Are your top performers burning out in silence?

The content and resources provided in this newsletter are for informational purposes only and should not be considered medical or legal advice. We hope this information can set you on a pathway to learning more about neurodiversity in the workplace. To ensure the highest quality content for our readers, all our articles are co-edited by Jane McColl, Senior People Manager at CareScribe. Happy reading!

Reading time: 5 mins

Maggie always looked like the colleague you could rely on. Quietly competent, diligent, and the kind of person who stayed late to make sure nothing slipped. But what her managers couldn’t see was the cost of appearing “fine.”

A lifetime of forgetting processes left her feeling she wasn’t good enough, even as she collected degrees and delivered results. In one role, after struggling to remember a task she’d been shown the night before, her manager snapped, “It’s not rocket science.” She ended up in the bathroom in tears. “I’ve got a Master’s, I’ve got a degree. I’ve taught. I still feel stupid.”

Is Maggie’s story a one-off or a sign of something bigger happening across workplaces?

Neurodiversity consultant Kerry Bentley FIEDP DipESG shared Maggie’s story during our recent Inclusive Workplaces webinar. It perfectly captures what internalised ADHD can look like at work: capability on the surface, exhaustion underneath, and a quiet belief that if you can’t keep up with the “typical” way of working, the fault must be you.

In this edition of our Inclusive Workplaces newsletter, you’ll explore what internalised ADHD really means, how it shows up in the workplace, and what you can do as managers and inclusion leaders to create an environment where ADHDers don’t just stay, but thrive.

Key takeaways for HR, managers and inclusion leaders

💙 Internalised ADHD is often invisible until burnout or quiet exits follow.

🙋🏻♀️ Employees do not need a diagnosis to receive adjustments at work. Support should focus on functional need.

🔥 The biggest unlock is today’s management: psychological safety, flexible norms, and strengths-based roles.

🤝 Inclusion is a win-win: when ADHDers thrive, retention, wellbeing, and productivity rise together.

You can listen to this article 🎧

As an assistive tech company, we value accessibility. That's why every edition of our LinkedIn newsletter comes with an audio version - so that you can listen to each article on your own terms and grab our key insights anytime, anywhere.

Can we spot internalised ADHD at work?

We often picture ADHD as outward restlessness or visible disorganisation. Kerry cautioned against that stereotype.

Internalised ADHD refers to traits and impacts that are felt internally rather than expressed externally, she explains, such as the constant busy brain, overthinking, anxiety, and emotional dysregulation. From the outside, someone may look calm and in control; inside, they’re paddling like mad just to keep up.

Two points matter for leaders:

• Visibility ≠ reality. Profiles shift by context (home vs. office); what you see externally “is often very much not the same” as what’s happening internally. Many employees “work three, 4 or 5 times as hard” as peers just to appear okay.
• It’s broader than inattentive ADHD. Internalised presentations can include both inattentive and hyperactive-impulsive traits with the hyperactivity showing up as mental restlessness rather than obvious movement.

Kerry also noted that we’ve historically under-diagnosed ADHD; many adults don’t realise they’re neurodivergent. That’s one reason not to gatekeep support behind labels.

Why high performers burn out: the masking loop

When the challenges stay inside, employees often mask to meet expectations.

That might look like meticulously organised calendars, spotless desks, and pristine deliverables — the very opposite of the chaotic cliché. But the order is doing a lot of heavy lifting: it’s a structure built to contain internal chaos. As Kerry put it, some ADHDers keep spaces more organised precisely because the internal load is so high. The price is energy, and over time, health.

The hidden cost for organisations

When internalised ADHD goes unseen, everyone loses. Employees cycle through stress, self-doubt, and exhaustion. Promotions aren’t pursued. Quiet resignations rise.

Kerry referenced recent findings from the City & Guilds Neurodiversity Index Report (2024), which found that over half of neurodivergent employees had taken time off work because of their neurodivergence. She also pointed to NHS research showing that adults with ADHD experience lower full-time employment rates and higher job turnover across the UK workforce. That’s the organisational reality behind the “they seemed fine” narrative.

Progression is hit too. If you constantly feel you’re underperforming, you’re unlikely to put yourself forward or to be seen by others as ready. That’s not potential; that’s context. And context is something leaders can change with the right supports.

What leaders often miss (and how to spot the right signals)

You can’t diagnose (and you shouldn’t try) but you can notice patterns that suggest someone is spending excess energy to maintain “okay”:

• Chronic evening catch-up and last-minute surges to meet deadlines
• Unpredictability in day-to-day capacity (brain fog days vs hyperfocus days)
• Over-organisation masking internal load (“together” on the outside, drained on the inside)
• Heightened reactions to feedback or perceived criticism (RSD)

Employees don’t need a diagnosis

During the session, Kerry asked a simple poll question: Do you need a diagnosis to have adjustments at work? The correct answer is no.

Under the Equality Act 2010, if an employee’s day-to-day activities are substantially and long-term affected, employers must consider reasonable adjustments. The practical principle is even simpler: support functional need, not labels.

Understanding this policy and ensuring line managers are aware of it removes a significant barrier for employees who have been waiting years for assessments or who don’t yet have a clear understanding of their needs.

Here are four shifts your organisation can make

Kerry framed inclusion through a universal-design lens: start with the main “meal” most people can eat, then tailor as needed. It’s faster, fairer, and more cost-effective than bespoke fixes from scratch. Here are four shifts to embed:

1. Lead with strengths and design roles to match

Don’t just tolerate differences; use them. Map the work to the person where possible. If someone’s strengths are crisis response, ideation, or stakeholder communication, orient tasks and goals accordingly. Teams with neurodivergent professionals are consistently shown to be more productive when strengths are leveraged and friction points supported.

2. Normalise atypical ways of working

Make it standard to discuss how people work best. Kerry recommends one-page profiles for everyone: a simple living document covering strengths, communication preferences, check-in cadence, and what gets in the way. This levels the playing field: the conversation becomes normal, not exceptional.

Kerry shared that tools like one-page profiles can prompt open conversations between managers and employees — questions like ‘What helps you stay focused?’ or ‘What do you find challenging?’ As she explained, inclusion starts with everyday conversations like these.

3. Build psychological safety into the rhythm of work

Regular, non-judgemental check-ins. Flexibility on where and when deep work happens. Movement breaks without side-eye. Quiet spaces, noise-management options, and thoughtful hybrid patterns. These are light lifts with outsized impact for ADHDers and useful for many others.

4. Tailor support where it matters most

Start with the person’s functional bottleneck (e.g., starting tasks, holding detail, managing sensory load) and co-design small changes. Examples Kerry shared: noise-cancelling headphones; temperature aids (fans/heaters); digital notepads; and assistive tech such as dictation tools.

“The most effective accommodations often don’t cost a penny,” Kerry emphasised. “They come from listening to your employees and really understanding their needs, and supporting them.”

In her recent survey on workplace support for ADHD, one answer stood out above the rest: a supportive and understanding manager.

Get your free guide to assistive technology!

Kerry reminded us that the most effective adjustments often start small. Offering tools like speech-to-text, captioning, and note-taking software can be game-changers for ADHDers who struggle with memory, focus, or organisation.

If you’re looking to turn this insight into action, we’ve created a free eBook on Assistive Technology, a practical guide to understanding, choosing, and implementing AT at work.

🚀 The best part? It’s free! [Grab your copy here]

Remember: supporting ADHD in the workplace is a win-win

Kerry finished with a simple truth: supporting ADHD in the workplace is an absolute win-win. People become happier, more creative, and more productive and the organisation benefits twice over through retention and performance.

Or as Maggie reminded us: everybody’s different; it’s working with the individual.

If your organisation wants to move from masking to thriving, start by making the invisible visible: treat “fine” as a conversation starter, not a finish line.

CareScribe is on a mission to make the world more accessible. We build assistive technology which levels the playing field for people with disabilities and enables users to be more independent in their studies and at work. Our small but mighty team builds software that thousands of people love: lightning-fast dictation software, TalkType, and our live-captioning and note-taking product, Caption.Ed. Explore how CareScribe can help you create a more inclusive workplace.