Lead with Your Heart

Stick to talking about your passions. With an interest-based brain, you’ll be able to put your best foot forward — and see if you really zing with someone — when you focus on what excites you. If you’re into horror films, for example, share that with your date and see how they respond. You may learn that horror isn’t their thing, but true crime podcasts are. (And that’s how the conversation keeps going and stays somewhat on track.)

LIVE WEBINAR ON NOV. 7: CONSCIOUS DATING WITH ADHD
Register for this free webinar and get an opportunity to ask your questions about dating. Plus, get the replay link to share.

Establish Clear Boundaries

Whether regarding first dates or small talk with colleagues and acquaintances, set clear rules for yourself about what you will and will not discuss. Consider these topics off limits:

• body fluids and functions
• odor and hygiene
• sexual history
• money
• medical history
• traumatic events and family histories

[Get This Free Download: Become a Small-Talk Superstar]

Devise Handy Summarizing Scripts

If you know that you’re prone to divulging too much information on a sensitive topic, like your rocky relationship with your parents, come up with a few phrases that satisfactorily capture the situation, like “I have difficult parents” or “I come from a challenging family.” These phrases say a lot, minus the details, which you’ll have a chance to share with your date if you do grow closer to them.

Bring It Back with a Laugh

Humor is fantastic for pivoting conversations when you realize you’re oversharing. Say, “Wow, I have had a lot of coffee today!” or “I definitely went down the rabbit hole there. Can we go back to what you were talking about?”

How to Not Overshare: Next Steps

• Get the eBook! The ADHD Relationship Guide
• Read: “5 Things I Learned from First Dates”
• Read: Dating Advice & Strategies for Adults with ADHD

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “Oversharing and Underinvesting: The Social Traps That Snare ADHD Adults” [Video Replay & Podcast #496] with Caroline Maguire, M.Ed., ACCG, PCC, which was broadcast on March 14, 2024.

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My 9-year-old son has always been a firework, from the very second of his surprise existence. If my pregnancy test could have displayed two zigzags instead of straight lines, it would have.

He has never followed the path well-trodden. Instead, he has swung from the trees shadowing its path, spinning and tumbling over it like a Ferris wheel free from its hinges. His brain is always busy. It darts and daydreams and never tells him to sit, breathe, and just be.

“I was the same as him when I was a kid,” my husband would say. “He’s just a little boy.”

He often spoke of marked similarities between them, and we thought our son had simply inherited a huge slice of his father’s personality. That this was just “them.” So we attributed his behaviors to that – a child who was beautifully energetic. If he wasn’t spinning or cartwheeling, he was singing or asking questions or making funny little noises. The only time he really rested was when he slept, when dreams took over and his compulsion to “fizz,” as he calls it, quelled.

Father and Son: Drawing ADHD Parallels

Analyzing my child’s behavior, helicoptering his nuances and traits, and researching “ADHD in children” until there was nothing left to Google came easy. Turning the lens to my husband, on the other hand, was trickier.

My husband flitted from job to job, struggled to prioritize, became easily frustrated with any task, and was unfocused. But we had gone through a fair chunk of sadness in the last few years — the death of one of our other sons, the loss of parents, our 9-year-old’s meningitis battle when he was a baby. I put my husband’s erratic nature down to stress and trauma.

[Read: “Let Me Tell You How ADHD Runs in My Family”]

All the while, the phone calls from my son’s exasperated teacher mounted, as did the sense that my son’s behaviors in school and at home were indicative of something bigger.

My mother-in-law was a special education teacher for many years. The more I called her to analyze my little boy’s behavior, the more parallels she’d draw between him and my husband. Eventually, the constant joke that they were two peas in a pod became a lightbulb moment for me. I made an appointment with an ADHD specialist – for my son and husband. Sure enough, after a careful evaluation, the specialist diagnosed both of them with ADHD in the same appointment. Their test scores were practically identical, she noted.

Like Father, Like Son

“How do you feel?” the specialist asked my son. She sat next to him on the floor as he clicked LEGOs together and bounced on his knees.

“Exhausted” he said. And my heart sank. Exhausted by trying to concentrate in school and being told off constantly, exhausted by coming home to homework cajoling, exhausted for being reprimanded for his impatience and other behaviors at the outskirts of his control.

[Read: “My ADHD Family Tree — Three Generations of Neurodivergence Revealed”]

I saw my husband’s face crumble a little as he knew that feeling all too well. And I realized that, as a wife and mother, I had failed them. To me, their behaviors were annoying, frustrating, and sometimes inexplicable. I had often said to my son, “Why is it always you? Why are you the one who always gets into trouble?” I sometimes dreamed of an easier marriage to a man who would stick at a job or for a man who would actually listen to me. I had no idea what either of them were going through. It was an incredibly emotional day for everyone.

We walked out of the specialist’s room with a deeper understanding of each other and a feeling that we can all start to be our truer selves.

Our ADHD Family

We’ve only recently entered the neurodivergent universe. We’re perched on a circling satellite looking into a place where words like “disorder,” “impulsivity,” and “disorganization” zoom by. But it’s other zooming words that captivate us — “spontaneity,” “creativity,” “courage.” We are going to run with these as fast as we can.

We’re not alone in entering this universe. We see many other families embarking on this journey, too. Some days we think we have a firm grasp on ADHD – and some days we don’t. And that’s OK, because all we can do is buckle up so the twists and turns don’t jolt the ones we love quite so much.

I would not change my son or husband for anything. We’ll bundle up all of the positives and challenges, stick them into our family jetpack, and navigate the steps, bounces, stumbles, and freefalls of this shared diagnosis together.

ADHD Family Ties: Next Steps

• Get This Free Download: ADHD Empowerment Month Calendar
• Read: 5 Ways to Build Bonds – A Guide for ADHD Dads
• Read: Helping Your Kids Find the “Awesome” in ADHD

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Dating fires up the dopamine that ADHD brains crave. Developing a relationship is new, exciting, and sometimes all-consuming — all of which can create elation and/or a perfect storm for ADHD traits like impulsivity, emotional sensitivity, and hyperfocus to ignite a fire. In this webinar, we’ll explore the complexities of online dating profiles and connections, first meetings, and the early stages of relationships — and introduce the process of mindful, conscious dating.

Join Master Certified Relationship Coach Amie Leadingham as we delve into dating apps, and learn why impulsivity, novelty-seeking, and people-pleasing can draw people with ADHD to prospects who appear to be risk-takers but not ideal partners. You’ll learn the importance of presenting your authentic self, setting healthy boundaries, and recognizing potential red flags. This isn’t just about finding love. It’s about embracing who you are on the road to discovering the healthy relationship you deserve.

In this webinar, you will learn:

• Strategies for creating an effective online dating profile that showcases your authentic self
• How to identify potential red flags and read between the lines in other people’s profiles
• Guidance on navigating common dating scenarios, including love bombing, impulsivity, and ghosting
• Techniques for setting and maintaining healthy boundaries

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meet the Expert Speaker

Amie Leadingham is a Master Certified Relationship Coach, author, wife, and mother of two amazing pugs. Her mission is to help singles find lasting love by conscious dating. She was named one of LA’s “Best Dating Coaches” and has been featured in a variety of media outlets including the CBS Network, Fox 5 News, LA Times, People Entertainment, Oprah Daily, Cosmopolitan, Newsweek, and more. Her mission is to empower singles to heal past programming, build self-confidence, and find a loving, genuine connection.

Dating with ADHD: More Resources

• Download: Understanding Rejection Sensitive Dysphoria
• Q&A: “What Are the Signs of a Controlling Relationship?”
• Read: The First Rule of Dating with ADHD
• eBook: The ADHD Relationship Guide

Webinar Sponsor

The sponsor of this ADDitude webinar is….

Managing relationships with ADHD can be challenging, and advice like “just communicate better” or “just be more organized” often falls short. That’s why we created Inflow, a tool to help you navigate relationships while living with ADHD. Developed by leading ADHD clinicians, Inflow uses science-backed principles to help you better understand your ADHD, improve communication, and strengthen your connections with others. Take the ADHD self-assessment today to kick off your Inflow journey.

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Closed captions available.

Do you ever feel so wrecked by a critique or comment from your partner that you can’t seem to recover for days? Or do you feel silenced and stuck because your partner interprets any constructive feedback as disapproval, and reacts in the extremes?

ADHD complicates relationships on its own, but adding rejection sensitive dysphoria (RSD) to the equation almost always amplifies the strife. RSD describes unbearable, painful feelings related to a real or a perceived rejection, and the ensuing belief that people will pull back their love and support. This heightened sensitivity intensifies reactions to the natural ups and downs of relationships and increases interpersonal conflict, hostility, and hurt. It can be very complicated for couples to manage conflict, discuss delicate subjects, and process emotions successfully.

In this webinar, Dr. Sharon Saline will show you how to manage the special challenges that arise in relationships touched by RSD and ADHD. You will learn how to navigate the thorny path of RSD in relationships and shift toxic patterns to healthier interactions. She’ll teach you how both partners can better regulate and handle challenging conversations with less blame, negativity, and over-personalizing while fostering connection and closeness. Dr. Saline will offer concrete strategies for making repairs, creating effective bids for connection, using collaboration for disagreements, and improving relational empathy. You will leave with practical tools to listen and reduce reactivity.

In this webinar, you will learn…

1. How rejection sensitivity dysphoria works and manifests in adults
2. How RSD impacts relationships and creates special challenges
3. Effective strategies for coping with typical patterns of conflict in couples
4. How to reduce reactivity and improve communication with greater empathy

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

RSD in Relationships: More Resources

• Download: Understanding Rejection Sensitive Dysphoria
• Replay: Strategies for Managing Your Sensitivities in Real Time
• Self-Test: RSD Symptoms Checklist
• Read: You Are Enough — Counteracting Imposter Syndrome, Perfectionism, & RSD
• eBook: The Emotions of ADHD

Obtain a Certificate of Attendance

If you attended the live webinar on October 9, 2024, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Sharon Saline, Psy.D., clinical psychologist and author of the award-winning book, What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life and The ADHD Solution Deck, specializes in working with children, teens, emerging adults and families living with ADHD, anxiety, learning disabilities, autism, twice exceptionalism, and mental health issues. (#CommissionsEarned) She lectures and facilitates workshops internationally on topics such as understanding ADHD, executive functioning, anxiety, motivation, different kinds of learners, and the teen brain. Dr. Saline is a regular contributor to ADDitudemag.com, among many other leading publications.

Learn more at www.drsharonsaline.com.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Listener Testimonials

“Really impressed with the content and how slick this production was! Thank you so much.”

“I have been with my partner for 25 years, and we’ve only just been diagnosed with ADHD. The webinar gave us hope.”

“I appreciated the ‘tricks’ to think about and try out when in the middle of a reaction.”

“Outstanding. Dr. Saline was excellent, both in substance and presentation.”

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The sponsor of this ADDitude webinar is…

Play Attention: Are your relationships being impacted by ADHD and Rejection Sensitive Dysphoria (RSD)? We can help. Play Attention, inspired by NASA technology and backed by Tufts University research, is designed to strengthen executive function, helping you manage these emotional complexities. Take our ADHD test or schedule a consultation to discover how Play Attention can support you in creating more balanced and harmonious interactions. Call 828-676-2240 or visit www.playattention.com.

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If you are trying to convince a loved one to get evaluated and/or to start treatment for ADHD, you already know the conversations can be frustrating and the decision is theirs alone. You can’t force a loved one to accept help, but you can lovingly nudge them in the right direction.

1. Start with shared experiences

Since you mention that you have ADHD, it may help to talk to your mother about your own symptoms and the experiences that led to your diagnosis. Ask if any of your experiences or challenges resonate with her. You can start to bridge the gap by sharing commonalities.

[Get This Free Download: ADHD in Older Adults]

2. Frame it as an opportunity

Even if your mother concedes to having symptoms, she may say, “What’s the point of getting diagnosed? I’ve lived this long without being treated.” To that, you can say, “If there were a way that your memory, forgetfulness, emotions, and overall functioning could improve, would you want to take the opportunity to explore it?” Another way to frame it: “If you had poor vision, would you try glasses to help you see better?”

If your mother agrees, then you’ve identified a common goal, which is crucial in negotiating. A possible small next step is to ask your mother, “If improving your memory is a goal of yours, can I get you to see this clinician who’s an expert in memory and cognition and see what they have to say?” (You may want to avoid saying “an expert in ADHD” since older people tend to only associate ADHD with children. It’s best to cite the symptoms the doctor can treat to increase buy-in.) This may have to happen over multiple conversations before you see results.

It helps to keep in mind that people generally don’t seek help for symptoms. Rather, we seek help when we experience distressing impairments that affect daily life, whether we see it or if it’s pointed out by others. If you frame discussions around how your mom may be suffering unnecessarily rather than on symptoms, she may be more open to seeking help.

3. Change your own perspective

If your mother still refuses to seek evaluation or treatment, then it’s time to focus your efforts on what you can control. If you are convinced that your mother has ADHD, then you don’t have to wait for a formal diagnosis to help her manage her symptoms and have more productive interactions with her. If you know your mother is forgetful, then rely on written information and reminders to help jog her memory. Expect your mother to show up late to events if she struggles with time management.

[Read: The Transformative Power of an ADHD Diagnosis for Older Women]

No matter the problem, don’t say, “Mom, why can’t you do this?!” Simply operate under the assumption that your mother has untreated ADHD, a condition that causes impairments and difficulty with functioning, and is doing the best she can.

My Mom Has ADHD: Resources on ADD in Older Adults

• Read: The Transformative Power of an ADHD Diagnosis for Older Women
• Read: ADHD in Older Adults — Distinct Diagnostic and Treatment Considerations
• Read: “I’m Newly Diagnosed at 90 — and So Thankful”

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “ADHD in Older Adults: Clinical Guidance and Implications” [Video Replay & Podcast #499] with David Goodman, M.D., LFAPA., which was broadcast on April 4, 2024.

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Q: “I’m going through a divorce. My child, who has ADHD, seems to be acting out more, and even lying. How should I handle this?”

Divorce is difficult for kids of all ages, and their stress and frustration may manifest in behavioral changes. Lying is a common behavior in kids with ADHD, especially younger children. Most of the time, parents are very concerned because they think, “I’m raising a sociopath. Why is my child lying? This goes against our family’s values.”

Why Children with ADHD Lie

In a divorce, lying can often take on another dynamic. A child may lie about what happens in the other parent’s home because they think it’s what you want to hear. Many feel that the divorce is their fault, and they see that you are sad when they leave you. Maybe they’re having a great time in the other house, and they feel bad that you’re alone. So, they might say negative things about what happens in the other home to make you feel better.

If this is the case, take a deep breath before you act. Some parents might think, “My ex can’t take care of our child. They’re eating candy for dinner and going to bed after midnight.” This might not be happening, or at least not to the degree that your child is saying.

[Q&A: “Inconsistent Routines and Discipline in a Shared Custody Situation”]

If you’re concerned about something you hear, don’t interrogate your child for details. Check in with the other parent, without making accusations. The more you and the other parent exchange information directly, the better the outcome for your child.

Become Your Teen’s “Board of Directors”

If your child is a teen, they may feel rushed toward independence by the divorce. They may also feel that they have to take care of the parent who’s struggling emotionally. On top of that, if their ADHD is not sufficiently managed, sometimes this can lead to acting out.

Divorce or no divorce, this is the time in a teen’s life when parents should be stepping back, letting go of the scaffolding, and letting their child fail a little bit. Start transitioning from being what I call the CEO of a child’s company to the board of directors. If this sounds like your issue, make sure that you are listening to your teen and asking questions. Try not to control a situation or offer advice; just listen.

Divorce, like any major change in the family, will bring up some really big feelings. The best way to start to manage your child’s emotions is by owning your own. It’s good modeling. We can’t hide what we’re feeling from our kids. You can say something like, “You know what? I’m feeling sad right now. I’m not going to feel like this forever. It’s going to pass. But today I feel sad, and that’s okay.”

[Free Parenting Resource: Your 10 Toughest Discipline Dilemmas – Solved!]

Reassure your child even when you think they don’t need it. Remind them over and over that the divorce was not their fault, and that while their parents’ love for each other might change and look different, each parent’s love for their child never fades.

Parenting through Divorce: Next Steps

• Read: The ADHD Co-Parenting Guide to Consistent Treatment
• Watch: Coparenting After Divorce — How to Manage ADHD Consistently Across Households
• Free Download: 5 Ways to Improve Emotional Control at Home

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Couples who have additional struggles may especially need that intimate connection to maintain goodwill during those inevitable ADHD moments. Here’s what to do — and not do.

How to Have Better Sex in ADHD Relationships

1. Avoid extremes. When a person with ADHD is defensive or minimizes reasonable requests, their partner may become controlling or retreat into resentful silence. If the non-ADHD partner criticizes the ADHD partner because they haven’t met expectations, the ADHD partner may become oppositional or passive. You want to avoid these extremes.

[Free Download: Manage ADHD’s Impact on Your Relationship]

ADHD doesn’t invent new problems; it just exacerbates the universal ones. Every couple has to negotiate different preferences or ways of doing things, but the heat is turned up when one partner isn’t managing their ADHD well and the other takes on the role of caregiver. As one respondent wrote in my survey on ADHD and relationships, “Parent-child dynamics in adults are a sex killer.”

If you don’t feel like an equal, or even on the same team, you may be less interested in sex with your partner. Generosity and excitement begin to fizzle and then you feel like roommates (boring).

2. Use sex to foster connection. In my research, I have found that those with ADHD are generally more interested in sex and more influenced by sexual stimuli. This totally makes sense. People with ADHD tend to have a harder time filtering out and resisting what is interesting in the moment.

This sexual eagerness can be positive in a long-term relationship when the couple is generally getting along well and sex is a fun, connecting experience. After all, every couple needs at least one person to initiate sex and to keep it from being the last thing that happens. Also, that ADHD quest for novelty can keep things exciting over the years.

[Watch: Are Symptoms, Medications Affecting Your Love Life?]

3. Prioritize fun. For couples with ADHD, three things are inextricably linked: your relationship, your sex life, and how well the partner with ADHD is managing symptoms. If you want one of these to be better, then you probably need to work on the other two. Working on your relationship and sex life will help you and your partner feel supportive of each other, which will lead to a willingness to manage ADHD more effectively. This positivity will lead couples to not only make more time for sex, but it also create more good feelings, playfulness, and generosity — so the sex is even better.

This is not just about the physical act of sex. It’s about feeling that your partner has your back and can handle it when you have an imperfect moment. It’s about giving and receiving generosity. It’s about rising above the mundane demands of adult life and prioritizing your time together. It’s about really wanting to be with this person. And that’s why you’re together, isn’t it?

Enhancing ADHD Intimacy: Next Steps

• Watch: ADHD and Sex — Building Focus and Attention for Intimacy
• Read: Can an ADHD Diagnosis Save a Relationship?
• Read: When Both Partners Are Diagnosed — Understanding the Other’s ADHD

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Nearly two-thirds of ADDitude readers ages 18 to 29 report feeling lonely “always” or “often,” according to a new survey of 4,170 adults with ADHD. Living or working with others made little difference; 89 percent of these young adults say they feel lonely even then. Only 19 percent say social media makes them feel more connected. In contrast, 46 percent of people ages 68 to 77—the demographic traditionally associated with social isolation — reported the same levels of loneliness.

“My ADHD makes it hard to remember to reach out or respond,” wrote one 28-year-old woman with inattentive ADHD, “but rejection sensitive dysphoria hits hard when I’m not reached out to or responded to, even though I acknowledge that hypocrisy. ADHD also makes it hard to leave the apartment (time management, overwhelm at what it takes to leave, energy to be social, executive function difficulties, etc.), so even if I’m invited, I find reasons to cancel.”

“For me, ADHD and loneliness impact one another,” wrote one survey respondent. “Now I neither want relationships nor do I have the energy to keep up the masking necessary to navigate relationships. It requires too much effort.”

When ADHD Symptoms Lead to Loneliness

The stories of social isolation shared by ADDitude readers were reflected in the findings of a recent meta-analysis of studies investigating whether young people with ADHD experienced greater loneliness than their neurotypical peers. The review of 20 studies, involving about 6,300 participants, concluded that people with ADHD who were younger than 25 had significantly elevated levels of loneliness due, in part, to mental health struggles, including anxiety and depression, and to “feeling different” because of their ADHD. Researchers called this an “important problem” of which clinicians should be aware for early identification and intervention, according to the study published in February in the Journal of Attention Disorders.¹

“I feel too quirky and awkward,” wrote one survey respondent. “I’m fun at first, but quickly become too much for others. I want there to be less of me.”

[Read: “Why Don’t I Have Any Friends?”]

For more than three-quarters of ADDitude survey respondents, feelings of loneliness are tied directly to ADHD symptoms, manifestations, and repercussions. According to the survey, the most common ADHD-related roots of loneliness include:

• low self-esteem: 67%
• rejection sensitive dysphoria (RSD): 65%
• social anxiety: 64%
• poor working memory: 63%
• “masking” who they really are: 59%
• executive dysfunction and disorganization: 57%

The Painful Toll of Loneliness

Loneliness correlates to mental health problems for 78 percent of adults with ADHD, who also report high levels of anxiety (65%) and depression (61%), among other comorbid conditions. For two-thirds of survey respondents, loneliness has led to toxic relationships, substance abuse, self-harm, binge eating, excessive spending, and porn addiction.

Among ADDitude readers who say they “always” or “often” feel lonely, only 26 percent live alone. Retirement, lonely marriages, physically limiting health conditions, and strenuous caregiving responsibilities were often cited by older survey respondents, who say that late ADHD diagnoses contributed to their loneliness as well.

“Grieving the loss of what I perceived as a ‘good’ life after my ADHD diagnosis made me feel like a failure,” wrote one older adult. “I cannot undo the damage or ill feelings caused by my past actions, and this recognition has caused me even more pain.”

[Read: The Science of Loneliness]

“When I feel lonely,” said one survey respondent, “I want to reach out, but I usually don’t because:

1.  ‘Out of sight out of mind’ has left too much time between interactions, and I feel shame over this.
2. When no one reaches out to me, or if I reach out and get no immediate response, RSD kicks in and I’m immediately overwhelmed with self-loathing.
3. I dwell on each previous interaction and why this person may be harboring ill feelings toward me.
4. Depression asks, ‘What’s the point of interaction? It’ll just exhaust you.’”

Causes of Loneliness For People with ADHD

More than half of the adults surveyed say they have trouble making and keeping friends for the following reasons:

• feeling overwhelmed
• fearing rejection
• experiencing social anxiety
• receiving few social invitations

“It’s a cruel loop,” one survey respondent said. “I feel safe when alone, so, much of the time, it’s a relief. But then, the loneliness is crushing.”

Coping with Loneliness

A spate of startups like the United Kingdom’s Timeleft and Friender are joining the veteran app Meetup in efforts to facilitate online connections that lead to real-life interactions. Some apps invite groups of strangers to meet for dinner at a specific time and place. Others work more like platonic dating apps where users scroll profiles before making plans. And some draw people together over common interests.

More than two-thirds of people say they feel less lonely when they reach out and connect with others in person, or via text or phone call. They also successfully alleviate loneliness through the following:

• physical touch: 62%
• engaging in a hobby: 58%
• spending time with their pet: 56%
• working with a therapist: 52%

“Letting the Mask Slip“ in Neurodivergent Friendships

More than half of adults surveyed say they relate better to, and feel less lonely around, other neurodivergent adults.

“Being with other neurodivergent folks validates my experience of living with ADHD,” wrote one survey respondent. “There’s less judgment.”

Said another adult with ADHD: “In a neurodivergent group, I don’t feel weird, and I can let my mask slip. It is less taxing and there is less of a chance of me freaking out later over social mistakes I might have made.”

Loneliness and ADHD: Next Steps

• Read: Birds of a Feather: The Joy of Neurodivergent Friendships
• Read: “How Do You Keep From Being Socially Isolated as an ADHD Adult?”
• Read: “Why Don’t I Have Any Friends?”

Sources

¹Jong A, Odoi CM, Lau J, J Hollocks M. Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis. J Atten Disord. 2024 May;28(7):1063-1081. doi: 10.1177/10870547241229096. Epub 2024 Feb 23. PMID: 38400533; PMCID: PMC11016212.

SUPPORT ADDITUDE

Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

“Social interactions rely on a complex orchestration of brain functions, from understanding another person’s point of view, recognizing their emotional state, feeling their emotional pain, and so on. Difficulties with any of these can affect our ability to connect to others,” says Ellen Lee, M.D., associate professor of psychiatry at the University of California San Diego. “The emotional pain and stress of loneliness can also take a toll on our brains.”

Lee was the corresponding author of a systemic review of 41 studies, involving 16,771 adult participants, examining the neurobiology of loneliness. Researchers in those studies used brain imaging and other scans to identify the differences in the brain structure and function of lonely people. The findings showed that some people were hard-wired for loneliness in the same way that some are hard-wired for anxiety.

Loneliness is defined as the emotional discomfort one feels when their need for intimacy and social connection goes unmet.

In the lonely participants, abnormal structure and/or activity was discovered in the prefrontal cortex, which mediates emotional regulation and inhibitory control; the insula, which plays a role in emotional pain and self-awareness; and in other parts of the brain. The review was published in the journal Neuropsychopharmacology in 2021.¹

[Test Yourself: How Severe Is Your Loneliness? Take This Quiz]

Lee says it’s possible that brain changes associated with ADHD, depression, and anxiety can lead to feelings of prolonged loneliness because people tend to withdraw from social interactions when they have low mood or other symptoms.

“Researchers are starting to study these links to understand if improving loneliness could be a way to improve these symptoms,” she says.

Lonely Brains Process the World Differently

In a study published in the journal Psychological Science in 2023, researchers discovered that lonely people viewed the world differently from each other and from nonlonely people. Using fMRI scans to examine neural responses to stimuli (videos) and other methods, the researchers also administered a loneliness scale and survey to evaluate the 66 study participants.²

They found that loneliness was associated with structural and functional differences in regions of the brain, and the researchers said their results remained significant even after controlling for individuals’ reported numbers of friends.

“Lonely people process the world idiosyncratically, which may contribute to the reduced sense of being understood that often accompanies loneliness,” the researchers said in the study. “In other words, we found that nonlonely individuals were very similar to each other in their neural responses, whereas lonely individuals were remarkably dissimilar to each other and to their nonlonely peers.”

The researchers said the findings “raise the possibility that being surrounded predominantly by people who view the world differently from oneself may be a risk factor for loneliness (even if one socializes regularly with them).”

Those findings echo the lived experience of many adults with ADHD who report feeling a sense of isolation due to their perceived difference. “I mostly feel like a dolphin in a sea of stingrays,” an ADDitude reader says. “I never meet people with whom I have anything significant in common, and with whom I can forge solid, lasting friendships.”

[Read: How to Make Friends As an Adult With ADHD]

The Evolutionary Function of Loneliness

Stephanie Cacioppo, Ph.D., a behavioral neuroscientist whose research seeks to understand how people experience different emotions, says evolution has sculpted the human brain to respond to biological mechanisms like hunger and thirst. Hunger, she says, is triggered by low blood sugar and motivates us to eat. Thirst helps us find water before we become dehydrated. Pain encourages us to take care of our body.

“Loneliness alerts us to potential threats, and damage to our social body, and in doing so, increases our motivation to bond with others,” says Cacioppo, author of Wired for Love. “It’s the brain’s way of telling you: You’re in social danger, you’re on the periphery of the group, you feel left out, misunderstood, you need protection, inclusion, support, and love. One of the most important things that love can do, it turns out, is shield us from the ravages of chronic loneliness.”

Cacioppo says it’s not uncommon for people to mask in the company of others when they don’t feel a sense of connection.

“Masking is totally understandable from a neuroscientific perspective,” she says. “The best solution is to stay authentic. Authenticity is the key to connectivity. Building connections with people while staying true to yourself can be a buffer against loneliness.”

How to Deal with Loneliness

Cacioppo offers several strategies to address chronic loneliness, encapsulated by the acronym G.R.A.C.E.:

Gratitude: Every day, write down five things you truly appreciate. Science shows that expressing gratitude improves emotional wellbeing.

Reciprocity: If you know someone who feels lonely, ask them for help or for advice. Showing respect can give a lonely person a sense of worth and belonging that decreases feelings of isolation.

Altruism: Helping others, and sharing your knowledge, will give you a feeling of self-expansion that is similar to what people experience when they are in a love relationship.

Choice: The tricky thing about loneliness is that, to some extent, it’s self-fulfilling. The more you think you are lonely, the more you are. To break the spiral, shift your mindset and choose to be curious about how you can make meaningful connections.

Enjoy: Smiling and sharing good times (or good news) with people helps reduce loneliness and increase happiness.

How to Deal with Loneliness: Next Steps

• Read: The Big Heart Approach to ADHD Acceptance & Self-Love
• Read: Are You Feeling Lonely?
• Read: Feeling Antisocial? Alone? Both? 3 Common ADHD Friendship Challenges
• Read: 13 Tips for Feeling Connected

Sources

¹ Lam JA, Murray ER, Yu KE, Ramsey M, Nguyen TT, Mishra J, Martis B, Thomas ML, Lee EE. Neurobiology of loneliness: a systematic review. Neuropsychopharmacology. 2021 Oct;46(11):1873-1887. doi: 10.1038/s41386-021-01058-7. Epub 2021 Jul 6. PMID: 34230607; PMCID: PMC8258736.
² Baek, E. C., Hyon, R., López, K., Du, M., Porter, M. A., & Parkinson, C. (2023). Lonely Individuals Process the World in Idiosyncratic Ways. Psychological Science, 34(6), 683-695. https://doi.org/10.1177/09567976221145316

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If you’re a mom who is raising children with ADHD, you may have complicated feelings about Mother’s Day. You may feel unnoticed and left out on this day, as the unique challenges and joys of caring for a neurodivergent child aren’t often widely represented. A “thank you” from your little one would be wonderful, you say. Then again, you also recognize that your child may have trouble expressing their thoughts and how they really feel about you, much less planning and executing breakfast in bed.

So this one’s for the amazing moms who are always in their kiddo’s corner, no matter what. The heartfelt thanks your kid would give you if they had the words (even if they accidentally forgot about Mother’s Day)? They’re all here:

[Read: What ADHD Moms Really Want This Mother’s Day]

5 Things Your ADHD Kiddo Really Means to Tell You on Mother’s Day

1. Thank you for understanding me. “Mom, you always try to understand me, even when I’m all over the place. I know it’s not always easy, but you make me feel like I’m okay just the way I am.”

2. I appreciate how you keep me organized. “The way you help me stay organized and on track is a lifesaver. Your checklists and reminders really help me, even if I don’t always show it.”

3. I admire your calmness. “When I get overwhelmed or upset, you stay so calm. It helps me feel safe and helps me calm down, too. You have this magic way of making everything better.”

4. I’m sorry for the tough days. “I know there are days when I really test your patience, and I’m sorry. Thank you for sticking with me through the tantrums, the meltdowns, and everything else.”

[Read: “Dear Mom of a Newly Diagnosed Kid with ADHD”]

5. Thanks for believing in me, even when I don’t believe in myself. “You always believe I can do great things, even when I mess up or get distracted. Knowing that you believe in me makes me feel like I can do anything.”

They might not thank you this Mother’s Day, but someday they will — whether through their words or actions. Until then, I’m here to remind you just how much you mean.

Mother’s Day & ADHD Families: Next Steps

• Read: 10 Thoughtul Mother’s Day Gift Ideas
• Read: “To My Kids: A Love Letter from Your Scatterbrained, Unpredictable, Truly Lucky Mom”
• Read: Overwhelmed Mom Syndrome — It’s a Real Thing
• Read: What Your Child Would Tell You About ADHD If They Had the Words

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sometimes it can be difficult to tell when a relationship has crossed a line from supportive to controlling. Let’s examine the differences between these two types of relationships, including how they relate to ADHD.

Signs of a Supportive Relationship

In a supportive relationship, partners emphasize individual autonomy (the ability to make your own decisions) and independence, encouraging each other to pursue personal interests, goals, and friendships outside the relationship. Both partners respect each other’s space and neither seeks to dominate or control the other. When decisions are made together, they consider the needs of both partners. For example, partners may discuss treatment for ADHD together, but the ultimate decision is entrusted to the partner with ADHD.

Respect is fundamental and communication is open, honest, and non-judgmental. Partners feel comfortable expressing their thoughts, feelings, and concerns without fear. Partners strive to understand each other’s perspectives and seek mutually beneficial solutions. ADHD may be seen as an issue, but it is never “weaponized” against a partner.

Supportive relationships encourage mutual emotional growth and development. Partners encourage and celebrate each other’s achievements and milestones. Each partner actively supports the other in their personal and professional activities, including involvement in ADHD-related groups or communities.

[Is Your Relationship Toxic? Take This Self-Test to Find Out]

Signs of a Controlling Relationship

In a controlling relationship, there is often a significant power imbalance. One partner seeks to control the other, dictating decisions and actions. A partner who attempts to address a power imbalance often gets belittled or ignored. The controlling partner may also use manipulation or coercion to maintain control.

A controlling partner may isolate the other from friends, family, or other sources of support in an effort to create dependency, making that person reliant on them for validation and decision-making. A controlling partner may tell the person with ADHD that they don’t need treatment and were easier before getting help.

Trust and transparency are often lacking in controlling relationships. The controlling partner may show jealousy, monitor the other person’s activities, or demand constant reassurance. The controlled partner may need to hide aspects of their life to avoid conflict.

Controlling relationships discourage emotional growth or interests that threaten the power imbalance in the relationship. The dominant partner may actively discourage the other person from pursuing personal interests, goals, or treatment for ADHD. A controlled partner who has a healthy support system and who is receiving effective treatment is more likely to leave a controlling relationship.

[Get This Free Resource: Manage ADHD’s Impact on Your Relationship]

A supportive relationship improves the wellbeing of both partners, whereas the power imbalance in a controlling relationship is damaging. Recognizing these differences is crucial for creating healthy, fulfilling connections with others.

Controlling Relationships and ADHD: Next Steps

• Read: The Gaslighting Risk — Why Adults with ADHD Are Particularly Vulnerable to Manipulation
• Read: “How I Recognized an Abusive Relationship from the Inside”
• Read: Why Do Toxic Relationships Swallow People with ADHD?
• Listen: “Gaslighting, Love Bombing & Beyond — How to Recognize (and End) Toxic Relationships with ADHD”

Stephanie Sarkis, Ph.D., is a clinical specialist in child and adolescent counseling.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Hormonal contraceptives (HC) may help stabilize the fluctuations in estrogen and progesterone that occur during the menstrual cycle and in perimenopause that are particularly impairing for neurodivergent women, however research has found a correlation between some types of oral HC use and higher rates of depression in women with ADHD.

The impact of sex hormones, including estrogen and progesterone, on ADHD symptoms in women has only recently become the subject of scientific inquiry. A recent study found that various ADHD symptoms wax and wane depending on the menstrual phase. Researchers found that estrogen has a protective effect for both cognition and emotional regulation, and that ADHD symptoms tend to worsen when estrogen drops. ¹

These findings are reflected in the lived experience of ADDitude readers. In a recent survey, a full 98% of respondents reported experiencing hormone-related changes in cognitive function and/or mood, including changes in focus, attention and memory as well as emotional regulation.

Oral HC, or birth control pills, typically contain synthetic estrogen and progesterone. In addition to preventing pregnancy, they are often used to treat heavy menstrual bleeding, painful cramps, irregular periods, polycystic ovarian syndrome, and acne. In addition, some clinicians prescribe oral HC to stabilize hormone levels in women and treat premenstrual syndrome (PMS) and/or premenstrual dysphoric disorder (PMDD), which impact two-thirds of women with ADHD, according to an ADDitude survey.

Until recently, the implications of oral HC use for women with ADHD were entirely uninvestigated, however a recent study published in Journal of the American Academy of Child and Adolescent Psychiatry (JAACP),² revealed that:

• Women with ADHD who used combined oral contraceptives (COC) or progestogen-only pills (POP) had more than five times the risk for depression compared to women without ADHD who did not use hormonal contraceptives.
• This elevated risk was not found among women with ADHD who used non-oral HCs, such as hormonal IUDs or progestogen implants. These women had the same risk of developing depression as did their non-ADHD counterparts.
• This elevated risk was also not found among women without ADHD who used oral HC.
• Women taking HC for medical reasons (heavy bleeding, irregular periods, PCOS) were twice as likely to develop depression as those who took it primarily to prevent pregnancy. Taking HC for medical reasons was more common in women with ADHD than it was in women without ADHD.

“Systemic hormonal contraception contains progestins that inhibit the ovulatory cycle and thereby ‘smoothens’ the hormonal profile, but it may also mimic the negative mood symptoms experienced from natural progesterone during the luteal phase of the menstrual cycle,” explains Lotta Burg Skoglund, M.D., Ph.D., a lead author on the study. “However, most women do not experience these negative mood effects and, somewhat counterintuitively, some progestins may even alleviate symptoms of PMDD.”

An ADDitude survey of nearly 5,000 women revealed that 93% of respondents aged 45 and older experienced elevated and aggravated ADHD symptoms in perimenopause and/or menopause. More than half of these women said their ADHD symptoms — including feelings of overwhelm, procrastination, and memory issues — had a “life-altering impact” in menopause. We know that for hormone replacement therapy (HRT) can effectively alleviate common symptoms of menopause, such as hot flashes, mood lability, and insomnia, and it may offer other benefits.

“Studies show that HRT, if initiated within 10 years of menopause, reduces all-cause mortality and risks of coronary disease, osteoporosis, and dementia,”³ explains Jeanette Wasserstein, Ph.D., in the ADDitude article, “Menopause, Hormones & ADHD: What We Know, What Research is Needed.” “Overall, recent research suggests that the risk in using any type of HRT is lower than previously reported in literature.”

Research has revealed heightened risk for some cancers associated with some forms of HRT, so Wasserstein highlights that a thorough consultation with a medical provider is critical before beginning HRT.

What We Don’t Know

No studies have probed the implications of HRT use for climacteric women with ADHD and we know very little about the potential benefits or risks of HC for women with ADHD.

“ADHD is a common illness, but few studies have looked at the association of hormonal stages and ADHD symptoms,” write the authors of a systematic review of sex hormones, reproductive stages, and ADHD published in Archives of Women’s Mental Health.⁴ “Notably, we did not find any studies investigating ADHD symptoms in other female physiological states such as pregnancy or menopause or looking at the response of patients with ADHD to hormonal treatments such as hormone replacement therapy.”

The small puzzle pieces of existing data are surrounded by questions. Why, for example, did women with ADHD on oral HC experience far higher rates of depression while those on hormone implants or IUDs did not? Until more research is conducted, researchers are left to theorize.

“It may be that, when taking oral birth control, women with ADHD might be extra susceptible to forget to take their birth control pills or may take them irregularly, causing hormonal fluctuations that may destabilize mood,” explained Skoglund in her ADDitude webinar, “The Emotional Lives of Girls with ADHD.” Also, a woman’s hormonal levels will fluctuate during assumed pill-free intervals.”

Some anecdotal reports suggest the use of oral HC, which minimize hormonal fluctuations, may improve ADHD symptoms in some women.

“I was surprised and amazed by the extent to which my focus and my executive functioning improved since I started hormonal birth control,” said Silvia, an ADDitude reader in Italy. “I totally reshaped my life: I decided to start coaching people again, joined a company and am thinking of going back to university again to obtain a second degree. I don’t experience mood swings anymore and I feel less exposure to RSD.”

These anecdotal reports offer promise. But without research, clinicians lack a solid foundation of data to make treatment recommendations.

“We need to find out why some women feel better with oral contraceptives and others feel depressed,” says J.J. Sandra Kooij, M.D., Ph.D. “It is about hormone sensitivity, and how hormones interact with neurotransmitters such as dopamine in women with ADHD, but exactly what drives this difference is still unclear.”

Given a total lack of research studies, there is virtually no reliable science regarding the risks and benefits of HRT for peri- and post-menopausal women. Among the many questions that remain unanswered are the following:

• Does HRT improve symptoms of ADHD in climacteric women?
• Does HRT pose unique risks, either physiological or psychological, to women with ADHD?
• Does HRT impact the efficacy of stimulant or non-stimulant medication for ADHD?
• Are there women with ADHD for whom oral HCs mitigate ADHD symptoms? If so, what is known about this patient profile that can help clinicians make treatment recommendations? What types of oral HCs are most effective and least disruptive for this group?
• What factors account for the increase in depression in some women with ADHD on HC? If oral contraceptives are taken daily as indicated, does the risk decrease?
• Does oral or non-oral HC impact the efficacy of stimulant or non-stimulant medication for ADHD?

Why It Matters

Hormonal contraceptives are among several first-line treatments for PMS and PMDD, which impact women with ADHD with heightened frequency and intensity.⁵ Symptoms of these mood disorders are frequently debilitating, and include suicidal ideation. A comprehensive understanding of possible treatment options for these women could significantly improve quality of life and reduce the risk of self-harm.

Reliable, well-tolerated contraception is also critical for girls and women with ADHD because they are six times more likely to give birth as teenagers compared with women without this diagnosis, according to a recent study led by Skoglund. ⁶

These dramatically heightened rates of unplanned pregnancy were also found in the groundbreaking Berkeley Girls with ADHD Longitudinal Study, led by Stephen P. Hinshaw, Ph.D., professor of psychology at the University of California, Berkeley. “By the time they reached their mid to late 20s, about 43% of the BGALS participants in the ADHD group had one or more unplanned pregnancies,” Hinshaw told ADDitude.

Research has found that experiencing unwelcome psychological side effects is the most commonly reported reason for the discontinuation of hormonal contraception, a decision which could have far-reaching implications.⁷

“Unwanted pregnancy undermines women’s schooling, health and social status and is directly linked to the negative psychosocial impact of ADHD on health, autonomy, academic performance, and quality of life,” Skoglund says. “Averting underage parenthood through effective contraception methods will likely benefit women’s education, empowerment, health and quality of life, their families, offspring, and society from a health economic perspective and have broad and public health benefits, extending far beyond the targeted group.”

What ADDitude Readers Tell Us

Hormonal contraceptives earn mixed reviews from readers, some of whom find them helpful in balancing mood and reducing ADHD symptoms; others report that HC use increases in anxiety, irritability and depression, among other intolerable side effects.

“Hormonal birth control affected me so negatively that I went off of it. It was highly disruptive to my mood and overall wellbeing,” says Jen, a reader in Utah. “I don’t mess with the hormones — even though they love to mess with me.”

“I had an IUD for 7 years. Within a few days, I could not believe the change in my mood. I felt more emotionally even and steady than I had felt in years,” shares ADDitude reader Anne.

“My PMDD was exacerbated by any hormone preparation, including the pill. The low-dose Mirena was an absolute nightmare for me,” says Nicole, an ADDitude reader. “I’m so hesitant to try anything to manage impending menopause, which has me ever more on edge, and I’m not sure yet how to advise my teen on these matters.”

“I started birth control due to PMDD. The mini-pill has been fantastic for my ADHD. I have fewer hormonal fluctuations,” says Karen, an ADDitude reader in Idaho. “I can finally rely on myself to be functional every day (as long as I get enough sleep and take my ADHD meds).”

“I detested the combined pill. It wrecked my mental health, and gave me dangerous migraines),” offers another ADDitude reader. “I was still disorganized, unmotivated with the added bonus of all the physical and mental downsides of the combined pill.”

ADDitude readers often report improved brain fog, memory issues, and mood swings while on HRT, though some say their doctors resist prescribing hormone replacement.

“As I approach menopause, my ADHD symptoms have worsened exponentially — severe memory and concentration problems, plus brain fog, mood swings, acne, sleep problems, fatigue. I’ve been barely able to work for almost a year now,” says Jennifer, an ADDitude reader in California. “I begged my doctor for HRT, but they won’t prescribe it since I’m not technically in menopause yet. They put me back on the pill to see if that would help, but it didn’t help at all with any of my current symptoms and gave me terrible cramps and made me feel crappy the whole time.”

“I am really glad to be on estrogen HRT because it is preventing the double-whammy of menopause and ADHD, at least for now,” says Jaime, an ADDitude reader in North Carolina.

“I have recently started on hormones for women in (peri)menopause, and the horrendous brain fog I’ve been dealing with for the past 18 months has lifted a great deal,” says Isabella, an ADDitude reader in the Netherlands.

“I am postmenopausal, and take estrogen replacement daily,” says Amy, an ADDitude reader in Michigan. “I think my ADHD is worse on days that I miss my dose of estrogen.”

What ADHD Experts Say

Given the known relationship between fluctuating hormones and ADHD symptoms, researchers must explore how we can safely employ HC and HRT to ameliorate both mood and cognitive symptoms.

“Given the increased risk of depression in women with ADHD, which may be further increased by oral HC use, future clinical trials on contraception need to include women with mental health problems, including ADHD, to guide prescribers on the best available choices for these women,” write the authors of the JAACP study.

“In medicine, women are still understudied because they are considered less reliable research subjects than men, due to hormonal changes during the lifespan,” explains Kooij in “Hormonal Sensitivity of Mood Symptoms in Women with ADHD Across the Lifespan.”⁸ “Women with ADHD have been even more understudied, while exactly their hormonal mood changes and increased severity of ADHD urgently need our research attention.”

“Females with ADHD are usually excluded from studies on contraceptive effectiveness and tolerability,” Skoglund explains. “As contraception is a burden for women to carry due to male methods being less effective, lack of knowledge on how different contraceptives affect women with ADHD may create an undue burden.”

Next Steps

• Contribute to research on the impact of perimenopause and menopause on ADHD symptoms by completing ADDitude’s ADHD in Menopause survey.
• Download this free resource: ‘Interventions for Treating ADHD During Perimenopause and Menopause’
• Read these new recommended reads on menopause:
  • The Menopause Brain: New Science Empowers Women to Navigate the Pivotal Transition with Knowledge and Confidence, by Lisa Mosconi, Ph.D.
  • The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts, by Mary Claire Haver, M.D.

HRT, Birth Control & ADHD: Related Reading

• Q: “Can Hormonal Birth Control Cause Depression?”
• Women, Hormones, and ADHD
• Depression Risk Higher for Women with ADHD on Birth Control: Study
• Menopause, Hormones & ADHD: What We Know, What Research is Needed
• Hormonal Changes & ADHD: A Lifelong Tug-of-War
• PMDD Has Affected My Whole Life
• PMS and ADHD: How the Menstrual Cycle Intensifies Symptoms

We Demand Attention: A Call for Greater Research on ADHD in Women

Intro: Top 10 Research Priorities

1. Sex Difference in ADHD
2. The Health Consequences of Delayed ADHD Diagnoses on Women
3. How Hormonal Changes Impact ADHD Symptoms in Women
4. How Perimenopause and Menopause Impact ADHD Symptoms, and Vice Versa
5. The Elevated Risk for PMDD and PPD Among Women with ADHD
6. The Safety and Efficacy of ADHD Medication Use During Pregnancy and While Nursing
7. How ADHD Medication Adjustments During the Monthly Menstrual Cycle Could Improve Outcomes for Women
8. The Long-Term and Short-Term Implications of Hormonal Birth Control and Hormone-Replacement Therapy Use Among Women with ADHD
9. How and Why Comorbid Conditions Like Anxiety, Depression, and Eating Disorders Uniquely Impact Women with ADHD
10. Early Indicators of Self-Harm, Partner Violence, and Substance Abuse Among Girls and Women with ADHD

Sources

¹ Eng, A.G., Nirjar, U., Elkins, A.R., Sizemore, Y.J., Monticello, K.N., Petersen, M.K., Miller, S.A., Barone, J., Eisenlohr-Moul, T.A., & Martel, M.M. (2024). Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Hormones and Behavior, 158(105466). ISSN 0018-506X. https://doi.org/10.1016/j.yhbeh.2023.105466

² Lundin, C., Wikman, A., Wikman, P., Kallner, H. K., Sundström-Poromaa, I., & Skoglund, C. (2023). Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 62(6), 665–674. https://doi.org/10.1016/j.jaac.2022.07.847)

³ Langer, R. D., Hodis, H. N., Lobo, R. A., & Allison, M. A. (2021). Hormone replacement therapy – where are we now?. Climacteric : The Journal of the International Menopause Society, 24(1), 3–10. https://doi.org/10.1080/13697137.2020.1851183

⁴ Camara, Bettina, et al. “Relationship between sex hormones, reproductive stages and ADHD: a systematic review.” Archives of Women’s Mental Health, vol. 25, no. 1, Feb. 2022, pp. 1+. Gale OneFile: Health and Medicine

⁵ Ali SA, Begum T, Reza F. Hormonal Influences on Cognitive Function. Malays J Med Sci. 2018 Jul;25(4):31-41. doi: 10.21315/mjms2018.25.4.3. Epub 2018 Aug 30. PMID: 30914845; PMCID: PMC6422548.

⁶ Skoglund C., Kopp Kallner H.,,Skalkidou A. et al. Association of attention-deficit/hyperactivity disorder with teenage birth among women and girls in Sweden. JAMA Netw Open. 2019; 2e1912463 https://doi.org/10.1001/jamanetworkopen.2019.12463

⁷ Lindh I., Hognert H., Milsom I. The changing pattern of contraceptive use and pregnancies in four generations of young women. Acta Obstet Gynecol Scand. 2016; 95: 1264-1272 https://doi.org/10.1111/aogs.13003

⁸ Kooij JS. Hormonal sensitivity of mood symptoms in women with ADHD across the lifespan. Eur Psychiatry. 2023 Jul 19;66(Suppl 1):S23. doi: 10.1192/j.eurpsy.2023.92. PMCID: PMC10417850.

And if ADHD runs in that family, the jam is not only juggling family life, health, and career, but also managing executive dysfunction, emotional dysregulation, and the complicated needs of other neurodivergent family members — diagnosed and otherwise. As “sandwiched” ADDitude readers tell us, this complex time of life is full of strain and overwhelm.

“The stress of being a mom to neurodivergent children, an employee, and a wife on top of caring for my mother seems absolutely unbearable at times. I don’t understand how others manage it all.”

“I am feeling overwhelmed with my role as a parent of an ADHD child while seeing changes in my own parents as they age.”

“My own ADHD is making it exponentially more difficult to assist my 90-year-old parents, both of whom I suspect have ADHD, as well as my three grandchildren, all diagnosed with ADHD.”

No matter the composition of your family’s sandwich, use the following strategies to reduce stress and practice self-compassion while you pull double or triple caregiving duty.

[Download This Free Parenting Guide for Caregivers with ADHD]

Sandwich Generation Strategies for ADHD Adults

1. Set boundaries.

Boundaries are tricky because they’re tangled up with cultural, personal, gender, and familial expectations. You may feel immense pressure to make others happy, even at the expense of your own happiness. Rejection sensitive dysphoria and perfectionism may amplify feelings of failure as you try to do it all. As uncomfortable as it may feel, setting boundaries is a skill you must learn and practice to prevent burnout and improve your wellbeing.

• It doesn’t have to be a hard “no.” Find alternative ways to politely decline or adjust a situation. Say, “Let me sleep on it and get back to you,” “Mom, I have to call you back after I have dinner,” “Can I take a rain check?” or “That sounds wonderful, but unfortunately, I won’t be able to help this time.” Practice declining offers in a low-pressure environment, like at a store when the cashier tries to upsell you.
• Be firm where you can be. Mute your phone or disable certain notifications. Question whether something really needs your attention now. If you work from home, consider creating color-coded signage that communicates your level of availability. Have conversations when needed about hot spots. For example, if you experience stress when your parents show up unannounced, talk to them about calling ahead or dropping by only on certain days of the week.
• Guilt will come up, but it doesn’t mean that you’re doing something wrong. You’re simply in unfamiliar territory. Be kind to yourself and know that you can feel the guilt and still choose to protect your boundaries.

 2. Know your hot spots.

Not all sandwiched caregivers feel the same squeeze. Identify your personal hot spots, such as interruptions, noise, clutter, food prep, emotional reactions, and/or transitions. Name your most nagging daily challenges — the ones that send ADHD symptoms into overdrive — and brainstorm steps to manage them.

For example, if grumpiness at the end of your workday clouds your evening mood, take 10 full, uninterrupted minutes to do a breathing exercise or a relaxing activity when your workday ends. Self-awareness alone can help mute your inner critic as you try to juggle it all.

[Read: How I Calm Down My ADHD Brain — 14 Quick De-Stressors]

Work with family members to identify and address their hot spots, too. For example, ask your teen to spend five minutes organizing a small section of their room when energy supply is high, not at the end of the day when ADHD medication has worn off.

3. Carve out time to do what helps you feel regulated.

Get serious about scheduling self-care time in your calendar. Self-care is anything that helps you feel calm and gathered, like non-negotiable buffer time between tasks and activities, a morning walk, a hearty breakfast, talking to a friend, reading or listening to an audiobook for 15 minutes, and even taking the time to make your bed (especially if clutter overwhelms you).

4. Don’t rush to problem-solve or cheerlead.

Validation — simply listening to and acknowledging how you or a family member else is feeling — usually lowers the volume on big emotions in ADHD households. Your child may feel devastated that they flunked their math test, but rather than rush to cheerlead (“Oh, I know you’ll do better next time!”) or suggest solutions like tutoring, start by saying something like, “I hear that you’re feeling disappointed right now, right? It totally makes sense that you feel this way because you studied so hard.”

 5. Use all available supports to lessen the burden.

Support comes in many forms, like asking a friend or family member to body double or help with a particular area of caregiving, leaning on a community program for adult or afterschool care, or using paid services like subscription meal kits, cleaning services, or a virtual assistant if financially feasible. As you decide which resources to utilize, remember that your time and energy are resources, too. Also, when you accept someone’s help, understand that they may not do it your way — and that’s fine.

6. What would you say to a friend?

Dual caregiving while managing your own life (and ADHD symptoms) is objectively difficult. Like other sandwiched adults, you likely aren’t giving yourself enough credit for juggling all that you do.  You may over-identify with mistakes, fixate on what you haven’t done, and think that you’re failing. You may feel as though things only get done when you beat yourself up.

When your inner critic pipes up, take a moment to practice self-compassion by asking yourself, “What would I say to a friend going through this?” Chances are that you’d never judge a friend the way that you judge yourself. Keep this question on a sticky note and place it on your mirror as a daily reminder. Remember that it’s possible to be compassionate and productive simultaneously.

7. Accept what you cannot change.

No, you did not ask to be in the middle of a complex, neurodivergent sandwich. But here you are. To guard your wellbeing, follow this credo: accept what you can’t change, change what you can, and know the difference.

You may not recognize your habit of claiming responsibility for things well outside of your control. You may feel it’s your duty to make your stubborn parents believe that ADHD exists and that it runs in your family — a common complaint I hear among sandwiched adults in neurodivergent families. Conversation after conversation, article after article, your parents may still choose to deny that your child has ADHD, that you have ADHD, or that they themselves exhibit symptoms. This is distressing, but remember that you’re doing your best and that accepting your current reality doesn’t mean that you’re siding with your parents or giving up.

When you focus on where you can make a difference and what you can relinquish, it will be much easier to disengage from energy siphons and find reasonable solutions for all the ingredients in your sandwich.

Sandwich Generation and ADHD: Next Steps

• Free Guide: ADHD in Older Adults
• Self-Test: 10 Questions to Reveal Parental Burnout
• Read: When ADHD (Literally) Runs in the Family
• Read: 12 Ways to Build Strong ADHD Families

You Are Not Alone: Additional Resources

• AARP Family Caregiving
• CDC – For Caregivers, Family, and Friends
• Family Caregiver Alliance
• Working Parent Burnout Webinar (from The Ohio State University)
• ADDitude – ADHD Support Group for Parents
• ADDitude – ADHD Support Group for Adults
• CHADD – Find a local ADHD support group

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “Squeezed in the Sandwich Generation: How to Manage ADHD in Yourself, Your Children, and Your Elderly Parents” [Video Replay & Podcast #490] with Danna McDonald, RMFT-SQ, RSW, which was broadcast on February 8, 2024.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Neurodivergent minds like ours are prone to oversharing because we love to immediately zing with people. We enjoy giving, sharing, and feeling like someone is our best friend after five minutes of meeting them. We want to convey to others that we’re an open book. That we’re sincere and authentic. A lifetime of challenges with social skills and making friends can also drive us to overshare in a desperate bid for connection.

Even if you exude high-quality friendship material, oversharing, as you and I both know, isn’t the best way to show it. In fact, it often backfires.

Curbing your habit of oversharing will come with time, but doing so requires lots of patience. Use these eight strategies to help you reel in your speech and share mindfully.

How to Stop Oversharing

1. Get to the root of it. Think back to moments when you’ve shared too much. Did you do it because you couldn’t stand the silence? Because you were nervous and dysregulated during the social interaction? Because you underestimated your intimacy level with the person or group? Did you even realize it was happening, or did someone point it out to you? Is it a combination of factors? Recognizing circumstances and situations that lead to oversharing is the first step to breaking the habit.

[Free Download: Become a Small Talk Superstar]

2. Go into “social spy” mode. Not sure what counts as oversharing? Try picking up on what others share about themselves and the varying degrees of familiarity in a group. Notice the unspoken rules that govern these conversations, and how others respond when someone discloses a detail about themselves. If a trusted friend of yours was part of the conversation, ask them later if they felt someone overshared, and compare your answers.

3. Gamify it! Challenge yourself to ask a certain number of questions before you start talking about yourself. You’ll reduce your chances of oversharing and be in a better position to bring up relevant topics for discussion.

4. Think, “How much do I trust this person?” Before you share an aspect of your personal life, pause and consider your level of familiarity with the person. Are they a friend, or are they becoming a friend? Put yourself in their shoes: If they were to share with you what you’re about to share with them, would it make you feel uncomfortable, given your current level of familiarity? (Tip: Carry something in your pocket to remind you of this question!)

5. Assess your emotional state to gauge your susceptibility to oversharing. A heightened or dysregulated state may make you more likely to, for example, vent to the receptionist about an earlier fight you had with your spouse as you check in for your doctor’s appointment.

[Read: Said too Much? How to Deal with Regret and Shame]

6. Practice telling tighter stories. There’s nothing wrong with sharing stories. But you risk oversharing if you tend to go off on a tangent. Before you share, ask yourself: “What do I want others to take away from my story? What’s its point?” If you catch yourself going down the rabbit hole mid-conversation, don’t fret. Gently steer yourself back and chuckle it off.

7. It doesn’t have to be all or nothing. Perhaps the detail or story you want to share verges into oversharing territory. Rather than throw it out completely, use it to inspire a more neutral talking point.

8. Don’t beat yourself up. Changing a habit takes time. Each time you enter a conversation, remember that you’re in practice mode. You’re not expecting perfection; you’re just working on a small piece of the puzzle. You’ll have good days, and you’ll have days when you’ll tell the person at the post office your life story. That’s okay. Tomorrow you’ll do better.

How to Stop Oversharing: Next Steps

• Free Download: The ADHD Friendship Guide for Adults
• Read: Is Your ADHD Causing Social Slip-Ups?
• Read: Don’t Just Talk, Communicate

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “An Adult’s Guide to Fostering Friendships with ADHD” [Video Replay & Podcast #478] with Caroline Maguire, M.Ed., ACCG, PCC, which was broadcast on November 2, 2023.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

On the flip side, mothers were portrayed as multitasking heroes who kept their families and homes from falling apart. Sure, these are stereotypes, but they’re mostly grounded in real-life expectations. Women are supposed to be the tidy, organized, and dependable ones. When you need help with homework, Mom’s the first one you ask. When you can’t find something, Mom knows where it is. When you need a special cake for your birthday, Mom can make it just right.

For a woman like me who struggles with ADHD, these expectations can be painful. Daddy is the one who keeps things running around here. He’s the organized and calm one. I do a lot. But if it weren’t for him, we’d have ice cream melting in the refrigerator.

[Read: “Housekeeping Is Not Motherhood.”]

I’m fairly traditional. I worked from home with my kids for years by choice. I wanted to cook their meals from scratch, but I almost always left out a crucial ingredient. I was there every time they pulled out a new board game, but I had a hard time sitting down and reading the instructions. I took them to fun places, but it was never a stress-free event. This mama forgot water bottles, diapers, wet wipes, and validation tickets. At some point, I realized I was the Dumb Dad.

For a long time, guilt and feelings of inadequacy plagued me. Not anymore. I’m so grateful to have a husband who grounds me. And with his support, I’m learning self-love.

The Dumb Dad may be bumbling, but he’s also adored. The kids never hold his cluelessness against him because his benevolence is clear. As my kids get older, they’re learning that their mom struggles with some things. And they know that it’s perfectly okay.

I’ve stopped trying to follow recipes or fix remotes. I’m focusing on the things I do well. I’m showing my daughter with ADHD all the tips I’ve learned to make life easier. I’m teaching her about civics and history, where I thrive. I’m hyperfocusing when my children need it, whether they’ve got a mysterious rash or someone needs to convince the city to put crossing guards at the school. I’m dancing and singing to all the kids’ songs because I’m a goofball like them and I know all the words.

I’m not the most organized mom, but I love my children more than anything on this earth. And they know it.

Gender Stereotypes and ADHD: Next Steps

• Read: The Motherhood Myth Is Crushing Women with ADHD
• Read: A Self-Care Guide for Moms with ADHD Raising Kids with ADHD
• Read: 12 Hurtful, Misogynistic Comments Women with ADHD Hear
• Read: To My Kids — A Love Letter from Your Scatterbrained, Unpredictable, Truly Lucky Mom

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.