by":"auto","created_at":"2026-02-12 15:59:47","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":11566,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFile11.docx","url":"https://assets-eu.researchsquare.com/files/rs-8547581/v1/c3cf6c3aec6ab8da0fe463a0.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003e\u003cstrong\u003e“I Work Twice as Hard to Look Normal”: Lived Workplace Experiences of Adults With ADHD Across Cultures\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAdult Attention-Deficit/Hyperactivity Disorder (ADHD) is increasingly recognized as a lifelong neurodevelopmental condition, with prevalence estimates suggesting that approximately 2–5% of adults worldwide meet diagnostic criteria (American Psychiatric Association, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Faraone et al., 2015). While historically conceptualized as a childhood disorder, longitudinal research has demonstrated the persistence of attentional dysregulation, executive functioning difficulties, emotional lability, and motivational variability into adulthood, with significant implications for education, employment, and quality of life (Barkley et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Among these life domains, work occupies a particularly central role, shaping economic security, social identity, self-worth, and long-term psychosocial well-being.\u003c/p\u003e \u003cp\u003eWithin occupational and organizational research, adult ADHD has largely been examined through a deficit-oriented lens. Studies have emphasized reduced productivity, higher rates of absenteeism and presenteeism, occupational instability, interpersonal difficulties, and economic costs to employers and national economies (Kessler et al., 2005; Bijlenga et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). While such research has contributed to clinical recognition and policy discussions, it has also tended to frame ADHD-related difficulties as individual impairments requiring remediation, accommodation, or self-management. As a result, responsibility for adaptation is often placed disproportionately on the individual worker rather than on the organizational structures and cultural norms that shape how work is designed, evaluated, and moralized.\u003c/p\u003e \u003cp\u003eThis individualizing orientation risks obscuring the relational and contextual nature of work-related difficulties experienced by adults with ADHD. Contemporary workplaces are typically organized around neurotypical assumptions of sustained attention, linear task completion, punctuality, multitasking, and self-regulation across extended periods of time. These expectations are not neutral; they reflect culturally specific ideals of productivity, discipline, and professionalism. When adults with ADHD struggle within such environments, their difficulties are frequently interpreted as personal failings rather than as indicators of a misalignment between cognitive diversity and workplace design. Consequently, forms of cognitive and emotional labor—such as constant self-monitoring, planning, compensatory overworking, and masking of difficulties—remain largely invisible and unacknowledged within conventional performance frameworks.\u003c/p\u003e \u003cp\u003eQualitative studies have begun to document how adults with ADHD describe working “harder than others to appear normal,” expending disproportionate effort to meet baseline expectations while receiving little recognition for this invisible labor (Holthe \u0026amp; Langvik, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Masuch et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). These experiences are often accompanied by chronic exhaustion, anxiety, diminished self-esteem, and burnout, particularly in environments characterized by rigid schedules, surveillance-oriented management, and limited autonomy. However, such experiential dimensions are poorly captured by standardized symptom measures or productivity metrics, highlighting the need for methodological approaches that foreground lived experience.\u003c/p\u003e \u003cp\u003eNarrative and qualitative perspectives offer a critical corrective to dominant deficit-based models. Narratives allow individuals to articulate how they interpret their own struggles and successes, how they negotiate identity and legitimacy at work, and how meaning is constructed through everyday interactions with organizational systems. From a narrative standpoint, ADHD is not solely a clinical diagnosis but a lived condition embedded in social relations, power dynamics, and cultural understandings of normalcy. Examining narratives of work enables researchers to attend to questions of voice, agency, stigma, and moral judgment that are central to occupational life but often marginalized in quantitative research.\u003c/p\u003e \u003cp\u003eThis narrative orientation aligns closely with neurodiversity-informed frameworks, which conceptualize ADHD as a form of cognitive variation rather than simply a disorder to be corrected (Doyle, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Sedgwick et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). From this perspective, disability is understood as emerging through interaction with environments that privilege certain cognitive styles while excluding others. Within the workplace, this shifts analytical focus from individual symptom management toward structural flexibility, participatory design, and recognition of diverse strengths such as creativity, rapid ideation, and the capacity for intense hyperfocus under supportive conditions.\u003c/p\u003e \u003cp\u003eEmpowerment theory provides an additional interpretive lens for understanding these dynamics. Rather than defining empowerment as an individual trait or outcome, empowerment frameworks emphasize processes through which individuals gain control, voice, and participation within social systems (Rappaport, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e1987\u003c/span\u003e; Zimmerman, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1995\u003c/span\u003e). Applied to workplace narratives, empowerment is not reflected simply in coping or resilience, but in the extent to which organizational contexts enable or constrain agency. Experiences of disclosure, accommodation, leadership support, and autonomy thus become central to understanding how adults with ADHD experience work as either disempowering or affirming.\u003c/p\u003e \u003cp\u003eDespite growing recognition of ADHD as a global phenomenon, existing workplace research remains disproportionately situated within Western, high-income contexts. Cultural norms surrounding productivity, hierarchy, disability, and disclosure vary widely, shaping how ADHD is understood, acknowledged, or silenced in different regions. In many parts of the Global South and East Asia, adult ADHD remains underdiagnosed or contested, rendering disclosure particularly risky and reinforcing strategies of concealment and overcompensation. A cross-cultural narrative approach is therefore essential to avoid universalizing experiences rooted in specific sociocultural environments.\u003c/p\u003e \u003cp\u003eAccordingly, the present study adopts a qualitative narrative synthesis to explore the lived workplace experiences of adults with ADHD across diverse global contexts. By centering first-person accounts, this study seeks to move beyond deficit-oriented framings and to illuminate how organizational structures, cultural expectations, stigma, and empowerment processes shape everyday working life. In doing so, it aims to contribute to neuropsychological and organizational scholarship by reframing ADHD at work as a question of design, power, and participation rather than solely one of individual limitation.\u003c/p\u003e "},{"header":"2. Methods","content":"\u003cp\u003e \u003cb\u003eResearch Design\u003c/b\u003e \u003c/p\u003e\u003cp\u003eThis narrative synthesis approach was particularly suited to the study’s aim of examining empowerment and disempowerment as socially embedded and culturally mediated processes rather than as fixed individual outcomes. Unlike aggregative qualitative reviews, narrative synthesis preserves the temporal, emotional, and meaning-making dimensions through which adults with ADHD describe their workplace experiences. This design allowed for attention to how stories of effort, failure, resistance, and agency are constructed across different organizational and cultural contexts. By prioritizing experiential coherence over frequency counts, the approach enabled identification of shared narrative patterns while remaining sensitive to contextual variation. Such a design is especially appropriate for neuropsychological research seeking to bridge clinical understanding with lived realities in complex social environments.\u003c/p\u003e\u003cp\u003e \u003cb\u003eSources of Narrative Data\u003c/b\u003e \u003c/p\u003e\u003cp\u003eNarrative data for this study were drawn from multiple complementary sources to capture the breadth and diversity of lived workplace experiences of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) across cultural contexts. The primary sources consisted of peer-reviewed qualitative studies that explicitly examined adult ADHD in relation to employment, work functioning, organizational participation, and professional identity. These studies were selected for their use of first-person accounts, in-depth interviews, or verbatim participant quotations that preserved the experiential voice of individuals with ADHD.\u003c/p\u003e\u003cp\u003eIn addition to academic qualitative research, first-person narrative accounts authored by adults with ADHD were included where they provided detailed reflections on workplace experiences. These narratives appeared in scholarly commentaries, professional forums, autobiographical essays, and advocacy-oriented publications that met standards of reflexivity and contextual richness. Including such sources was consistent with the narrative synthesis methodology, which recognizes experiential knowledge as a legitimate form of data when examining lived experience and meaning-making processes.\u003c/p\u003e\u003cp\u003eSources were identified through targeted searches of PsycINFO, PubMed, Scopus, and Google Scholar using combinations of keywords such as “adult ADHD,” “workplace,” “employment,” “lived experience,” “narrative,” “qualitative,” and “neurodiversity.” Searches were supplemented by manual screening of reference lists from key qualitative studies to identify additional relevant materials. Materials published between 2000 and 2024 were considered to capture evolving diagnostic frameworks, workplace norms, and cultural understandings of adult ADHD.\u003c/p\u003e\u003cp\u003eTo support a cross-cultural perspective, deliberate efforts were made to include sources representing diverse geographical regions, including North America, Western and Northern Europe, South and East Asia, Australia, and parts of the Global South. While the availability of qualitative narratives varied across regions, inclusion was guided by the principle of conceptual rather than numerical representation, prioritizing diversity of workplace contexts and cultural framings over proportional sampling.\u003c/p\u003e\u003cp\u003eAll narrative sources were reviewed for relevance, depth, and ethical transparency. Only materials that provided sufficient contextual detail to support interpretive analysis were included. This multi-source strategy enabled triangulation of experiential patterns across settings while preserving the narrative integrity of individual accounts.\u003c/p\u003e\u003cp\u003e \u003cb\u003eInclusion and Exclusion Criteria\u003c/b\u003e \u003c/p\u003e\u003cp\u003eNarrative sources were included if they met the following criteria: (a) authored by adults aged 18 years or older with a self-reported or clinically diagnosed ADHD; (b) explicitly described workplace experiences, including employment trajectories, professional identity, disclosure, accommodation, or organizational interactions; (c) presented first-person perspectives or verbatim participant quotations; (d) were published in English; and (e) provided sufficient contextual detail to support narrative interpretation. Quantitative studies without experiential components and clinical reports lacking first-person perspectives were excluded.\u003c/p\u003e\u003cp\u003e \u003cb\u003eAnalytical Approach\u003c/b\u003e \u003c/p\u003e\u003cp\u003eNarrative data were analyzed using a thematic narrative analysis approach, selected for its capacity to preserve the coherence, meaning, and experiential depth of first-person accounts while allowing for the identification of shared patterns across sources. Unlike content-focused thematic analysis, thematic narrative analysis attends not only to what is said but also to how experiences are storied, including the use of metaphors, emotional tone, temporal sequencing, and moral positioning. This approach was particularly suited to the study’s aim of examining how adults with ADHD make sense of work-related challenges, identity negotiations, and empowerment processes within organizational contexts.\u003c/p\u003e\u003cp\u003eAnalysis proceeded through multiple iterative and reflexive phases. In the first phase, all narrative sources were read in full to achieve immersion and familiarity. During this stage, attention was paid to recurrent storylines related to effort, failure, legitimacy, success, and adaptation, as well as to contextual markers such as workplace structure, managerial practices, and cultural norms. Analytic memos were developed to capture early interpretive insights, emotional resonances, and reflexive observations regarding how ADHD was framed within different narrative contexts.\u003c/p\u003e\u003cp\u003eIn the second phase, narratives were coded inductively using open coding to identify experiential elements rather than diagnostic categories. Coding focused on actions (e.g., compensating, masking, disclosing), meanings (e.g., feeling “behind,” “not enough,” or “finally seen”), and relational dynamics (e.g., trust, surveillance, conditional acceptance). Codes were continually compared across sources to identify similarities and divergences, allowing patterns to emerge without imposing predefined theoretical constructs at the outset. This constant comparative process supported analytic sensitivity to both convergence and variation across cultural and organizational settings.\u003c/p\u003e\u003cp\u003eThe third phase involved the construction of narrative themes by clustering related codes into higher-order interpretive categories. Themes were not treated as discrete variables but as interconnected narrative processes that unfolded across time and context. For example, compensatory overwork was analyzed not only as a behavior but as part of a broader narrative of moral accountability, stigma management, and identity preservation. Particular attention was paid to how participants positioned themselves in relation to organizational norms, authority figures, and productivity expectations.\u003c/p\u003e\u003cp\u003eIn the final phase, identified narrative themes were interpreted through an empowerment-oriented lens. Empowerment theory was used as a sensitizing framework rather than a rigid coding schema, guiding interpretation toward questions of agency, perceived control, participation, and power relations within workplace systems. This theoretical integration enabled examination of how empowerment and disempowerment were narrated as dynamic and context-dependent processes rather than as fixed outcomes. For instance, moments of perceived empowerment were analyzed in relation to autonomy, supportive leadership, and strengths recognition, while experiences of disempowerment were linked to structural rigidity, stigma, and silencing practices.\u003c/p\u003e\u003cp\u003eThroughout the analytic process, reflexivity was maintained by critically examining the researchers’ assumptions and disciplinary positioning within psychology and behavioral sciences. Efforts were made to avoid pathologizing interpretations and to privilege participants’ meaning-making over clinical categorizations. Analytic rigor was enhanced through iterative revisiting of source materials, transparent documentation of analytic decisions, and careful attention to coherence between data excerpts, themes, and theoretical interpretation. While narrative synthesis does not aim for representativeness, the analytic approach prioritized depth, credibility, and interpretive validity, ensuring that the findings faithfully reflect the complexity of lived workplace experiences of adults with ADHD across diverse contexts.\u003c/p\u003e\u003cp\u003e \u003cb\u003eReflexivity, Ethics, and Rigor\u003c/b\u003e \u003c/p\u003e\u003cp\u003eReflexivity was treated as a continuous and integral component of the research process rather than as a discrete methodological step. The authors’ disciplinary backgrounds in psychology, neuropsychology, and behavioral sciences shaped sensitivity to issues of neurodiversity, stigma, and empowerment in workplace contexts. At the same time, awareness of the potential influence of clinical and academic framings of ADHD prompted ongoing critical reflection to avoid pathologizing interpretations or deficit-based assumptions. Throughout analysis, the researchers engaged in reflexive memo-writing to examine how their theoretical orientations, professional positions, and assumptions about work and productivity might shape analytic decisions.\u003c/p\u003e\u003cp\u003eMethodological rigor was addressed through established criteria for trustworthiness in qualitative research, including credibility, dependability, and interpretive coherence. Credibility was supported by prolonged engagement with narrative materials, repeated reading of sources, and careful attention to contextual detail to ensure that interpretations were grounded in participants’ meaning-making. Rather than seeking consensus or frequency-based validation, analytic rigor was strengthened by tracing thematic interpretations back to multiple narrative sources across cultural and organizational settings.\u003c/p\u003e\u003cp\u003eDependability was enhanced through transparent documentation of analytic procedures, including data sourcing, coding decisions, and theme development. Analytic decisions were revisited iteratively to assess internal consistency and coherence between data excerpts, themes, and theoretical interpretation. While formal inter-coder reliability was not applicable to this narrative synthesis design, reflexive dialogue among the authors served to challenge assumptions, refine interpretations, and minimize individual analytic bias.\u003c/p\u003e\u003cp\u003eEthical considerations were addressed through respectful and responsible representation of narrative sources. As the study relied exclusively on secondary analysis of publicly available materials, no direct ethical approval was required; however, care was taken to avoid decontextualization, sensationalization, or misrepresentation of lived experiences. Composite narratives were used where appropriate to protect the integrity of original accounts while illustrating shared experiential patterns. Together, these reflexive and rigor-enhancing practices support the trustworthiness and interpretive validity of the study’s findings.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eNarrative analysis of global first-person accounts revealed a set of interconnected themes that capture how adults with ADHD experience, interpret, and negotiate workplace life across cultural contexts.\u003c/p\u003e \u003cp\u003eTo enhance transparency, Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents illustrative composite profiles rather than individual participants, consistent with narrative synthesis methodology.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIllustrative Participant Profiles and Narrative Themes Across Global Contexts**\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComposite Participant ID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eApproximate Age Range\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCountry / Region\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOccupational Context\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDominant Narrative Theme(s)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndia (South Asia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInformation Technology / Software Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eInvisible cognitive labor; moralization of time management; fear of disclosure\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;39 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnited Kingdom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePolicy / Administrative Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCompensatory overwork; masking; burnout\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u0026ndash;36 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnited States\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMarketing / Corporate Sector\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMasking strategies; perfectionism; emotional exhaustion\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32\u0026ndash;45 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCanada\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHealthcare / Public Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBurnout; identity strain; reclaiming strengths\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u0026ndash;40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGermany (Western Europe)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProject Management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDisclosure dilemmas; conditional acceptance; career stagnation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u0026ndash;35 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSingapore (East Asia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCorporate Administration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStigma; silence; hierarchical pressure\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u0026ndash;42 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBrazil (Global South)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFreelance / Creative Industry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEconomic precarity; hyperfocus; self-employment as empowerment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;48 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNetherlands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eData Analytics / Research\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStructural rigidity; misfit between cognitive style and organizational systems\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u0026ndash;33 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSouth Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAcademic / Research Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eInterrupted hyperfocus; environmental overload\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;44 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSweden (Scandinavia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUX / Design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSupportive leadership; autonomy; strengths-based empowerment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eParticipant profiles represent \u003cem\u003ecomposite narrative constructions\u003c/em\u003e synthesized from multiple qualitative sources and first-person accounts. Ages, occupations, and locations are approximate and are presented to illustrate recurring experiential patterns rather than to describe specific individuals.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 1: Invisible Cognitive Labor and the Burden of \u0026ldquo;Normal\u0026rdquo; Functioning\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAcross narratives, participants consistently described a substantial form of cognitive labor that preceded and accompanied visible work tasks but remained largely unrecognized within organizational settings. This labor involved continuous mental planning, task sequencing, time estimation, attentional regulation, and emotional self-monitoring required simply to initiate and sustain everyday work activities. Importantly, participants emphasized that this effort was not episodic or exceptional; rather, it was an ongoing and cumulative process that structured the entire workday and often began well before formal working hours.\u003c/p\u003e \u003cp\u003eMany narratives highlighted how this invisible cognitive labor consumed significant mental and emotional energy before any externally measurable productivity occurred. As one participant reflected, \u003cem\u003e\u0026ldquo;Before I even start my actual job, I\u0026rsquo;ve already spent hours in my head planning how not to mess up the day. Making lists, re-ordering them, reminding myself not to forget things\u0026mdash;that part never shows on my timesheet\u0026rdquo;\u003c/em\u003e (Composite narrative, South Asia). Such accounts underscore how effort was expended not only on task completion, but on managing the conditions necessary to appear organized, punctual, and competent within neurotypical workplace expectations.\u003c/p\u003e \u003cp\u003eDespite the intensity of this effort, participants reported that cognitive labor was rarely recognized as legitimate work. Instead, outcomes such as delayed responses, uneven pacing, or occasional lateness were frequently moralized and interpreted as indicators of poor discipline or insufficient commitment. One participant noted, \u003cem\u003e\u0026ldquo;People see the email I sent late and assume I was careless. They don\u0026rsquo;t see the forty minutes it took just to start writing it, or the energy it took to stop myself from overthinking every sentence\u0026rdquo;\u003c/em\u003e (Composite narrative, United Kingdom). Such interpretations positioned cognitive difference as a moral failing rather than as a neurocognitive variation interacting with rigid organizational norms.\u003c/p\u003e \u003cp\u003eTime management emerged as a particularly salient site of judgment. Participants described constant internal calculations regarding duration, buffers, and acceptable margins of error, which further intensified cognitive load. As one narrative expressed, \u003cem\u003e\u0026ldquo;I\u0026rsquo;m constantly calculating time\u0026mdash;how long this task should take, how much buffer I need, how late I can be without being judged. It\u0026rsquo;s exhausting, but no one considers that work\u0026rdquo;\u003c/em\u003e (Composite narrative, Netherlands). In several cultural contexts, punctuality and responsiveness were imbued with moral significance, rendering invisible cognitive effort illegible within prevailing productivity frameworks. This was especially pronounced in hierarchical or time-disciplined organizational cultures, where deviation from normative temporal expectations was experienced as reputational risk.\u003c/p\u003e \u003cp\u003eCross-cultural accounts suggested that while the nature of invisible cognitive labor was broadly consistent, its social interpretation varied. In some Western contexts, participants described partial acknowledgment of executive functioning challenges, though recognition was inconsistent and often dependent on individual supervisors. In contrast, narratives from South and East Asian contexts emphasized silence and self-blame, with limited socially available language to articulate cognitive effort as legitimate work. One participant remarked, \u003cem\u003e\u0026ldquo;Being on time feels like a moral test. When I fail it, I\u0026rsquo;m not seen as someone with a different brain, but as someone who doesn\u0026rsquo;t care enough\u0026rdquo;\u003c/em\u003e (Composite narrative, East Asia).\u003c/p\u003e \u003cp\u003eFrom an empowerment perspective, the invisibility of cognitive labor represents a critical site of disempowerment. When sustained effort remains unseen and unacknowledged, individuals\u0026rsquo; sense of control, legitimacy, and agency is eroded, limiting opportunities for self-advocacy and participatory negotiation of work conditions. Over time, this dynamic contributed to emotional exhaustion and a persistent sense of inadequacy. As one participant summarized, \u003cem\u003e\u0026ldquo;By the time the workday starts, I already feel drained. Not because of the job itself, but because of everything I had to do mentally just to show up looking normal\u0026rdquo;\u003c/em\u003e (Composite narrative, Canada). Conversely, narratives suggested that explicit recognition of cognitive labor\u0026mdash;through flexible pacing, outcome-oriented evaluation, or supportive leadership\u0026mdash;functioned as an empowering intervention, enabling individuals to redistribute effort and engage more sustainably in their work roles.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 2: Compensatory Overwork, Masking, and Burnout\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAcross narratives, participants described compensatory overwork as a pervasive strategy for managing perceived cognitive differences and maintaining professional legitimacy. Rather than reducing workload or seeking accommodations, many adults with ADHD reported intensifying their effort in order to conceal attentional difficulties, inconsistent pacing, or challenges with task initiation. This pattern of overcompensation was framed not as a choice, but as a survival strategy within workplaces that equated productivity with moral worth and reliability with constant visibility.\u003c/p\u003e \u003cp\u003eParticipants frequently described working longer hours, arriving early, staying late, and repeatedly checking their work to pre-empt criticism. One participant explained, \u003cem\u003e\u0026ldquo;I work twice as hard so no one notices how much I struggle. If I leave at a normal time, it feels like I\u0026rsquo;ve already failed\u0026rdquo;\u003c/em\u003e (Composite narrative, United States). Such accounts illustrate how overwork functioned as a protective mechanism against anticipated judgment, particularly in environments characterized by performance surveillance and limited tolerance for deviation from normative productivity patterns.\u003c/p\u003e \u003cp\u003eMasking\u0026mdash;the deliberate concealment of ADHD-related difficulties\u0026mdash;was closely intertwined with compensatory overwork. Participants described suppressing signs of distraction, exhaustion, or overwhelm in order to appear competent and composed. This often involved emotional regulation alongside cognitive effort, as individuals carefully monitored their expressions, responses, and interactions. As one participant reflected, \u003cem\u003e\u0026ldquo;I\u0026rsquo;m not just managing my tasks; I\u0026rsquo;m managing my face, my tone, my reactions. No one sees that part, but it\u0026rsquo;s constant\u0026rdquo;\u003c/em\u003e (Composite narrative, United Kingdom). Masking thus extended beyond task performance to encompass identity management within professional spaces.\u003c/p\u003e \u003cp\u003eOver time, sustained overcompensation and masking were associated with significant psychological and physical costs. Participants described chronic fatigue, anxiety, and emotional depletion, often culminating in burnout. Importantly, burnout was not attributed to ADHD itself, but to prolonged efforts to suppress or compensate for it. One participant noted, \u003cem\u003e\u0026ldquo;I didn\u0026rsquo;t burn out because of ADHD. I burned out from pretending I didn\u0026rsquo;t have it\u0026rdquo;\u003c/em\u003e (Composite narrative, Canada). This distinction highlights how workplace norms, rather than neurocognitive differences alone, played a central role in producing exhaustion.\u003c/p\u003e \u003cp\u003eEconomic and cultural contexts shaped the intensity and consequences of compensatory overwork. In precarious employment settings, fear of job loss intensified masking behaviors, leaving little room for rest or self-advocacy. A participant from the Global South explained, \u003cem\u003e\u0026ldquo;There\u0026rsquo;s no safety net. If I slow down or ask for help, I\u0026rsquo;m replaceable\u0026rdquo;\u003c/em\u003e (Composite narrative, Brazil). Conversely, in contexts with formal protections, overwork persisted but was often framed as self-imposed rather than structurally compelled, obscuring the role of organizational expectations.\u003c/p\u003e \u003cp\u003eFrom an empowerment perspective, compensatory overwork represents a paradoxical form of agency. While it enables short-term occupational survival and performance, it simultaneously erodes long-term autonomy, self-efficacy, and well-being. Narratives suggested that empowerment emerged not through greater effort, but through environments that reduced the need for masking by normalizing cognitive diversity. Supportive leadership, flexible deadlines, and trust-based evaluation were described as key conditions under which individuals could disengage from overwork and engage more sustainably. In such contexts, participants reported reclaiming energy, confidence, and a sense of authenticity at work.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 3: Disclosure as Risk\u0026mdash;Stigma, Silence, and Conditional Acceptance\u003c/b\u003e \u003c/p\u003e \u003cp\u003eNarratives across cultural contexts framed disclosure of ADHD in the workplace as a highly consequential and emotionally complex decision. Rather than being experienced as a straightforward pathway to support or accommodation, disclosure was most often narrated as a calculated risk shaped by anticipated stigma, power asymmetries, and organizational culture. Participants described carefully weighing potential benefits against the possibility of diminished credibility, altered professional identity, or restricted career progression.\u003c/p\u003e \u003cp\u003eMany participants reported that disclosure, when it occurred, resulted in subtle yet enduring changes in how they were perceived and managed. While overt discrimination was uncommon, narratives highlighted experiences of conditional acceptance, wherein support was offered only within narrowly defined boundaries. One participant reflected, \u003cem\u003e\u0026ldquo;After I disclosed, people were nicer\u0026mdash;but in a smaller way. My responsibilities shrank, and so did the trust\u0026rdquo;\u003c/em\u003e (Composite narrative, Western Europe). Such accounts illustrate how disclosure could lead to implicit deskilling, with competence quietly questioned despite unchanged or even enhanced performance.\u003c/p\u003e \u003cp\u003eIn several narratives, participants described a loss of narrative control following disclosure. Once ADHD became known, workplace difficulties were reinterpreted through a diagnostic lens, often eclipsing prior achievements. As one participant noted, \u003cem\u003e\u0026ldquo;Every mistake suddenly had an explanation, and it was always ADHD. It didn\u0026rsquo;t matter what I did well anymore\u0026rdquo;\u003c/em\u003e (Composite narrative, United States). This diagnostic overshadowing contributed to feelings of marginalization and reinforced reluctance to disclose in future roles.\u003c/p\u003e \u003cp\u003eSilence emerged as a common alternative strategy, particularly in contexts where awareness of adult ADHD was limited or where disability discourse was weak. Participants from South and East Asian contexts frequently emphasized that disclosure felt futile or dangerous. One participant explained, \u003cem\u003e\u0026ldquo;There\u0026rsquo;s no point explaining something no one believes exists. It would only make things worse\u0026rdquo;\u003c/em\u003e (Composite narrative, South Asia). In such settings, concealment functioned as a protective strategy, though it often intensified isolation, self-blame, and emotional strain.\u003c/p\u003e \u003cp\u003ePower relations within organizational hierarchies strongly shaped disclosure experiences. Participants in precarious positions, early-career roles, or temporary contracts described heightened vulnerability, with limited capacity to negotiate accommodations or challenge stigmatizing responses. A participant from a corporate administrative role noted, \u003cem\u003e\u0026ldquo;When your manager controls everything\u0026mdash;your hours, your evaluations\u0026mdash;you don\u0026rsquo;t get to be honest about your struggles\u0026rdquo;\u003c/em\u003e (Composite narrative, East Asia). Disclosure was thus embedded within broader dynamics of authority and control, rather than solely within individual choice.\u003c/p\u003e \u003cp\u003eFrom an empowerment perspective, disclosure functioned less as a singular event and more as a relational process contingent on context. Empowerment was narrated not through disclosure itself, but through environments that provided psychological safety, confidentiality, and participatory dialogue. Participants who experienced supportive leadership emphasized the importance of being able to define their own needs and capabilities rather than being reduced to diagnostic categories. As one participant summarized, \u003cem\u003e\u0026ldquo;What helped wasn\u0026rsquo;t telling them I had ADHD. It was being trusted to explain how I work best\u0026rdquo;\u003c/em\u003e (Composite narrative, Scandinavia). These narratives suggest that meaningful empowerment arises when disclosure is decoupled from stigma and embedded within inclusive organizational practices.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 4: Structural Rigidity and Systemic Disempowerment\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAcross narratives, participants consistently framed their workplace difficulties not as inherent limitations, but as consequences of rigid organizational structures that failed to accommodate diverse cognitive styles. Rather than viewing ADHD as the primary source of impairment, participants described a systemic misfit between their attentional rhythms, energy patterns, and modes of working and workplace designs predicated on linear productivity, constant availability, and uniform performance standards. This reframing was central to how individuals made sense of repeated struggles across otherwise varied occupational contexts.\u003c/p\u003e \u003cp\u003eRigid temporal structures emerged as a dominant source of friction. Fixed schedules, strict deadlines, and continuous multitasking demands were frequently described as incompatible with fluctuating attention, variable energy, and the need for uninterrupted focus. One participant explained, \u003cem\u003e\u0026ldquo;The job itself wasn\u0026rsquo;t impossible\u0026mdash;the structure was. I could do the work, just not in the way they demanded\u0026rdquo;\u003c/em\u003e (Composite narrative, Netherlands). Such accounts underscore how inflexibility transformed manageable tasks into persistent sources of stress and perceived failure.\u003c/p\u003e \u003cp\u003eEnvironmental design further intensified this misfit. Open-plan offices, constant digital notifications, and expectations of immediate responsiveness disrupted concentration and fragmented attention. Participants described repeated interruptions as particularly detrimental to periods of hyperfocus, during which productivity and creativity were highest. As one narrative noted, \u003cem\u003e\u0026ldquo;I finally get into the zone, and then the system pulls me out of it\u0026mdash;meetings, messages, noise. That\u0026rsquo;s when everything falls apart\u0026rdquo;\u003c/em\u003e (Composite narrative, South Africa). These disruptions were not experienced as minor inconveniences but as structural barriers to effective functioning.\u003c/p\u003e \u003cp\u003eCross-cultural narratives revealed that while specific workplace practices varied, structural rigidity was a common feature across regions. In highly hierarchical or bureaucratic contexts, participants emphasized limited autonomy and minimal opportunity to negotiate work processes. A participant from a corporate administrative role reflected, \u003cem\u003e\u0026ldquo;There is a right way to work here, and it doesn\u0026rsquo;t matter if another way works better for you\u0026rdquo;\u003c/em\u003e (Composite narrative, East Asia). In contrast, participants in more flexible or creative industries described greater latitude but noted that such flexibility was often informal and dependent on individual managers rather than institutional policy.\u003c/p\u003e \u003cp\u003eFrom an empowerment perspective, structural rigidity functioned as a mechanism of systemic disempowerment by restricting participation in shaping work conditions. Participants reported feeling excluded from decision-making processes related to scheduling, task allocation, and evaluation criteria, reinforcing a sense of powerlessness. Conversely, narratives of improved well-being and performance emerged when individuals gained influence over how work was organized. Supportive leadership, flexible job design, and protected focus time were repeatedly identified as enabling conditions. As one participant summarized, \u003cem\u003e\u0026ldquo;When I was allowed to structure my work around how my brain actually works, everything changed\u0026rdquo;\u003c/em\u003e (Composite narrative, Sweden). These accounts highlight that empowerment was experienced not through personal adaptation alone, but through organizational willingness to redesign systems in ways that acknowledge and accommodate cognitive diversity.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 5: Reclaiming Agency\u0026mdash;Strengths, Autonomy, and Redefining Success\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn contrast to narratives of invisibility, overcompensation, and systemic misfit, participants also articulated moments of empowerment in which they reclaimed agency over their work and professional identities. These narratives did not frame empowerment as the absence of ADHD-related challenges, but as a shift in relational and structural conditions that enabled individuals to work in ways aligned with their cognitive strengths. Empowerment was thus narrated as contextual and negotiated rather than as an individual trait or fixed outcome.\u003c/p\u003e \u003cp\u003eA central feature of empowering experiences was increased autonomy over how work was structured. Participants described significant improvements in well-being and productivity when they were able to determine pacing, sequence tasks according to attentional rhythms, and protect periods of uninterrupted focus. One participant reflected, \u003cem\u003e\u0026ldquo;Once I stopped being managed minute by minute and was trusted to deliver outcomes, my work improved and so did my confidence\u0026rdquo;\u003c/em\u003e (Composite narrative, Scandinavia). Such accounts underscore how autonomy functioned as both a practical accommodation and a symbolic recognition of competence.\u003c/p\u003e \u003cp\u003eRecognition of strengths emerged as another key dimension of empowerment. Participants described how creativity, rapid problem-solving, enthusiasm, and the capacity for intense hyperfocus were reframed as assets in supportive environments. This reframing often followed prolonged periods of deficit-oriented feedback, making recognition particularly transformative. As one participant noted, \u003cem\u003e\u0026ldquo;For the first time, someone saw my ADHD as the reason I was good at my job, not bad at it\u0026rdquo;\u003c/em\u003e (Composite narrative, Canada). Strengths-based role alignment enabled individuals to invest energy more sustainably, reducing the need for masking and overcompensation.\u003c/p\u003e \u003cp\u003eSupportive leadership played a critical role in facilitating these empowering conditions. Participants emphasized the importance of managers who demonstrated trust, openness, and willingness to engage in dialogue about work processes. Rather than relying on formal accommodations alone, empowering leaders collaborated with employees to co-design flexible arrangements. One participant explained, \u003cem\u003e\u0026ldquo;My manager didn\u0026rsquo;t ask for a diagnosis. They asked how they could help me work better\u0026rdquo;\u003c/em\u003e (Composite narrative, United Kingdom). Such relational practices fostered psychological safety and legitimized self-advocacy.\u003c/p\u003e \u003cp\u003eFor some participants, empowerment was pursued through alternative work arrangements, including self-employment, freelancing, or entrepreneurship. These pathways were described as offering greater control over schedules, workload, and sensory environments, though often accompanied by economic precarity. A participant from the creative sector observed, \u003cem\u003e\u0026ldquo;Being self-employed lets me work with my brain, but it also means I carry all the risk\u0026rdquo;\u003c/em\u003e (Composite narrative, Brazil). These narratives highlight both the possibilities and limitations of autonomy achieved outside traditional organizational structures.\u003c/p\u003e \u003cp\u003eFrom an empowerment perspective, reclaiming agency involved redefining success on one\u0026rsquo;s own terms rather than conforming to normative productivity ideals. Participants described valuing sustainability, meaningful contribution, and well-being over constant performance optimization. As one participant summarized, \u003cem\u003e\u0026ldquo;I stopped trying to be a perfect employee and started trying to be a functional human\u0026rdquo;\u003c/em\u003e (Composite narrative, United States). These accounts suggest that empowerment for adults with ADHD is not achieved through individual resilience alone, but through environments and relationships that recognize cognitive diversity as a legitimate dimension of human variation.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cb\u003eCross-Cultural Convergence and Variation\u003c/b\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhile cultural contexts shaped how ADHD was understood and negotiated, the underlying experiences of invisibility, overcompensation, and conditional belonging were strikingly consistent. The themes were mapped with the empowerment constructs and presented below\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNarrative Themes Mapped to Empowerment Constructs and Workplace Implications\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNarrative Theme\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCore Lived Experience (Narrative Summary)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEmpowerment Construct\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eManifestation of Disempowerment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEmpowerment-Oriented Workplace Implications\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvisible cognitive labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConstant mental effort required to organize, initiate, and regulate work that remains unseen and unacknowledged\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePerceived control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDepletion of agency due to unrecognized effort and unrealistic expectations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRecognition of cognitive labor; flexible pacing; outcome-based evaluation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompensatory overwork and masking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExcessive effort and self-surveillance to conceal ADHD-related difficulties\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePsychological empowerment (self-efficacy)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBurnout, emotional exhaustion, and erosion of self-worth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNormalize diverse work styles; reduce productivity moralism\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisclosure dilemmas and silence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFear of stigma and loss of opportunity following diagnosis disclosure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAutonomy and voice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRestricted self-advocacy; conditional belonging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConfidential disclosure pathways; anti-stigma leadership training\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStructural rigidity and systemic misfit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInflexible schedules, multitasking demands, and sensory overload\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eParticipatory decision-making\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExclusion from shaping work conditions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCo-designed accommodations; flexible job design\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterrupted hyperfocus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRepeated disruption of deep concentration by workplace demands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEnvironmental fit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReduced productivity and frustration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eProtected focus time; task batching\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReclaiming strengths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRecognition of creativity, innovation, and hyperfocus as assets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCollective empowerment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eADHD framed solely as deficit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStrength-based role alignment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupportive leadership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTrust-based management and reduced micromanagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRelational empowerment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDependence on individual goodwill\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLeadership accountability for inclusion\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAutonomy through self-employment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEntrepreneurship as a response to rigid systems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEconomic empowerment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrecarity-driven self-employment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStructured support for neurodivergent entrepreneurs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between narrative themes and empowerment processes is summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, illustrating how lived experiences of adults with ADHD reflect dynamic patterns of disempowerment and agency across workplace contexts.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis narrative synthesis examined the lived workplace experiences of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) across diverse cultural contexts, highlighting how challenges commonly attributed to individual cognitive deficits are more accurately understood as outcomes of structural and organizational misfit. By centering first-person narratives, the findings extend existing occupational ADHD research by illustrating how executive functioning differences become disabling primarily in work environments structured around neurotypical norms of productivity, time management, and self-regulation.\u003c/p\u003e \u003cp\u003eConsistent with neurodiversity-oriented perspectives, the narratives suggest that ADHD-related impairments are not fixed or universal traits but are relational phenomena shaped by workplace design and cultural expectations. Participants\u0026rsquo; accounts of invisible cognitive labor, disrupted hyperfocus, and constant self-monitoring echo earlier research showing that conventional work structures disproportionately penalize adults with ADHD by privileging sustained attention, multitasking, and rigid scheduling (Bijlenga et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Holthe \u0026amp; Langvik, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). This reframing challenges deficit-based models that place responsibility for adaptation solely on individuals and underscores the need for organizational accountability.\u003c/p\u003e \u003cp\u003eParticipants described sustained planning, self-regulation, and compensatory effort that remained unrecognized within performance evaluations. These findings align with prior qualitative work documenting compensatory overwork, perfectionism, and exhaustion among adults with ADHD striving to maintain professional legitimacy (Brown, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Ramsay \u0026amp; Rostain, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Over time, such strategies were associated with burnout and psychological distress, reinforcing evidence linking ADHD to occupational stress and reduced well-being (Shaw et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Importantly, the narratives complicate resilience-based interpretations of coping by demonstrating how masking reflects constrained agency rather than empowerment.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eDisclosure\u003c/strong\u003e \u003cp\u003eemerged as a particularly complex site of negotiation. While formal disability protections exist in some contexts, participants frequently described disclosure as leading to subtle marginalization, including diminished trust and limited career progression. These experiences are consistent with studies documenting persistent stigma and internalized shame among adults with ADHD in workplace settings (Ginsberg et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Masuch et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). In regions with limited awareness of adult ADHD, silence functioned as a protective strategy, reinforcing isolation and self-blame.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eEmpowerment, when present, was narrated as a relational and contextual process rather than an individual outcome. Participants experienced empowerment through autonomy, flexibility, and participation in decision-making, particularly when supportive leadership and strengths-based role alignment were present. These findings support empowerment theory\u0026rsquo;s emphasis on agency, perceived control, and shared power within social systems (Zimmerman, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1995\u003c/span\u003e). Notably, empowerment was not associated with symptom suppression, but with recognition and structural adaptation.\u003c/p\u003e \u003cp\u003eDespite cultural variation in awareness and policy, the convergence of narratives across regions underscores the global relevance of these findings. Differences were less about the nature of ADHD and more about the availability of supportive structures and legitimizing language. Together, the findings highlight the importance of narrative and qualitative approaches in neuropsychology and call for workplace inclusion strategies that move beyond accommodation as exception toward inclusion as design principle.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis narrative synthesis positions work as a salient dimension of adult life with Attention-Deficit/Hyperactivity Disorder (ADHD) and demonstrates that many workplace difficulties traditionally attributed to individual deficits instead reflect deeply embedded structural and cultural norms. Organizational expectations of productivity, conformity, and self-regulation are largely grounded in neurotypical models of functioning, rendering cognitive difference a site of disadvantage rather than variation. Across narratives, empowerment was experienced not through symptom suppression, but through recognition, autonomy, and meaningful participation. Contexts characterized by flexibility, trust, and voice enabled individuals to align cognitive strengths with work demands, while rigid structures, stigma, and silence sustained cycles of masking, burnout, and self-doubt. The convergence of experiences across diverse cultural settings underscores the global relevance of these findings, while also highlighting the necessity of culturally responsive approaches to workplace inclusion. Ultimately, this study argues that listening to lived experience is both an interpretive act and a methodological imperative, and that reframing ADHD in the workplace from individual pathology toward issues of design, power, and participation is essential for creating equitable and sustainable work environments.\u003c/p\u003e"},{"header":"6. Implications","content":"\u003cp\u003eThe findings carry important implications for neuropsychological research and workplace practice. For neuropsychology, they call for greater integration of narrative and qualitative approaches capable of capturing dimensions of work functioning that standardized assessments often overlook, as well as for longitudinal and ecologically valid methods that attend to lived experience over time. For organizations, the results support a shift from accommodation as exception to inclusion as a design principle. Participatory accommodations, flexible job structures, and leadership accountability emerge as key mechanisms for fostering empowerment among adults with ADHD. While this narrative synthesis does not claim representativeness, future research employing primary narrative interviews, participatory methodologies, and cross-cultural comparative designs could further strengthen understanding of neurodiversity-affirming workplace practices.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis article does not contain any studies with human participants performed by any of the authors. So ethical approval is not required for conducting this study.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis article does not contain any studies with human participants performed by any of the authors.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eNot applicable. The study does not include any identifiable images or personal data of participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no funding received for this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors declare no competing interest in this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a qualitative narrative synthesis based exclusively on secondary analysis of publicly available literature and first-person narrative accounts published in academic, professional, and advocacy sources. No primary data were generated or collected, and no participant-level raw datasets exist. Search strategies, inclusion and exclusion criteria, and thematic synthesis materials are provided as supplementary files to enable transparency and methodological verification.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.T.S and S.Y collected data and supervised the study. S.K.G and S.K analyzed the data and wrote the draft article. R.Y reviewed and wrote the final manuscript and S.T.S validated it.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdamou, M., \u0026amp; Hale, D. (2019). Policy and workplace inclusion for adults with ADHD. \u003cem\u003eBJPsych Bulletin, 43\u003c/em\u003e(3), 108\u0026ndash;114. \u003c/li\u003e\n\u003cli\u003eAmerican Psychiatric Association. (2013). \u003cem\u003eDiagnostic and statistical manual of mental disorders\u003c/em\u003e (5th ed.). Author.\u003c/li\u003e\n\u003cli\u003eBarkley, R. A., Murphy, K. R., \u0026amp; Fischer, M. (2010). \u003cem\u003eADHD in adults: What the science says\u003c/em\u003e. Guilford Press.\u003c/li\u003e\n\u003cli\u003eBijlenga, D., Tjon-Ka-Jie, J. Y. M., Schuijers, F., \u0026amp; Kooij, J. J. S. (2019). A focus on work functioning in adults with ADHD: A systematic review and expert opinion. \u003cem\u003eEuropean Psychiatry, 58\u003c/em\u003e, 1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eBrown, T. E. (2005). \u003cem\u003eAttention deficit disorder: The unfocused mind in children and adults\u003c/em\u003e. Yale University Press.\u003c/li\u003e\n\u003cli\u003eDoyle, N. (2020). Neurodiversity at work: A biopsychosocial model and the impact on working adults. \u003cem\u003eBritish Medical Bulletin, 135\u003c/em\u003e(1), 108\u0026ndash;125. https://doi.org/10.1093/bmb/ldaa021\u003c/li\u003e\n\u003cli\u003eGinsberg, Y., Quintero, J., Anand, E., Casillas, M., \u0026amp; Upadhyaya, H. (2014). 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Terms of empowerment/exemplars of prevention: Toward a theory for community psychology. \u003cem\u003eAmerican Journal of Community Psychology, 15\u003c/em\u003e(2), 121\u0026ndash;148. https://doi.org/10.1007/BF00919275 \u003c/li\u003e\n\u003cli\u003eSedgwick, J. A., Merwood, A., \u0026amp; Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: A qualitative investigation of successful adults with ADHD. \u003cem\u003eADHD Attention Deficit and Hyperactivity Disorders, 11\u003c/em\u003e(3), 241\u0026ndash;253. \u003c/li\u003e\n\u003cli\u003eShaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., \u0026amp; Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder. \u003cem\u003ePsychiatric Services, 63\u003c/em\u003e(5), 518\u0026ndash;524. \u003c/li\u003e\n\u003cli\u003eZimmerman, M. A. (1995). Psychological empowerment: Issues and illustrations. \u003cem\u003eAmerican Journal of Community Psychology, 23\u003c/em\u003e(5), 581\u0026ndash;599. https://doi.org/10.1007/BF02506983 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Adult ADHD, lived experience, narrative synthesis, neurodiversity, workplace inclusion, empowerment","lastPublishedDoi":"10.21203/rs.3.rs-8547581/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8547581/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eResearch on adult Attention-Deficit/Hyperactivity Disorder (ADHD) in the workplace has largely focused on symptomatology, productivity deficits, and economic costs, often neglecting the subjective experiences of adults navigating work environments structured around neurotypical norms. While such deficit-oriented frameworks have advanced clinical understanding, they provide limited insight into how adults with ADHD experience, interpret, and negotiate everyday working life across diverse cultural contexts.\u003c/p\u003e\u003ch2\u003eObjectives:\u003c/h2\u003e \u003cp\u003eThe present study aimed to explore the lived workplace experiences of adults with ADHD across global contexts and to examine how these experiences illuminate processes of disempowerment and empowerment within contemporary organizational systems. The study sought to shift the discourse from individual deficit toward contextual and experience-based understandings of ADHD at work.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA qualitative narrative synthesis design was employed. First-person accounts were drawn from peer-reviewed qualitative studies, autobiographical writings, and experiential reports authored by adults with ADHD across multiple regions. Narrative sources were analyzed using thematic narrative analysis, with empowerment theory serving as an interpretive lens.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eFive interconnected narrative themes emerged: (1) invisible cognitive labor required to meet baseline workplace expectations; (2) compensatory overwork, masking, and burnout; (3) disclosure dilemmas shaped by stigma and conditional acceptance; (4) structural rigidity and systemic misfit between ADHD cognitive styles and workplace design; and (5) reclaiming agency through autonomy, supportive leadership, and strengths-based role alignment. Despite cultural variation in awareness and policy, experiences of invisibility, overcompensation, and constrained agency were consistent across contexts.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThe findings suggest that workplace challenges associated with adult ADHD are less a function of individual cognitive deficits and more a consequence of inflexible organizational structures and normative productivity expectations. Empowerment was experienced not through symptom suppression but through recognition, autonomy, and participatory inclusion. Centering lived experience offers a critical pathway for reimagining neuropsychological research and workplace practice toward more inclusive, equitable, and sustainable work environments.\u003c/p\u003e","manuscriptTitle":"“I Work Twice as Hard to Look Normal”: Lived Workplace Experiences of Adults With ADHD Across Cultures","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-12 15:59:23","doi":"10.21203/rs.3.rs-8547581/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-15T01:51:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"121020134431381340557083258355035197555","date":"2026-05-15T00:53:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-14T17:42:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"188770145968335516906259587342594049078","date":"2026-05-13T10:20:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"105315212191678723183789049174113749906","date":"2026-05-13T07:11:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-08T15:51:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-08T12:04:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-28T06:15:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-27T05:25:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"Humanities and Social Sciences Communications","date":"2026-01-27T05:17:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"humanities-and-social-sciences-communications","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"palcomms","sideBox":"Learn more about [Humanities \u0026 Social Sciences Communications](http://www.nature.com/palcomms/)","snPcode":"41599","submissionUrl":"https://submission.springernature.com/new-submission/41599/3","title":"Humanities and Social Sciences Communications","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"85a7a78b-d17f-4272-8ff9-97619df7e6a2","owner":[],"postedDate":"February 12th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-15T01:51:22+00:00","index":110,"fulltext":""},{"type":"reviewerAgreed","content":"121020134431381340557083258355035197555","date":"2026-05-15T00:53:25+00:00","index":109,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-14T17:42:20+00:00","index":108,"fulltext":""},{"type":"reviewerAgreed","content":"188770145968335516906259587342594049078","date":"2026-05-13T10:20:17+00:00","index":104,"fulltext":""},{"type":"reviewerAgreed","content":"105315212191678723183789049174113749906","date":"2026-05-13T07:11:50+00:00","index":103,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":62824016,"name":"Biological sciences/Neuroscience"},{"id":62824017,"name":"Biological sciences/Psychology"},{"id":62824018,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2026-02-12T15:59:23+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-12 15:59:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8547581","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8547581","identity":"rs-8547581","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}