Guide

When work gets hard: ADHD and autism during a PIP, sick leave or a medication change

What to do, what to ask for and where to get free help when ADHD or autism meets a hard moment at work.

Nine short chapters. Go to the one you need now. Each one stands alone.

Chapter 01~1 min read

Start here

After this chapter you will know what this guide covers and how to use it.

This guide is for neurodivergent people going through a hard time at work. That includes people with attention deficit hyperactivity disorder (ADHD), autism or both. It covers five moments: a performance improvement plan, a disciplinary, burnout or sick leave, a change in medication, and a long wait for an assessment.

These are often the moments when people first talk about being neurodivergent at work. You may not have planned to. That is normal. Each chapter says what is happening, what you can ask for and where to get help.

This guide is general information for people in the UK. It is not legal or medical advice. Chapter 08 lists free places to get advice about your own situation.

If you feel unsafe or think you might harm yourself, call 999. You can also call Samaritans for free, at any time, on 116 123.

Chapter 02~4 min read

A performance improvement plan (PIP)

After this chapter you will know what a PIP is and how to make it fair for you.

A performance improvement plan, or PIP, is a written plan. It says what your employer wants to change in your work, by when, and how they will check. It is often the step before a formal process. That makes it stressful.

Sometimes the problem in the PIP is caused by ADHD or autism. For example, missed deadlines, slow replies or trouble in busy meetings. If so, your employer’s duty to make reasonable adjustments applies to the plan too. That includes the targets, the deadlines and the way your work is checked.

What you can do

Ask for the plan in writing, if you do not have it. Ask what “good” looks like for each point, with an example.
Say if ADHD or autism affects any point. You can explain the effect without naming the condition. For example, “I miss verbal deadlines. I meet written ones.”
Ask for adjustments to the plan. For example, written tasks, one priority at a time, a check-in each week or more time for one target.
Ask for adjustments to the meetings. For example, the points in writing before the meeting, time to think before you answer, or notes after it.
Ask to bring someone with you. At a formal disciplinary or grievance meeting, you have the right to bring a colleague or a trade union representative. For a PIP meeting, you can ask. Many employers agree.
Keep a record of every meeting: the date, what was said and what you agreed. Chapter 07 shows a simple way to do this.

Chapter 03~3 min read

A disciplinary

After this chapter you will know your rights in a disciplinary process.

A disciplinary is a formal process about your conduct or performance. It can lead to a warning or, at the end, dismissal. Employers in the UK should follow the Acas Code of Practice on disciplinary and grievance procedures.

What you can do

Read the letter slowly, more than once. It should say what the problem is, when the meeting is and that you can bring someone.
Bring someone. You have the right to bring a colleague or a trade union representative to the meeting.
Ask for adjustments to the process. For example, a quiet room, breaks, questions in writing or more time to prepare. Your employer must consider these.
Explain any link to ADHD or autism. If something you did was linked to your condition, say so in writing before the meeting.
Get advice early. Acas, Citizens Advice and trade unions give free advice. Chapter 08 has the links.

Chapter 04~4 min read

Burnout and sick leave

After this chapter you will know how to take time off and come back well.

Burnout happens when the effort of coping runs out. Many neurodivergent people describe it after months of masking, which means hiding their differences to fit in. It can look like deep tiredness, losing skills you had, or not being able to start anything.

Taking time off

Talk to your GP. If you are off sick for more than seven days, your employer can ask for a fit note. A fit note can also suggest changes to help you go back, such as fewer hours.
You decide how much to share. You can say “I am off sick on my doctor’s advice” and stop there.
Rest is the treatment. Try not to check work emails. If that is hard, ask a colleague to tell you only what really needs you.

Coming back

Ask for a return-to-work meeting. Use it to agree what will be different this time.
Ask for a phased return. This means starting with fewer hours or days, then building up.
Ask for an occupational health referral. Occupational health is a health service that advises your employer on what will help you at work.
Ask about sickness absence linked to your condition. You can ask for it to be recorded separately, so it does not count towards absence warnings. This can be a reasonable adjustment.

Chapter 05~3 min read

A change in medication, or a shortage

After this chapter you will know what to tell work, and what you do not have to.

Starting, changing or stopping medication can affect your focus, sleep and mood for a while. A shortage can do the same with no warning. In recent years, people in the UK have had problems getting some ADHD medicines.

What you can do

Talk to your GP, specialist or pharmacist first. They may be able to suggest another form or another pharmacy.
You do not have to name your medicine. You can tell your manager “My treatment is changing. For the next few weeks, I may need more time on some tasks.”
Ask for short-term changes. For example, fewer meetings, written tasks, a deadline moved or a quieter place to work.
Agree a date to review it. Then the change has an end, and nobody has to remember to ask.

Chapter 06~2 min read

Waiting for an assessment

After this chapter you will know what you can ask for before you have a diagnosis.

In the UK, waiting lists for an adult ADHD or autism assessment can be several years long. You do not have to wait for a diagnosis to get help at work.

You can ask for adjustments now. Describe what is hard and what would help. A diagnosis is useful evidence, but you can ask without one.
You can apply for Access to Work. It does not need a formal diagnosis. See our Access to Work guide.
Some employers pay for a private assessment. It is not a legal duty, but it is worth asking HR.

Chapter 07~2 min read

Keep a simple record

After this chapter you will have one place for everything that happens.

When work gets hard, it is hard to remember who said what, and when. A simple record helps you in every meeting. If things go further, it is also your evidence.

Write down each meeting on the same day: the date, who was there, what was said and what was agreed.
Send a short email after each meeting. For example, “Thanks for today. To check, we agreed…”. Then there is a shared record.
Keep every letter and plan in one folder.
Write down how you are. Your sleep, energy and what helped. This can help your GP and occupational health.

A notebook, a document or an email folder all work. If you use Humble, you can keep a note for each meeting and link it to your manager, so every meeting appears in order on their timeline. Linking is private: your manager sees nothing. See Keep a record of your work adjustments.

Chapter 08~2 min read

Where to get free help

After this chapter you will know who to contact for advice about your own situation.

Acas (opens in a new tab): free, fair advice on work problems, including disciplinaries, grievances and absence.
Citizens Advice (opens in a new tab): free advice on your rights at work.
Your trade union, if you are a member: advice and someone to come to meetings with you.
Your GP: health, fit notes and medication.
Occupational health, through your employer: advice on what will help you at work.
Samaritans (opens in a new tab): free to call on 116 123, at any time, if you need to talk.