Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects the development of the nervous system, leading to variations in brain function. As a result, people with ADHD experience executive dysfunction – deficits in cognitive processes that are necessary for the control of behaviour. This includes regulating emotions, memory, and self-control and can affect learning ability and processing speed. As difficulties are related to brain function, the agreed upon treatment for ADHD is stimulant medication, however, some people find that even on medication, their mood and anxiety symptoms continue. This is why the most effective treatment for ADHD is a combination of medication and psychological intervention. The following are examples of some ADHD symptoms that influence anxiety and depressive symptoms.
Motivation is one of the biggest difficulties people with ADHD face. Research believes this could be because of lower levels of dopamine, which limits the brain’s ability to both recognise rewards and seek them out. This results in a lack of motivation to engage in tasks where dopamine isn’t available (homework) and addiction to tasks that give dopamine (gaming, social media, shopping, drugs, alcohol, etc.). As today’s education system is based on sitting down, studying and memorising information, people with ADHD often have difficulties completing homework tasks, leading to deficits in academic performance. It is common for people with ADHD to believe their performance is due to personal flaws (“there is something wrong with me”) and thus failure beliefs (“I will fail”, “I am a failure”). This makes the motivation to study even more difficult as the risk of failure is perceived as high, and therefore ‘not trying and failing is easier than trying and failing’ as a mentality is hard to escape. If you have been prescribed medication for your ADHD and still procrastinate and avoid important tasks, it may be because of underlying failure beliefs which can be challenged with the help of a psychologist.
Impulsivity is speaking, behaving, or making choices without taking the time to consider the consequences of actions. There is a view that people with ADHD are impulsive because of the dopamine system discussed above but also because of slowed communication between the decision-making part of the brain (pre-frontal cortex) and the action centre of the brain (thalamus). This results in difficulty completing tasks of disinterest (as discussed in motivation), lack of self-control (addictive behaviour), speaking without thinking and making big life decisions without thinking them through. This translates to behaving in ways that are later regretful and that are inappropriate in social contexts. Therefore, it is common for people with ADHD to feel socially excluded, like an alien or inherently flawed. This results in behaviours aimed at reducing the frequency of judgement, such as avoiding social situations or masking to fit in. Consequently, people with ADHD may feel like they don’t fit in anywhere and that no one truly knows them. While medication can reduce impulsivity, it cannot challenge isolation beliefs that influence loneliness and therefore, may help to explain the maintenance of uncomfortable symptoms.
A neurotypical brain (someone without ADHD) is like an intersection that runs on a traffic light system. Thoughts, feelings and events are all processed in a regulated and organised way by the traffic lights (pre-frontal cortex). A neurodivergent brain is like an intersection that has no traffic lights. Only one traffic controller has to navigate the flow of oncoming traffic independently. Using this analogy, we can see that the traffic controller’s attention will automatically be drawn to large and fast oncoming traffic. Therefore, if a big truck driving 200km an hour is approaching, the traffic controller will be forced to let that through first. In other words, big emotions such as anger and sadness will be experienced at a greater intensity with limited ability to stop them. This leads to overwhelm, overstimulation and thus breakdowns, meltdowns, outbursts and impulsive responses. Consequentially it is not uncommon for people with ADHD to have experiences of friendship loss, abandonment, social exclusion and frequent conflict. Having negative experiences in response to emotional expression can lead to shame and therefore, extreme efforts to suppress or avoid emotions because they are viewed as ‘bad’, ‘uncontrollable’ or ‘weak’. Hiding emotions reduces connection opportunities and leads to numbness, depression and anxiety symptoms. The more emotions are suppressed, the stronger and more uncontrollable they become, leading to unhelpful self-soothing strategies such as self-harm, comfort eating, alcohol and drug use. Emotional regulation is a skill that can be taught and therefore, psychological intervention can be a more effective treatment strategy than medication.
If you resonate with any of the above symptoms, it is recommended that you reach out for psychological support. Understanding how ADHD symptoms can influence your mood and behaviours is essential in de-stigmatising ADHD and developing coping strategies individually tailored to you to support navigation through a neurotypical world. Your psychologist will also support increased awareness of the strengths of ADHD to support your success and well-being.