When people talk about Attention-deficit/hyperactivity disorder (ADHD) the typical list of symptoms referred to includes:
Disorganization
Impulsivity
Difficulty with attention
Procrastination
Hyperactivity, etc...
One of the most impactful- yet least discussed symptoms of ADHD is shame.
The risks of being exposed to long-term shame include:
Anxiety
Depression
Substance use
Eating disorders
PTSD
First I think it is important to discern the differences between guilt and shame. Guilt is an emotion felt when "we have done something wrong or bad". Shame is an emotion felt when we believe that "we are wrong or bad". In other words, guilt is related to an action, shame is related to ones belief of character.
Understanding and addressing this dimension of ADHD is critical to improving the emotional well-being of individuals living with this diagnosis.
How shame develops in relation to ADHD:
With a diagnosis of ADHD there is a cyclical nature of the symptoms experienced... Disorganization often leads to procrastination, which can then spark impulsivity, which results in more disorganization. This becomes breeding grounds for feelings of shame especially when we pair them with societies expectations around "efficiency" and "effectiveness".
Societies expectations of conforming to certain standards of behavior, efficiency and productivity does not accommodate the unique challenges faced by those with ADHD. Those who struggle with their symptoms of ADHD tend to experience feelings of alienation and self-doubt.
Most people with who have symptoms of ADHD can think of times when someone (whether it was a teacher, peer, parent, sibling, etc.) labeled their behaviors as "lazy" or "careless". Maybe you've heard someone say something like: "They're so smart- I just don't understand why they don't want to complete their homework assignments."
ADHD is not a choice- yet, so much messaging comes from the perspective of these symptoms somehow being chosen by the person suffering rather than exploring through a lens of compassion and curiosity of neurodiversity.
Overtime, the constant struggle to meet societal and self-imposed standards can lead to a sense of embarrassment, guilt, and low-self esteem which at long term exposure can form internalized shame.
Ways to begin combatting the shame:
You might be starting to ask yourself, "OK, so what do we do about this induced shame?"
Here is where curiosity and compassion need to take the front seat.
Curiosity leads to exploration.
This exploration includes:
-What symptoms of ADHD show up in my life?
-How are these symptoms getting in the way of the life I'd like to be living?
-What ways have I tried to manage these symptoms before?
One of the most important points to explore in the curiosity stage is...
-What is my internal narrative around these symptoms?
Often the internal narrative that individuals with ADHD have about themselves sounds something like this: "I'm not good enough", "I must just be lazy", "I'm a failure", "I'm inept", the list goes on...This negative self talk feeds the cycle of shame as individuals struggling with ADHD internalize these narratives and believe they are an accurate reflection of their worth. These narratives destroy ones sense of confidence, motivation and overall mental health.
Curiosity can help diminish shame by reframing self-perception through viewing behaviors and thoughts not as failings, but instead as peculiarities to be examined with interest and understanding.
This is where compassion comes in...
Compassion is a critical component in the treatment and management of ADHD. Compassion needs to be received not only from yourself, but also from others. Choosing a treatment team (school support, healthcare providers, mental health providers, etc.) that lead through a lens of compassion are key components in developing a plan to manage and accommodate the symptoms you are experiencing.
Compassion in combination with curiosity fuels the discovery of personalized coping mechanism to manage symptoms of ADHD experienced. Through a compassionate lens you are able to explore unique patterns and triggers through a solution focused approach.
A critical internal narrative creates avoidance, and lack of motivation where as practicing a more compassionate internal narrative makes room for encouragement and exploration.
Annabella Lipson is a Licensed Mental Health Counselor at Peaceful Living Mental Health Counseling in Scarsdale, NY.
She enjoys working with young adults & adults who are dealing with grief, constant sadness, anxiety, PTSD and other heavy emotions that make it difficult to enjoy the present moment.
Annabella has an innate ability to make her clients feel comforted and cared for as they confront their grief and loss. She incorporates a combination of Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), EMDR Therapy, Ego-state Interventions and Mindfulness practices in her counseling sessions.
Annabella is available to take clients residing in New York and Florida, virtually and in person.