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Understanding ADHD and Mental Health

Understanding ADHD and Mental Health
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Understanding ADHD and Mental Health

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder categorized by two primary symptoms: inattention and hyperactivity/impulsivity. There are three types of ADHD: inattentive, hyperactive/impulsive, and the combined form, which is most common. Inattentive behaviour may manifest as a lack of attention to detail, careless mistakes, difficulty listening, poor organizational skills, and being easily distracted. Hyperactive/impulsive behaviour often includes excessive fidgeting, trouble staying seated, restlessness, interrupting others, and engaging in risky behaviour without considering the consequences. Individuals with ADHD have differences in executive functioning causing them to have difficulty with self-regulation, attention, and behaviour inhibition. These challenges significantly impact their performance and interactions at school, work, and in social settings.

ADHD and Self Esteem


Untreated ADHD affects all areas of life including school, work, family and romantic relationships, health, and co-occurring mental health concerns. Individuals with ADHD know these challenges well. As functioning is impacted, people with undiagnosed ADHD may wonder what’s wrong with them and label themselves as “stupid” or “less than.” They may see their peers performing differently and negatively compare themselves to those who don’t need assistance managing ADHD symptoms. These pervasive impacts then often lead to struggles with self-esteem.

ADHD and Intelligence


It is common for people with ADHD to believe that they lack intelligence; however, this is not the case. ADHD has nothing to do with intelligence. It is a disorder that impairs functioning and does not affect intellectual capability. People with ADHD may feel less intelligent because they often face difficulties with typical school and work tasks, due to challenges with functioning. For instance, someone with ADHD may have trouble writing a paper because of the organization and planning involved. However, if asked to complete the same assignment verbally or if they were taught concrete organization skills, they would do much better. This illustrates that the issue lies in the method of task execution, not in cognitive ability.

Comorbid Mental Health Concerns


Moreover, individuals with ADHD are more likely to experience co-occuring mental health concerns. Two mental health concerns that are more common in individuals with ADHD are social anxiety and substance use disorder. 


Social anxiety involves a fear of being judged or rejected by others in social situations. Individuals with social anxiety might avoid social interactions or feel anxious before, during and after these situations. People with ADHD are more likely to struggle with rejection sensitivity dysphoria, where they exhibit heightened emotional responses to rejection due to a fear of losing love or support. Symptoms can include feeling easily embarrassed, ashamed, or angered after rejection. They may also struggle with low self-esteem and have high expectations of others. Social anxiety and rejection sensitivity dysphoria are more common in individuals with ADHD due to their difficulties with self-regulation, which makes it harder to manage their emotions. Challenges with self-awareness, emotional regulation, and differences in neurodevelopment also make it difficult for those with ADHD to pick up on social cues, increasing their susceptibility to social anxiety.


Substance use disorder is another psychological disorder that is more common in people with ADHD than the general population. Approximately 25% of individuals in treatment for alcohol use disorder have ADHD, and children with ADHD are 2-3 times more likely to abuse substances. This higher prevalence is partly due to lower levels of dopamine in the brains of individuals with ADHD. Dopamine is a neurotransmitter associated with motivation and reward. The deficiency of dopamine leads those with ADHD to crave dopamine and seek activities that increase dopamine levels, such as substance use. Once substance use begins, the craving for dopamine intensifies, leading to increased and repeated use of the substance.


Treating ADHD can make it significantly more manageable and can reduce its impacts on daily functioning. ADHD can be treated using medication and/or psychotherapy. The medications prescribed for ADHD include stimulant drugs and non-stimulant options like atomoxetine. These medications increase dopamine and adrenaline levels in the brain, helping to improve focus and control impulsivity. Stimulant medication in particular, reduces the likelihood of developing a substance use disorder by 30-50% among individuals with ADHD. Additionally, stimulants decrease the risk of injuries, accidents, suicide, and obesity for those with ADHD. Stimulant medication is most effective at lowering the risk of substance use disorder if started before age nine.


It is also advised to work with a psychologist, psychotherapist, or social worker trained in treating ADHD. These professionals provide strategies to improve functioning skills, which are essential for school, work, and relationships. Therapists collaborate with individuals to develop specific behavioural strategies to address the unique areas the individual faces challenges with. Therapists also help those with ADHD to build self-awareness. When a person has awareness that a difficulty is happening in real time, they are then better able to reach into their toolkit and use a coping skill. Additionally, they can provide support in building social skills, improving self-esteem, and navigating relationship challenges exacerbated by ADHD.  Therapists might also recommend environmental modifications to better accommodate individual needs. Such changes can include accommodations at school or work, advocating for the individual’s needs, and identifying supportive resources. Lastly, therapists can address comorbid mental health concerns with strategies specifically tailored for those with ADHD.


If you suspect you might have ADHD, an ADHD assessment can be very beneficial. This assessment is a thorough evaluation process designed to diagnose ADHD. Receiving an ADHD diagnosis can offer a deeper understanding of the unique ways the disorder presents itself in your functioning. A comprehensive report will be provided that includes tailored treatment options, resources and coping strategies. Additionally, ensure psychodiagnostic testing is included in the assessment to help identify any co-occurring mental health conditions.


To learn more about getting an ADHD Assessment, reach out for a free 15-minute phone consultation with our Clinic Coordinator. During this call, you can discuss your concerns, and the Clinic Coordinator can schedule a FREE 30-minute pre-screen assessment to determine if a full assessment would be beneficial for you.


With the right support and strategies, individuals with ADHD can harness their unique strengths and lead fulfilling lives. It’s important to remember that ADHD does not define one’s capabilities or worth; rather, it’s a different way of interacting with the world that can be managed effectively with understanding and appropriate interventions.




Barkley, R. (2022, November). ADHD, Executive Functioning, and Health Outcomes. [Presentation]. Professional Education Systems Institute.


Didier, J.W. (2022, November). The Critical Intersection of ADHD & Addiction. [Presentation]. Professional Education Systems Institute. 


Nowell, D. (2022, November). ADHD, Neurodiversity, and Clinical Practice. [Presentation]. Professional Education Systems Institute.


Saline, S. (2022, November). ADHD, Social Anxiety and Rejection Sensitivity. [Presentation]. Professional Education Systems Institute. 


Saline, S. (2020, November). Social anxiety and ADHD. Psychology Today. Retrieved from


Tuckman, A. & McCabe, J. (2022, November). ADHD Struggles with Self-Esteem and Labels. [Presentation]. Professional Education Systems Institute.


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