Low self-esteem is a common sign in people with ADHD which can be defined as a decreased sense of self and a reduced feeling of personal confidence as a result of having ADHD (Edbom, Lichtenstein, Granlund & Larsson, 2006).
It can manifest for many diagnosed with this condition as several behavioral and emotional-based responses.
By understanding how and why it arises, you can then begin working towards rebuilding and developing a more positive self-identity, ultimately leading to a better quality of life.
Let us now discuss some of the most common signs to look out for, their suspected or likely cause, and some coping strategies to manage them.
Before doing so though, it is important to note that ADHD-related low self-esteem can appear differently in people, so this is not a definitive list of signs.
If you have concerns about this area, consulting a professional who specializes in neurodiverse conditions can help you by answering your questions and providing management strategies (e.g., using CBT techniques).
Feelings of Shame
Deep feelings of shame can often manifest due to various difficulties ADHD may bring for many aspects of life (Scheel, 2014).
This can create identity issues and increased struggles with having a secure and healthy self-image.
For example, a student with ADHD who consistently struggles with academic tasks and receives a low grade may internalize this as incompetence or inferiority compared to the rest of the students, which can lead to a sense of shame and embarrassment.
These feelings of shame can further hinder their academic progress and self-esteem, creating a negative cycle.
What causes feelings of shame?
Feelings of shame due to ADHD-related difficulties can be incredibly common for many, and this can arise from others or be self-inflicted.
“I’ve had pretty negative thoughts about myself and ADHD since I was little, especially when people are nagging me about things when I mess up. I try to do things right, but I can’t. I think it’s the way I’ll always be.”
From Eccleston et al. (2019).
The lack of emotional and behavioral control that accompanies ADHD can lead to regretted actions that strongly influence feelings of shame.
Struggles with emotional regulation may lead to outbursts of anger or frustration that later evoke shame.
Impulsivity can manifest in reckless behaviors, substance misuse, or outbursts that don’t align with one’s values, subsequently generating profound shame.
How to cope with feelings of shame?
Make a conscious effort to acknowledge your strengths and achievements. Many people with ADHD possess unique qualities like creativity, problem-solving skills, and resilience.
Dedicated research has also been conducted on ADHD-positive strengths, with several uncovered, such as divergent thinking and adventurousness (Sedgwick, Merwood, Asherson, 2019).
Start by listing some of your own attributes and accomplishments and celebrate them. If you struggle to do this yourself, ask a friend or family member what it is that they appreciate about you.
By focusing on what you excel at, you can begin developing a more positive self-image, recognizing the value you bring to various aspects of life, and moving away from shame.
Low Confidence
Several ADHD-associated difficulties, such as impulse control, inattention, and hyperactivity, often lead to experiences of failure, frustration, and external criticism.
These factors can erode an individual’s confidence over time (Schubert & Bowker, 2019).
For example, someone may be giving a presentation at work, but they got distracted, lost their train of thought, and ended up misspeaking several times. Afterward, they felt heavily distraught, berated themselves, and felt like a failure.
This harsh self-criticism can affect their self-esteem, making them more hesitant to contribute to future discussions and share their ideas.
What causes low confidence?
The frustration stemming from the day-to-day challenges of managing ADHD symptoms, such as forgetfulness or impulsivity, can significantly lower an individual’s confidence.
This can make someone question their capabilities and ultimately undermine their self-esteem.
For example, despite your best efforts, you continue to face struggles, and it feels like no matter how hard you try, you are still unable to function the same way when you compare yourself to your peers.
A quote from a study participant stated the following in relation to ADHD and frustration:
“‘I get frustrated a lot of how I lack in college work, I would just be very easily distracted and then just lower self-esteem. Like it can happen before I go to do something and then getting frustrated during. Before I start something, I think, what’s the point? I can’t do that anyways”
From Watters et al. (2017).
How to cope with low confidence?
Avoiding the trap of comparing yourself to others can be beneficial for most people, but it is particularly important for those with ADHD, as these comparisons can lead to unhealthy standards and feelings of inadequacy.
It is important to remember that every person’s journey is unique. So, instead of looking outwards for reasons to compare and diminish your self-esteem, concentrate instead on your personal progress and development.
Your path may involve different challenges and goals, and that is absolutely fine. By appreciating your individual journey, you can begin cultivating a more positive self-image.
“Previously, I thought it was a shame to have ADHD. Now, I think it is important to accept who I am no matter what. There is no point comparing myself to others because I will not be similar anyway. I am myself, and I think that is more than good enough.”
Tom, from Rasmussen et al. (2022)
Being Self-Critical
A negative self-perception can easily arise for someone with ADHD as they may highly fixated on all their perceived mistakes and very little on their accomplishments.
“I get frustrated because everyone else can do it and I can’t and I get frustrated out of that.”
From Watters et al. (2017).
Any said success can often be minimized or dismissed due to this heavy self-critical mindset.
For example, you love playing a musical instrument, but you struggle with focusing and practicing regularly.
When you make mistakes while learning songs, you harshly criticize yourself and compare your progress to your peers.
This self-criticism can lower your self-esteem and make you doubt your musical abilities, leading to a loss of confidence in playing and practicing.
Interestingly, this can even be seen through social media, as research has indicated increased levels of self-critical tendencies within an ADHD population. (Guntuku, Ramsay, Merchant & Ungar, 2019).
The study analysis implies social media use could lead to excessive rumination on past failures and increase impulsive emotional expression, both feeding self-critical attitudes.
This further highlights how many ADHDers struggle with this mindset and how online spaces may perpetuate this self-belief as the norm if you have this condition.
What causes self-criticism?
Many people with ADHD can put a lot of pressure on themselves to overperform, overachieve, and overcompensate for any self-identified areas they may “lack” in.
This can lead to behaviors such as having very high standards for themselves and their work and frequent comparisons with others.
However, comparing your performance to that of peers who do not have ADHD can lead to feelings of inadequacy.
This is further amplified by rejection sensitivity common in ADHD, where any perceived criticism or imperfection is deeply felt.
The combination of unattainable standards, negative social comparisons, and heightened sensitivity ultimately fuels harsh self-criticism.
How to cope with being self-critical
Challenge your thoughts by actively identifying and questioning any frequently occurring negative self-talk.
For example, start by catching these negative thoughts as they arise. Then, interrogate them. Are they based on concrete evidence, or are they assumptions and self-criticisms?
Here are some examples of how to reframe negative thoughts into more balanced, realistic statements:
Negative thought: "I always mess up everything." Balanced thought: "Is it true that I always mess up everything? No, there are many times where I have succeeded at things." Negative thought: "I'm so disorganized, I'll never improve." Balanced thought: "I have gotten better at being organized in some ways, like keeping my desk tidy. I can continue to work on it."
Some CBT techniques on reframing thought patterns that you can try are:
- Catch it, check it, change it cycle
- Distance yourself from the emotion and critically reflect on what is worrying you (e.g., how likely is it that it will occur)
- Pretend that it is not you but one of your loved ones going through it. What would you advise them? How does the situation seem now that you are looking at it from a 3rd person perspective?
- Catch yourself when you are going in unhelpful thought loops, e.g., all-or-nothing mentality, catastrophizing, etc.
Feeling Inadequate
People with ADHD may feel inadequate both internally and externally.
Internally, people with ADHD may have a diminished sense of self-worth, view themselves as less valuable or less competent compared to others and display perfectionistic tendencies (Wang, Sheveleva & Permyakova, 2019).
Externally, this comparison with people close to them (colleagues, family, friends), as well as their wider society, can lead to perceptions of falling short compared to peers or societal expectations.
For example, during a social gathering, your friends share their accomplishments and personal successes.
Due to your ADHD-related challenges, things like planning and commitment-keeping have led to difficulties in similar life areas. You begin to feel unable to match their success, and inadequacy creeps in.
These feelings prevent you from sharing your own experiences, impacting your ability to connect with your friends and ultimately diminishing your self-esteem in social situations.
What causes feelings of inadequacy?
Imposter syndrome describes when someone feels like their achievements and successes have not been rightfully earned despite any clear evidence proving otherwise.
This intensifies self-criticism, as ADHD-related challenges create a heightened sense of internal failure, perpetuating feelings of inadequacy.
“I felt like a fraud, blagging my way through life, and trying to keep up with everyone else. I reasoned that I just wasn’t trying hard enough, and that I was defective.”
From Webster (2018).
This frequent hiding of your genuine self can begin to take a toll and massively plummet positive self-perceptions.
As a result, this can prevent people from being present and enjoying their time interacting with others as they are so focused on all the ways they are lacking.
How to cope with feeling inadequate
Positive self-talk entails replacing self-criticism with self-compassion. This form of emotional regulation focuses on consciously replacing negative thought patterns and perceptions about oneself with positive ones (Mainali, 2020).
It may be difficult to try and adopt this mindset, especially if all you have known is being self-critical, but a good first place to start is by imagining talking to yourself as you would to a supportive friend.
This shift in self-talk can be transformative, fostering self-acceptance and nurturing your self-esteem (Parker, Hoffman, Sawilowsky & Rolands, 2011).
Example:
Negative thought: "I'm terrible at making friends, there must be something wrong with me." Positive response: "Making friends can take time. I have unique qualities people appreciate once they get to know me." Negative thought: "I can't seem to focus on anything, I feel so stupid." Positive response: "I have strengths and talents, even if focusing is hard for me."
Identity Issues
Confusion about one’s identity is often linked with struggles in having a healthy self-concept and identity capital.
Individuals may struggle to fit into societal norms and define who they are, leading to feelings of being fundamentally different from others and the need to mask their ADHD symptoms.
“I constantly feel like I’m performing but I have no idea how to stop. It’s frustrating and confusing. I’m so tired all the time.”
‘Chris’
A sudden ADHD diagnosis can also impact someone’s identity issues, especially in a teenage population, as they are trying to develop their adolescent identity (Eccleston, Williams, Knowles & Soulsby, 2019).
For example, people with ADHD often have great artistic natures, so imagine you are a creative young professional.
Due to ADHD struggles, you face career instability as you struggle to focus, stay organized, and often jump to opportunities impulsively.
Comparing yourself to your successful peers, doubts over your identity as a creative can arise with questions about your belonging in such a profession. This can erode your self-esteem and disconnect you from your creative passion.
What causes identity issues?
Identity issues may arise from excessively masking ADHD traits.
Many individuals with ADHD engage in masking behaviors to fit into societal norms or expectations. The need to mask can arise in various situations and even around loved ones as well.
This constant masking can make someone with ADHD feel like an impostor in their own lives, contributing to self-esteem issues (Mylett, 2022).
For example, constantly pretending to be organized at work while struggling with actually being very disorganization can create a sense of inauthenticity, further undermining self-doubt thoughts and generating reduced self-esteem.
How to cope with identity issues
Recognizing masking behaviors linked with ADHD is the first step in dealing with and coping with identity issues.
Is there a difference in how you behave at home in your own company compared to social situations? Do you feel the need to mask who you are with certain people and not others?
By identifying masking behaviors for what they are and reflecting on under which circumstances you seem to be engaging in them, you will further understand yourself better and begin uncovering who you are.
You can begin to slowly unmask, only if you so wish, starting with people who you are most comfortable with and who accept you as you are. Educate others about masking and why you do it to further their understanding.
Difficulty Saying No
Many people with ADHD struggle to say no, often driven by a desire to please others and avoid conflict or rejection. This can lead them to overcommit to tasks and favors, even when overwhelmed.
Chronic overextension results in exhaustion, frustration, and diminished self-confidence when unable to meet commitments. Over time, difficulty asserting boundaries can negatively impact self-esteem.
For example, you may find it difficult to say no to your colleagues’ requests for help at work. As a result, you end up overflowing with tasks and constantly looming deadlines.
This leads to decreased self-confidence in your perceived ability to succeed in this job, in addition to elevated stress and fatigue levels.
The most common cause of difficulty saying no: people pleasing
People pleasing is deeply linked with ADHD as it often stems from a lack of belief in one’s self and capabilities.
This generates behaviors such as being unable to say “no” to requests from others or often crossing personal boundaries in an effort to be helpful and avoid confrontation or being rejected by others.
This lack of personal confidence can also become outwardly projected in the need for external validation that they are indeed intelligent, good people, capable, etc.
People pleasing can be a more heightened trait in girls and women with ADHD compared to boys and men with ADHD (Taylor & Keltner, 2002).
“It was kind of put into the DNA quite young that you follow these rules, you smile the right way, you say the right things, and then people like you, and if you don’t do that, then you’re not worth our time… I definitely learned that I needed to follow certain rules in order to be accepted.”
Avigail Gimpel, from ‘How People Pleasing Shows Up For Those With ADHD’
How to cope with struggles in saying no
Coping with the difficulty of saying no, especially for individuals with ADHD, involves practicing assertiveness, setting priorities, and using strategies like pausing before responding, setting boundaries, and seeking support.
Recognize that saying no is a means of safeguarding your well-being, preventing over-commitment, and ensuring that your commitments align with your goals.
It is important to honor your boundaries so you can truly feel fulfilled in your life and relationships.
Ensure you are communicating your needs and limits confidently, and reflect on past experiences for learning.
Situation: Your colleague asks if you can take on an additional project because they are overloaded. You already have a full plate. People-pleasing response: "Sure, I can take that on for you." (Leads to over-commitment and stress) Assertive response: "I appreciate you thinking of me for this project. Unfortunately, my workload is at capacity right now. I'm happy to brainstorm some other options though - maybe we could divide the work between a few team members instead?"
Tendency to Withdraw and Isolate
It can be hard to keep up with social interactions and maintain relationships, as people with ADHD may find it challenging to remember appointments, follow conversations, engage in social activities, or understand social rules.
“When I go to my ADHD group, we chat a lot about- we feel like there was a day in school where everyone learnt the social rules … this is how you go about, you know, communicating with people. And we all kind of missed that day like, everyone just gets it and we just didn’t get the rules. We just missed that day, where they just told everyone how to be a person.”
From Webster (2018).
To avoid the embarrassment of making mistakes in social situations, they might choose to withdraw from social gatherings and isolate themselves to protect themselves from potential criticism and judgment.
For example, you miss a lot of social events or are often late due to difficulties organizing time. You then begin declining invitations to future social events and spend more time alone to avoid letting people down or being judged. Over time, this self-imposed isolation can make you feel lonely and lead you to question your ability to maintain meaningful social connections, ultimately lowering your self-esteem.
What causes self-isolation tendencies?
Social anxiety, rejection sensitivity, and stigma surrounding ADHD commonly lead to isolation.
Social anxieties (which commonly coexist in ADHD) arise from struggles with skills like sustaining focus during conversations. Rejection sensitivity causes withdrawal to avoid perceived judgment. Stigma creates shame and an urge to conceal one’s difficulties by avoiding interactions.
Poor organizational skills and hyperfocusing on solitary tasks also play a role. However, the desire to hide perceived flaws coupled with social challenges creates a cycle of isolation that can worsen ADHD symptoms and lower self-esteem (Houghton, Roost, Carroll & Brandtman, 2015).
How to cope with self-isolation tendencies
Choosing to be in the company of individuals who offer support, encouragement, and understanding can do wonders for your self-esteem.
Research indicates that even from a young age, social support is key in children with ADHD (Mastoras, Saklofske, Schwean & Climie, 2018)
Try sharing your ADHD-related challenges with friends and family who are nonjudgmental and empathetic as well, as it can provide a great sense of belonging by absolving yourself from all the pressures of masking and trying to hide symptoms.
You could even start with online communities and support groups to find others who have similar experiences to you if you struggle socially. You may be surprised how common your ADHD experiences are.
Their support can significantly contribute to enhancing your self-esteem, as feeling understood and valued by others reinforces a positive self-concept (Manning, 2007).
FAQs
What can lead to low self-esteem in ADHD?
There is no overall consensus as to why this manifests in individuals, as each person is unique in their primary ADHD symptoms and environmental factors. However, several reasons can be suspected:
- Emotional dysregulation: Heightened emotional sensitivity, rapid mood swings, and difficulty managing emotional responses. These fluctuations can lead to frustration and self-criticism.
- Impulsivity: Rushed decisions and emotional outbursts that can lead to social conflicts, damaged relationships, or regrettable actions.
- Social interaction struggles: Forgetfulness, difficulty in following conversations, and impulsive remarks that can lead to misunderstandings, social isolation, or feelings of being socially inept.
- Imposter syndrome: Self-perception of being a fraud, fear of being exposed as incapable, constant doubt over abilities, and minimization of achievements.
- Work/academic challenges: Maintaining focus, hitting deadlines, and managing tasks and workload demands can be challenging. Other challenges include frequent setbacks, underachievement, and lower performance.
Can ADHD stigma contribute to low self-esteem?
ADHD stigma contributes to low self-esteem by leading to frequent criticism, blame, and misunderstanding of symptoms as personal flaws rather than a neurological disorder.
This can cause people with ADHD to internalize negative perceptions, assume they deserve poor treatment, and view themselves as inadequate or unworthy. The stigma undermines self-worth.
How Can Having Undiagnosed ADHD Affect Self-Esteem?
Undiagnosed ADHD can significantly impact self-esteem due to the symptoms, behaviors, and daily struggles that ADHD generates (Webster, 2018), but without being able to give a name to what they are experiencing.
Consistent difficulties in many areas of life can lead to feelings of inadequacy, shame, and self-doubt as they do not know what is wrong with them.
Additionally, the challenges associated with ADHD may be misunderstood as laziness or lack of effort, further eroding one’s self-esteem.
Thus, raising awareness of ADHD, recognizing the different ways it can manifest, and how gender plays a role in this is a good first step to building self-esteem.
How does being a woman with ADHD affect self-esteem?
Being a woman with ADHD can present additional unique challenges in managing self-esteem-related challenges.
Specifically, women with ADHD may be more likely to develop coping mechanisms that mask their symptoms, making it harder to receive an accurate diagnosis.
This can result in a long history of unexplained difficulties and, consequently, a negative impact on self-esteem.
Additionally, it is important to note that societal expectations and generalized gender stereotypes (e.g., women are often expected to be organized, be able to multitask, be calm and reserved, etc.) can further contribute to feelings of inadequacy.
For example, ADHD stigma can impact women to a higher level (Holthe, 2013), which can make it even more tempting for them to keep masking behaviors activated and engaged.
Can ADHD make people feel insecure?
Yes, ADHD can make people feel insecure. Several struggles associated with ADHD, such as impulsivity, emotional regulation challenges, and trouble sustaining attention, can contribute to and lead to feelings of insecurity.
The fear of making mistakes or being judged for not meeting societal or personal expectations can contribute as well (Barkley, 2020).
However, with proper diagnosis, support, and understanding from one’s self and loved ones, individuals with ADHD can learn to manage their symptoms and improve their self-esteem, reducing feelings of insecurity.
Can people with ADHD be confident?
People with ADHD can absolutely be confident. Anyone, whether neurodivergent or neurotypical, may struggle with confidence at times.
It is, thus, important to think about this concept as a skill that can be worked on and developed.
A good way to start is by understanding your strengths and challenges, accepting who you are (self-love is key for this), and developing strategies to manage your ADHD symptoms.
This change will not happen overnight, but have faith and trust that your confidence levels can grow through targeted efforts.
Seeking professional help if you are struggling with this may also be a good avenue for support. Professional ADHD support, such as cognitive-behavioral therapy (CBT) and coaching, can help individuals learn tools and techniques to navigate their daily lives more effectively.
References
Barkley, R. A. (2020). Taking charge of ADHD: The complete, authoritative guide for parents. Guilford Publications.
Eccleston, L., Williams, J., Knowles, S., & Soulsby, L. (2019). Adolescent experiences of living with a diagnosis of ADHD: A systematic review and thematic synthesis. Emotional and behavioural difficulties, 24(2), 119-135.
Edbom, T., Lichtenstein, P., Granlund, M., & Larsson, J. O. (2006). Long‐term relationships between symptoms of Attention Deficit Hyperactivity Disorder and self‐esteem in a prospective longitudinal study of twins. Acta paediatrica, 95(6), 650-657.
Fischer, A. G., Bau, C. H., Grevet, E. H., Salgado, C. A., Victor, M. M., Kalil, K. L., Sousa, N. O., Garcia, C. R. & Belmonte-de-Abreu, P. (2007). The role of comorbid major depressive disorder in the clinical presentation of adult ADHD. Journal of psychiatric research, 41(12), 991-996.
Guntuku, S. C., Ramsay, J. R., Merchant, R. M., & Ungar, L. H. (2019). Language of ADHD in adults on social media. Journal of attention disorders, 23(12), 1475-1485.
Holthe, M. E. G. (2013). ADHD in women: Effects on everyday functioning and the role of stigma (Master’s thesis, Norges teknisk-naturvitenskapelige universitet, Fakultet for samfunnsvitenskap og teknologiledelse, Psykologisk institutt).
Houghton, S., Roost, E., Carroll, A., & Brandtman, M. (2015). Loneliness in children and adolescents with and without attention-deficit/hyperactivity disorder. Journal of Psychopathology and Behavioral Assessment, 37, 27-37.
Taylor, E. W., & Keltner, N. L. (2002). Messy purse girls: Adult females and ADHD. Perspectives in psychiatric care, 38(2), 69.
Mainali, S. (2020). Being an imposter: Growing out of impostership. JNMA: Journal of the Nepal Medical Association, 58(232), 1097.
Manning, M. A. (2007). Self-concept and self-esteem in adolescents. Student services, 2, 11-15.
Mastoras, S. M., Saklofske, D. H., Schwean, V. L., & Climie, E. A. (2018). Social support in children with ADHD: An exploration of resilience. Journal of attention disorders, 22(8), 712-723.
Modesto-Lowe, V., Chaplin, M., Soovajian, V., & Meyer, A. (2013). Are motivation deficits underestimated in patients with ADHD? A review of the literature. Postgraduate medicine, 125(4), 47-52.
Mylett, M. (2022). ” I wish I could just be myself”: Social camouflaging, internalized stigma, and internalizing mental health problems in adult ADHD.
Parker, D. R., Hoffman, S. F., Sawilowsky, S., & Rolands, L. (2011). An Examination of the Effects of ADHD Coaching on University Students’ Executive Functioning. Journal of Postsecondary Education and Disability, 24(2), 115-132.
Rasmussen, I. L., Ørjasæter, K. B., Schei, J., & Young, S. (2022). Rise and shine: exploring self-esteem narratives of adolescents living with a diagnosis of attention-deficit/hyperactivity disorder. International Journal of Adolescence and Youth, 27(1), 569-581.
Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 241-253
Scheel, C. N., Bender, C., Tuschen-Caffier, B., Brodführer, A., Matthies, S., Hermann, C., … & Jacob, G. A. (2014). Do patients with different mental disorders show specific aspects of shame?. Psychiatry Research, 220(1-2), 490-495.
Schubert, N., & Bowker, A. (2019). Examining the impostor phenomenon in relation to self-esteem level and self-esteem instability. Current Psychology, 38, 749-755.
Wang, K. T., Sheveleva, M. S., & Permyakova, T. M. (2019). Imposter syndrome among Russian students: The link between perfectionism and psychological distress. Personality and Individual Differences, 143, 1-6.
Watters, C., Adamis, D., McNicholas, F., & Gavin, B. (2017). The impact of attention deficit hyperactivity disorder (ADHD) in adulthood: A qualitative study. Irish Journal of Psychological Medicine, 1-7.
Webster, N. (2018). ADHD in adulthood: A qualitative study of lived experience, self-esteem, diagnosis and service provision in the UK. Published online.
