A: People with rejection sensitive dysphoria (RSD) experience extreme emotional pain related to real or imagined rejection, and they often respond intensely to any perceived injury or threat. In relationships marked by RSD, it’s difficult for one partner to separate amid distress.

Follow these four strategies to reduce conflict and halt toxic patterns.

#1. QTIP (Quit Taking It Personally)

Listen to your gut. If your partner’s bad mood really about you? If you’re lecturing, yelling, or interrupting instead of listening to your partner, ask yourself, “Why am I talking?”

#2. Use a ‘Takeback of the Day’

Here’s how this forgiveness freebie works: Each day, you or your partner can say, “I said something I regret. I’d like it to be my takeback.” Then the receiver agrees to take a breath and figure out how to forgive the partner without resentment.

[Read: How ADHD Impacts Sex and Marriage]

#3. Extend the Benefit of the Doubt

Don’t assume your partner has done something purposely harmful, painful, inappropriate, or irresponsible. Get some clarity by using “I” statements such as “I’m curious about,” “I wonder,” “It’s confusing to me,” “I was surprised,” or “It hurt me when…”

#4. Follow These STEPS

This five-step plan can help dysregulated couples reverse course, cool down, and move forward.

• Self-control. During intense conversations, focus on the physical signals that suggest you’re becoming activated. Is your heart beating faster? Are you perspiring or speaking louder? You can avoid a massive eruption if you catch your dysregulation early.
• Time apart. Establish a plan for signaling when you need a break during a conflict (one of my clients says, “giraffe”) and for taking time apart to cool down and stabilize. Agree on what works for both of you.
• Evenness. Being accountable for your actions returns relationships to baseline. Consider why you are upset and what you could have done or said differently. How can you express your thoughts or desires more effectively and empathically next time?
• Practice reflective listening. When intense feelings escalate, designate one person as the talker and the other as the listener. The talker says what’s on their mind, uninterrupted, for a set time. Then, the listener reflects and repeats what they heard – “What I heard you say is X. Did I get that right? Is there anything else?” Reset the timer and switch roles so each person is heard.
• Strategize. Set small goals that nurture positive connections. Schedule monthly date nights, or make it a daily goal to recognize something your partner did for which you’re thankful or grateful (e.g., “Thanks for cooking dinner.” “I really liked how you folded my clothes.”).

[Read: How ADHD Ignites RSD]

Q: As the non-ADHD partner, my concerns rarely get addressed. Everything I bring up is taken as a criticism or an attack that elicits strong reactions from my partner. I feel stuck and unheard, always walking on eggshells. What can I do?

A: Your question signals that you and your partner are not connecting as equals. I recommend discussing how to comfortably ask for help using questions based on curiosity, not blame.

• “How do we want to ask each other for help and support? The way we’re doing it isn’t working.”
• “When I tell you something, it seems that your reaction is anger and defensiveness. How should I say things in a way that would be easier for you to hear?”
• “How can I help you slow down and manage your feelings?”
• “I noticed that you looked at me. Was there anything behind that look? I’m prone to interpreting that look as a criticism, and I’m wondering what the thinking was behind it.”

If you are uncomfortable having this conversation, I strongly encourage you to find a couples therapist.

Hurt Feelings & Shame Spirals: Next Steps

• Read: 11 Rules for Fighting Right and Forgiving Faster
• Free Download: Manage ADHD’s Impact on Your Relationship
• Read: When You’re So Sensitive It Hurts
• Read: The One Ground Rule for Fighting Fair in an ADHD Marriage

Sharon Saline, Psy.D., is a clinical psychologist and the author of The ADHD Solution Deck.

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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.

Use the examples below to help you explain ADHD to your child in easy-to-understand language that diminishes shame and accentuates strengths.

Executive Dysfunction: A Short-Staffed Airport Control Tower

Our brains are like busy airports with control towers that guide the airplanes of executive function — planning, prioritizing, organizing, managing time, and other skills that help us get through everyday life — to take off and land smoothly.

Except the ADHD brain’s control tower isn’t always well-staffed. It often feels like you’re the only one who showed up to work! You scurry around ensuring that airplanes take off and land without incident — a feat that requires enormous amounts of energy. Sometimes, airplanes become delayed in their take off, or fail to take off altogether.

This is called executive dysfunction. It’s why an ordinary day at school feels so exhausting for you, and why some things may seem harder for you than for your classmates.

How to Support Executive Function Skills: Next Steps

• Read: Your Child’s 7 Executive Functions — and How to Boost Them
• Read: How to Sharpen Executive Functions — Activities to Hone Brain Skills
• Free Download: Common Executive Function Challenges — and Solutions

Regulation: A Volume Button (Sometimes) Gone Haywire

Do you sometimes feel absolutely stuck, unable to get started on your homework even though everyone tells you to “just do it?” Does it ever feel difficult to wind down and get to sleep?

If you answered yes, your brain’s volume button may be stuck or off kilter. The volume buttons in our brains help us regulate and moderate energy, emotions, appetite, sleep, and activity levels. In ADHD brains, the volume button sometimes gets jammed, or it develops a mind of its own, tuning to sound levels that don’t match your commands.

You know your volume button is at zero when it feels impossible to get anything done. It looks like a lack of motivation and procrastination. Maybe you have no appetite, and you struggle to get out of bed.

Sometimes, for no reason in particular, your brain’s volume button will ramp up to 100. Big feelings will flood your brain, your appetite will surge, and it will feel impossible to stop scrolling through social media or to turn off your video game. Even falling asleep will be difficult with a mind that is going full blast.

Self-Regulation: Next Steps

• Read: How to Teach Emotional Regulation Skills
• Read: How to Motivate an Unmotivated Teenager
• Read: Why Task Switching is Difficult for ADHD Brains — and 7 Ways to Smooth Transitions

Sensory Sensitivity: Operating with No Filter

Every minute of every day, our brains filter through sensory input from inside and outside of our bodies. But the filters in ADHD brains are sometimes unreliable — allowing too much or too little information to break through. Often, every little input is received and processed in your brain, making you ultra-sensitive to things like how clothes feel on your body, the intensity of certain smells, the lighting in your classroom, and other sensations. Everything competes for your attention.

This is why hanging out with friends can feel so tiring sometimes. It’s not that you don’t like spending time with them, it’s just that your brain heightens the sensations of everything around you, draining you of your energy as you try to handle competing stimuli.

Sensory Sensitivities: Next Steps

• Read: What Is Your Child’s Sensory Profile?
• Read: Too Loud, Too Bright, Too Sticky!
• Free Download: Sensory Issues — Triggers, Symptoms & Types of SPD

Rumination: A Sticky Gearbox

We all have bad days. To move past challenges, you rely on your brain’s gearbox to shift out of negative thinking and cruise into a lighter perspective. If you find that you’re stuck in loops of negative, toxic thoughts, it’s because your gearbox is sticking — a common problem in ADHD due to emotional dysregulation. Once you notice what’s happening, strategies from cognitive behavioral therapy can be incredibly helpful in getting you unstuck.

How to Shift to Healthier Thoughts: Next Steps

• Read: How Do I Teach My Teen to Manage Emotions?
• Read: When Your Child Wants to Give Up
• Read: How Can I Help My Teen Adopt a Growth Mindset?

How to Explain ADHD to Kids and Teens: More Resources

• Free Download: 5 Ways to Build Self-Advocacy Skills
• Read: Your Brain Is a Ferrari
• Read: How Do You Talk to Your Child About ADHD? Advice from Fellow Parents
• Read: Your Brain Is Amazing! 5 Things All Neurodivergent Teens Need to Hear

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “The Emotional Lives of Girls with ADHD [Video Replay & Podcast #488]“ with Lotta Borg Skoglund, M.D., Ph.D., which was broadcast on January 23, 2024.

SUPPORT ADDITUDE
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Research suggests that women with ADHD are more likely than their neurotypical peers to engage in sexual exploration at a younger age and to have multiple sexual partners. Their behavior is often an attempt to find validation or soothe the emotional chaos that ADHD can create. For some, it’s a way to fill the void created by low self-esteem or a lack of meaningful connections.

Here’s what that looks like for the women with ADHD who have trouble setting boundaries, misjudge risk, and suffer poor self-esteem: In seeking connection, they find themselves in risky encounters without considering the potential consequences. They tolerate disrespect or unsafe situations to avoid rejection.

Risky Sex and Women with ADHD

Many teen girls and women with ADHD are unprepared to handle the consequences of risky behavior, whether it’s dealing with a sexually transmitted disease or an unintended pregnancy.

Understanding how ADHD affects decision-making, through education and self-awareness, can empower women to take a step back before acting. That can mean practicing how to assert your needs and say “no” under pressure to build confidence in relationships, and using checklists to plan safe dates, manage contraception, and schedule health check-ups.

[Read: How ADHD Impacts Sex and Marriage]

Dealing with Low Self Esteem

From a young age, females with ADHD endure criticism for being impulsive, disorganized, and/or emotionally labile. These experiences can create a narrative of self-doubt, where they internalize the idea that they are the problem. This mindset doesn’t disappear in adulthood and often affects their relationships.

When things go wrong in sexual relationships, due to a lack of intimacy, mismatched desires, or conflicts with a partner, many women with ADHD blame themselves. Self-blame can have a profound impact on self-esteem and emotional wellbeing. It can lead to feelings of shame, guilt, and worthlessness that make it harder to address the real issues in a relationship. Instead of expressing her needs and desires, a woman may withdraw in fear of rejection or criticism.

If you have experienced any of this, here’s how to shift your internal narrative:

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

Making Healthy Choices

Emotional Hypersensitivity

Women with ADHD are deeply affected by any criticism, real or perceived. If a partner declines intimacy, you interpret it as a rejection because of your low self-worth.

• Do this: Recognize external factors. Work stress, family pressures, or physical health issues can all influence intimacy. Relationship struggles are rarely the fault of only one person.

Difficulty Communicating Needs

Expressing desires or frustrations can be challenging, especially for women who fear being misunderstood. When conversations about sex go awry, it’s easy to assume you’ve done something wrong.

• Do this: Communicate openly. Tell your partner how ADHD affects your emotions. Together, explore ways to navigate challenges without placing blame.

Negative Self Talk

Many women with ADHD have an inner critic who harps on their perceived flaws. This voice can be particularly harsh around the vulnerable topic of sex.

• Do this: Letting go of self-blame begins with embracing your authentic self and recognizing that you deserve relationships in which you feel valued and supported.

Build Intimacy and Healthy Relationships

Breaking the cycle of self-blame is an essential first step toward a fulfilling sexual relationship. Next comes the work of building and maintaining healthy intimacy. ADHD can sometimes create barriers, but you can strengthen your bond by:

• Planning regular moments together when you intentionally block the distractions that steal your attention.
• Focusing on what brings you joy. Physical affection, emotional vulnerability, and shared activities all contribute to a sense of closeness. If medication or stress dampens your libido, get advice about alternatives or supplements that can support sexual health.
• Learning to say “no” to situations that don’t feel right. This empowers you to protect your wellbeing and foster healthy relationships.

You deserve a relationship in which you feel loved, respected, and understood – not despite your ADHD, but because you are uniquely you.

Risky Sex, Hypersexuality and ADHD: Next Steps

• Watch: “ADHD and Sex: Building Focus and Attention for Intimacy”
• eBook: Women with ADHD
• Watch: Living with ADHD – It’s Different for Women 

Susan Young, Ph.D. is a clinical psychologist in London.

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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.

Reserve your spot in this free webinar, and get the event replay link plus a 15% discount to ADDitude magazine

Not available June 11th? Don’t worry. Register now and we’ll send you the replay link to watch at your convenience.

Does your teen with ADHD overreact to small comments, withdraw suddenly, or seem constantly on edge? They may experience rejection sensitive dysphoria (RSD), a phenomenon common with ADHD. Not a formal diagnosis, RSD refers to intense feelings of pain following an actual or perceived rejection; a person with RSD may anticipate someone pulling back friendship, love, or support over a gesture, a misunderstanding, or a small disagreement.

Parenting teens with ADHD typically means navigating intense emotional storms, executive functioning challenges, and unpredictable hormonal shifts. When you add RSD to the mix, this combination can feel overwhelming and exhausting for everyone.

This webinar is designed to increase your ability to understand what’s really going on beneath the surface and to offer support through the ups and downs of adolescent sensitivity with compassion and clarity. Award-winning author, international speaker, and consultant Dr. Sharon Saline will explain how to manage the heightened emotional sensitivity in teens that often accompanies ADHD. After discussing the science behind RSD and how it relates to social anxiety, she will explore how hormonal changes in adolescence amplify emotional intensity and increase dysregulation in teens. Dr. Saline will show you how to assist kids in identifying triggers, reducing negative self-talk, and lowering shame. You’ll learn practical, evidence-based strategies for helping your adolescents feel more in control of their emotions, more connected to you, and more confident in themselves.

Learning Objectives:

• Understand the connections between ADHD and RSD in teens
• Learn how hormonal changes during puberty impact brain development, mood swings, and emotional sensitivity
• Recognize common signs of Rejection Sensitive Dysphoria (RSD) in teens, including emotional shutdowns or outbursts
• Gain practical tools for de-escalating emotional outbursts and helping your teen name, manage, and recover from big emotions
• Explore communication strategies that foster trust, reduce shame, and build resilience

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

RSD in ADHD Teens: Resources

• Free Download: Evaluate Your Teen’s Emotional Control
• Read: How ADHD Ignites RSD: Meaning & Medication Solutions
• Read: Have a Teen with ADHD? Encourage Communication & Avoid the Drama
• Read: The Key to ADHD Emotional Regulation? Cultivating Gratitude, Pride & Compassion
• eBook: The Parents’ Guide to Raising a Teen with ADHD, Part One

Meet the Expert Speaker

Sharon Saline, Psy.D., is a 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 (#CommissionsEarned) specializes in working with children, teens, emerging adults and families living with ADHD, anxiety, learning disabilities, autism, twice exceptionality and mental health issues. Her unique perspective, as a sibling in an ADHD home, combined with decades of experience as a clinical psychologist and educator/clinician consultant, assists her in guiding families and adults toward effective communication and closer connections. 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 ADDitude and Psychology Today, a featured expert on MASS Appeal on WWLP-TV, and a part-time lecturer at the Smith School for Social Work. Her writing has been featured in numerous online and print publications including MSN, The Psychotherapy Networker, Smith College Studies in Social Work, Attention Magazine, ADDitude Magazine, Psych Central, and Inquirer.com. 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.

Webinar Sponsor

RSD is common in teens with ADHD—but it’s manageable. Play Attention uses NASA-inspired technology that lets users control cognitive exercises with attention alone, empowering your teen to build focus, emotional regulation, and resilience. Proven to improve executive function and backed by Tufts University research, our program blends AI-powered personalization with a dedicated focus coach—for that human touch. Start with our ADHD test or schedule a consultation. Home and professional programs available. www.playattention.com

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

Closed captions available.

Black women with ADHD often live in a state of high performance and hidden (largely ignored) exhaustion — constantly managing symptoms while navigating the pressure to show up as competent, composed, and emotionally controlled. This webinar explores the compounded impact of rejection sensitivity and double-masking, a survival strategy wherein both ADHD symptoms and aspects of cultural identity are suppressed to avoid judgment, stigma, or rejection.

The session will break down how this cycle of masking starts early, how it shows up in adulthood, and its effect on mental health, relationships, and sense of self for neurodivergent Black women. Participants will gain insight into the emotional toll of chronic masking; the generational messages that shape how Black women relate to rest, vulnerability, and achievement; and how race, gender, and neurodivergence intersect in complex, often overlooked ways.

This session is for Black women with ADHD, the providers who support them, and anyone who wants to better understand how racial and gender dynamics intersect with neurodivergence.

In this webinar, you will learn:

• How ADHD commonly presents in Black women and why it’s often missed or misdiagnosed
• What rejection sensitivity looks like and how it can drive overcompensation, perfectionism, and self-silencing
• The emotional and physiological cost of double-masking and chronic emotional suppression
• How generational messaging like “be twice as good” and “never let ’em see you sweat” impact self-worth and behavior
• Practical, culturally responsive strategies to reduce masking and build emotional safety
• What healing and authenticity can look like for Black women with ADHD

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 and ADHD in Black Women: Resources

• Free Download: Understanding Rejection Sensitive Dysphoria
• Read: New Insights Into Rejection Sensitive Dysphoria 
• Read: How ADHD Ignites RSD: Meaning & Medication Solutions 
• Read: Rejection Sensitivity Is Worse for Girls and Women with ADHD
• Read: “I Could Have Been Myself for So Much Longer.”
• Read: Why ADHD Is Different for People of Color

Obtain a Certificate of Attendance

If you attended the live webinar on May 22, 2025, 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

Diane Miller, Psy. D., M.Ed., a dedicated clinical psychologist who specializes in adult ADHD, racial identity issues, and sex therapy, holding a Doctorate in Clinical Psychology and a Master’s in Human Sexuality from Widener University. With over a decade of expertise, she has dedicated her career to serving marginalized communities across various settings such as community mental health, and psychiatric hospitals. Currently at The Center for ADHD in Philadelphia, she empowers individuals to navigate ADHD’s complexities, fostering self-acceptance and proactive living. Dr. Miller’s approach is deeply informed by her extensive work with underserved populations, offering a therapeutic space of trust, equity and support.

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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“Nothing activates the brain so extensively as music.” — Dr. Oliver Sacks, neurologist

Science shows us that music lights up no fewer than nine regions of the brain. Research demonstrates that these areas — responsible for everything from decision making and memory to emotional regulation and sensory feedback — are activated and largely benefited by music, which increases dopamine and smooths temporal processing. And personal experience confirms these findings for many individuals with ADHD, who find that they study, work, and process the world better with music. This has certainly been true for me.

In this webinar, we will study the neurological power of music by reviewing existing research on everything from mood and social skills to sustained attention and auditory processing. We will delve into research specifically on music therapy for individuals with ADHD, and on academic outcomes with and without background music for students with ADHD.

In this webinar we will answer the questions:

• What areas of the brain are activated by music?
• How does listening to music specifically help with ADHD symptom management?
• What type of music is best for promoting concentration and memory?
• Can music help with emotional dysregulation and rejection sensitive dysphoria?
• And more.

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.

Music and ADHD: Resources

• Free Download: Your Free Guide to Music for Healthy ADHD Brains
  
• Read: Music That Focuses the Brain
• Read: Music Therapy: Sound Medicine for ADHD
• Read: Rhythm Notion: 10 Benefits of Music for ADHD Brains

Obtain a Certificate of Attendance

If you attended the live webinar on June 5, 2025, 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

Roberto Olivardia, Ph.D., is a clinical psychologist and Clinical Instructor of Psychology at Harvard Medical School. He maintains a private psychotherapy practice in Lexington, Massachusetts, where he specializes in the treatment of ADHD, executive functioning issues, and issues that face students with learning differences.

He also specializes in the treatment of Body Dysmorphic Disorder (BDD), Obsessive-Compulsive Disorder (OCD) and in the treatment of eating disorders in boys and men. He is co-author of The Adonis Complex, (#CommissionsEarned) a book which details the various manifestations of body image problems in men. He sits on the Scientific Advisory Board for ADDitude and serves on the Professional Advisory Boards for CHADD, Attention Deficit Disorder Association and is a Featured Expert for Understood. He is an avid music fan with ADHD.

#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.

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Brain Balance helps kids, teens and adults with ADHD, learning differences, anxiety & more through our integrative cognitive development and brain wellness program. Our approach combines cognitive, physical and sensory training with nutritional guidance to strengthen and build brain connectivity without the use of medication. Stronger connections translate to improved attention, behaviors, and social-emotional well-being. www.brainbalancecenters.com

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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Stimulant medication may normalize certain brain regions impacted by ADHD in children, according to a cross-sectional neuroimaging study of 7,126 children aged 9 to 10 recently published in Neuropsychopharmacology.¹

Study participants were divided into three groups. The “no-med ADHD” group included 1,002 children with severe ADHD symptoms who were not taking stimulant medication. The “stim low-ADHD” group included 273 children whose ADHD symptoms were mild and well-managed with stimulant medication. The “TDC” group included 5,378 typically developing controls.

ADHD symptoms experienced by the no-med ADHD group were associated with brain structure abnormalities not seen in the TDC or stim low-ADHD group, including:

• lower cortical thickness in the insula (INS), a brain area associated with saliency detection or the ability to prioritize information
• less grey matter volume in the nuclear accumbens (NAc), a brain area associated with reward processing and motivation

Children in the stim low-ADHD group showed no significant differences in these brain areas compared to controls. This contrast in structural MRIs suggests that stimulant medication may work to normalize some (but not all) brain regions and improve symptoms in children with ADHD.

Stimulant medication was not associated with improvement in all brain regions. Among those not impacted were the following:

• the caudate (CAU), a brain area responsible for motor control
• the amygdala (AMY), a brain area responsible for emotions

“This result is consistent with previous studies,” the researchers wrote. “Reduced volume in children with ADHD in the CAU is one of the most replicated findings in sMRI studies. No effect of stimulant medications was found in the CAU in the participants with ADHD in several cross-sectional studies. Along the same lines, longitudinal studies on children pointed to the improvement of volumes in the CAU associated with age but not stimulant medications… and two previous studies also pointed out there was no effect of stimulant medications on the AMY.”

Non-stimulant medication did not significantly impact brain structure.

A separate validation analysis included 273 participants with high ADHD symptoms who were taking stimulant medication; the results were consistent with the main study and still suggested that stimulant medication had a positive and noticeable effect on the brain structure of children in this group compared to the no-med ADHD group, even though both groups had high symptom severity at the time of the study.

“These findings are important for the treatment of children with ADHD using stimulant medication,” the researchers wrote.

Stimulant Medication & the ADHD Brain

Stimulants are the first-line treatment for ADHD in children aged 6 and older, teens, and adults. However, some people with ADHD discontinue medication due to side effects. The most common side effects reported by caregivers in ADDitude’s 2023 treatment survey were appetite suppression, irritability or moodiness, and sleep problems.

“Our current medication treatments for ADHD work quite well, but unfortunately, many children stop the treatment or stop taking medication,” said Jonathan Posner, M.D., in his 2020 ADDitude webinar, “Secrets of the ADHD Brain: How Brain Imaging Helps Us Understand and Treat Attention Deficit.” “In fact, the majority of teenagers with ADHD will stop treatment within two years.”

Understanding the parts of the brain that are impacted by stimulant medication can help refine treatment and determine “which of those changes are responsible for symptom improvement versus side effects,” Posner said.

“One of the things that brain imaging has shown is that the development of the brain in children with ADHD seems to be somewhat delayed,” Posner said. “But the overall course of development in children with ADHD versus without ADHD is very similar. It’s almost as if the ADHD brain is a couple of years behind. The very optimistic part of this is that it ultimately does catch up for most children with ADHD.”

For the majority of patients, ADHD symptoms do continue into adulthood, and the prevalence of ADHD in adults is rising. ^{2, 3} However, the present study confirmed Posner’s observations and found that children with even severe ADHD caught up developmentally for the region of the brain responsible for prioritizing information.

MRI scans showed greater cortical thickness in the INS region for the stim-low ADHD group and TDC group compared to the no-med ADHD group. However, data from a two-year follow-up analysis showed these differences were no longer present. Development of the INS is complicated, the researchers noted, but they suggested that “the No-Med group has delayed INS development at baseline, which eventually catches up to the other children.” Researchers theorize that stimulant medication may speed up this process and will continue to follow up with children over the next few years.

Limitations & Future Research

Participant data was obtained from the Adolescent Brain Cognitive Development (ABCD) study, an ongoing study since 2019 that will follow children over 10 years. Data was obtained via structural MRIs and symptom questionnaires and analyzed using linear mixed-effects models (LMM). The study included measures of cortical thickness, cortical area, cortical and subcortical volumes, and total intracranial volume.

The ABCD study lacked diagnostic information for ADHD; therefore, researchers grouped participants using latent class analysis (LCA) and 18 ADHD symptoms from the K-SADS — a moderately reliable test of affective disorders and schizophrenia. Children with bipolar disorders and anxiety disorders, oppositional defiant disorder, obsessive-compulsive disorders, and conduct disorders were excluded from the study.

Results indicate that stimulant medication may enhance brain structure and alleviate ADHD symptoms; however, this study was cross-sectional and did not establish clear causation. Information on the mean dose and duration of participants’ stimulant medication use was missing from the study. Additionally, researchers warned that the study did not fully capture the association between brain structure and ADHD severity. The stim-low ADHD group was much smaller than the other two groups, which may have hindered the study’s results. The two-year follow-up (in line with ABCD study release 4.0) included fewer participants (3,992 after exclusion criteria). Results should be interpreted with caution.

Future research should further incorporate supplemental data on stimulant use, study stimulant use by patients with severe ADHD, and include more longitudinal data.

Sources

¹Wu, F., Zhang, W., Ji, W. et al. (2024). Stimulant medications in children with ADHD normalize the structure of brain regions associated with attention and reward. Neuropsychopharmacol, 49, 1330–1340. https://doi.org/10.1038/s41386-024-01831-4

²U.S. Centers for Disease Control and Prevention. (2024, October 4). ADHD in adults: an overview.
https://www.cdc.gov/adhd/articles/adhd-across-the-lifetime.html

³American Psychiatric Association. (2019, November 15). ADHD increasing among adults.
https://www.psychiatry.org/news-room/apa-blogs/adhd-increasing-among-adults

Running late again? Missing appointments and deadlines? Losing focus and motivation for tasks? And where did you put those car keys? It’s no secret that people with ADHD often bear the burden of living with these and other functional impairments caused by executive function (EF) weaknesses.

Executive function is a set of skills that allow people to plan for short- and long-term goals, make adjustments to meet those goals, manage time effectively, remember what they’ve heard and read, and exhibit self-control. In many people with ADHD, executive function doesn’t work as it should because the parts of the brain that control these skills are impacted by ADHD. And that affects everyday actions like making decisions, meeting financial responsibilities, adapting behavior in response to a changing environment, and navigating relationship dynamics. But there are strategies you can employ to improve these skills for better results.

In this webinar, you will learn:

• About the cognitive skills that define executive function
• About the brain-based mechanisms that cause many people with ADHD to have weak executive function skills
• How working memory difficulties can manifest in workplace settings, social interactions, and personal organization, leading to common struggles such as forgetfulness, procrastination, and difficulty in planning
• Whether these challenges evolve with age and how adults with ADHD can adapt to or mitigate these changes over time
• About practical strategies and interventions to develop skills that enhance executive function and working memory

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.

Download or Stream the Podcast Audio

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Executive Functioning in Adults: More Resources

• Self-Test: Do You Have a Working Memory Deficit?
• Read: 7 Executive Function Deficits Tied to ADHD
• Read: How Adults with ADHD Think
• eBook: The Adult’s Guide to Stronger Executive Functions

Obtain a Certificate of Attendance

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Meet the Expert Speaker

Peg Dawson, Ed.D., NCSP, received her doctorate in school/child clinical psychology from the University of Virginia. She worked as a school psychologist in Maine and New Hampshire, and recently retired after 30 years at the Center for Learning and Attention Disorders in Portsmouth, New Hampshire, where she specialized in the assessment of children and adults with learning and attention disorders. Along with her colleague, Dr. Richard Guare, she has authored many books on the topic of executive skills, including The Smart but Scattered Guide to Success, a self-help book for adults who want to strengthen their executive skills.

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Strong self-advocacy skills — i.e., the ability to ask for and secure support when it matters — is a strong indicator of success for people with ADHD. Everything from executive dysfunction to the emotional impact of ADHD and its comorbidities are made more manageable with the right kind of help. But the same ADHD characteristics that make assistance so important also make asking for it really tough.

So we asked ADDitude readers to share their experiences with self-advocacy and offer any tips, hacks, or hints that have helped them get helpful help. Here’s what they told us:

Why We Ask for Help

“I see requests for help as opportunities to build relationships and connections.” —Catherine, Washington

“When I ask for help, it makes me feel like a failure. But I remind myself that I need to set an example for my kids, so I will ask my husband for help by explaining that I need to prioritize something else so can he please cook dinner?” —Kate, Australia

[Read: The Fear of Failure Is Real — and Profound]

“I’m midlife and the gig of doing it all by myself is up: I have crashed and have to ask for help now. The trick is choosing relationships in every area of life with people who have high standards of relations, reciprocity, and compassion. I choose now, rather than hoping others will get me. It changes everything!” —An ADDitude Reader

“I think having a background in addiction recovery is an asset to ADHD coping. I am already aware that in some areas, I need support outside of myself. Therefore, I am already practiced in asking for support. I know that if I try to cope on my own, it may lead to unhealthy behaviors.” —Krysta, Canada

“I have a 15-minute rule. If I am stuck for more than 15 minutes, I ask for help. I instill this in my employees as well. Asking for help tells me that they are comfortable with communication, and humble.” —John, Florida

“If I notice my RSD is preventing me from asking for support, that often indicates that I’m not getting what I need from that relationship to feel safe.” —AJ, Utah

[Read: How ADHD Ignites RSD – Meaning & Medication Solutions]

How We Ask for Help

“I prefer typing out a text or email rather than orally asking for help, but if text/email is not an option, writing a script can help me prepare for a face-to-face request.” —Chandler, Pennsylvania

“Ask for something super tiny to get practice at asking for help.” —Katrina, Australia

“I have set up keywords with my husband, so when I say those words he knows I am feeling lonely and I need help.” —April, Oklahoma

“My ADHD can make me quite impatient, so I need to give people time to process my request, or take the action I’ve asked for. It helps to remember this isn’t rejection, and they don’t have to drop everything then and there in order to be willing to help.” —Trish

“To address loneliness, I have learned to say ‘I need a hug.’ Often it opens the door for me to share more about what is going on.” —Claire, Pennsylvania

“I identify a person with complementary skills, and I spontaneously contribute to our shared objective by doing the tasks they find laborious. The reciprocal task division follows naturally. Nobody has to ask, no gift debt is engendered. We are actively helping each other.” —Dettie

“I imagine that I’m giving someone good news when I’m about to ask for something I feel nervous about.” —Kelsie, Mississippi

“I have to just accept that asking feels awkward, and it probably always will.” —Sarah, Georgia

“I always express gratitude to any person who is willing to body double with me and I describe how it was helpful. For example, ‘You read your book while I was doing bills and I got sooo much more done. Thank you. Let me know when you are reading your next book.’” —An ADDitude Reader

“I offer help, often. That makes me feel better about asking for help. In my mind, I’ve kind of already paid for the help that I need by helping others, and now I’m cashing out.” —Helen, Maryland

“I practice a lot of ‘I statements,’ like, ‘I feel so overwhelmed by the number of tasks I have to do and I need extra hands.’ It’s not easy, but if you start with positive ‘I need’ statements, and practice, it’ll start feeling like second nature.” —Vanessa, Texas

“I try to set up check-ins with team members at work so it’s easier to ask for help while working on a specific project.” —Christina, Louisiana

“Give yourself 10 seconds of bravery. Start counting backwards from 10 and, before you hit one, say what you need to say to the person.” —Charlie, Australia

“Before asking for help at work, I always make sure to have a list made up of things I need help with. It shows my boss and team members that I have come prepared, with a plan.” —Melissa, Minnesota

“I have realized that I need to be very concise and direct when asking for help, instead of talking about how much I need help and giving reasons.” —An ADDitude Reader

“I use an app such as Goblin Tools to break down tasks, then I ask for specific help. I find that if I say I need help in a non-specific way, people are less ready to help, but if I say, ‘Can you declutter this one drawer please?’ then I’ll get help. The act of breaking the task down helps reduce my overwhelm, too.” —Laura, New Zealand

“One thing that helps is to talk to friends about what is going on, just to gauge what their capacity is for listening or coming up with solutions I am blind to. More eyes and brains on a problem are a good thing.” —Sarah, Germany

“With my teenager, it is mostly a choice-based, task-related ask: ‘Would you be willing to help me with Option A or Option B and at what time?’” —Kristen, Michigan

“At work, I have a personal checklist of resources to exhaust. If I can’t find the answers after doing due diligence, I reach out to an appropriate team member. Having researched on my end allows me to reach out with a more informed and confident ask for help.” —Sharon, Ohio

ADHD Self Advocacy: Next Steps

• Quiz: Rejection Sensitive Dysphoria Symptom Test
• Quiz: How Severe Is Your Loneliness?
• Download: The Emotions of ADHD

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.

Share your stories of ADHD resilience in the comments section.

“I lost my three-year-old daughter to a rare form of cancer. I remember wanting to die, too. A voice in my head said, ‘You have three other kids who need you to find a way to go on. Because if life hits them the way it’s hit you, they will know they can overcome.’” — Tracy, Canada

“I struggled with depression and anxiety in my first semester of college because of major imposter syndrome and ended up having to go home on medical leave for suicidal ideation. No one expected me (maybe not even myself) to get up the next morning and apply for a job. Hitting what seemed like rock bottom helped me find a hidden, gritty, scrappy fighter within me. I knew I needed time and experience outside of the academic arena to show me that there is more to life and that I have value and talent beyond what any classroom grade might assign me.” — Rebecca, Connecticut

“I failed out of college. Then, I took a semester off, went to community college, eventually enrolled in a four-year program, and graduated with a Bachelor of Science in accounting.” — Erin, Missouri

“Being diagnosed late in life, raising three kiddos with ADHD, surviving a high-conflict divorce, running a school, and navigating a teen through trauma and treatment — ADHD resilience, it’s a real thing.” — Katie, Arizona

[Get This Free Download: Secrets of the ADHD Brain]

“Having ADHD and dealing with setbacks has made my teenager resilient and allowed him to build strong boundaries. When he realized he was being mistreated by ‘friends,’ he recognized that their negativity was contagious and dangerous to his mental health because he was emotionally sensitive. Recognizing his sensitivity to unpleasant behavior gave him the motivation to end old relationships and seek out new ones that are positive and more rewarding. This is a life skill that more teenagers need to live happier lives.” — Jane, Tennessee

“I was told I might not be able to walk again. Yes, I suffered from depression, but I had small goals and kept going. I worked hard. I pushed myself (with my high expectations), and now I can walk with a walking stick. It was one of the most challenging things I’ve ever had to do. It has taken me years to get to where I am today. But I did it because I’m resilient and strong. I’m grateful. I’m proud. Thank you, ADHD.” — Sam, U.K.

“A childhood full of bullying, misunderstanding, and criticism drove me to seek out therapy. That self-exploration gave me an early advantage in self-acceptance and how to deal with others, especially in the decades when I went undiagnosed. I’m a veteran human being now.” — Dee, Canada

“I have fallen on my face so many times over the years, but each time, I climb back up and get a little more success — money, lifestyle, health, etc. I have endurance tattooed on my back (I should add resilience).” — Angie, Virginia

[Join the ADDitude Support Group for Adults with ADHD]

“I try to be resilient by giving myself grace when I forget things and try to complete multi-step tasks. I tell myself it’s ‘OK if I don’t get it right the first time.’ Allowing myself to try again took a long time to accept because I like to get things perfect the first time.” — An ADDitude Reader

“I taught a class of 16-year-olds who hated my guts. Going to work was like entering a war zone. My work colleagues could not believe how I kept going. At home, I also took care of my husband, who suffered from a work injury. I refused to give up. Former bosses still talk to me, and some former students smile and publicly say, ‘Hello.’ My marriage and career continue to thrive.” — Louise, Australia

“I have big emotional reactions to setbacks and rejection, especially involving others. Since learning more about RSD and ADHD, I try to allow myself to feel my feelings so I can build resiliency and move forward. I remind myself that, while people may not understand me, I know who I am.” — Ellen, Massachusetts

“My 10-year-old son faced significant challenges when he developed arthritis and severe asthma following a post-COVID infection. This condition made physical activities like running and playing soccer and basketball difficult, often leaving him in pain and short of breath. Despite his efforts, some teammates were unkind, telling him he was hopeless and suggesting he should quit. When he shared his feelings with me, he showed determination, leaving me in awe. He said, ‘I’ve heard what they’ve said, but I want to finish the season because I made a commitment. I’ll keep doing my best, stay positive, and not let their comments get to me. After the season, I’ll find an activity that better suits my abilities.’ True to his word, he persevered through the season and eventually discovered jiu-jitsu and ninja training, activities that he loves and excels at.” — Jo, Australia

“I have learned that my value is not determined by what I do or have not done or how much I weigh or what others say about me. I have learned to forgive myself and move on. I’m also not afraid of admitting and taking ownership of my mistakes. I try to teach my son this, too.” — Glenda, California

“I don’t know how I survived the five years of my life when I was pregnant, had two young sons, and worked in an industry where an 80-hour workweek was expected. As an ambitious advertising executive and new mother, I flew more than 100,000 miles a year, breast-pumped on the road, and stayed up until 3 a.m. working on new business pitches. I had no clue that I even had ADHD until this year!” — Tyra, Arizona

“I continue to write despite never finishing a single project. I have three unfinished novels, an overflowing drawer of unpublished poetry, and ideas for more. Despite the unsuccessful struggle to complete or publish any of this, I am actively working on a non-fiction book, mostly because I can’t not do it.” — David, Oregon

“I can think of several times in my adulthood where I was resilient: Going to nursing school at age 27, finishing at the top of the class, completing college at age 43, becoming licensed in the state and nationally as a nursing home director, and becoming a director of a bankrupt facility. Despite wanting to drown many times, my mind would rebound, and I kept swimming.” — Enola, Oklahoma

“I had five different majors in college. I spent my 20s jumping from job to job, unsure of what I was good at or wanted. I returned to school and got my Ph.D. at age 39. Ten years later, I am tenured and an associate dean at a major university. I work with people who know that they benefit from my ADHD superpowers and accommodate my less super ADHD symptoms. I regularly get to use my position to help neurodivergent students.” — Ted, California

“I co-founded a charter school 22 years ago. Keeping it on track through many challenges required a lot of perseverance.” — Morgan, California

Perseverance & Resilience: Next Steps

• Read: Building Resilience Begins Here – 6 Motivation Strategies for ADHD Families
• Download: How Well Are You Handling Stress?
• Read: “I Am What I Choose to Become!”

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.