“Lazy” is often used as an explanation when a person is struggling to begin, organise, remember, sustain attention or complete a task. It can carry a great deal of shame. But a blog cannot determine whether those experiences are ADHD, anxiety, low mood, burnout, trauma, sleep disruption, a physical health issue, an access need, workplace pressure or something else. ADHD is a neurodevelopmental condition that requires appropriate assessment. It should not be self diagnosed from a list of traits, an online post or a difficult period at work. Some people with ADHD may recognise challenges with attention, organisation, impulsivity or regulation; others may have similar experiences for different reasons. Assessment can consider history, context, functional impact, health information and other explanations. The phrase “not laziness” can still be useful when it challenges a moral judgement. Difficulty is not evidence that someone lacks character or effort. At the same time, no single description speaks for every neurodivergent person, and people do not have to prove how hard they are working in order to deserve support. CBT may be considered after assessment where appropriate. It is not a self directed productivity programme, a promise that routines will work for everyone or a substitute for diagnostic, medical, workplace or educational advice. Where CBT informed work is suitable, it is developed collaboratively with a qualified clinician and adapted to the person’s priorities, capacity, sensory needs and circumstances. Support may also involve a GP, a specialist assessment service, occupational health, workplace adjustments, education support, medication conversations, practical tools or rest. No article can decide which option is right for one person or predict a particular outcome. For related information, see neurodiversity affirming support at lyceumclinic.co.uk/cbt for neurodivergent people/, the guide to CBT informed support for neurodivergent adults at lyceumclinic.co.uk/guides/cbt support for neurodivergent adults/ and the ADHD and work guide at lyceumclinic.co.uk/guides/adhd at work west london/. If distress includes crisis, thoughts of self harm or an inability to keep safe, urgent appropriate help is needed.