3 Common Internal Struggles People with ADHD Face

Adult clients who present with attention-deficit/hyperactivity disorder (ADHD) often describe their frustration of the mind leading them towards questions of great importance and a sense of not feeling satisfied (a craving for stimulation). Rejection sensitive dysphoria and emotional hyperarousal precipitate clinically significant symptoms of distress. The ADHD mind has an interest-based nervous system that is not motivated by rewards and consequences, and this may eventuate in motivational and time challenges and achieving below potential (e.g., not finishing what one starts).

3 internal struggles commonly reported by adults with ADHD

1. The activation spiral of thinking creates cognitive dissonance with relation to setting realistic limitations (what is realistically achievable) in contrast with to-do lists that causes distress. Time blindness and difficulties with prioritizing and organizing may result in chronic stress. When one's sense of value is associated with productivity, survival mode thinking may activate the threat and drive systems.
2. The social anxiety spiral of thinking leads to subjugating, masking, reassurance-seeking, and/or overcommitting to things. These behaviors are particularly adverse for mental health. The values people hold (authenticity, loyalty, fairness, and kindness) may spiral into unrelenting expectations of the self, feeling guilt, and the self-limiting belief of not feeling good enough.
3. The existential spiral of thinking is a questioning of one’s purpose, meaning, and connections in life. Deconstructing this to the point of feeling lost may lead to symptoms of sadness and grief.

8 techniques to help center the mind and body

1. Learning to be mindful of your emotions in a curious and non-judgmental manner (Acceptance Commitment Therapy) allows you to change how you pay attention to emotion and sets the framework for managing distress in a healthy way.
2. The pioneering work of neuroscientist Bruce Perry’s model of Sequential Engagement and Processing highlights the importance of regulating (calming the stress responses) and connecting through a relational approach before reasoning (e.g., attempting to feel self-assured).
3. Subconscious urges have a distinct sense of urgency to them and may trigger the vulnerable child within. Conscious thought and taking action may not produce change. Rather, change may require you to memorize that feeling and move what you have learned from the conscious mind to the subconscious. Schema therapy is a powerful treatment approach that allows people to identify psychological defenses and self-defeating patterns that begin early in life.
4. Embracing the authentic self (e.g., checking in with what you feel and need at any given moment in time) fosters a genuine connection with the self and others.
5. Activities that are regulatory, rhythmic, and/or involve movement are beneficial for completing stress cycles (to help the body move out of survival mode thinking).
6. Neurodivergent minds need to rest and recharge. There are many different types of rest, including, sensory rest, creative rest, emotional rest (having the time and space to freely express how you feel), and social rest.
7. Positive traits of ADHD—of which there are many—include being kind, passionate, creative, honest, curious, innovative, and good in a crisis (able to compartmentalize). Clients with ADHD often report their innate ability to thrive in situations of variety, rapid change, and that reward innovative thinking.
8. Neurodivergent minds benefit from feeling the flow of operating within their own space and time. Flexibility (accommodations) allows people to minimize the negative and leverage the positive.

Ultimately, we want to empower neurodivergent individuals to feel comfortable to ask for the accommodations and support they need. By offering respect, support, and flexibility (accommodations in the workplace), we will encourage self-determination, empowerment, and innovations for the good of all. If a person is genuinely proud of who they are, it helps them to navigate the world better. In this way, expectations become more realistic and do not require the person to meet standards that are unreasonable.

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