Can we pay attention to our own happiness? Adult ADHD and low self-esteem

Adults with ADHD generally have lower self-esteem than non-ADHD adults. Why is this, and what can be done about it?

Self-esteem is a measure of ‘How you feel about who you are’ or ‘an individual’s positive or negative attitude toward the self as a totality’. How you feel about yourself often drives behaviour in public and in private, and the impact on having low self-esteem can be damaging to one’s quality of life. This can even leading to depression or criminality.

Everyday life can have an impact upon our self-esteem. The way events occur, or people communicate may lead individuals to believe that they are many things, from lovable and intelligent to disliked and incompetent (sometimes and confusingly, all simultaneously). Many mental health issues are associated with lower levels of self-esteem. The same can be said for ADHD. Adults with ADHD often grow up being exposed to negative messaging about their abilities and may also generally experience things going wrong throughout their lives. It is therefore easy to understand how living with ADHD can lead to low self-esteem.

ADHD and stigma

A fundamental cause of issues with self-esteem in ADHD is the disorder’s stigma in society. ADHD is often experienced as being stigmatising. Because of this stigma, children with ADHD are less likely to tell their friends that they are taking medication than those with epilepsy, even though both have a neurological basis and require daily medication. Children with ADHD have reported feelings of alienation, name-calling and being treated differently. It’s no wonder these feelings can persist into adulthood.

 

Even adults diagnosed with ADHD in adulthood often say they feel different from other people and experience negative judgements. This stigma is not always perceived or imagined; it can be very real. Evidence has shown that others’ perceptions of individuals with ADHD are often negative. Non-ADHD adults can see ADHD adults as being less socially desirable than peers with a general medical problem or an ambiguous flaw. 

The behaviour traits of ADHD can lead to underachievement (and other negative outcomes) that ‘normal’ society sees as important. This is particularly common in relationship, academic and occupational areas. These ‘negative outcomes’ often lead ADHD adults to experience failures in many parts of life. These failures combined with negative social feedback or social rejection from those around them can lead to the development of low self-esteem. Supporting this, a recent study indicated that having ADHD inherently correlated with lower self-esteem. This doesn’t mean EVERY adult with ADHD has less self-esteem than EVERY non-ADHD adult, just that on average, the chances are higher.

What can be done?

Having low self-esteem can be treated. Evidence suggests that a combination of cognitive behavioural therapy (CBT) and ADHD medication can improve self-esteem. This study indicated that psychoeducation for ADHD, anger management, the role of emotions, relationship skills, time management and problem-solving were effective when combined with ADHD medication.

One of the first steps toward managing these feelings is to learn to emotionally accept the existence and impact of ADHD on your life and personality.

Author: James Brown PhD.

Editor: Alex Conner PhD.