ADHD And Shame

How Empathy And Healthy Guilt May Help

Photo by Kat J on Unsplash

Shame is more debilitating than any other component of ADHD, and causes the most emotional havok.

Shame vs. Guilt

Shame is what people with ADHD try to hide, even from themselves. And unless you’re finely attuned to what shame looks like and feels like, you won’t recognize it. Yet shame is more debilitating than any other symptom of ADHD, and causes the most emotional havok. While guilt (the feeling you get when you know you did something wrong) can lead to repair by simply admitting and apologizing, shame leaves you feeling inherently flawed, bad and ultimately unworthy. It’s not as if you’ve done something “bad;” You are bad. According to Dr. Edward Hallowell, a pioneer in the field of treating ADHD, shame is “toxic,” even “traumatic.” It raises stress hormone levels and corrodes memory and executive functions. Shame, he says, is arguably the most painful of all the symptoms associated with attention deficit disorder.

In the Beginning…

In its early incarnation, ADHD was called Minimal Brain Dysfunction, a pathologizing term which stirred up connotations of people who were just not right in the head. When I was an undergraduate in psychology at UCLA in the 1970s, the name had changed to Hyperkenetic Syndrome, suggesting less pathology; Instead it focused more on the aspect of hyperactivity. Later, it was called Attention Deficit Disorder. According to the DSM, it took two forms: ADD and ADHD, the H having been removed in cases where there is no hyperactivity or impulsivity. Today, both types fall under one label: ADHD.

Shame not only erodes self-esteem, but interferes with the ability to form healthy relationships, to succeed in careers, and even to speak up for fear of judgment and humiliation

Gender Differences

It’s no surprise that more boys than girls get diagnosed. Their “acting out” behavior renders them more visible than the quiet daydreamers sitting in the back of the classroom. The latter may be girls with ADHD. It used to be that boys were diagnosed with ADHD, while girls were diagnosed with ADD. In her book Women With Attention Disorder; Embrace Your Differences and Transform Your Life, author Sari Solden notes that ADHD inattentive type (formerly ADD) is the most common form of the disorder in girls.

Emotions are so fraught for people with ADHD that they try to suppress, deny or avoid them altogether.

Shame and Blame

A common dynamic among sufferers of shame, in general, and people with ADHD, in particular, is their proneness to the Shame and Blame Cycle. This starts when the ADHD individual is confronted about some annoying behavior. They have two choices: Feel the shame and embarrassment and add it to the stockpile of other shaming incidents; or defend against the shame by blaming the other person; making it their fault, turning it around and creating a wall of confusion, even gaslighting their so-called attacker. This may seem preferable from a self esteem perspective, but the shame does not evaporate. It dives down even deeper, into the unconscious. And relationally, it probably causes more problems than accepting the blame and feeling the shame. Afterall, no one wants to be counter-blamed or gaslighted. It’s a sure way to end a relationship.

The healthy response is to apologize or make amends. People with ADHD go immediately to shame, bypassing healthy guilt.

Getting Help

If you suffer from shame-based ADHD or think you might have it:

  1. Most importantly, avoid shaming comments. We all make mistakes. When we do, we feel guilty; that’s the appropriate feeling to have. The healthy response is to apologize or make amends. People with ADHD go immediately to shame, bypassing healthy guilt. You can help the ADHD person shift from shame to guilt by avoiding comments like “You always…” “You never…” “You did it again…” which leads to their feeling they can never do anything right. This generates more shame.
  2. Use humor. Being able to laugh at one’s “growing edge” is a healthy antidote to shame. When you joke about a behavior, you encourage your loved one to do so as well. By saying something like, “I think you’re having an ADD moment,” in a kind, non blaming tone, you create an atmosphere of lightness around what the person is doing. And you give them permission to do so too.
  3. Recognize your own contribution to problems between you, even if you think your ADHD partner is mostly to blame. If you are right, your partner is wrong. This sets up a “no win” situation that can ignite the shame and blame cycle. Maybe your tone or level of anxiety activated a reaction, although not intentionally. You can point that out. You may, for example, recognize that your own intensity or strong feeling has activated them, without blaming yourself or them.
  4. Try a little empathy (and tenderness). Try to put yourself in their place. Imagine what you would want or need from others, and try to be that person.


The degree of impairment from ADHD varies. Symptoms range from mild to severe. Some people have discovered effective ways of managing, minimizing and dealing with their symptoms by adulthood. For some, ADHD is the least of their struggles. Loved ones are essential to their treatment plan; their understanding, compassion and sense of what unique gifts the ADHD person brings makes a huge difference. After all, they are not their ADHD; ADHD is just something they have, something they wrestle with. And don’t we all wrestle with something?

I am a licensed MFT, Certified Jungian Analyst and published author and writer. I am interested in anything that affects humanity

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store