ADHD, Empathy, & Dopamine: A Study, Book Excerpt, and Definition

ADHD empathy dopamine
What can a published study — and an excerpt from my first book —  explain about ADHD, empathy, and the neurotransmitter dopamine? That’s what this post is all about.

You can also listen to the podcast version of this post: ADHD, Empathy, and Dopamine.

I started noticing a remarkable phenomenon 20 years ago. That is, stimulant medication, which targets dopamine, enhances empathy (or at least the ability to act on empathy) for many adults with ADHD. How is this possible and is it universal?  Nothing is universal with this highly variable syndrome called ADHD, but we can think about how it’s possible.

In This Post on ADHD, Empathy, and Dopamine

I’ll tackle the topic from three angles:

1. Defining empathy (it’s not what most people think — at least it’s more complex).

2. Excerpting a passage on empathy and relationships from Is It You, Me, or Adult A.D.D.?

3. Sharing details from yet another study pointing to a connection between dopamine and cognitive empathy (defined shortly).  This happens not because the medication creates empathy. Rather, the medication enhances dopamine transmission. Just as stimulant medication can strengthen innate empathy in some people with  ADHD. In other words, they have always possessed that empathy—but haven’t been able to reliably access or express.

This Post’s Sub-Topics

  1. Connection Between Low Empathy and Narcissism
  2. Empathy is Not Sympathy or Compassion
  3. Excerpt from Is it You, Me, or Adult ADHD?: ADHD and Empathy Regulation
  4. ADHD and Poor Empathy: All Take and No Give
  5. Stimulant Rx for ADHD Can Enhance Empathy
  6. Recent Study: Dopamine and Fair-Mindedness
  7. What About So-Called Empaths?
  8. Study Details: Follow the Money
  9. Boost Dopamine — Increase Sensitivity to Inequality
  10. Study Conclusion
  11. Two More Posts on ADHD and Empathy here at the ADHD Roller Coaster

low empathy and narcissism in relationships

ADHD, Low Empathy, and Narcissism: What’s the Connection?

It’s true that we can think of low empathy as fertile ground for narcissistic behavior. Trouble is, narcissism has been seen as a very poor prognosis—that it, it does not respond to treatment. That’s one reason I am sharing important research on that topic.

It is hard for me to over-state how commonly mental-health professionals see narcissism—or even Narcissistic Personality Disorder—where there is instead poorly managed ADHD.

This point is critical: Low empathy sometimes increases with ADHD medication.

Until individuals and couples—and mental-health professionals—understand this, the risk is a far more permanent label: narcissist. My friend Taylor J. wrote of her concerns about her daughter here: ADHD and Empathy: Was I Raising A Narcissist?

Empathy sounds simple. But it’s really a complex phenomenon. In fact, some people with ADHD have trouble reining in their empathy. They might call themselves empaths, as I explain below.  Stimulant medication often helps them, too. It’s all about the self-regulation:  not over-doing, not under-doing, but finding the middle ground.

Hang in there. The concept should become more clear as you keep reading.  And be sure to read the comments for illuminating first-person insights.

ADHD, empathy, and dopamine


Empathy is Not Sympathy or Compassion

We often confuse empathy with other behaviors—sympathy, kindness, compassion, and the like. Empathy is not those behaviors or traits—though it might accompany them.

The most commonly accepted understanding of empathy is this: the quality that lets us “get in another person’s head.” When we empathize, we momentarily step outside of our own needs, thoughts, and desires.  We contemplate what another person might be feeling.

There is a difference, though, between empathic and “relating”.

For example, if you’ve been in a bad car accident, for example, you are probably better able to relate to the experiences of other people who survive crashes. You “know how it feels.” But what if you’ve never been in an auto accident? What is the mental process that allows you to imagine what it is like for someone else?

That is a very simple example, but it is meant to drive home the point: Empathy is what allows us to imagine what another person is feeling, even if we’ve never been in that situation ourselves.

Moreover, empathy can allow us to step back from our own emotions, in trying to understand the mindset of a person who is disagreeing or even opposing us.

The cognitive scientists have terms for various types of empathy. But the one we’re most familiar with is called cognitive empathy. It simply means: Imagining how the other person feels and what they might be thinking. It’s also called perspective-taking. Walking in another person’s moccasins.

To Recap on What Empathy Is—And Is Not:

  • Empathy is not compassion or kindness, not exactly. And it’s not sympathy.
  • Contrary to widespread misperception, having empathy for a person doesn’t necessarily mean forgiving that person or letting someone off the hook.
  • On the simplest level, empathy is simply being able to “understand where that person is coming from. “


empathy adhd dopamine

Book Excerpt: ADHD and Empathy Regulation

Being able to empathize is key to successful negotiations, including in personal relationships. It can also help us understand why humans do some of the horrible things they do—and, with any luck, helping them to act in more humane ways.

Impaired empathy often destroys relationships where ADHD symptoms go unrecognized or unaddressed.

But deficits in empathy cut both ways in ADHD-challenged relationships. Typically, both partners become more mutually empathic, once they both start learning about the causes and varied manifestations of ADHD.

Consider this excerpt below from my book, Is It You, Me, or Adult A.D.D.?.  In it, I name “low empathy” as one of three common ADHD-related deficits that can derail relationships.

ADHD & Poor Empathy: “All Take and No Give”

“My wife seems to have empathy for movie characters, stray animals, or the grocery store clerk,” Alex offers. “But when it comes to her husband and teenage daughter, she often acts downright self-centered.”

Actually, empathy involves two sets of skills, according to [psychologist Robert] Brooks:

  • The ability to take the perspective of another person
  • The ability to understand and identify emotions

Yet, for many people with ADHD, the world can seem so chaotic and their focus so erratic, they don’t even know what they feel, much less what someone else feels.

Even if an adult with ADHD possesses both sets of empathic skills listed above, the person’s impulsivity or rigidity might obscure seeing the world through another’s eyes.

“And if a person is lacking in empathy,” Brooks adds, “he or she is likely to misread a situation and misunderstand the intentions of others. They often expect others to adapt to them, but they aren’t as willing to change themselves.”

It could be that change seems impossible—and the resulting feeling of powerlessness frustrates them even more.

empathy and brain

Stimulant Rx for ADHD Can Enhance Empathy

In general, we can’t assume that all humans are capable of “normal” levels of empathy. Empathy is largely a function of the brain, and we all have different capacities.

Treating ADHD with medication often enhances the ability to act empathically. Certain coexisting conditions, however, such as Asperger’s Syndrome, complicate the picture.

[Don’t worry! Elsewhere in the book, I address the empathy deficits in the partners of adults with ADHD. But remember, some of them have ADHD, too. Moreover, empathy distributes on a continuum among humans; there is no one-size-fits-all.]

Recent Study: Dopamine and Fair-Mindedness

The 2015 study from the University of California, Berkeley, isn’t the first to examine the effects of dopamine’s effects in the brain when it comes to empathy.

For example, 0ne 2014 study showed that gender plays a role in cognitive empathy. See The dopamine D4 receptor gene shows a gender-sensitive association with cognitive empathy: evidence from two independent samples. Interesting, eh?

This study bears particular relevance to ADHD because this D4 gene variant has been associated with (but is not exclusive to) ADHD.

Star Trek Empath Deanna-Troi
Star Trek Empath Deanna Troi

What About So-Called Empaths?

It’s worth noting: Women carriers of a certain gene variant (the 7R-allele) scored higher in cognitive empathy than female non-carriers.

I can’t help but wonder if this might explain the folks who call themselves empaths.   As far as I know, the only empaths are the telepathic Betazoids such as Deanna Troi on Star Trek.  But I see the term bandied about a lot these days, applying to regular humans.

What I’ve also seen around this phenomenon is “empathy” being used to emotionally bully.  In fact, no one can know for certain how another person is feeling. Sometimes being over-confident of one’s empathic powers—and perhaps having poor boundaries and trouble picking up signals in more direct ways—can lead to problems.

In men, however, those with the 7R variant scored lower than than men who did not have it.

The UC-Berkley researchers took a different approach in their 2015 paper, published in Current Biology: Dopamine Modulates Egalitarian Behavior in Humans.

Mechanism-of-action-of-tolcapone on empathy and dopamine
Tolcapone mechanism of action

Study Details: Follow the Money

Study participants, on two separate visits, received a pill containing either a placebo or a medication called tolcapone.

(Tolcapone prolongs the effects of dopamine, a neurotransmitter associated with reward and motivation in the brain. Stimulant medications such as Ritalin and Vyvanse also target dopamine; they slow the re-uptake of dopamine at the synapse, the gap between neurons. Tolcapone works a bit differently. This FDA-approved drug is used to treat people with Parkinson’s disease, a progressive neurological disorder affecting movement and muscle control, which are also affected by dopamine.)

This double-blind study of 35 participants, including 18 women.  Neither participants nor study staff members knew which pills contained the placebo or Tolcapone.

Dopamine Modulates Egalitarian Behavior in Humans.

Boost Dopamine — Increase Sensitivity to Inequality

Participants then played a game in which they divided the money among themselves and an anonymous recipient.

The result: Participants receiving Tolcapone divided the money with the strangers in a fairer, more egalitarian way, compared to participants who received the placebo.

According to the press release at the UC-Berkley website, “Altering brain chemistry makes us more sensitive to inequality”:

Andrew Kayser MD PhD
Andrew Kayser MD PhD, UCSF School of Medicine

By connecting to previous studies showing that economic inequity is evaluated in the prefrontal cortex, a core area of the brain that dopamine affects, this study brings researchers closer to pinpointing how pro-social behaviors such as fairness are initiated in the brain.

“We have taken an important step toward learning how our aversion to inequity is influenced by our brain chemistry,” said the study’s first author, Ignacio Sáez, a postdoctoral researcher at the Haas School of Business. “Studies in the past decade have shed light on the neural circuits that govern how we behave in social situations. What we show here is one brain ‘switch’ we can affect.”

The researchers also say that future research may lead to a better understanding of the interaction between altered dopamine-brain mechanisms and mental illnesses, such as schizophrenia or addiction, and potentially light the way to possible diagnostic tools or treatments for these disorders.

“Our hope is that medications targeting social function may someday be used to treat these disabling conditions,” said Andrew Kayser, a co-principal investigator on the study, an assistant professor of neurology at UC San Francisco and a researcher in the Helen Wills Neuroscience Institute at UC Berkeley.  See Kayser’s lab website: The Cognitive NeuroScience of Self-Regulation


This is a small study, one that remains to be replicated.

(I’m not sure what to make of the fact that it was jointly sponsored by the school of business and the neuroscience center, with funding from sources including the Defense Department.)

But the study adds to the increasing body of research around the role of dopamine and so-called “pro-social” behaviors such as fair-mindedness and empathy.

More on ADHD Relationships

You’ll find many more posts on Adult ADHD here on the ADHD Roller Coaster, from all angles, including relationships:

Breaking out of ADHD Relationship Dysfunction — After Not Breaking a Fall

Adult ADHD and the Automatic No — And Automatic Yes

What has been your experience of empathy as it relates to ADHD?

If you have ADHD, or if your loved one does, have you seen empathy impairments or enhanced abilities to empathize with medical treatment?

Or maybe you’ve seen something else entirely.

—Gina Pera


148 thoughts on “ADHD, Empathy, & Dopamine: A Study, Book Excerpt, and Definition”

  1. Tamara Connaughton

    This article provides fascinating insights into the intricate relationship between ADHD, empathy, and dopamine, shedding light on how these factors may impact individuals’ experiences and behaviors.

  2. Yvonne Conrad

    I stumbled upon this article while searching key words for ADHD and empathy; this is mind-blowing (in a good way), and I’ve read every reader’s comment and response by Gina.
    I must tell you that I cried alligator tears from seeing my lived experiences being described by total strangers and for the first time feeling ‘visible’, feeling ‘heard’, feeling validated and empowered.
    Thank you all for (re)telling my story through yours, and for unwittingly giving me the courage to persevere through a toxic three-year marriage to a man who was only diagnosed with ADHD at my insistence a year into our marriage at the age of 60 (by a $500 hour psychiatrist who doesn’t take insurance – and oh by the way, he kept ‘’forgetting”, despite gentle reminders to file the insurance claim after the visit; so (more) $$ down the drain) .
    We’ve spent thousands in co-pay with therapists not at all versant in ADHD – one even denying its existence in adults, which I believe has aided in my husband not “believing” he has it, and then layer in the stigma amongst many black Americans when it comes to issues related to mental health; triple-threat.
    Although it was recommended by our recent therapist that we each see a separate therapist who specializes in adult ADHD (VERY hard to find) , nothing has happened on his end, except delay, deflect, deny, disrespect, stonewall, unregulated emotions and the like.
    I feel sad, alone, hurt, isolated, disrespected, discounted, dismissed and depleted. Yet, despite all of that, I persevere; seeking information to better understand with empathy, ADHD’s impact on the neuro-diverse brain vs my neuro-typical one. I’ve attempted to share symptoms and their ensuing behaviors to help him understand but it’s unwanted.

    Gina, your perspective that “denial is complicated” and “not take his reflexive responses as his true perspective”, although difficult to handle, gives me some hope.
    I will definitely be poring over your recommended reading, to become even more informed.
    In the meantime, how do I (we) source for an adult ADHD therapist, and how do I get more information about your couples therapy sessions?

    Thank you SO much for blessing me today. It’s been a well-spent couple hours.

    1. Dear Yvonne,

      I love it when someone makes all this hard work …. worth it. 🙂

      I’m glad you found my blog, particularly this post.

      I hear you when you say:

      Gina, your perspective that “denial is complicated” and “not take his reflexive responses as his true perspective”, although difficult to handle, gives me some hope.

      It IS difficult to handle. And trust me, it’s difficult for me to say. Because sometime there’s…..blowback. In my face. 🙂

      Typically, this comes from people who just don’t know what I’m about, are unfamiliar with my work, and/or just cannot let go of what they know to be “right” (perhaps reinforced by therapists and the poorly informed elsewhere, including some ADHD conferences!) and prepare to learn something new.

      Living with ADHD — in oneself or a loved one — isn’t for lightweights! :-). It takes enormous intelligence and empathy to “get it” — and then to start working smarter, not harder.

      It’s so unpleasant when folks confuse my message with the pat messages found elsewhere — that it’s just a matter of “understanding” and “accommodating.”

      No, it’s not that simple. Unless you are trying to find your way to an early grave. That doesn’t serve the ADHD Partner, either.

      As the leading expert on ADHD and relationships worldwide, I know this topic better than the majority of therapists — often including those claiming ADHD expertise. I co-authored THE only professional guide to ADHD couple therapy. It’s based on the evidence of what works for Adult ADHD therapy and what works for couple therapy. Preeminent experts in both fields highly endorse our guide.

      I urge caution in seeking therapy. It truly can make things worse. That was true in 2008, when my first book came out (and featured a chapter saying as much). It’s even more true now, as there is more need chasing less supply.

      I created my online training to provide what Adult ADHD therapy, including couple therapy, should be providing. But seldom does. And to do it at warp-speed, cost-effectively.

      You can learn the details of Course 1 here:

      Here’s a Q&A blog post about it. Since then, I’ve released Course 2, all about physical strategies (optimizing medication and sleep, nutrition and exercise):

      Please contact me with any questions.

      take care!

  3. What I’ve read, on reputable websites is that people with ADHD tend to be MORE empathetic that neurotypical people. Where is the evidence that they are less so? Could you point me towards some peer reviewed articles or other sources please?

    1. Hi Cris,

      I appreciate the question. Yes, I understand why are you confused. The so-called “reputable” websites you mention are muddying the issue.

      Many pander to people with ADHD, telling them what they want to hear. These marketing lines have become so repeated online, they are accepted as dogma.

      They depict people with ADHD as clones — everyone alike. It’s ADHD vs the “Non-ADHD” wars. To which I say rubbish.

      The forces behind many of these sites seem to think that if they emphasize enough positives — a contrarian view of ADHD — well, something will happen. You’ll subscribe. You’ll buy their coaching, counseling, whatever.

      What makes you so sure, though, that they are “reputable” sites? Are you aware that a massive number of sites, including solopreneurs and commercial websites — even “non-profits” to a large degree — are funded largely by one ADHD pharma’s largesse (but not disclosed) — a pharma whose marketing message is “ADHD positives”? (They maintain it’s easier to sell their product that way, and they are quite profitable. But it does confuse people nonetheless.)

      I have a different approach: honesty and rigorous research. It’s an approach that emphasizes the enormous variability of this syndrome we call ADHD among the individuals who have it. No cookie cutters. It’s individual by individual.

      I actually do rely on the science — and, thus, avoid simplistic platitudes. I’ve offered a complex look at ADHD, empathy, and dopamine in that post—and since my first book’s publication, in 2008. Did you read the post? How about the comments? I could be wrong but I don’t think so.

      What have these other sites offered you in the way of the “peer reviewed articles or other sources” you are demanding from me?

      I based my writing on 25 years experience in this field and many solid sources, including what we know of the neurobiological issues associated with ADHD (e.g. impairments to higher-order brain functions such as empathy, conscience, reflection, etc.). ADHD symptoms themselves can make even the most emotionally empathic person extremely self-centered. Being “sensitive” is not the same as being empathic. Being emphatic is about perspective-taking — putting yourself in someone else’s shoes. It’s a rather complex brain function.

      There’s also clinical research and studies such as this one.

      It feels more like you’re calling me on the carpet for educating on a topic that few are willing to risk discussing publicly for fear of offending someone. Or, because they truly do not understand the complexity, much less know how to explain it. Or care.

      Here’s another post on empathy:

      I believe that people with ADHD and their loved ones deserve the most accurate and useful information I can present. I’ve never seen pandering help anyone. It only seems to prolong their suffering.

      Oh, and I’ve never accepted pharma industry support of any kind. It makes a difference.


  4. After my 7-year-old son was diagnosed with ADHD (ADD), his pediatrician told me, “Children like this grow up to abuse alcohol/drugs and go to prison.” That was 40 years ago, and so far, the prison thing hasn’t happened. I don’t think he’s even been arrested. I attribute this to his mother’s care and my absence. We separated when he was still an infant.

    My work excelled, but I burned every employment bridge I ever had. Interacting with others was strained and awkward. I tried to blend in, but my unacceptable behavior caused relationships to crumble and friendships to end. So many hurt. So many regrets.

    As a loner, I drank heavily for years.

    On December 13th, I became an octagenarian.

    My son’s pediatrician didn’t know I had done a couple of stretches in prison when I was in my early 20s, once in California and once in Nevada. He didn’t know anything about me, but my son’s prognosis could have been mine, and it would have all been correct.

    His ability to do this 40 years ago is stunning and reveals a great deal about ADHD.

    That’s what holds my interest now, educating our current legislature to show them the insidious nature of ADHD and its prevalence in our criminal justice system. A treatable neurodevelopmental disorder is running amuck, creating a revolving door of recidivism. It’s time we fix it.


    1. Hi Jim,

      Happy Birthday!

      Yes, I’ve long found it ….what’s the polite word for it….misguided to send so many people to prison who have diagnosable and treatable brain conditions.

      The prison-industrial complex has been making blood money from these unfortunate souls. It’s way past time for it to end.

      This book might give you some ideas…


  5. After being married for ten years I am just beginning to understand that my husband has ADHD, and just how many of our issues stem from it. His mom just told me that she always thought he had ADHD as a kid, after TEN years of confusion and not knowing if everyone’s marriage is so difficult, painful, and lacking in empathy.

    So I’ve been researching like crazy, learning so much and hoping to find anything that can help because I have been so hurt by these ADHD behaviors. He is very resistant to diagnosis and even more to medication. This idea of an inherent lack of empathy rings so true and leaves me feeling so alone.

    He is defensive at every turn. I have said, “It would be a comfort to me to know that you can understand why x could be upsetting to me.” His first response was that he didn’t do the thing I was referring to. His second response was to narrow his eyes and say, “you just want me to say that I did something wrong.”

    I then restated that I just wanted to know if he understood my point of view of the situation.

    I don’t think he is aware of anything but his own intense emotions, and I have sympathy for that, it has helped me understand so many intense situations we have been in. But can it excuse atrocious behavior? Is he less responsible for his actions than a typical person?

    I have read advice that blaming things on their ADHD and not on them is the way to a better relationship.

    Do I just have to laugh off bad behavior as “oh there goes his ADHD again!”

    I am worn out with managing his moods and irritability. I think he enjoys fighting, perhaps it gives a hit of dopamine or a rare moment of focus so he enjoys it? I am tired of the focus being on my understanding him and his adhd with no hope that he can understand and empathize with me.

    Thank you for this informative post. I want to read your book as well.

    1. Hi Rachel,

      I’m glad you found my blog. I do recommend that you read my first book—and consider taking my course.

      Trying to manage a spouse’s moods is a one-way ticket to depression and exhaustion.

      “Blaming things on their ADHD and not them is the way to a better relationship”? In a sense, yes. That’s why my book’s title is “Is it You, me, or Adult ADHD?” :-). But the “ooops, blame it on ADHD” thing applies only when someone is on board with diagnosis and strategies — not in the full throes of significant impairment.

      Confronting a spouse with poorly managed ADHD about each transgression or mistake is also a surefire way to trigger long-established defenses.

      Finding your way out of this depends on getting a solid education. (My advice: Ignore most of what you see online; it doesn’t come from people with true expertise in ADHD, only self-promotion.) It also likely depends on evidence-based treatment.

      Don’t expect him to just say, “Oh, great idea!” 🙂

      First, you need to get very grounded in what ADHD is — and is not. You need validation of your perceptions. And, you need to let a lot of this settle in your mind before even approaching him about an evaluation, much less treatment. That’s my time-honored advice.

      Moreover, the sorry fact is that we cannot depend on the average mental healthcare provider to help us. Including many claiming ADHD expertise. Expecting that truly can make things worse. Hard to believe but true!

      If we want to turn around our marriages and families, we need to get educated, validated, and start spear-heading the changes. It’s not fair. It’s exhausting. But it’s just reality, unfortunately.

      take care

    2. Hi Rachel, your response could’ve been written by me – with the exception that I’ve been with my husband for almost 30 years (24 of those years married).
      I am with you on excusing atrocious behaviour. The only thing keeping my husband out of real trouble now is that he has never hurt me physically.
      I’m new to this journey, and very grateful to have discovered Gina’s rollercoaster!

  6. Hi fellow readers 🙂 I was diagnosed with ADHD when I was about 7 years old I’m 20 now, and I’ve been on stimulant medication since I got diagnosed. Both my parents worked in the medical field and so I grew up with extremely caring parents and of course that means I learned the importance of having compassion for others. With ADHD comes sensitivity and I have always been a sensitive person, both physically and mentally, I can handle myself a lot more now but when I was little everything upset me, and of course my parents got upset with me sometimes but they always reacted to my feelings with an understanding of why I feel that way and they were able to put themselves in my mindset.
    As an adult as I’ve grown up with always being on meds and my extremely empathetic parents, I’ve developed a kind of superpower of empathy, that I’m very proud of, I help my friends through difficult situations and I’m able to be there for them when they need someone one. I know I don’t have an actual super power but it’s a trait that I have that I can say was developed through a combination of my parents upbringing and my medication and I think it’s one of my favorite traits in me 🙂

    1. Hi Olivia,

      Thanks for your sharing your story here.

      I bet that your empathy is one of your friends and loved ones’ favorite traits in you, too. 🙂


  7. Findingvthe terminology to explain the inherent abusiveness of ADHD behavior is difficult without a PhD… and perhaps even with one…. I finally concluded after 3yrs of toxic rollercoaster following a few weeks of lovely hyperfocus, where we fell in love, that the issue for my 50yr old unmanaged ADHD partner (diagnosed age 21 in college, but unaddressed—and long forgotten—after Adderrall got him through graduation), is that he cannot recognize others EXIST, perhaps cannot recognize the separateness of anything outside himself and his need from that other. person/thing.
    G-Rated example. After a horrible episode of lashing out and name-calling, we agree with trepidation to meet at a small restaurant, a safe place, as he always wants to look good, heroic even, in public, in front of family, etc. The restaurant unfortunately was very loud, Led Zeppelin blassting, only table offerred was large, near the open kitchen. We would have to yell to hear each other. I can’t eat, talk, or connect in that environment (expression of self, NOT criticism of him, after all, I chose the restaurant). I say, “Isn’t it loud in here, you’re way over there, let’s ask for that booth or get outta here.”
    Him, “No, you’re fine.” And that’s final, the man has spoken and he orders.
    Translation: ALL unwelcome communication (from me) is perceived as potential criticism/conflict. So in HIS mind, I was worried HE thought too loud etc. so he corrected me and shit me down.
    I exist too. I need to express MY needs and my experience.
    All I ask after an ADHD attack on me or a forgotten date, or failure to check the car work was done before paying the service, etc is that I be heard. He can then decide, later, if the cost to him to make a different choice NEXT TIME (and PROMPT himself to realize there IS a choice) is really a greater cost than the cost/pain experience avoided for me?

    This calculus never happens. It’s near reptilian striking out instead, lashing out, immediately, at near ANY movement or sound that he PERCEIVES could become criticism of his behavior. Any such sound on my part is cut off by a shutdown retort as above (so I suffered an hour of cacophony and a $120 dinner tab), or by an insta-tantrum which creates an impenetrable “wall of sound” after say the first 3 words of a sentence. Interruption is always chosen over listening. Always.. The interruption is usually an evasion, lame excuse, defense, etc.

    Like, after letting my dog out, unleashed, into a busy 4-lane street in San Francisco at rush hour because he “had no choice, [you] said let’s meet out front and he (the dog) wouldn’t let me put the leash on.!!! How was I supposed to know a UPS truck was there!!!”” This after terrifying outcome of my dog circling UPS truck in center lane of traffic (wanting a treat), an angry UPS driver, much honking, luckily my dog survived. I say What? There cpuld have been a bus? I don’t care if Santa Claus is singing outside the front door, he cannot go outside offleash! ADHD takes over, “I wish he WAS hit by a bus, you too you B/5(H!!.” All followed by fist pounding, and packing up and bailing (typical sequence of events). He cannot see there were other choices. Dog needs a leash to be safe but dog won’t let me put it on,. Stop, ask self, what can I do here? Go get Emily to ask her to leash him? Wait for Emily to come in? He absolutely cannot see there are choices.

    He’ll be an hour late to pick me up from the airport with no heads up. His excuse, “I COULDN’T call you (like, to let you know to grab an Uber to meet up later), MY KIDS were in the car, they FREAK out if I text and drive.” So, I felt abandoned at the airport on a holiday, a trip that was, again, designed to try to reconnect after prior unrepentant episodes of rageful name-calling over a failure of unmanaged ADHD. Like, hello, (1) pull over and text you’re an hour late then re-enter the roadway, (2) hand the 13-yr old the phone to do it, showing them how to be responsible when traffic—or poor planning—causes you to be late, (3) call and leave a voicemail using hands-free calling., again modeling respectful behavior for children.
    His children don’t trust him so he’s on eggshells on the (very rare) occasions his ex allows them to see him. Consequences of ADhD behavior in their marriage? No doubt.
    I could give 1000 examples of rude behavior, and after three years NONE of it has been apologized for except, after much battling, the cheating and lying about an existing friend-with-benefits when we first met, who he never gave up….

    On our first date, he casually me mentioned he “doesn’t do conflict well” after telling me he was divorced four years prior. Looking back, what I didn’t realize, is ANY sound from me, any action or event that isn’t easy or fun or simple = conflict. I cannot overstate enough that ADHD definition of conflict.
    Any unwanted intrusion to doing what he wants how he wants and when he wants is met with extrene anger—the defensive/offense armory comes out in a split second creating chaos and a wall of sound to prevent any words getting through from me. If I don’t immediately shut down my existence (needs, opinion, knowledge, ideas), he’ll block, deflect, avoid, bail, literally Uber to the closest airport and fly away.
    As if my explaining why I like something is criticism, why I would prefer something else is criticism. And most certainly after feeling emotionally abandoned, insulted, crushed, if I dare to explain why I feel that way when X happens, it is, by definition, criticism that must be prevented from airing at all cost. If it means burn-down-the-house rage, throwing things, police visit, etc.
    All I wanted was the opportunity to say three sentences, to provide insight into how his actions affect others, for him to ponder. Not to CHANGE him but to encourage learning about the ADHD default reaction, to encourage ADDING skills to try other choices… He will never let me finish a sentence…
    After 18 months of these confounding, hurtful, abusive experiences I racked my brain what this could be. My friends were yelling Narcissist, Get Out. His wife replaced him after 21yrs marriage with young kids, after carrying on a relationship INSIDE their home for a year until she was engaged, and he had NO idea, totally oblivious their marriage was over. Relying on my old theory that a man will always reveal on a first date what will kill the relationship, I relived the entire conversation, and I remembered, he did say when talking about his 6-year college experience, his mom dragged him to a therapist where he got an ADD Rx for Adderall.

    HaiGE red flag but I had no idea of Adult ADHD. I thought nothing of it—like most Americans, I associate the diagnosis with wiggly kids in school. In the 1980’s. When two working parents and latchkey kids had become the norm. But I was desperate. After 18 months of abuse, I googled “Adult ADD relationships.”
    OMG, it was us. It took months of the lamest excuses to finally get him to a therapist. I found the guy! He had a great blog that helped me. The therapist wanted him to bring me in and my ADHD partner wouldn’t. Initially he lied, saying the guy was no longer available or raged that it was none of my business, if I occasionally asked, Are you getting something from the sessions? Or, do you feel differently on the meds—I hear it takes awhile to fine-tune them? He had bailed. He had popped a few Adderaall then back to rude/rage/defensive/evasive abuse whenever I try to exist—be a different person than him with different desires, needs, sources of joy— in his presence (or on the phone). As if the opportunity to share in another’s joy, or help avoid another’s concerns, is not a great way to expand your own experience in life. Imagine never having the joy of seeing your dog get excited over a bone….

    Remarkably, he briefly joined a zoom ADHD support group where I believe they tried to pump each other up and he was told (I believe) “Never apologize for who you are.”

    He becane remarkably arrogant after that. My needs (or the first 3-4 words of a short paragraph needed to express them) were referred to as self-centered and arrogant. He’d fly off the handle at a PERCEIVED slight (like I like to add pepper to my eggs) and when I said it hurts that I can’t share myself (or half those words got out) he’d start defending himself screaming about how do I think he’s lived this long if he doesn’t know how to cook… and I beg for the yelling to stop. I’m still suffering six Friday nights in a row of him forgetting our date or not being available by phone when a flight is late and I need to adapt our plan, on top of every nane-calling not apologized for, neber talked about, and he’s screaming that he doesn’t need me to tell him about the anchor of my most-watched business news channel, screaming I must think he’s stupid if Indon’t think he can watch TV by himself, and the defenses are coming so hard and fast I eventually beg for the Wall of Sound to STOP. “See, this is the thing, it’s YOU who won’t listen!” To a bunch of lame defenses and excuses to an attack I never made? To a sentence I wasn’t permitted to finish?
    Exhausting. Gaslighting.

    After 3 years of abuse with absolutely defiant refusal to apologize, cheating on me, lying to me, avoiding any innocent question, raging at me for asking “How far out are you?” on a night he promised (but now obvioysly forgot) to drive to my home after work, and I’m cheerfully just preparing dinner on a Friday night,… Not mad. Not even atvthis point taking the risk of asking for an ETA estimate. Just hoping for a quiet evening and some miracle breakthrough—like a real conversation between two people, it never happens and I’m done.
    I think it’s a grave injustice to society to reinforce with ADHDer’s that they have no accountability for the effects of their behavior.
    After he threw a pie at me on Thanksgiving because I wanted to express a thpught about the stock market, he raged at me for 20-30 minutes, and when I said Jesus, you just abused me for 40 minutes at 90 decibels,” his response, “Get put of my house and go to get therapy yourself if you don’t feel good, and it was only TEN minutes.”
    Bam. His excuse—he says the toxic abuse didn’t last EXACTLY as long as I perceived it did.

    I’m done. It seems to me the ADHD brain works overtime to manufacture ANY excuse/reason, no matter how inane, to block out other’s existence, to avoid accountability, to avoid feedback, to avoid maturing, to avoid resoecting others and sharing a friendship, to avoid connection as a human being. No willingness to be himself yet ALSO where possible accommodate others where simple, easy, better choices abound. To create a win-win. Because the second win, yours, really doesn’t exist for him. He can not grasp that concept. There seems no trigger for “Uh oh, somethong is not what Inexpected; What are my choices RIGHT NOW?”
    Doesn’t happen. Just opens the door anyway, or starts screaming or keeps driving or lets dog out or enjoys sex offered by another woman, etc. whatever is in front of him AT THAT MOMENT.
    Sorry state of being for a 50yo intelligent man who can be funny, takes amazing photos, cooks a great breakfast, and will do ANY favor you ask, except acknowledge your existence by LISTENING to your experience or feelings and considering them in his choices. It seems clear this is because outside of his beliefs about himself—like being a hero for cleaning your gutters—you truly do not exist as a separate, easily delighted being…
    I hope you can find a way to show ADHD adults that’s a lonely, unfulfilling way to live.

    1. Hi Emily,

      I appreciate your experience — and taking the time to detail it.

      You wrote: I hope you can find a way to show ADHD adults that’s a lonely, unfulfilling way to live.”

      For 20 years, I’ve worked to show adults with ADHD and their partners that there is typically a better way.

      But I’m not sure I’m the arbiter of what’s a fulfilling life. 🙂

      It sounds like the death knell came with the Adult ADHD group that, seemingly, traded in narcissistic supply.

      While a certain amount of self-acceptance is wise, promoting denial because there’s nothing else on offer seems…..deceptive and lazy.

      If you haven’t read my Adderall post — or my first book — you might want go do so now. They will probably explain a lot.

      take care,

    2. Wow, the person you are describing sounds to me like they are, in addition to having ADHD, also suffering from some form of narcissism. Or rather they are causing you to suffer from their narcissistic behavior. I know that is not a term to use lightly, but as someone who has suffered through narcissistic abuse, I believe that really might explain what you have experienced. If you haven’t already read about it, I would suggest it. It might help you. I hope things are better for you now then they were when you posted.

    3. Hi Bo,

      ADHD is associated with higher risk of narcissism.

      As I wrote about in this post, empathy is often impaired with ADHD. Poor/Low empathy is the foundation of narcissism — a poorly defined term that covers a lot of territory.

      This all presents a gray area that’s difficult for many people to navigate. Narcissistic behaviors will improve in some people with ADHD once they start treatment. Some will simply become more adept with their narcissism. All kinds of possibilities.


    4. I am ADHD. I have had 10 narcissists and my last one was a LTR with a covert narcissist was particularly abusive so I know the difference. She sounded a lot like your partner, same tactics. What you’ve described are not solely (or even largely) adhd issues. I’m basically an expert on narcasistic abuse. You need to get out of there. You’re in a toxic narcasistic abusive relationship and he will never value or hear you, it will *never* change. As long as you keep trying to make him see, you’ll continue to have hope and you’ll keep allowing him to abuse you. Go to reddit r/npd and hear what the narcissists there have to say. Learn as much as you can through YouTube/books/support groups etc. get therapy to address codependency and heal or you will continue to attract the same type of partners But by all means, gtfo.

    5. Thats not ADHD at all. Plenty of men like him doing all that who aren’t ADHD. None of what you described there covers anyone I know with the condition. What it does cover: narcissistic abusers and people with a lack of character / morality and toxic people. This isn’t the place to blame your relationship choices and vent. That’s what therapy is for. No disorder should be used as a way of justifying or condoning abuse. People with ADHD don’t need to read this monologue of a dysfunctional relationship which you persevered with. That’s for you to go explore why you spent 3 years with an abusive and toxic man. Its nothing to do with ADHD.

    6. Hi Mollie —

      I’m curious. How do you know what ADHD is and isn’t? How many people do you know who have ADHD? How much do you know about the genetics, about impairments to higher-order brain functions….such as the research examines in this post?

      Nowhere did Emily claim “all people with ADHD do this”.

      It is quite common online to talk about “the ADHD brain” as if it’s a monolithic “tribe” of people. It’s not. In the U.S. alone, it’s 10-30 million individuals with variable manifestations of this highly variable syndrome. With all the rest of personality, background, education, etc. to consider.

      No one is condoning abuse. Including the kind that happens online when strangers feel a need to invalidate a vulnerable person.

      No one made you read her comment. It wasn’t there for you. It’s there for her — and others who might relate.

      “This isn’t the place to blame relationship choices and vent,” you wrote. Actually it is.

      This has nothing to do with you. If you have an opinion, you can share it without discounting or blaming other commenters for their situations.

      I leave your comment here only to show the subtle forms of bullying that come from some people who might have ADHD but who know little about it beyond their personal experience, yet still find it necessary to invalidate the experiences of others.

      I have a no bullying policy here.


  8. Josephine Scherer

    Hi Gina
    I have really identified with what has been recorded from other people’s experience of what it is like to live with people with ADHD
    I had a partner of 17 years with ADHD
    who I separated with when my son was 4 years old
    My son also has ADHD
    I have only concluded this in the last 2 years
    I am now 71 years old and still looking out for my son and waiting for a diagnosis
    I am exhausted with all the drama and disruption ADHD has caused me for the last ,50 years and 39 years for my son and 79 years for my ex partner
    Who I have just informed and he did not know about ADHD although he asked me why I had not told him before ?
    I believe he recognises the devastation it has had on relationships
    It is such a relief to have so many people have the same and similar descriptions and experiences of living with relatives with ADHD
    I really thought I was on my own
    So many people outside of these relationships do not understand because people with ADHD can come over as attractive confident charming the joker happy ect
    I am going to get your books
    It may be a little late in the day for my my ex partner and myself except hopefully I have and will get to understand my son a little better through from all the information on your sight and in your books
    I hope that my son can get same relief and also my grandson who I also believe may have ADHD
    If I am successful in getting my son the medication for ADHD he has been on a waiting list here in the UK for the last 2 years
    Will it work?
    I am at my wit’s end as I continue to try to help my son and hopefully my grandson
    I myself have dyslexia so I am sorry if this is all a little hard to decipher and understand
    Thank you ,thank you for helping me to realise I am not on my own and not going mad
    At least their are other people who understand
    I just hope I can now help them and myself Best wishes
    Josephine scherer

    1. Dear Josephine,

      I’m so grateful that my work has helped expand your understanding of ADHD — and, I hope, make a real difference for you and your family.

      I find your words absolutely clear, nothing to “decipher.”

      Granted, 71 is a bit…advanced….to be learning about ADHD. But a man who just completed my first course is 72, and just started medication treatment after finally being diagnosed. He is having a strong positive response to the medication.

      Everyone presents a different case, however. This man is particularly healthy and fit. No complicating physical conditions.

      For some people, living for many decades with undiagnosed ADHD means they suffer from chronic sleep debt, “self-medicating” habits (food, substances, etc.), destroyed relationships, under-employment, and more.

      It really just depends.

      I do encourage you to read my books and consider taking my course. Or for your ex-husband to take it. Videos are more relatable than books for some folks with undiagnosed/untreated ADHD.

      Moreover, many people are really enjoying the opportunity to meet and speak with others, during the course option that come with 6 Zoom Q&A sessions. With me and other course participants.

      Solving Your Adult ADHD Puzzle — for Couples and Individuals.
      COVID has definitely amplified ADHD-related challenges for MANY people — even as it’s made evaluation/treatment harder to come by. In the UK, it was hard before COVID.

      It will really behoove you to be educated about how medication should be approached (see my first book), to prepare for your son’s appointment. We just cannot count on the average prescriber or even some self-proclaimed “ADHD specialists” to know what’s what. And yes, teamwork is the best approach.

      How will some professionals feel about a young man’s mother being involved? The truth is, they should be asking for third-party feedback — a spouse, family member, close friend. But they often don’t. If your son asked if you could be included, it would be easier. Just a thought.

      take care,

    2. Josephine if your adult son is still waiting after 2 years for NHS treatment, it’s a common problem, especially during the COVID pandemic.

      My advice is to search online and find a private clinic specialising in ADHD diagnosis and treatment which could offer an assessment for your son, the fees vary somewhat so you may need to contact several.

      It is crucial that you first ask any doctor or clinic involved in diagnosis to confirm if also licensed to prescribe ADHD medicines, if not, look elsewhere.

      Your son could be assessed within days and following a treatment plan soon after, with follow up appointments to assess if the medicine is suited to his needs, or if alternatives may be preferable.

      After some months you could then ask an NHS GP to consider prescribing medicines on the NHS following the prescription regimen confirmed by the private consultant (not all GPs will do this so your son may have to find an alternative NHS GP).

      I have never had a need to previously consider private treatment for myself or my family but in the case of my son with ADHD in the first year of university study it was an absolute necessity. He is now able to continue at university and is so very grateful for the diagnosis (at last) and medication which are helping him to pursue his goals and bring some considerable degree of stability in his life.

      Diagnosis and ADHD medicine are just the beginning, after initial treatment your son would likely still benefit from further consultation with NHS specialists when available to him at some point in the future.

    3. I have ADHD myself and I’m 67 years old, meditations do help a lot with my attention span and aides with completing my over thinking brain. I also have undiagnosed dyslexia, I think your statement is very understandable, also both your son and grandchild will do a lot better once meditations become available. Good luck from Minneapolis Minnesota.

  9. I have spent hours reading this site today.

    My husband and I are in couples therapy (EFT) but it just is not making any difference at all. He has untreated ADD, he’s 44.

    I am practicing and he just is not. Just like our last therapy, which then reinforces he cycles we go through. Our therapist said he is ADD informed, but I realise from reading today that our entire cycle is centred around ADD and we are treating it all as attachment based cycles. I have realised so much today!

    Why he blurts out such awful things at really vulnerable moments for me. I lost my job and he said ‘I wouldn’t have moved in with you if I’d have known you might lose your job’. I was paying most of our rent at the time due to his debt.

    I have wanted to understand the WHY of him doing these weird things when he’s such a good kind person. I think I found my answer today.

    He can’t fathom cause and effect so he repeats the same mistakes, forgets promises and breaks his word then defends that as he’s smart as hell so can justify anything, he always has music playing in his head and I’ll say something and he will reply with a line from a song, work drains him totally so he flatlines in front of the TV for the rest of the night, doesn’t come to bed with me as he stays up until 2am, loads of empathy for TV characters but cannot attune emotionally to me, has an automatic no, has OCD, bait and switch hyper focus for the start of our relationship, he can’t plan, can’t finish tasks, 0 to mega frustration and anger in 2 seconds and just gets stuck repeating himself over and over in a way that used to alarm me as it was like a stuck robot and I would get frightened by the lack of human connection.

    He is a beautiful human being with wonderful traits and heart. But this is serious and couples therapy has made me put so much emphasis on me not reacting to him, understanding he is protecting, doing all the work…..but that isn’t going to work I realise now.

    I’m going to get exhausted and it won’t be healthy. We are equal partners and I don’t want him to work ‘harder’ as he’s clearly working his ass off coping in all these ways he has learned to.

    I will read the books and see if there is any better way to suggest assessment/help. I have done before but he said he doesn’t need anything as he likes how he is. I respect that – but it is hard to explain that his ADD impacts me as he has no awareness of it, and has such sensitivity to perceived criticism.

    His daughter now realises she has it too so I hope he can model for her what it’s like to work with our innate processing differences from empowerment not shame. Easier said than done. But I want to see if I can support him to get there. Thank you SO SO SO much for this incredible resource. The time and expertise in here is mind blowing. I appreciate you. N x

    1. Dear Nadia,

      No matter how many times I read “Wrong Therapy” stories, they still make me cringe.

      It’s nothing less than a public health DISASTER.

      Then, even if by some miracle, couples happen upon a truly ADHD-savvy couple therapist, they must then identify a prescriber who won’t throw Adderall at the ADHD partner.

      These problems in the mental-health system are deeply entrenched and insidious. When mental health workers rely on Psychology Today PR pieces by self-promoters, the various “health” sites that milk ADHD “keywords” to boost their traffic, when one pharma has way too much influence over what we see online….it’s not going to end well for individuals struggling with these issues.

      I encourage you to learn all you can. Read my first book. The more you become educated, the less of a block your husband’s apparent “denial” can be.

      Denial is complicated. I would not take his reflexive responses as his true perspective. He might want help but doesn’t know how to get it, is afraid of medication, afraid of being diagnosed “crazy” and so much more. It’s why I devoted three chapters to denial in the book.

      Soon, I will launch my online training. I am well and truly exhausted but this will be a game-changer for individuals and couples. If you’re subscribed to my blog, you’ll receive notification.

      Solving Your Adult Puzzle — Including in Relationships

      Best of luck to you two. You are on your way!


  10. Hello,

    Thanks for your response. I agree with absolutely everything you’ve said. I actually realised my impulsivity got the better of me when I wrote that, I feel a lot of it and have nowhere really safe to put it. But I also believe entirely with what you are doing and saying… I do want to really drive home how absolutely valuable your book is.

    I am just terrified daily, about (as you say touch on) the fact that my experience of therapy, and seeking help, was so utterly traumatic and I believe uninformed, as well as the awareness and popular opinion I’ve met on the other side. I understand completely that we must not do the narcissistic supply thing of stroking egos with giftedness, or create an expectation that partners must shirk their needs to appease dysregulated, forgetful other half’s. I wholeheartedly believe this is all true.

    And… that shirking your needs, was my realty growing up, as I say I strongly believe both my parents have ADHD, (and can see it in past partners so also know the feeling from the partners side of being ignored etc) my childhood was one of double standards and confusion, but paradoxically sensing somewhere that everyone was doing their best… and then I met therapists and experienced these growing societal narrative around narcissism which initially perpetually eroded my faith in almost everyone around me and in myself… And I’m so scared of this… lack of nuance. Stephen Covey says, ‘you have to believe in the people’ and its something I hold in my heart… I chose to believe there is a grain of good, and a want to be compassionate and empathetic in almost every human being… I get lost at the point of psychopathy, and i’m still on a journey of learning and growth.

    But knowledge about deficits in the brain, and neurotype have helped me see the best in people. All people. I might not be able to cope with ever type of person, all the time, day to day… but I can process our exchange… and find their way of relating… and appreciate the good that exists in them and see where they are coming from, if not in the moment, then when I step away.

    My reality, I felt, was the opposite yet the same as yours, rather than having to deal with someone who was dysregulated when I was not, in my romantic relationships (though yes this happened and in my childhood) I moreover felt a pressure to hide and curb myself, which of course you are aware of… I felt exactly that thing of having to deal with other peoples emotional landscape, prioritise them, and meet them where they’re at, I felt the onus was on me to change, and I could only manage it for so long, until I would break and become dysregulated. I now have insight and hold the core value, that has existed in me since childhood that I expect no-one to accommodate me in the sacrifice of their own needs, only to meet me somewhere manageable for us both, and communicated in a way that we can manage together… and journey together towards improving that… and I know that’s what you are all about and giving to people.

    I hope so much my words were not exhausting (and these, conciseness still my area of feeling at odds with the world)

    But … I am myself exhausted on an inherent soul and body level. By the collective unawareness, which you are cutting through as best you can with the relative blunt knife available… the problem needs a chain saw! So I thank you for that. I very likely did write, from a place of emotional knee jerk pain… and I totally invite and am glad you held your ground in your response, it’s what I want for all people… I thought I would share a piece of prose. To say how traumatic I have found my experience of being me, of trying to seek help, and of feel mislabeled in my life:

    “You know in school when a popular kid engraves something horrible about you onto a desk… so the whole class can see, and it becomes some sort of collective shared truth, that lives both at war inside you and as fact in everyone else who sees it…

    I think being misread or misdiagnosed by a therapist, or judged due to popular inaccurate and outdated stereotypes, feels the same…

    Due to the power, and importance of these experts and their ideas and the prevelence of them in mass social awarenss… it’s like these notions about what you are at your very core, have been carved onto the fabric of the universe…

    … a place it should not have been written, and deep down, both you and the universe know, it was not meant to be carved there, the assessment was dehumanising, crude and lacking in compassion

    … the universe does not think you are that thing any more than the desk did… it is not a fundamental truth, but the population of the world will see it that way, they will interpret everything you do through that lens, just like the class did, and there’s nothing you can do about it…

    If you try to defend yourself, or prove your self, change yourself or choose yourself, whether you keep to yourself, or try to make connections and friends, it is pointless, anything you do will only affirm the carving… so, you are stuck with it, it is almost impossible to move beyond the identity you’ve been given without inadvertently reinforcing it, it is with you in every moment, it is branded onto your very soul, even though the act of branding you… defies nature, it has already been done… so it might as well be true”

    Thanks for all you do, for your patience and thorough enquiries, I’m still on my path, with an open mind and heart… the first step for me is knowing I don’t know… and from that I will keep learning x

    1. Dear Amy,

      Thank you for understanding my intentions.

      I find you express yourself beautifully and sensitively. Writing is not easy on any level, so I admire that.

      I am about to launch my online training — many years in the making. For too many years, I’ve fielded e-mail and blog comments…”can you refer me to someone.” Too often, I cannot. And even when I can, too often, I’m disappointed in the experience they report.

      Dr. Robin and I spent 4 hard years producing the couple therapy guide — years that were largely uncompensated given the nature of clinical guides (not blockbuster sellers….but this one is doing far, far better than most).

      I regret not “taking it to the people” earlier. Therapists aren’t exactly falling over themselves to learn and practice the rigors of Adult ADHD-Focused Couple Therapy .

      But I do things the old-fashioned way: I work extremely hard and responsibly to earn my credentials.

      Stay tuned for notice of the launch. Within days.

      Limping to the finish line…..

      take care, Amy,

  11. Hi, I’m listening to your book. I absolutely loved it but the bit about ADHD and empathy really felt, scant, slightly ummm, how to say un-responsibly handled in comparison to the rest of the book … and… well a bit un-empathetic… (I know its not coming from that place but it scared me… as i want to share this book with non ADHD people so we can both be on the same page more… I yearn for a more mutually empathic world)…

    Once upon a time I wouldn’t have said those negative comments here… for fear of upsetting you… I feel things very strongly… I hate the idea of hurting others… and while I know confusing my own experience of hyper sensitivity with empathy (which I have done in the past) (rejection sensitive dysphoria has helped me understand myself and others in my family) … I know my past habit of thinking I was protecting people from feeling rejected, by avoiding saying certain things that might hurt them, and confused this with being empathic (it both is and isn’t) like you said having had an experience and relating is not empathy…

    But I think caring enough to try and protect others … is a clear sign of the roots of cognitive empathy. And something that is core to who I am is wanting everyone to get along and feel happy and understood, (dysfunction was rife in my family growing up, adhd has given it context… but as a result the very heart of what makes me tic is wanting to understand what makes others tic, to avoid miss-understandings). But when others couldn’t understand me, or didn’t want to share… in the past this is where I seemed un-empathic to them in my overwhelm, because I couldn’t let it go… ADHD re-frame… I wanted us to explain every inner working of our mechanics, get it all on the table and find strategies… I was begging for mutual empathy… but it was making others see me as un-empathic… maybe they wanted space, or they couldn’t speak as much as me… etc… My intentions were there but my methods were from my perspective… An ironic and painful bind for me… that i’m moving past with the deep work I’ve done. (though conciseness is still a challenge so apologies for a long message).

    I have been reading much more about the Double Empathy deficit and as soon as I did, it was so familiar to me… it was the thing I’d known was there but no-one else did, when I tried to explain, during misunderstandings. I think it relates to ADHD just as much as ASD.

    You say you go onto discuss partners, and their inability to empathise with ADHD, in your book (impulsive so writing this before having got there yet)… But that brief intro to people with adhd regarding lack of empathy was for me the low point of the book… it left me feeling cold, and yet again unseen and unsafe, a feeling at odds with the rest of your book… which has has me smiling laughing and nodding…

    The internet and culture in general is literally smeared with links between low empathy and ADHD as well as other conditions (many that form when adhd is not diagnosed and treated like ODD and BPD)… And the more I research the more I really feel that this double empathy deficit is at play. But that too many are getting out their toxic people and narcissist stickers and slapping them on people… therapists included. (an ironically un-empathic and narcissistic thing to do?)

    My fear is that as a culture, who is only just learning about psychology, neuroscience etc (a field in it’s infancy) we’ve therefore got so much catch up to do with deeper understanding and nuance of people, their behaviour and importantly their intentions (we are like a world moving from, the world is flat, to OHHH it’s round, in our sophistication of ‘getting’ human nature)… I think that anyone seeking to represent the confusion that ADHD can cause… could take real OTT care to go into AS MUCH detail, or really spell out, as clearly as possible about empathy strengths of people, or of many people with ADHD to protect them from the stereotyping that, merely gliding over the potential and existence of empathy in an ADHD person, reinforces with an often ignorant general public (who have their own lack of cognitive empathy when it comes to difference) I think great care needs to be taken not to fuel this ignorance and the stereotypes that stop people being seen, and hinder mutual empathy.

    To highlight an example of how empathy lives in me… I am called super Nanny by my sister, I can pacify children and old people like no-one else. Screaming overwhelmed excitable kids, leave them with me and they’re calm and focused, seen and heard. They don’t want to do their homework? I’ll make it into a game show… this is why I always identified as an empath… and I do believe you need deep empathy to relate to children… but the funny thing is… children and elderly people are two populations who are facing their own executive function deficits, something I inherently can empathise with… and before learning about ADHD, these groups always made more sense to me than other people. But, I don’t just understand them I can feel them… every thought I can guess it and I know what to say to make them feel understood… and with children, I protect them too, from the confusion and judgement I grew up with.

    Similarly a grieving, distraught person, I get that… it’s how something I can relate to… but… here’s the kicker… when I need those people to get my overwhelm, they often told me my lack of ability to calm down is a lack of empathy for them… ummmm?

    But (brain scans are showing that actually the bits of the brain needed to calm down are impaired… so, them asking me to calm down, isn’t it a bit like me asking someone with a broken toe to stop limping… I mean don’t get me wrong I have calmed down in the past, more often than not, by forcing a behavioural shift… but not by altering or tending to my internal needs… so instead by totally disconnecting with myself… not because I was actually calm… But I empathised and heard their needs, internalised the shame… and I damaged myself in the process, and when that got too much I periodically couldn’t calm down, and at these points others told me I was not empathising (or implied that essentially)…

    So non ADHD people in my past, as well as people with adhd traits that clashed with mine (again adhd reframe, I think both my parents have it… and this has helped heal rifts)… so, e.g, someone being hyper when I cant process etc and visa versa caused misunderstandings … and as I hate misunderstandings I would get deregulated and find it hard to be able to let things go, I hyper focused on wanting to fix it… so would seem un-empathetic to them… and they to me; The double empathy deficit…

    But even at my most distraught… I always felt and thought about what they were thinking and feeling… it’s just that often, knowing what I knew about myself and my reasons for doing or not doing things, I felt that their reading of the situation and of me was … wrong and unfair. I knew what I was up against, even if it didn’t have a name… and they were telling me I was bad.

    This of course… would make me hurt…

    what I needed to know was it wasn’t their fault they couldn’t empathise with me, and they needed to know more about what I was experiencing…

    Seeing impairment, before behaviour…

    In order for me to be able to act upon my empathy this stuff needed to be there for us. For me, it was a sense of injustice that at times (when my emotions got too much) stopped me being the bigger person, (though I tried as often as I could) a weight that felt like it was always expected of me.

    If you feel you simply have a crap brain, and someone is shaming you for forgetting their birthday (just an example), when you’ve been reminding yourself all month that it’s coming, due to fear of hurting them, but still manage on the day not to remember, caught up in the chaos of your difficult undiagnosed ADHD life

    … and yet you’re always letting them off the hook for the sorts of mishaps you yourself make (because you’ve reasoned that’s empathy)… then it’s going to put a dampener on your willingness to act on your empathy in that moment when they tell you you don’t care about them. And when the same sorts of misunderstandings happen in reverse the same is going to happen… Now, with insight… I can say, im so sorry I tried to remember all month please know I care very much, and I totally understand why you’d assume I don’t… but really its my brain, not a reflection of how I feel… the efforts i’m making to attempt to overcome my brain deficits are the reflection of how I feel.

    ADHD awareness allows me to know what’s in the room… what’s gone wrong… and tell the other person… but I always empathised… I just knew that doing so, without any one acknowledging my side, left me on the back foot…

    I spent a long time in really damaging therapy being (after a lifetime of this already) labeled and clearly read as un-empathic… I have daily ruminating memories of this and feel deep pain about that therapy (I was re-traumatised by it). The psychoanalytical style of it (where they did that blank faced mirror technique) left me terrified and dysregulated… But I was still feeling them, feeling every inch of their micro expressions, searching for them, seeing them as feeling people within their eyes, even when they were trying to look blankly at me… I wanted shared empathy, but with no context of who they were as whole people, or why they were staring stone cold at me, and the echoes of authority figures judging me from childhood… I had no chance of empathising with them (because they were being intentionally ‘neutral’) so I had nothing human in the interaction to ground me… I now know DBT which is often used with ADHD patients speaks against all the methods they used… as does trauma therapy…

    So it feels unfair… that I came out of that therapy i’m sure with endless notes about a lack of empathy and no hint of them seeing or explaining to me about ADHD —-

    me: ‘sorry I was late, I got up early but just before leaving I had 10 mins to spare and I zoned out, I have no idea how it happening… then I ran all the way here’ Therapist: ‘ a part of you clearly didn’t want to be here’

    me: ‘can you please send me that regualr appointment time YOU re-arranged for another time, by letter so I don’t forget it’

    therapist, with short voice ‘I think you are more than capable of getting a pen and writing it down’ (implying I was being entitled)

    And my subsequent reactions to this, getting overwhelmed and crying – i’m sure was noted as a further lack of empathy

    Only… the whole time I was well aware and analysing both cognitively as well as sensing them, tone of voice, expressions etc… I was empathising, putting myself in their shoes… but that was the problem I empathised that they didn’t empathise with me… I thought I had a condition that no-one had discovered yet… I couldn’t understand what was going on, I never knew what ADHD actually was! And then I did… and then it all made sense… But it took me hell bent on working out what was causing the double empathy deficit (not my therapists) they assumed it was me lacking empathy…

    so… what was missing then? if it wasn’t my empathy…

    here’s what I think:

    knowing why they weren’t understanding me… (the double empathy deficit)

    An ability to communicate the misunderstanding (eg… saying, I know you might feel I am being rude… but I am asking for you to send a letter, because the appointment is over a month away, and I will just have to hold the appointment time in my head by obsessively ruminating on it everyday, in order to attempt to remember it, and still… I might forget, which causes stress and shame, and I also can’t trust myself not to lose the paper I write it on, or forget that I saved it on a note and even if I set a reminder for everyday in the week running up I might not even look at it when my alarm goes off, by habitually swiping it away… but if you send me a letter the event will be more memorable and official and that will help me remember etc) (I now have tools and other ways to take notes of appointments… but at the time I was lacking adhd tools or awareness…) I was doing my best…

    SO, in the absence of tools, and with a brain prone to dy-sregulation, the inability to calm down, in perceiving being miss-understood was an ever perpetuating barrier to… caring more or equally about them… than me in that moment of overwhelm…) and please know i’m someone who literally forced myself to keep my emotions inside with many people, by detaching, much of the time… but later crying in the toilets or being so exhausted I had no life etc… to the point of breakdown.

    I know what you wrote regarding empathy… wasn’t intended negatively. I see you have the line about ‘some with ADHD have a problem reining in their empathy’ but I do think there’s an issue in all this. I think it has to do with the responsibility of knowing the audience, and society as an audience don’t have much time for seeing ‘lack of empathy’ as nuanced… which is ironic…

    I wonder if for me… it is in SPS, I believe I have ADHD and also the SPS trait… (ive seen people say sometimes SPS looks like ADHD but I have too much literal ADHD symptoms for that… But I think they create a tug of war in me… and I want it to be known that its a lonely place to be in what I do view as a world lacking in the right info to create better mass cognitive empathy much of the time…

    … and even lonelier when you think professionals, will label you with just the right label, for an ignorant public audience to write you off… or If new doctors see notes, that say anything related to ‘low empathy’ I’m doomed before we’ve started our interactions… if someone reads about ADHD and no empathy… and I try and get on the same page by saying hey I have ADHD… again I’m doomed before we’ve started… so I think its an area to tread really carefully in… people need to know it’s complicated, but they need that spelled out and they need to see its a two way street, and they need that spelling out… Simply brushing past it, isn’t going to get it in many peoples’ heads. it’s going to take time, and I think people like you can champion that much needed space to say ‘its complicated’ so more people really hear… x

    I do thank you for your book though xxx

    1. Dear Amy,

      I appreciate your taking the time to thoughtfully detail your reasons as to why that few paragraphs about empathy in my book didn’t sit well with you.

      I do understand. I have been the beneficiary of much kindness from my friends who have ADHD.

      Did you read L. Frieson’s essay here? I think you’ll find it speaks to the spirit of your comment here—and “Double Empathy”.

      I am too tired to make this short, but I felt you deserved an answer as thoughtful as your comment.

      Here goes!

      My Mission

      One reason I took up this mission is the thought of vulnerable people affected by ADHD people seeking mental-healthcare. “Luck of the draw” doesn’t begin to describe it.

      I imagined these people, alone and confused, seeing therapists and psychiatrists who would project onto them all kinds of harmful psychological narratives. I’d met these therapists and psychiatrists when I ventured into early psychiatry discussion forums.

      For twenty years, I have emphasized self-education and self-advocacy. Most people don’t want to believe it….they even get angry when I suggest it….that the average therapist knows little to nothing about ADHD. Same for prescribers. But that’s the truth.

      Requirements for Understanding ADHD: Intelligence and Empathy

      I’ve always said it takes enormous intelligence and empathy to begin to understand ADHD. And that is what I’ve always tried to bring to this topic: intelligence and empathy — and a keen ability to navigate gray area.

      ADHD is a highly complex syndrome — though we’d never get that from most of the Internet. A major marketing strategy is to maximize site traffic by using the popular keywords that lump all people with ADHD into one stereotype: ADHD Brain, Rejection Sensitivity Dysphoria (a blog post topic for another day), etc. (I’ve seen the data when I finally analyzed my site’s traffic, in comparison to others on Adult ADHD. Shocking. And the public largely has no clue.)

      I believe if you go back and re-read the passages on empathy, you’ll find that I wasn’t being un-empathic but truthful. I do believe that truth is important. So did the top ADHD expert I quoted in that chapter, Robert Brooks, PhD.

      Many adults with ADHD have told me that my book provided a much-needed breakthrough about empathy. For one, they finally understood the lifelong criticism of “You’re not empathic” — and understood that maybe treating their ADHD could help with that, along with overall ADHD symptoms. Their loved ones also wrote to thank me for helping them to better understand adults with ADHD.

      Moreover, I did indeed explain in the book, again and again, that ADHD is a highly variable syndrome.

      The Importance of Knowing Many People with ADHD

      Given this great variability, it’s a hard topic to write about with any level of accuracy. Especially when half of the dominant themes online are at best inaccurate, at worse harmful.

      I’m curious. How many adults with ADHD do you know? I mean personally.

      The thing is, many people with ADHD don’t know many other people with ADHD. Maybe a few. But, for the most part, most know only what they read online. This can be useful, if one vets sources wisely.

      Overall, the big mistake they make is assuming that everyone with ADHD is like them. More commonly, masses of individuals with ADHD relate to certain parts of others’ experience.

      Maybe you know, in person, many adults with ADHD. But I’m pretty sure I have a much wider and deeper and longer view of adults with ADHD as individuals. You can’t sit in a room with 25-40 people (newcomers and veterans) every month, for 15 years, and not see the clear differences among the individuals who have this highly variable syndrome. I also know this from the 10,000 partners of adults with ADHD who have come through my online discussion group.

      I also have a strong command of the literature and the consensus issues among highly placed experts.

      The Cultural Context in Which I Wrote the Book

      When I was writing this book (published in 2008), precious few experts were publicly (as opposed to academic circles) talking about many of the issues I covered, in the context of relationships, in particular. Especially not in the popular culture, which was filled with a certain psychiatrist’s blockbuster marketing message: “ADHD means you’re the life of the party and can start an airline!” marketing tropes.
      (This was largely before the Internet took off, so it was newspaper and magazine articles, “Dr. Phil” appearances, highly compensated conference lectures, etc.)

      Yet, many of the adults with ADHD who were attending my local discussion group, here in Silicon Valley, were confused! They found that that this marketing message created discomfort and anxiety.

      What if they were socially anxious? What if they couldn’t remember a joke? What if they hadn’t achieved anything close to the career success they’d imagined — much less started an airline?

      Did that mean they failed at having the “good kind” of ADHD? What kind of empathy was being shown to them?

      Is it better to be truthful — and therefore truly helpful — or is it better to blow narcissistic smoke up the skirts of adults with ADHD, and gaslight their loved ones? The media love “contrarian” ideas. Hence, this idea that “ADHD isn’t a disorder, it’s a gift” sells.

      The appeal for some is obvious: To hear that a major figure say they weren’t the equivalent of boring “Muggles” — that they were in fact more gifted, more special, more creative than “neurotypicals” — filled a deep hole inside marked “less than” by years of living with unrecognized or poorly managed ADHD symptoms.

      But, it’s still narcissistic supply. It’s not going to elevate their lives, for the most part. It felt dishonest to me.

      The clear message was: Their neurotypical-partners should stop harping about “You forgot this” and “Do you remember our conversation about X?” They should expect little in the way of day to do cooperation, chore-sharing, and attention from these superior “gifted” people with ADHD. They should instead resign themselves to a life of neglecting their own needs so they could serve as the executive assistant to their ADHD partners.

      Meanwhile, as I mentioned, I had also been leading discussion groups for the partners of adults with ADHD. I saw the devastating real-life impact of these “denialistic” marketing messages on group members. In person and also online.

      That was the context in which I was writing. Against a toxic tide of “Giftism.”

      Then, just at that time, the 2008 economic meltdown happened. People in general had a more sober viewpoint of job security, etc. after that.

      When the book came out, however, the people marketing “happy stories” to adults with ADHD slammed my book as “negative” and said many untrue things about it and me. It was very ugly, and I haven’t forgotten these people. (I also have noticed that many have co-opted the concepts that I spent many years studying and developing and writing about.)

      If the book had not had such a warm and grateful reception overall, I would have been crushed. Because they were the opposite of empathic. They were vicious and devious.

      Twelve years later, the book is still highly popular. Including with adults who have ADHD. I think that says something.

      About The Two-Way Street

      To your point about two-way street: Yes, I think I understand.

      It’s one thing, however, to be understanding of and patient with a friend’s tendency to get extremely emotional and “overwhelming.”

      It’s another thing to survive another person’s dysregulated behaviors every day, in every way. It’s unsustainable.

      There seems to be this idea that, because a person does not have ADHD, the person should be a font of limitless empathy for the person who does. But we should remember: Our human brains are not designed for two. 🙂

      There’s a difference between being empathic and enabling behaviors that aren’t doing a person any good — and probably much harm.

      I try to clarify that difference.

      Thanks for writing,


    2. Amy, are you me?!?
      Seriously, every word of this hit home.

      Thank you for taking the time to write this comment – it had to have taken ages to craft and it beautifully expresses the same thoughts and challenges I’ve experienced my entire life. I’m 48 and was just diagnosed with ADHD and ASD about 8 months ago. I didn’t know anything about either condition and was absolutely blindsided by the diagnoses. All the years I spent trying to live up to expectations I simply could not meet, feeling like a failure, being told I’m broken, or that I’m just lazy, or that I’m selfish…I could go on and on. Trying to explain to people why I behave the way I do and why those labels are untrue and hurtful has always felt like a futile effort. I don’t know if it will really make a difference, but I intend to share your words with family and friends who, frankly, seem to spend very little time contemplating the inner workings of their own brains, let alone the inner workings of mine.

  12. Hello Gina,
    41 year old here. I just got diagnosed with ADHD a few weeks ago. My partner, of a tumultuous 6 years, recommended I get a psych eval because of the difficulties I have with communication & empathy & honesty with them and my hyper sensitivities to sounds and smells and a whole bunch of other stuff.
    A problem has occurred twice this week, where I have misspoken and caused a lot of hurt and trouble.
    The first event – I talked about a past collaborator (a woman) and although I did not intend to collaborate with this person in the future I described a hypothetical situation in which I would collaborate but I would invite my partner over and we could all have dinner.

    In hindsight, i didn’t need to say ANY of that. I just needed to say – There is this woman who I used to collaborate with, and I have no intention of collaborating with them ever again and they pose no threat to our relationship.
    The second problem – the discussion about the collaborator cause a lot grief for my partner and triggered them because in the past I have been unfaithful and a liar about my collaborations with women. So my partner saw this as an attempt at me being underhanded, tricky and manipulative. Unfortunately, my words totally support her suspicions but my intention was literally the opposite.

    I feel like I fumble with my words in a high stress situation.

    The second error on my part, came a few days after that. My partner and I had been making up, discussing and processing my fumble (about the collaborator) and had had many intense days of my partner voicing their anger and yelling at me. We did make some headway though and things were starting to calm down. We averted a break-up.
    BUT then I forgot to tell my partner that I had been invited to my friend’s , lets call him Dirk, party. And instead of inviting my partner to Dirk’s party, I said ‘I’m going to Dirk’s party tonight, but you probably wouldn’t want to go anyway’.

    I TOTALLY FUMBLED. i knew that my partner wants to be invited to events with my friends, and i did have opportunities to mention it, but because of all the high-stress situations, yelling and processing I couldn’t find the time to actually form and state the sentence ‘Do you want to come to Dirk’s party with me?’.

    Now we are at an impasse again, my partner feels like they can’t trust me, and that I don’t want to bring them around my friends and that I’m embarrassed of them.

    The saddest and most infuriating thing for me is that i did want to bring them to the party but I literally had not formulated that thought in my mind until I blabbed and fumbled the statement that ‘they wouldn’t want to go’.
    I’m feeling a bit hopeless but also I do think and feel that this is due to what ADHD does to my brain. Sometimes I can’t formulate, or speak the most simple thing, especially when I’m highly stressed or feeling attacked…

    On the flip side I have been showing my partner lots of care by cooking, cleaning, doing repairs and gifting them things they need weekly.

    It is like I can come through with the Physical Tasks but I can’t come through with the Verbal Tasks.

    What would you recommend I say to my partner?

    What would you recommend I do to help me with my verbal tasks and processing of thoughts before I speak….

    1. Dear Oscar,

      Ouch!!! I feel your pain. And your partner’s pain.

      Her survival instinct must be on the watch, lest the past repeat itself.

      You are trying new behaviors, and you need optimism and positive reinforcement.

      If you read/listen to my first book (Is It You, Me, or Adult A.D.D.?), you’ll learn about how ADHD sometimes means having a weak “internal voice.”

      You’ve heard the expression, “I don’t know what I think until I see what I say?” Probably uttered first by an adult with ADHD. 🙂

      A stronger internal voice means we can “rehearse” what we plan to say and think it through, revise, before laying it on the recipient.

      You don’t mention medication. Is that in the cards?

      By improving internal communication, stimulant medication can often improve what you describe. It can help you have more forethought, less blurting. Even in “high-stress situations.”

      Compared to many physical tasks, mental tasks are much more complicated. Because they require our neurons “communicating” clearly with each other about complex and sometimes unforeseeable factors. (I talk about that in a chapter on medication.)

      Still, it can also take active “revising of old scripts” — well-honed over the years of living with unrecognized ADHD.

      Scripts such as “mindreading” — where you assumed you knew how your partner would react to an invitation.

      Also “avoidance” — perhaps you feared your partner’s negative reaction (e.g. “Dirk the dirtbag? Why would you think I’d want to go to HIS party? yadda yadda yadda”). So, you just skipped it.

      I write about all this in the book, and I expand upon these concepts in my new online training. Available soon!

      Please be sure to subscribe to my blog here, so you’ll be notified.

      Good luck!!!


  13. Is there a reason for a 13 year old boy with untreated adhd to find himself becoming very angry when others pick on someone who means a lot to him (girl). To the point that he becomes so angry and distracted by this issue that he can’t focus on anything else. Then he thinks that convincing himself he doesn’t care about the person anymore is the best way to regain focus? Only to discover that didn’t work yet come back only to do it over and over again in these moments of being overwhelmed by worry and fear for the person?

    How can I help him process this?

    1. Hi Kriste,

      Well, there are probably plenty of reasons, some of them involving ADHD and some of them involving being offended by bullies. 😉

      But, as you point out, it seems to be beyond this….”distracted by this issue that he can’t focus on anything else.”

      ADHD commonly has a common of emotional dysregulation. There can also be difficulty transitioning — from one activity or even from one thought to the next.

      When the anger he feels actually gets that adrenaline pumping and helps him to feel more “clear” and energized….it can become almost like an addiction.

      If your son doesn’t have a better strategy to transition out of this state, he’ll come up with the best he can — i.d. convincing himself he doesn’t care about the person anyway. One extreme to the other….also common with ADHD. The challenge? Finding the middle ground. That requires more complex focus and thought.

      I’m not sure it’s an issue of “processing” so much as treating his ADHD.

      With ADHD, we talk about the problem not being “not knowing what to do” — but “doing what you know.” 🙂

      At 13, he probably realizes this is not the best strategy. But maybe he has trouble “doing what he knows.”

      I hope this helps.

  14. Hi Gina,

    I have been dating a guy who is 40yos. He was upfront about his ADHD (diagnosed this year) but I didn’t really know anything about ADHD as I went in and continued the relationship. He has also been honest about past relationship fails and his longest only being (tumultuous) two years.

    A week or so in he started comparing our relationship to his past. There were a few occasions that he and I hit a wall of frustration both trying to express ourselves. I didn’t think too much of it but I didn’t know how to deal with it. His frustration seemed more intense than mine.

    After four weeks he said he needed to take two weeks to see where he was at with everything. Basically a two week break.
    We stayed close, talking as much as usual but I was cautious to respect his request and boundaries. We laughed and joked so much like we had through the dating time. And lengthy phone calls continued.

    In this time I started doing a LOT of researching on ADHD. (Purchased your audio book) And quite a few behaviors make sense. And a lot of it doesn’t bother me but makes sense – the lateness/time management, his disorganization, forgetfulness.

    Then I read about hyperfocus and quickly realized that’s what he had done with me. And now I feel like this is the root of some of his present issues.

    A few days before the two weeks ended I wrote an in-depth letter about why I thought he was such an amazing guy and how much I love and respect I had for him and what he did for me. But more so, after the two weeks he tried to talk to me about the relationship but could only give reasons why it wouldn’t work. I tried to turn the reasons around and justify how it could work but he continued to be defensive. Communicating about relationship is obviously an issue for us.

    Later that day we joked and laughed over the phone and I told him the conversation wasn’t over because he really hadn’t heard what I had to say but he insisted it was. And before we ended the call he mentioned he couldn’t stop going on Tinder. This hurt me but I knew we aren’t dating and appreciated his honestly with me.

    Three days later I saw him and he was incredibly standoffish. I tried to engage with him but it felt forced and unnatural. I stopped by his house to drop off the toaster oven for him to borrow. He mentioned he’d ran out of pet food. Then he had to quickly leave to go to a meeting.

    I followed into the weekend with a text messages, purchased food for his pets and left it at his house , called a couple of times (only to get a missed call back and a 5 min long voice mail sounding like he was at a bar) I also
    sent an email saying I was worried about him. Only to be ignored.

    Then today I saw his car parked on the street where I was running errands and tried to engage in phone calls or text messages to no avail. I tried his door and saw him on the balcony so I messaged him but he ignored me. I felt a bit obsessed and started feeling a bit stalker-like paranoid. So I left and called as I was leaving only to leave a voicemail hoping he was alright.

    He called me some hours later. Still standoffish. I told him I was worried about him. He admitted he was very overwhelmed at the moment, really focusing on getting his projects done. He was also annoyed with work and people and friends – and everyone really – it sounded like he was really down on life. And then he said he was packing to stay at a friends house and he was planning on staying with her for the rest of the week.

    I feel really heartbroken but also frustrated and confused. I really want to be there for him, support him in anyway, because I deeply care for him. He’s done so much for me in that short time. I want to reciprocate. But it feels like he is pushing me away. And now I’m scared I’m coming across as an obsessive stalker because maybe I’ve done too much research and I’m trying too hard.

    So my questions are: what do I do? Do I give him the letter I wrote about all the reasons I feel we should be together?

    Or do I continue to text often to let him know I’m thinking of him and care about him, be patient and compassionate and hope we come out best on the other side?

    Or not? do I just let go? Am I sounding like an obsessive stalker? Does he really just want to date after we had such a strong connection? I really don’t know.. I can’t tell. I’m still emotionally invested but now I feel anxiety driven.

    I would be so grateful for your advice.

    1. Dear Sarah,

      You both are in such a painful situation. I feel for you.

      I’ll point you to two sentences early on in your post:

      There were a few occasions that he and I hit a wall of frustration both trying to express ourselves. I didn’t think too much of it but I didn’t know how to deal with it. His frustration seemed more intense than mine.

      That last bit is the key, I’m thinking.

      For you, this is a one-time thing. For him, this is a lifelong pattern. Time after time, hope for a new relationship crashes on the rocks. Again and again. And he doesn’t know how to get past it. So, he moves on to the next one.

      I imagine more than a few of his past girlfriends felt as you did — they want to help him. And that might just push him away faster and farther. I imagine he doesn’t want “help”. He doesn’t want to be pitied or the “one down” in the relationship. He just wants a relationship of equals.

      The hyperfocus phenomenon is part of the pattern, yes. And maybe he is one of those people who will just go through life chasing romantic shadows, not knowing why the “thrill is gone” after a few weeks. And not caring.

      But it seems like he might care, given his “intense” frustration. He just doesn’t know how to break the pattern. In fact, I am writing about this right now for my online course. Breaking the pattern involves some serious effort made toward ADHD treatment and developing new mindsets and strategies.

      A significant part of my readership is 50-something men with late-diagnosis ADHD who finally came to realize that the common denominator in all their failed relationships was….them. And the culprit seemed to be their poorly managed ADHD.

      You don’t mention if he takes medication. For many, medication is the singlemost effective treatment strategy — the foundation for other strategies.

      So, when you say “Communicating about relationship is obviously an issue for us”, I’d say not likely; maybe that is only the tip of the iceberg. So much of couple therapy and relationship books emphasizes “communication” as the key to everything. But what you are dealing with is not something that will improve with better communication, in my opinion, but only with earnest ADHD treatment. Then, the fine-tuning with communication.

      Definitely, it sounds like you are obsessed and maybe even a bit stalker-ish. 🙂 But I understand it.

      It’s such a nagging mystery in your mind, it’s hard to stop. You feel there is so much good potential for you two, you are willing to work with him on the ADHD issues (such as you understand them), and he’s just shutting you out. At the same time, you feel for him, his frustration that another promising relationship didn’t work out. You want to help him, and you want him to know that. But I would not advise sending your letter yet. Not until you know more about what might be required.

      I encourage you to go back to my book and read closely the Three Success Strategies. That is, the third part of the book, which details treatments and ADHD-friendly strategies.

      Then think about if you are really ready to take up this mission, including access to local expertise, financial resources for treatment and medication, etc.. He has 40 years of poor coping responses honed into a well-oiled machine. It takes effort and desire to start changing counterproductive coping responses into more productive, positive ones.

      Also, you say that his being late, etc. doesn’t bother you — that it’s a minor issue. But I can assure you, those behaviors are all part of a piece. And, over time, they can grind you down to a nub.

      You don’t mention anything about his attitude toward his ADHD diagnosis—how much he’s read, what he’s read, what he’s done to begin managing symptoms better. That is really the key.

      I’m sorry if this is not the advice you were hoping for. But it is my sincere best advice, given years of experience and observation.

      Best of luck to you. Take care of yourself.


    2. Hi again Gina,

      I may not have been initially very clear because feeling helpless but:

      I’ve never met anyone else that I’ve enjoyed being with as much as him and I have never been able to be myself as much as I can with him. And I feel it is the same for him – our connection is strong.

      We spent hours and hours talking about everything. Our record was a four hour phone call. We share secrets with each other, we share thoughts we both hadn’t ever told other people before. We have so much fun together.

      Yes, he is taking medication. I understand he’s been on it for three months. ( I don’t remember the medication name.) And he seems very comfortable talking about his ADHD diagnosis (to me but I’m not sure about others). He has done some research because it was he who suggested to doctors that it was ADHD. But I’m not sure the extent of research or strategies. He is aware of some and had asked/trusted me to manage his finances – and we had discussed but hadn’t had the chance to implement.

      You are 100% about him thinking it’s a lifelong pattern. He’s voiced it. Often. And this is where my frustration came in trying to convince otherwise. (also hence the letter).

      Also after the two weeks he said he wanted to be “besties” and always wanted me in his life.. so I feel that is a positive?

      So I’m a minute into part three of the book and hearing themes of:

      The positives are from showing strength and as well as strategies. (I’ve not stopped – I’m continuing on but this stood out for me)

      But this is about of what I suggest in my letter to him that I had to write the letter because he would not listen to what I had to say. And I feel I deserve/respected to be heard. So do you still think I should hold off with giving it? Or could it possibly be detrimental?

      Also – do you think I’d benefit from your online course?

      And what about him? Do you think it would hurt our situation any further if I shared the link with him?

      I don’t want to loose him. He is the most incredible person I’ve ever known. Yes, now I feel ashamed of my “stalker/obsessive” actions – but it was from feeling so helpless. It also came from a scared place of loosing him. So thank you for calling me out.

      So with that do you think there still any hope for us? Do I give him space and continue to hope? Or is it too far gone?

      I’m so grateful for this opportunity to discuss as I didn’t have anywhere to go and I tried to see a therapist to discuss but I can’t get in for two weeks more weeks.

    3. Hi again, Sarah.

      First, to be clear. I was not “calling you out” on the stalker bit. I said that I understand it. The connection and then his contrary behavior have set up a huge puzzle in your mind, and the impetus is to solve the puzzle.

      Second, “he is taking medication” really means little.

      1. Is he taking it during the times of interaction?
      2. Has it been carefully “dialed in”?
      see my medication chapters for more on that.
      3. Is he sleeping? What are his health habits?
      All these play a bit role in how well the medication works.

      Yes, I believe my course would benefit both of you. That’s why I’m working so hard to finish it. But it’s not available yet. In the meantime, my book is available. So you’ll want to read it closely.

      I don’t know what to tell you about the letter. I haven’t read it. 🙂

      But from what I am picking up here, I think it’s always wiser to let emotions cool a bit. Sit on it and revisit next week or so.

      You say that “he would not listen to what I had to say.” But maybe you aren’t hearing what he is telling you — that is, this is too hard, he needs to back off, he doesn’t know how to transition from a rather intense beginning to a stable ongoing relationship, or he has simply lost interest. That kind of intensity is exhausting to keep up.

      Whatever you have to say is not going to change how he copes with ADHD—or doesn’t. It’s not about “respecting” you. It’s not about whatever you have to say. It’s about him being caught in old habitual patterns, it seems. There is no “one right thing” that you can say that will fix this situation as you hope.

      I would also suggest, you do sound very desperate to continue the relationship. Desperation is never a good motivation. It could scare him away entirely, that you seem to have so much riding on the relationship. But also for you, maybe this is a good opportunity to step back from the emotions and think about reality going forward. For example, he has asked you to manage his money and yet you two don’t have a stable relationship? I find that a bit concerning, especially that at 40 years old he cannot trust himself to manage his own money. Outsourcing it to you can be a real setup for disappointment and conflict, for both of you.

      I encourage you to give yourself and him some space to relax a bit and get your bearings.

      Take care,

  15. Hi Gina,
    thank you so much for this article.

    Recently I was talking to a guy I’ve been seeing for about five years now. He ended up telling me that I always talk about myself, and I’m never attentive to his needs or aware of how he is feeling during our conversations. He said that when he tries to tell me something I just don’t have the attention span to listen and so he doesn’t tell me things and just tells his other friends instead. He said he loves me anyway, but he just doesn’t talk to me about himself. Meanwhile, I was feeling like every time I ask him something he always responds with short answers, and I feel I have to fill the silence so I end up just talking about myself (maybe because somewhere along the line he decided he couldn’t talk to me)…

    I have to say, this was a shock and it really broke my heart to hear. First of all that I don’t have a long enough attention span to listen but also that he doesn’t feel heard and he doesn’t feel like he can talk to me.

    After that, I confided in my roommate about our discussion and she lovingly told me that she also feels like sometimes when people are talking to me or telling me something I tend to respond by turning the conversation back to myself and relating whatever story was said on a time that I had felt that way and she said it throws people off and makes them feel like they aren’t being heard… She said I don’t do it too intensely and it’s not a huge deal but it is present.

    Since then I have found it really hard to communicate with other people because I catch myself wanting to respond by relating all the time and not knowing how to be empathetic in other ways. Another friend also confirmed that I do this tonight so I’m realizing and reevaluating all my friendships and relationships and how I make everyone else feel.

    I would like to think that I am caring and mindful about others and I thought I was a good listener… I am a yoga teacher and I’ve been working on yoga, meditation, and trying to be a self-aware human for quite some time and I have always thought of myself as being compassionate and deeply wanting to find a way to help others in life and I guess I just feel so sad that I can’t actually portray this… And I do feel as if I some of my relationships would be closer if I didn’t do this.

    Now I feel like shutting down and not talking to anyone so I don’t make those mistakes while communicating… But I also know that’s not a solution.

    There were times in the past where I felt highly empathetic towards others, and I remember being able to really help I felt more caring as well. I think sometimes my capacity to tap into that ebbs and flows but I would love to make it more of a constant as I think it feels really good to help others and hold space for them.

    I did recently lower my Concerta dose because I felt some chest discomfort while on the higher dose. I think it did help me be more empathetic, but now I don’t want to raise my dose again due to the side effects, but I also want to be able to hold space for others and that’s deeply important to me as well and especially after reading some of the comments, I definitely do not want to come off to anyone as self-involved or narcissistic. I really want to work on this.

    Thank you for reading and listening and sharing this article. Sometimes its really hard to hear about the things we need to work on or be aware of as an ADHD person and it’s nice having supportive people out there to help!

    Thanks again,


    1. Dear Adrienne,

      Thanks for sharing your experience.

      I’m reminded of my 7-year-old friend who has learned in his school to talk about a “growth mindset.” 🙂 He used to be very self-conscious of criticism ….a bit of a perfectionist. But now he’s learned that he can grow and has power over changing behaviors, etc. that are causing problems for him.

      So, kudos to you on your “growth mindset.” You read an article that led you to question just how empathic you were being with a boyfriend and roommate — when inside you feel very empathic. That has to feel a bit shocking.

      Some people with ADHD react to my writing about ADHD and empathy challenges by getting angry with me and attacking me (“shoot the messenger”). They have told themselves that people with ADHD have superior empathy.

      But it’s not so simple, is it?

      From where I sit, you’ve shown admirable maturity, self-reflection, and true empathy—even in the face of information that could have very well resulted in defensive reactions.

      That’s the good news. And it’s certainly not time to “shut down.” Rather, it’s time to expand in a “growth mindset,” right?

      You have a lead on an issue that seemed to have been causing discomfort for you even if you couldn’t identify it.

      re: Concerta issue….some thoughts:

      1. Is it brand or generic? That can make a BIG difference. So you want to rule out that potential factor.

      2. Have you also been assessed for anxiety, depression, etc.?

      Most adults with ADHD have one co-existing condition. And half of adults with ADHD have two.

      Too often, the person receives only a stimulant. It might help with ADHD symptoms but a stimulant can exacerbate other neurobiological vulnerabilities (to depression, anxiety, etc.). And these can manifest in mental or physiological symptoms.

      Many adults with ADHD report the best results from taking 2 medications. I know….that is seldom what anyone wants to hear. But just putting it out there.

      Chest discomfort can be an indicator of anxiety. If you are consuming caffeine, that can be a catalyst with the stimulant, so you might want to cut that out or try green tea instead.

      I hope this helps. Take care of yourself!

  16. Hi Gina,
    Thanks for your help. When I read your book a few weeks ago it was one of the largest paradigm shifts I ever experienced. I related so deeply to the other partners of ADHD mates. My partner has been in treatment for a few months (with an ADHD specialist) and has been taking meds for about two weeks.

    I am struggling with what I perceive as a new deeper realization that my partner may never be able to know what I want/need at a particular time and be able to provide it. That she is so completely absorbed with the chaotic emotions in her head, that she cannot really put herself in my head and anticipate, or even appreciate, my emotions.

    We specifically discussed the story in your book about the husband who swings his arms around while telling a story, hits his wife, she says ‘ouch’ and he gets angry for her overreacting and making a big deal about nothing. A day later we lived out almost the exact story.
    My partner responding with aggressive defensiveness from hearing my ‘ouch’, without any time in empathy, makes me feel terribly alone. When it doesn’t get better even after calm discussion and I hear the defenses of you are overreacting, or you are trying to make me seem crazy, or you are starting a fight for no reason… I feel resigned.

    I love my partner very much, and, at the same time, I want to have a relationship with someone that has the brain capacity for another perspective. I accept that it may not be physically possible for her and I am not angry at her but that makes me feel even more alone. I alone now must decide if this is a life I want to live with. Where showing reaction to what I perceive as a hurtful comment can cause days of anger and defensiveness. I wish I could talk about it with her.

    1. Hi Mike,

      Sorry to be late in approving your message.

      I’m glad my book has been helpful in “shifting your paradigm.”

      Until we know what is afoot (the various potential contributions of poorly managed, unrecognized, etc. ADHD), we can remain in a befuddled, foggy, even frozen state. The conflicts and disagreements can seem so bizarre, we (the “partners of”) might keep telling ourselves…”surely, I’ve misunderstood, mis-heard, miss….something.”

      The “aggressive defensiveness” can be a complex phenomenon. But unraveling the complexity starts with understanding ADHD, as best we can. But it doesn’t end there.

      ADHD is considered a highly treatable syndrome. But unfortunately, too few prescribers/therapists know how to treat it. So, both we and our ADHD partners are left to struggle, often thinking, “well, this is as good as it gets.”

      Being able to take another perspective can be a critical component of human relationships…even of being a happy, self-fulfilled human.

      It’s only been two weeks since she started taking medication? (And who knows how competent the prescriber.)

      Symptoms can improve quickly with proper treatment. But it can take much longer — and takes effort — to start revising old dysfunctional mindsets and automatic responses.

      I am writing about it right now for my online training. Wish I could produce the training faster. But reading my book closely should help.

      take care,

  17. I am 79 yrs old and never diagnosed with ADHD but it’s obviously me. I was expelled from nursery school age 3. I was fuzzy brained at times. Would have glimpses of eternity when I could see forever after I was put on amphetamines for weight control at ten. I can still remember when my fuzzy brain cleared. I trained myself to make lists to know where to begin. A teacher once commented on my inability to explain how I arrived at math answers. “It just came to me” made him angry. I am also an empath. I have always identified with unfairness and written about it, fought it. Always inventing shortcuts to the finish. Depression I learned to redirect into curiosity. Have I cured myself or just invented ways to go around the problems and take advantage of the good parts…

    1. Hi Jana,

      I did not know toddlers were being expelled from nursery school 70 years ago.

      To think you had to take “weight-loss speed” to find clarity. I wonder how many women experienced that in those times. Lots, I bet. But they were probably told, “Well, sure, speed does that!”

      You ask, “Have I cured myself or just invented ways to go around the problems and take advantage of the good part?”

      Only you can answer that. But in my experience, every individual with ADHD has a different experience of living for many decades without benefit of diagnosis. Some do well. Some do poorly. Some can adapt. Some cannot because their challenges are too big.

      take care,

  18. Jennifer Hall

    I am an empath and have ADHD. It is hard seeing articles like this especially when we are being boxed in and classified the same way. Has anyone done any scholarly journals on the ADHD individuals who feel others emotions so strongly to the point that it is sometimes unbearable? If so please share.

    1. Hi Jennifer,

      Thanks for your comment. I’m sorry that you seem…disappointed (?) with this post.

      I’m puzzled as to how you see this article as “we are being boxed in and classified the same way.”

      No ADHD advocate and expert has emphasized ADHD is not “one size fits all” more than I have. For years. Seriously, the last thing I do is put my friends with ADHD (and even people with ADHD I don’t know!) into boxes.

      Did you maybe miss these parts?

      —Empathy sounds simple. But it’s really a complex phenomenon.
      In fact, some people with ADHD have trouble reining in their empathy; medication often helps them, too. It’s all about the self-regulation:  not over-doing, not under-doing, but finding the middle ground.

      —Impaired empathy often destroys relationships where ADHD symptoms go unrecognized or unaddressed.

      But deficits in empathy cut both ways in ADHD-challenged relationships. Typically, both partners become more mutually empathic, once they both start learning about the causes and varied manifestations of ADHD.

      You ask for research from a “scholarly journal” and I thought that’s exactly what I have provided.

      Did you notice this part:

      This study is particularly relevant to ADHD because this D4 gene variant has been associated with (but is not exclusive to) ADHD.

      Women carriers of a certain gene variant (the 7R-allele) scored higher in cognitive empathy than female noncarriers. In men, however, those with the 7R variant scored lower than men who did not have it.

      Is this proof that women with ADHD are more empathetic than women who do not have ADHD? No.

      This study was about one gene—which is not exclusively found in individuals with ADHD.

      ADHD is a highly individual condition. There are many aspects of personality on top of the variable symptoms of this variable condition.

      Moreover, many genes have been associated with ADHD—hundreds, in fact—and all of them are associated with human traits. That means people with ADHD are not a separate species. 🙂 Rather, their human traits are more extreme or greater in number –and causing problems for them. That’s the basics of the diagnosis. If there’s no impairment, there is no diagnosis.

      I wonder if what you describe is necessarily empathy. You describe “feeling others emotions so strongly to the point that it is sometimes unbearable.” That, as I mentioned, can be more of an issue of emotional self-regulation.

      I’ve always found it tricky to attempt to mind-read others, to know what they are feeling. I can try to empathize, but I check with them as to how well I’m doing.

      In other words, I don’t assume I am feeling others’ emotions accurately. In fact, one well-known poor coping response to growing up with unrecognized ADHD is called “mind-reading.” It’s assuming that we know what others are feeling, and it can get us into trouble.

      When it comes to the term “empath,” I worry that it is convincing people with ADHD whose emotions can get the best of them… that this is their “personality” rather than part of ADHD emotional dysregulation. That is, something they can better manage.

      The term “empath” seems to have come out of nowhere to being a popular SEO keyword. 🙂

      It describes a race of people on Star Trek, and as far as I know, that’s the only official usage.

      I’m very familiar with Elain Aron’s work (Highly Sensitive Person), and I’m familiar with how it’s being misappropriated by bloggers and others. Especially vis a vis ADHD.

      I bet if you read some of the comments, you’ll hear from other women who share your experience.

      Empathy is a wonderful thing. I wish more people had it. But empathy is often misunderstood.

      Take care,

    2. I cry a lot when I feel the pain of others. I try to say happy things to encourage.

  19. I don’t know if I’m ADHD (getting an eval soon) but I think a lot of this speaks to me.

    I try really hard to be empathetic and and do right by people, but I often come across as self-centered and uncaring. Apparently it’s because I try to fix problems through actions and active problem solving instead of through active listening and showing genuine concern. For example, if someone is overwhelmed with work, I’ll try and lighten their load by helping with their work if I can, or doing another task or chore so they don’t have to. If someone is sad, I’ll listen, agree with what they’re saying, and ask if I can do anything to make things better (like doing something fun or buying a treat). What I don’t do is provide emotional support or follow up on how the person is feeling, and overtime my support seems more superficial than a genuine desire carry any kind of emotional burden.

    I’m also told that I’m not inquisitive of others and attentive to what’s important to them, and that this comes across as me being selfish, unempathetic, and uncaring. The thing is that I do care, and do want to know about people, but it’s like there’s a million questions are constantly flying through my head and I never seem to actually follow up with these questions and actually vocalize them. I can never seem to consistently make an effort to learn about what makes people tick and make it feel like their interests and emotions are important to me. I’ve spent years trying to make a concerted effort to do this better and to be more emotionally supportive of people, but I get so lost in my mind and the daily chaos of trying to manage my own life, and before I know it months have passed and I’ve made no progress.

    I’m so lonely and this pattern of behaviour has hurt my friendships and my relationship. I feel so selfish for not doing what should be an easy task, and I’ve let down people I care deeply about. It’s like there’s a disconnect between the love, caring, and curiosity that I carry in my heart and how I actually outwardly enact those feelings.

    Not sure if this makes sense, but I hope it’s something I can work out.

    1. Dear David,

      You absolutely do make sense. And I know you aren’t alone in being mystified by an apparent “disconnect” between your intentions and outcomes.

      I’m not one to make hard-and-fast generalizations about “the sexes” but the evidence suggests that what you describe first is at least more common to men than to women. Men are expected (or expect themselves to) “take action.” Solve problems! Not so much on the emotional support part.

      So, this is something you can learn about and take steps to avoid jumping in with problem solving without asking first, “How can I help and support you?” You might find this article interesting:


      And yet a lot of people don’t know how to listen to someone venting. Usually, people take one of two attitudes. Option 1 is to jump in and give advice — but this is not the same as listening, and the person doing the venting may respond with “Just listen to me! Don’t tell me what to do.” Option 2 (usually attempted after Option 1) is to swing to the other extreme, and sit there silently. But this doesn’t actively help the person doing the venting to drain their negative emotions. Consequently, it is about as rewarding as venting to your dog.

      The next part you describe…superficially could describe ADHD-related challenges in selecting a plan of action, following up, etc. But it could also reflect your confusion about how to best express your good intentions.

      The balance might tilt toward ADHD if you experience other typical ADHD challenges in the rest of your life. My first book could help you sort this out — and then know how to proceed:

      I hope this helps. Good luck!


    2. Greetings Gina, David and others,

      David, your reflections are thoughtful and well articulated, and actually show a lot of personal insight. Don’t be too hard on yourself, there are many factors influencing this pattern. Dopamine isn’t the only thing on the scene, its important to consider oxytocin, anandamide and other love/ bonding/ feel good molecules. This topic is extra interesting to me, like two mirrors facing each other it can get confusing. I recognize a part of your story as the struggle of someone who is empathic to a fault and probably was never educated about how to utilize and field this skill. (probably more of an embodied empathy and less cognitive)

      I think sometimes to jump to fix or solve is a learned reaction, which can be related to literally feeling what the other feels, causing an anxiety to resolve the feeling. But because we are not that other person, our instant reaction can often be self serving. My education as a counselor, meditation/yoga/ creative expression practices helped me and help me cultivate the capacity to be uncomfortable with others. I feel thats sort of key with listening. Allowing others to have their difficulties and pains without needing to solve them ourselves is a powerful boundary. It also opens up space to choose to step in when requested and agreed upon.

      Now about this topic in general: I have been seeking out information that can help me understand my own experience with medication this last year. I am 30, taking ritalin for the first time as a prescription, though I got it from friends throughout my undergraduate program and a bit in high school. What I have found to be the most significant is my increased SELF-empathy and my ability to recognize and act on imbalances in my social relationships. I will research more about this prosocial behavior fostered by sustained levels of dopamine in the frontal cortex… I’ve been trying to understand how medication helps me serve myself more instead of being such a people pleaser. It seems to faciltate more healthy narcissism for me (paying attention to self and self needs, even as simple as hygiene). I feel when we have biochemical balance internally, we reach far less to aquire it externally.

      Many layers. Thanks for the interesting and supportive site Gina.

    3. Beautiful said, Rose. Thank you!

      Yes, self-empathy!

      I responded to another readers this way:

      The fact is, whether we have high empathy or low empathy, we function best in life when we are more capable of MANAGING that quality.

      With high empathy, we need to create boundaries and structures so that we can remain emotionally and physically healthy, taking care of ourselves.

      With low empathy, we need to learn actions that help us to stay connected to others. (And there are plenty of people with ADHD who are low empathy, too.)

      ADHD presents challenges in self-regulation; that is the core. So, it makes sense that your son is better able to regulate his emotions, with Concerta on board.


  20. Hello. So I’ve read about this years ago and I knew I was an empath and I am an adult with ADHD. What’s fortunate is I am one of the few selected that has the multiple levels of empathy and can control them all. Things can get a little crazy and over whelming. Just can’t be in a room with a bunch of people with distress written all over them. When I take my medication for ADHA it’s like I wanna help everyone I come across because as you know stimulants can increase the power of empathy. I’ve learned to shut it off. Sometimes it’s not easy. Everything I’ve read in here is 100%. Alot of thing i commonly do everyday. From reading this, I had no idea was related to being an empath. It’s funny because some of the research that I found in this website I knew I had because I had a(feeling) and to read exactly what I was already feeling is an amazing feeling lol… Anyways thanks for helping me realize that I’m not crazy. I love it!

    1. Dear Steven,

      Thanks so much for writing. Any day that I’ve helped someone to know they’re not crazy is a good day. 🙂

      I’m curious, though…yes, taking a stimulant medication can improve the ability to empathize for some folks with ADHD. But for others who are “overly empathic,” medication can help them to better regulate those feelings and reactions — gain a little distance from them.

      So, if the stimulants make you less able to handle your empathic feelings, I wonder if you’re taking a stimulant that is unsuitable for you.

      For some people, Adderall (for example) can create a type of tunnel vision. It can amplify whatever they target. And that’s not a good thing.

      Anyway, I’m happy for your discovery!


  21. Hi Gina,

    I’ve been with my 38 year old husband for five years, and in January I was looking for advice for our problems online when I realized he likely had ADD. He got evaluated, and, sure enough, he scored 97% on the inattentiveness scale. He’s a mechanical engineer by profession, so he’s been rewarded by society for certain ways of being, as you mention, but has no concept of what empathy could be like.
    I’m hoping he and his doctors will figure out medication (just started very low Ritalin this week), but that can’t fix this problem, and, quite frankly, he dislikes being in any way uncomfortable (feelings, schedules, listening to me talk about myself, letting me have my own life because his feels out of control).

    My question is, I guess, whether adults can make the same kinds of progress as kids on empathy. It feels like there are a lot of defense mechanisms preventing empathy from getting through, and I’m so near the end of my rope exhausted, as I have chronic illness and am thus reliant on him for a lot of things he can’t manage.

    I feel so sad that I’m the first one to see this and suggest that he gets assistance, but I’m also losing it from what feels like parenting a sociopathic 6 year old who has excuses for everything and lies all the time.

    Hope that makes sense


    1. Hi J,

      Yes, you make sense. I understand perfectly.

      You are correct, at least to a degree, in suggesting that lifelong habits are not easily overcome, even when the underlying psychiatric condition is recognized and treated. The therapeutic model for ADHD is based on cognitive-behavioral therapy, and it helps the person break down old assumptions and reflexive thought and actions — and replace them with new, healthier thoughts and actions.

      As far as the medication, for some people with ADHD, the stimulant medication can definitely improve empathic feelings and actions.

      For others, there are other issues that contribute to low empathy—autistic spectrum disorders, for example. The fields of engineering and science are sometimes seen as fitting the “autistic profile.”

      Autism researcher calls autism “extreme male syndrome” and associates it with “high systems” skills such as math, science, architecture, etc. At the other end of the polarity is empathy. The empathy-systems polarity. Men in general are higher in systems, though some women are higher than some men. Women in general are higher in empathy, though some men are higher than some women.

      The “high systems-low empathy” profile can be hard-wired. That is, not responsive to medication.

      It’s early days for your husband’s treatment. I strongly encourage you to get involved; don’t leave it up to him and his doctors. Too much can go wrong.

      At least read the medication chapters in my book, to see how the medication “dialing in” process should go:

      Good luck,


  22. I have a lovely friend who is ADHD, he has all the hallmarks plus his son is too. I have worked with ADHD children so i can spot the traits quite quickly. If i try and explain I’m upset about something (recently because he seems to be hyperfocusing so I don’t hear from him for ages), he just puts his own side (quite defensively) and sets out his own boundaries very quickly without taking mine into account. He is a very kind and loving person in many other ways but does blurt stuff out which is quite hurtful sometimes. Lots to love but hard to swallow the hurt sometimes. I’m very laid back and forgiving but find the relationship hard work sometimes. Empathy is not a strong point for him I’m afraid.

    1. Hi Suzanne,

      This is a very common manifestation for people with poorly managed ADHD. Perhaps especially in men.

      I encourage you to avoid “swallowing the hurt” because after awhile, that can become an unquestioned pattern.

      Being “laid back and forgiving” can create a world of hurt in the long run.

      Please take care of yourself,


    2. Thanks Gina, yes i know i have to set better boundaries. I think i have probably been too understanding, probably because i have to be in the work i do and avoid taking things personally. I’m taking a break from the relationship for a while now, see how i feel in a few weeks perhaps.,


  23. I have adhd myself and although I am very empathic in general I definitely have some issues with intention empathy. I’m not terrible at It but sometimes I really don’t know where to put myself when people talk about certain things that are emotive to them. I have learnt this because i don’t usually know what is the best way to empathise without giving an opinion which may not be truly helpful or the best way. I almost feel like the lights are on but no one is home sometimes when it comes to intentiinal empathy I think about it logically instead I have realised my only way to try to be empathetic is to challenge there beliefs I think i do this because I can’t really get in there head completley and this is my subconscious way of taking another stab at it. Sometimes I miss the full depth of there intentions and have difficulty with the guidance to know what I should say or not say it is a bit tricky so sometimes i give advise that maybe should have been more diplomatic or i should have just listened and said little. Sometimes I am too quick to give an opinion I see where they are coming from but I am not completley in tune with the whole picture. I can give advise that everyone is thinking but I am most likely the one to say it and it is probably because of this. I always feel bad afterwards and regret some of the things I say.

    1. Hi Lemmy,

      I remember years ago reading a book on male-female romantic relationships. The author said that, “Women want men to listen to their problems, and men want to fix them.” 🙂

      Maybe that’s what you’re talking about. A male thing. Not an ADHD thing. 🙂

      I used to date a man whose “empathic” response was to challenge my beliefs. I learned a lot from him.

      Maybe you can practice reining in the advice. But it sounds like it comes from a good place, and it might actually be helpful! 🙂


  24. I would bet money that my husband has undiagnosed ADHD. After reading Is It You, Me or Adult ADD? He fit so much of it. The hardest thing is the lack of empathy and what comes off as self centersness. There is never any thought for me or what would help me or make my day easier – it’s always me catering to his needs and being thoughtful. Whether it’s me taking our daughter out or distracting her so he can have plenty of alone time or just time to do things around the house. He’s always taking “breaks” when he’s at home. He very rarely joins us for family outings and certainly doesn’t show any initiative to set up something to do as a family, whether it’s as simple as eating out together or a little more complicated such as taking a family vacation. Forget even going to a movie. You can see the thought of “Why so they want to inconvenience me and take up my time?” And he doesn’t “see” how that affects us. Certainly me I feel like I lack support in many crucial areas. So much burden is on me because he thinks he works (and probably tries really hard to be a good employee), that excuses him from other responsibilities (unless it’s yardwork which he enjoys). And forget him listening to my feelings – he will stonewall, blame, get irrationally angry and cal me names and cuss if I inisiat on taking about any “problem” that makes him feel like I am “lecturing” him or complaining.” I certainly don’t have someone I can even dream about the future with – he can’t seem to have any introspective conversation of any kind. How I wish I could get him to see that he has an issue that needs to be addressed. He relies on various substances too – they al seem benign but nicotine was the worst and he quits and starts, quits and starts, and quits … but he doesn’t listen even when I point out that he’s clearly self medicating. He just doesn’t won’t admit that he needs to see a doctor about anything… what can I possibly do?

    1. Hi Bunny,

      I’m sorry to read of your situation. It’s an all-too-common one.

      You say you read the book. It’s a very dense book. Many people benefit from multiple, careful readings.

      This time, go back, closely read the “getting past denial” chapters, and try putting those strategies into action, one by one.

      Sorry to say, you probably will continue to beat your head against the wall if you only continue to point out that he’s self-medicating, “needs a doctor,” etc.

      good luck!

    2. You are describing my former marriage to a T. I got him to go to marriage counseling where he told the counselor he was there to witness him telling me the things I was doing wrong. 30 years later he’s married again and decided I wasn’t so bad after all. My cat died just before he moved out. I still miss that cat.

  25. I am female with adult adhd and I’ve always been very empathic. After medication, Im still empathic, but I just take the time to appreciate others and give more love because I realize that it feels good to make other people feel good. I didn’t always have the energy for that awareness prior to meds.

    1. Hi Sarah,

      Great point.

      It’s easy to see why some people with ADHD who feel empathic become very hurt when accused of not acting empathically.

      Big difference between feeling and acting. It takes more cognitive effort and higher-order brain processes, for sure.


  26. Pingback: On the Deeply Spiritual Nature of Empathy – All Is Love

  27. WOW !!!! When I go back into some of these comments with a bit more attention to them, ( ahem, ADD) I feel so sad. There are so many people out there suffering !!! Going forward in total darkness and trying !!

    Gina, I’m going to read your info now, I probably should have done that before I posted above .. But….. Reading some more of these comments just gets me right in the “emotional gut” I can’t wait to see what you have to say and some of the strategies you recommend !!

    To some of the people that say “Gosh, I got left out of the empathetic gene pool.”

    I don’t necessarily know if that’s the case? I’m just wondering if these people aren’t just “unknowingly” protecting themselves from something that just feels like too much to handle. Whether their aware of that feeling or not. Almost like subconsciously doing it ? ( just like many of us self medicated because we just couldn’t figure it out )
    Anyhow, once again big prayers going out to all of those that are suffering so badly. This too shall pass, and be ok. You have to believe that in your heart, even on the most difficult days. And there is nothing “wrong” with anybody on here. We are all different. I just hope that each person eventually finds their way of walking tall and feeling good. There are billions of people out in this world, that’s what helps make it so unfathomable and unique !!!

    Alright, enough hyper focusing , hahaha !!
    Bye for now.

  28. I have scrolled through many of the comments here, I have not yet gotten to your article, ( just not that far yet on this site ) The thing that attracted me here was the correlation to ADHD medecine and the empathetic part of our brain or the correlation between them. But…. I find it really surprising that I haven’t seen much about being an “Empath” ? Everybody hang in there on this one with me, ok ? It tends to come across as sounding a bit “New Age” or to some, possibly just “a little bit out there”

    For years and years , I was called selfish, inconsiderate, high strung, difficult, and sassy,,, mostly during younger years. I have been on medication the majority of my life due to various diagnoses such as ADD, OCD, PTSD, and a “Depression that has never seemed to get better” no matter what has been tried, etc. And believe me, over the years I have tried !!!
    Biofeedback, hypnosis, meditation, medications, light therapy, etc… it seems I’ve been open to any suggestion a psychologist would make that might help.

    It wasn’t too long ago, about six months, my niece stumbled across an article she sent me. It was titled something like “Are you an Empath ?” So I read it.

    HOLY COW !!!! There I was,, on paper,, me,, the majority of the traits (now as an adult) I could so readily relate too. And it seems I’m reading ,in many of these comments, some of the same behaviors !!! As a child I would have never been able to connect with this theory, nor understood it. But, I DO know that as a child I shut inward towards myself, craved alone time, and found people to be just generally overwhelming, so I would act like a negative child towards them ( hence seeming selfish ). I was often unexplainedly exhausted and would go nap or sleep for long periods of time.
    ( hence lazy ) T.V., especially the news, music, and media have always impacted me strongly.( possibly the reason for the label “difficult child” ) Here might be one possible reason, ( keep staying open minded with me, )

    Let’s say for example, that as a child your parents watch the news, and it’s on when your around, no one thinks any big deal about it, right ?

    As an adult and even more recently, I’m realizing this couldn’t be further from the truth !! especially in today’s society where we are bombarded with visual, audible, constant media. When you are about in public there are things all around you that you simply don’t get a choice as to whether you intake that information or not !! ( Anyone had to deal with their child acting so badly that you finally had to leave where you were ?) I bet more of you have than not. As a grown woman I can now choose to not watch the news or certain things on T.V. , and I have been doing that for a long time now, because I just can’t take the overwhelming feelings I get when I see it. I actually “feel” the other people’s pain . I couldn’t have expressed that as a child. But, some days I would cry for no reason and feel like the whole worlds weight was on my back. Making me not the easiest child to be around.

    Now that I have read about being an Empath and I have put some of its theory’s into practice, I find my life all of a sudden getting much “lighter” and “easier” to deal with. I am now seeming to come across more and more people ( They are easy for me to spot ? ) that I am able to somewhat help with the “being an Empath” theory. And I know, I know, it sounds a bit way too deep or weird. But, I bet that many of you parents out there have experienced “intuitive” behaviors from your child that made you say “Hmmmmmm?”

    Before I knew anything about this “theory” I knew my young daughter was probably going to have some of my behaviors. I was so angry with my genetics !!! I was very sad that she feels so sensitive about things, that she ruminates over and over about things that bother her or things she feels fearful of. Here is one of those intuitive stories– At four years old she told her dad and I that she didn’t want to eat meat. We though it was probably a texture issue but gosh darn it , we eat meat in this house for our protein !

    So, further on in time, she keeps saying or mentioning that she really doesn’t want to eat meat with every dinner. She is now almost seven. So her dad and I said “ok, but you have to be willing to go to the store with us and pick out some different kinds of beans and other things to get your protein, AND be willing to try them more than once. She was so happy to have her needs heard and went to the store and picked out choices she thought looked interesting. ( Another thing I bet many of you parents out there know, is empathetic or not, your child is highly intelligent ,sometimes more so when it’s something they “want” verses “needs” to do ) So her father and I finally let her have a say in what she ate.

    She is 100% happier and I find that I am no longer nagging her to eat. The whole point of that long story is, that if you read about Empaths, they can actually “feel” or be “sensitive” to the energy that comes from food. If any one has read the book “The Secret” it supports a theory that energy is all around you. What you think is what you will attract. It makes me wonder sometimes if instead of ADHD, or Depressed, or OCD, or “Difficult”, that some people are just way more sensitive to the energies put out there in the world by media, people, animals, the list is endless. I’m NOT in any way invalidating any diagnosis on anyone !!!! Let me be very clear about that. I just find it interesting since I started to learn about being an Empath more and more things have kind of “clicked” together, and started to make some sense . Now, I am only just beginning to explore this realm. So my knowledge is only to a certain extent right now. I do feel that a child would not be able to fully understand this “theory” of energies and empathy, but I do however feel that a parent ( who’s trying to “survive” this diagnosis or behavior ) might possibly benefit from looking into it. If you have some time to read,and are willing to be open minded about it, I don’t think you would have anything to lose. It seems to me that if someone is taking a dopamine enhancing medication, ( I take one myself ) that these “feeling” pathways would be more “wide open”, in regards to how you feel about someone or something or any stimuli.

    The more I study about being an Empath and the more I practice the actions it suggests, oddly …… The easier my life and my daughters life have become. I know to many people out there I probably sound crazy. And that’s ok too, but please don’t leave hateful or negative feedback, because I think as parents of… And being, “one of the diagnosed” any information could possibly be a benefit. If you feel it isn’t for you, then move forward with what works. I have nothing but prayers for every parent and person that has made a comment. Some days feel like a battle that won’t end until death !! Some days I still want to just crawl into bed. All I want to say and do, is let people out there know about something that is helping me. And I felt it somewhat relates to medecine and empathy and just how hard it is sometimes to put your finger on “why ???”
    Why do they act like this ? Why do I feel like this ? Why doesn’t this or that help ?
    I know this post is a million miles long, but if it could possibly help — one — person, then it is totally worth every word. ” I feel ” that it’s definitely something to consider. I don’t think, and I’m definitely not saying that people should be without their medications, (myself included ) but there are behaviors and practices in this theory that have helped me . I just want to thank anyone who took the time to read this.
    And to end it ” Dear Gina, I find it odd that the study was supported by the Defence Department and the others as well !! Ha.
    Also, I apologize to anyone that DID talk about “Empath” because looking back on these comments I see some people have touched base on it !!!
    Nowadays , anything is possible, we are moving forward and discovering new things at an alarming rate. Hopefully many of those things will be used for the better !!!!! Much Love,

    1. Beautifully said, Julie. Thank you for joining in the discussion.

      I think the “bottom line” here is that some people with ADHD “feel more empathy than is comfortable” for them and find it hard to manage. Other people with ADHD are so distracted/impulsive, they can’t pay attention to the empathic feelings they might possess.

      Either way, the core issue is about “managing feelings” — including being able to feel them without being overwhelmed. Being able to discern when it’s a useful point of empathy (a loved one, a real person in need, etc.) or when it’s a manufactured point (a sad commercial on TV). 🙂


    2. Undiagnosed Adhd empath
      + Covert Narcissist.
      I didn’t know this until very recently…
      2 kids and 12 years later….
      I want to help. Any advice for the adhd at 31. I lose everything. Forget what I’m saying if Interrupted, and miss critical info while I’m looking right at you. Did this all happen because she felt alone? Did I forget too many special days? Did she ask me to do something…..and I do 6 other things Instead? Maybe even 1 for a neighbor or friend. Did I shut off her love for the world?

  29. OMG! Finally the missing piece! I’m over 50 and my ADD is SOOO bad now. I was writing off a lot of my obsessions with just being hyper focused. I get so worked up over Trump as if its my personal duty in life to alert the innocent and ignorant and bring awareness to his evil deeds. Just today I stumbled on the word “Empath” and it was the same light bulb when my sister reminded me (at 40ish) that as a child I had ADHD but my Mom didn’t like the “zombie” effect. So she took me off the meds. It was suddenly so obvious, the years of struggling in Jr. & High School and the struggles all my life. Then late 40’s it was really causing havoc! Then I thought oh no, ADHD & Empath. And discovered this.
    Well, it doesn’t fix me but somehow it reassures me a little bit.

    1. Hi Laura,

      I’m so glad you found your “missing piece” here on the ADHD roller coaster. 😉

      It’s so unpredictable…..what will be the “linchpin” that ties everything together.

      It’s different for everyone, but this piece certainly spoke to many people.

      Keep up the good work about Trump! haha!


  30. Hi Gina,
    Thank you for this page – article and comments.

    Could you please comment on…
    a) is mirroring body language a way to transmit “empathy”.
    b) could there be a reinforcing loop of a dopamine self-doping, empathy-seeking behavior?
    c) is “b” helping us feel good, protected when in large groups?

    Thank you,

    1. Hi Adrian,

      You asked:

      Could you please comment on…
      a) is mirroring body language a way to transmit “empathy”.
      b) could there be a reinforcing loop of a dopamine self-doping, empathy-seeking behavior?
      c) is “b” helping us feel good, protected when in large groups?

      A: I’m afraid I don’t have good answers for you, or maybe I don’t understand the questions. Mirroring another person’s body language is sometimes used as a way to help a person feel what the other is feeling, but not very reliably, I would think.

      B: Perhaps you are asking if a person with ADHD might “self-medicate” by acting compassionately or empathically toward another person? I suppose that’s possible. It’s a “good” feeling to be helpful sometimes, and to connect with another person through compassion.

      C: You mean, if you focus in on listening and “being present” with one person in the group, that can help prevent a feeling of overwhelm from being in a crowd? I suppose that’s possible, too. 🙂


    2. adrian amariei

      Hi Gina,
      B) we all meet people that complain; about small things or about important matters. Is complaining (sometime) a way to elicit empathy? And then, when the complainer receives empathy… is that a dopaminergic event with an echo in the Nucleus Accumbens?

      thank you,

    3. Hi Adrian,

      You ask: Is complaining about small things or even important things sometimes a way to elicit empathy?

      Seems like a very complex question to me!

      Some people are chronic complainers. It’s just what they do.

      Some people with depression or anxiety complain about many things, because they are seeing the world through the depression/anxious filter. Some people with ADHD “self-medicate” by always searching the horizon in order to identify pending catastrophes. Or they complain as a habit, a way to stay engaged. The same way that some folks with ADHD keep asking questions during a presentation, to stay engaged and not have their attention wander.

      Then there are people who simply feel overwhelmed and alone, and might have plenty to complain about. They might share the litany of things with anyone who will listen, so they can connect, feel “seen” and understood. Less alone. Perhaps that’s what you might call a “dopaminergic event” but I have no idea where it echoes. 😉 Or perhaps it more involves oxytocin.

      Of course there are many more possibilities than those above.

      It’s important to point out, though, the differences among empathy, sympathy, and compassion. This writer contrasts the terms:

      Sympathy is the heightened awareness of another person’s plight as something to be alleviated (Lauren, 2005). The emphasis here is awareness i.e. coming into the knowledge that there is another person’s whose situation is deserving of your attention and that there is some element of pain/suffering that that person is experiencing. From there, care and concern are shown towards that person. It typically sounds like this, ‘I’m sorry for your loss’ or ‘I hope you are coping well.’

      Empathy is the attempt of one who is self aware to understand and even vicariously experience another person’s situation and emotional state (Baron-Cohen, 2006). Most people refer to this as ‘being in another person’s shoes’. Literal examples include wearing your other half’s shoes or a husband putting on a pregnancy suit to see how the wife’s mobility is affected carrying a baby. The emphasis here is experience i.e. being able to almost feel what the other person is going through. It typically sounds like this, ‘It sounds like you had a bad day at the office and you probably need a break’.

      Compassion is taken a step further, where a person feels empathy and then a desire to help alleviate the suffering of the other person. The emphasis here is on action i.e. wanting to help.


      I hope this helps.

    4. adrian amariei

      Hi Gina,
      related to A), I have found in “The Age of Empathy: Nature’s Lessons for a Kinder Society” by Franz De Waal:

      “This is precisely where empathy and sympathy start—not in the higher regions of imagination, or the ability to consciously reconstruct how we would feel if we were in someone else’s situation. It began much simpler, with the synchronization of bodies: running when others run, laughing when others laugh…”

      Is mirroring body language something that people with ADHD manifestations do?

      kind regards,

    5. Hi Adrian,

      De Waal’s is an interesting notion. But I think he’s out on his own limb there.

      Some people will mirror body language (e.g. hunched-over shoulders, head tilted down, etc.) in order to approximate feeling what the other person is feeling. But this is definitely a very limited method of finding empathy.

      I find the work of Simon Baron-Cohen, an autism researcher, very interesting in regards to brain-based empathy. You might want to look into it.


  31. Great subject!

    I’ve been re-reading “The Selfish Gene” by Richard Dawkins recently, and I began pondering about the fact, that my personal empathy for animals, especially dogs and horses, is abundant and always in favour of their reasoning for their behaviour, in other words, I always take their side, whereas with people and my empathy towards them, I tend to get a bit more “skeptic” of their agenda and tend to focus on the “holes in the cheese, not the whole cheese”, which sometimes makes me seem like I don’t have any empathy, which is certainly not the case, IMO.

    What do you think? Recognise any of this or am I just babbling?


    1. HI Peter,

      I’ve met quite a few people who feel as you do toward animals and people.

      I suspect it’s because animals can’t talk. And so one’s own feelings can be projected onto them.

      Also, animals don’t have complex needs. As people do.

      Figuring out people calls on higher-order brain processes, which might be problematic for some folks with ADHD.

      So, they err on the side of “friend” or “foe”—sometimes quite inaccurately and to their detriment.

      Great book The Selfish Gene.


  32. Pingback: ADHD, Empathy & "Raising a Narcissist" - ADHD Roller Coaster with Gina Pera

  33. I don’t know my mother, I, and my 30 year old daughter, and 2 of her sons have Add, the 3rd son has a anxiety disorder.
    My mother didn’t seem to have much empathy though she could pretend very well. She was also bipolar and didn’t emperthize with her children’s emotions at all.
    I was just the obsolete , not that I wanted to be I just was..also a intuitive person and can feel other emotions. To this day I am overly sensitive to any injustice or pain in this world. I am not bipolar.
    My daughter diagnosed adhd, learning developmental disabled, occ, has bipolar our problem is she is cold to me and her children but nicely, nice to all others, unless they refuse her what she wants.
    When she was n adhd medicine as a child she was so sweet. But stopped in high school and started attacking her teachers, she wound up at butler mental hospital. They tried to restart her medicine but her dad showed up signed her out,said you don’t need that crap! Well fast forward to now she’s 30, as said 3 boys, 1 anxiety disorder.. I remember when he was 5 he told her he wanted to throw her computer out the window because he feels invisible. I wanted to cry for him. She screamed her head off at him. I seem to over identify with him and she seems like a 3 hour a week mom only. Now. The two youngest 8,7, are going though IEPs for add and she’s freaking out on them. And threatening there dad to go after full custody if he even try’s to put them on medicine for it. She did so well on it herself but has a whole different played out story in her mind of how she was victimized, I feel really sad because we can’t have a relationship. She attacks me for not agreeing or doing things for her. She is jealous of the attention I give her son’s and stops my visitation rights because of it. I had to call dcyf because her son was being molested by his dad’s brothers son? She called the investigator and said I made it all up because I don’t like there dad? They closed the case.
    Meanwhile her son was peeing and pooping his pants regularly at the age of 7-8 when he was trained by me at 3 with no problems. My question is this me? Is it her. ADHD, bipolar, or mom covered up for my uncle who molested me and my siblings. So I see a repeat pattern. At this point I just want o move out and try to see the boys when I can. I know she will punish me for leaving but it’s to upsetting to live this way. I’m always worringing about her boys and if I say one thing she attacks ruthlessly, with lies about my character, her childhood, whatever she feels will work in the moment?? I am so alone and confused. They should have books on how to deal with people like this?

    1. Hi Sissy,

      I can’t imagine how painful this must be for you. I don’t know how you can continue living with her and retain your sanity.

      It’s a huge problem, parents whose own ADHD+ goes poorly managed while their children are given IEPs, etc. The whole family deserves treatment.

      As for this: “She did so well on it herself but has a whole different played out story in her mind of how she was victimized.”

      You can see this same phenomenon play out in comments to various articles online about ADHD. Adults who were treated in childhood form some of the most vehement critics of “drugging children.” Granted, many received poor medical care and very little attention was paid in teaching them about their ADHD and “owning” it. So, one can hardly expect good long-term results. But others simply resented being treated for a “disorder” they don’t believe they have. They want to blame the rest of the world. To their detriment.

      There are probably books that address dealing with people like your daughter (as you describe her). But I’m not sure how far they go toward protecting your sanity. The degree of concessions you’d have to make — and constantly holding your tongue instead of countering her distortions — that might be hard to take.

      One that might be helpful is called “Walking on Eggshells.”

      Good luck,

  34. I think of it this way. Those of us with ADD feel empathy the same way anyone else does. The problem is, we don’t always notice when someone requires it. It’s like how a toddler might try to help an infant who is crying, but not one who is giving off less intrusive distress signals.

    If I notice that you are in pain, I want to help you. But sometimes I just don’t notice. Combine that with my emotional disregulation, and I might end up mad because of your out-of-character behaviors, when all you want is a hug.

    Thank goodness for ADD medication.

    1. Hi Josie,

      Great analogy. The partners of adults with ADHD report that, when the situation is “serious” or “acute,” their partners often pull through. But when the situation is more chronic (needing ongoing support), no effort is seen.

      And, of course, empathy is variable thing in all humans, including those with ADHD and those without.

      Yes, I agree…thank goodness for ADHD medication. Much of the public simply has no idea…..


  35. I have ADHD and thanks for this post. This post (rant) will take me ages to type but here goes.

    I have been reading (actually listening to) your book. I am in the “ADHD and Sex” chapter. Your book has convinced that my girlfriend of 6 years might most likely also have ADHD.

    I also read Thomas E. Brown’s book on ADHD and watching Dr. Barkeley’s videos on youtube.

    Now coming to what I wanted to say:

    After reading Dr. Brown’s book and half way through your book I feel extremely depressed and angry. I WANT to feel normal, I WANT to know what it feels like to be a normal person for a day (as they call them: NeuroTypical). I am angry at the cards I have been dealt with :(. I feel bad about how I have made myself isolated from planet earth. I have no friends.

    I spend all my time at work, which thankfully is understanding of my ADHD needs and pays well and I am also thankful that I have been extremely conservative with my money. Having money made me “ok” with myself for an year.

    The only thing that taught me to empathize was strattera, but it KILLED my sex life (I think permanently). Even with meds that I can live with (adderall), I dont know what I feel, and I am just about realizing the ENORMOUS price I have paid. No family ties, no long term friends.

    I dont know where to start. Just feel down and out. Feel like liquidating all my assets, quit my job and do something crazy, but thankfully I dont have the attention and patience to go through with that crazy plan.

    1. Ach Lokesh, let’s hear it for lacking attention and patience to go through with that plan. 🙂

      I’m really sorry you feel angry and depressed half-way through my book. I’ve devoted the last 16 years to supporting adults with ADHD, often without pay, so that is surely not my intent. For adults with ADHD, I usually recommend starting with the Success Strategies, so they don’t get so discouraged. Please skip ahead to the medication chapters and see if the medical treatment you received bears any resemblance to what you SHOULD have received.

      Are you sure Strattera is not viable? Maybe a lower dose? Too many docs start too high.

      The issue of sex and ADHD is so complex. I just wrote a very involved chapter on it for my new book (for therapists treating ADHD-challenged couples). Some late-diagnosis adults with ADHD have developed the “poor coping strategy” of dealing with every emotion by using a sexual outlet. Then when the medication “normalizes” their sex drive, they think they’ve lost it.

      It’s very tricky to find a sex therapist who understands ADHD, but it might be worth looking.

      You obviously express yourself well, you are smart, and you desire greater empathic capacity. You have much going for you. Please don’t give up on finding better help.


  36. Pingback: TDAH, empatía y dopamina | Dra. Elena Díaz de Guereñu

  37. Wow i always thought i was empathetic, but now i’ve read this perhaps not.
    During arguments or cross words, i have often been told “its not all about me” these words greatly upset me as for the life of me i can never understand what i have done to make people think like this, well i can see now i must have missed out when the empathy cells were installed. 😉
    I am cursed with Bipolar as well as ADHD (plus anxiety too).
    Lel.. middle aged female.

    1. Hi Lel,

      It must be very hard to bear, this seeming disconnect between your intentions and what the people around you reflect back. Knowledge is power, though.

      Bipolar, ADHD, and anxiety combined….. I hope you have a good MD.


  38. This is me – so much so I’m a little freaked out by how accurately it has described why my brain works, thinks & acts in ways that people look at me like I’ve just touched down from Deep Space! My whole life has been a roller coaster of emotional confusion & constant self evaluations where I frantically search my brain’s memory vault for the evil thing I said or did that resulted in me losing another friend. I have anxiety/panic attacks when my son or husband come down with a cold or sick because no matter how hard I try, caring for them triggers something in my brain that makes me treat them like they’re sick just to spite me & inconvenience me. I tend to use anger & nastiness as my emotions of choice if I’m under extreme stress or worried, sad or nervous. It confuses everybody around me who just can’t understand why I act the way I do & say the things I say. Frustration with myself for not being able to control these feelings & thoughts, soon becomes depression which results in shutting myself up at home (locking doors, turning off phones & ignoring everybody for days/weeks) & I jump into my imaginary safe place in my head & escape from life/reality indefinitely. I function only to collect my son from school, cook dinner, wash uniforms only & as soon as I know family have left for school/work, I return to my happy place. Bills are left unpaid, appointments get missed, groceries run down to nothing, important things are forgotten without a second thought or concern. Suddenly I come back to life ready to go another few rounds with reality & find the nightmare & serious dramas I have inflicted upon my family when I ran away AGAIN! Enter my team of psychiatrist, psychologist, job assistance counsellors, etc etc to hastily repair the damage i’ve caused yet again & pulling all their strings to get me out of the hole I keep digging for myself. Occasionally, I actually make tiny steps of progress & the timeframe between my “episodes” gets longer & longer. I still trip over & screw up but everyday I’m finding it a little bit easier to snap myself out of it & mentally lock the door to my happy place so I’m forced to deal with my problems rather than freak out. I’m beginning to believe that my fellow Tuckshop Mothers really DO like me & consider me to be one of their friends, which is something I’ve never experienced before in my memory – the “emotional bond” of genuine friendship has been such a mind blowing eye opener for me – I guess the butterflies & nervousness we feel when we experience our “first kiss” or accomplish something like being elected School Captain or acceptance into university. For the first time since I was diagnosed (not only ADHD but severe depression & anxiety – can’t have one without the others) 1000yrs ago – apparently it was actually 11yrs, I’m believing not only in my head but in my heart as well (I now understand what people are on about when they refer to things “coming from their heart” – I put it down to instinct or “gut feelings”) that I can beat this thing – ok maybe not beat but fight enough to scare the crap out of it & leave me alone for a while! Years of denial, frustration, helplessness, loneliness & even acceptance of having no fight left in me to be of any value/use to anybody or anything. I believe without any shadow of a doubt, that it was at this point that Divine Intervention took control & removed any of the “mental triggers” that convinces people with similar mental & emotional despair to end their lives as nothing else will ever stop the pain of living. I remember hating myself because I didn’t even have the guts to consider suicide as an option. Now I look back & can’t comprehend how my life ever became THAT bad – the answer is simple – nobody cared enough or stopped long enough to think that I might have something wrong with me – other than just being a cold hearted selfish bitch! I could never understand why people would think of me in that way because I had & still do spend my whole life desperately trying to do the right thing & be a good person worthy of a crumb of happiness (just once)?but never seeming to achieve it. It’s been the biggest struggle of my life to get to where I am today – I am proud that I can allow myself to really see a tiny speck of light at the end of the tunnel & finding enough inner strength to take baby steps & move closer towards it – rather than automatically thinking it’s a trick & run away. With my amazing team of doctors, family & FRIENDS, I am tentatively letting go of them holding my head above water & learning to swim on my own. I’m still terrified of the event that might trigger me to fall into the abyss again but so far, I am not allowing the paranoia & fear to sit & fester anymore. Empathy is not something we should ever take for granted – it is the key to our survival as human beings & enhances all of the good & positive actions we do everyday without thinking about it. I can’t wait to see what I am capable of next!

  39. I just read your article regarding empathy and ADHD. It really resonated with me on many levels. I was diagnosed with ADHD 18 months ago after I saw all the hallmarks in my middle child. My psychologist spoke with me about it and I have been on medication for the last 18 months. The article was so insightful because my ex-husband would say that one of the biggest struggles in our relationship was my self-centeredness. Since being medicated, he has noticed that i am better able to see his point of view and work with him when we have conflicts. I am excited to follow this line of research, especially as a former researcher.

    1. Hurrah for your psychologist, Cris. Many have yet to receive the ADHD memo.

      Yes, the research is interesting, isn’t it? Especially with the UC-Berkeley study, being jointly sponsored by the school of business and the neuroscience department….hmmmm.


  40. Myself, my husband, and one of our sons display ADD and ADHD symptoms. This empathy thing is a huge part of how we interact with each other and the people beyond our family. At times we have so much empathy, mostly for people outside our family, while with each other we tend to be harsh and easily irritated. My husband and son struggle with the negative self talk and my empathy is non existent during pms. My husband noticed a great deal of difference when he first started taking stimulant medication. Commenting often how he could feel things he never felt before. Unfortunately the negatives overtook the positives and he is not able to take the medication. We all continue to struggle with this. At least this article gives me a little perspective.

    1. Hi Penny,
      I’m sorry that your husband felt he had to abandon medication. I encourage you and him to re-consider.

      The “negatives” of medication are typically due to physician error (assuming the patient takes it as directed).

      Sometimes the dosage is too high or it’s the wrong type of stimulant, or co-existing conditions (that is, depression, anxiety, bi-polar disorder) are overlooked and thus made worse by the stimulants.

      I really hope that you find a way to struggle less and enjoy life more. Just remember that all prescribing physicians are not created equally.

  41. The challenge with having so much empathy for others is in trying to keep from feeling so intensely that my feelings then become negatively affected too.

  42. i found this very interesting. I am 35. Never been diagnosed with adhd. But from what some others hv said I think I need to see a dr. I am really emotional. When I’m alone. I’ll cry watching the dumbest things on t.v. But then my son can do the smallest thing and I get so mad so fast. I think I definitely need to see a dr. Thanks for the artical

    1. Hi James,

      You’re most welcome.

      “Emotional dysregulation” is a common feature with ADHD, with various degrees of it.

      Then again, “depression” can manifest as you suggest in men. There tends to be more of an irritable component than there is with women, so I’m told by experts. (Though “depression” can make women irritable, too. “Depression” being serotonin-related issues.)

      Good luck sorting it out.


  43. This is something I have looked at in myself trying to sort out for the last few years.

    I have always been highly empathetic to the point of it making me a very over involved “caretaker” personality, even at a very young age.

    I quickly learned as a tween that hearing world news was not good for my emotional health. It was too easy for me to put myself in other’s situations and become overwhelmed with emotion, feeling helpless that I could not do something to help in someway, with everything I heard about. It was depressing, anxiety making and overwhelming.

    Yet, in the last 10 years, since I was dxed ADHD, I struggled for a long time wondering if I was in fact NOT an empathetic person, but just conditioned to be a sympathetic caregiver person having been raised by a narcissistic and alcoholic mother who essentially abandoned any motherly day to day behavior toward me past the toddler stage in my life.

    My 18 years as a “latchkey” kid from 5 yo on at home, involved me becoming the “mother” to my younger brother, stand in wife to my father as far as home management with cleaning and cooking went, and constantly catering to her teenage like ego and histrionics.

    It was survival mode as basic as it gets in an abusive situation. I learned to read her fast just by tapping into her energy before she even spoke a word to avoid the verbal and physical abusive.

    It took me a long time to realize that my strong empathy is what made me a survivor. I could quickly feel where she was going and head it off at the pass to avoid the utter emotional chaos she sought to fulfill her needs.

    But my “nurture” then left me doubting people when my empathetic nature allowed me to get involved too easily with people who would abuse that quality in me and use me. ( friendships to relationships)

    This confusion for me was compounded by the fact that being ADHD and swinging over into the Autism Spectrum- I have been accused all my life of talking too crass and harsh with people, and being to matter of fact and cold.

    In my own personal relationships I was often accused of lacking empathy and being unable to put myself in other people’s shoes. ( mostly when I’m PMsing..with lower estrogen when I am most UN-empathetic)

    It was hard to be accused of one thing but feeling the complete opposite inside most of the time. it was the basis for most of my debilitating anxiety in my 20’s. Obviously regulating/balancing that was an issue that I never considered to be part of my chemistry makeup, which I was years away from know was an issue.

    My husband has always joked that he is the “woman” and I am the “man” in our relationship, because he wants to talk things out and I want to “fix things”

    I am a very logic minded thinker and science and fact based problem solver. This made me a great leader and manager in jobs over the years. I’m the one who doesn’t panic when a fire breaks out in a locker room and it needs to be put out, or someone has a heart attack in the store.

    I am able to have that matter of fact-ness and personal distance needed in being a manager of workers. But, when it comes to my ADHD and ASD kids, I empathize with them a lot more than I pull back and be the parent, which caused arguments with my husband in parenting, because it left him “being the bad guy”.

    I worked through a lot of my inner struggles with understanding my own empathy and realized that I AM a highly empathic person, and my desire to help others is genuine, not a built in survival technique I learned in my first 18 years.

    But, I still have to be very mindful of where I direct my empathy and when, and be sure that the intentions of others who receive my empathy is genuine as well, because otherwise it can become toxic fast.

    Often my husband has to remind me I’m being to “Data” and I need to be more ” Deanna Troy” in a situation, because either from conditioning or chemistry ( or both) I have shut down my highly empathetic ability in that situation when empathy would bridge the gap and help find a solution easier and faster.

    It’s exhausting!

    Such a complex thing, isn’t it!

    Thanks for sharing this article Gina! It was well worth your time, I think.


    1. Hi Ril,

      My brain was spinning just from reading your eloquently told story. What a Hero’s Journey life has been for you thus far. And now you do so much to help others.

      Talk about complexity; you had so much to “de-tangle”—never easy when we have only other imperfect human beings, with their own inherent biases and blindspots, as our mirror. Not to mention unrecognized ADHD in the picture.

      The Star Trek reference is apropos…I used to call my husband “Commander Data” and he called me The Empath. In reality, I am also a problem-solver who has little patience endlessly hashing over emotions. Emotions are important, we must pay attention to them, but not too much attention, imho. I was probably a CBT therapist in my past life. 😉

      A funny story…from when our friends Rick and Ava Green were visiting. They were telling us about a technique they learned, wherein one person in the couple asks the other person, “Tell me what you need right now.”

      I turned to my husband and said, “Tell me what you need right now.”

      He said, “I need for you to shut up.”

      Then we both cracked up laughing. Ava and Rick were politely quiet, though wide-eyed. 🙂

      We’ll talk about the important stuff when we need to, rest assured.

      Thank you for joining in the discussion!


  44. Yup this is me alright but as a female, I could argue that during PMS my empathy is even higher than normal as I can get emotional, so not only do I have big empathy for all the things, but I will be crying too! I will go on a crusade of championing causes :p

    1. Jennova – It might be that your ADHD (assuming you have it) intensifies during your periods, leaving you less able to manage the beneficiaries of your empathy.

      Dr. Patricia Quinn (one of my top, top favorite ADHD experts) has long suggested that women with ADHD might need a little higher dosage of stimulant during their periods, to compensate for the estrogen drop.


  45. Kathy Adams-House

    Facinating, Gina, especially in light of yesterday’s presentation by Bailey and colleagues. I sent your article on to him.


    1. Aren’t you proud of your boy, Kathy? It is no mean feat to understand all that science-y stuff! 🙂


  46. Jennie Friedman

    Wonderful article, Gina. As always, it was thorough and well though out. I enjoy reading all you have to share especially when you tie the science into it. You have a real knack for making yourself easily understood. Keep up the awesome work you do!
    Jennie Friedman

    1. Thanks so much, Jennie.

      It’s pretty tricky to be accurate and thorough without being boring and pedantic ——all in the recommended short length of a blog post.

      I do try, though. And, when I’m lucky, the folks reading bring comments that richly expand the topic.

      Thanks for reading and the kind words.

  47. My husband and teenage daughter and son all have ADHD. My daughter, who is inattentive type, is an emotionally mature and empathetic person overall. My husband and son on the other hand, are more “ring of fire”, combined type. Both struggle daily with empathy with personal relationships. Yet at times can be overly empathetic. This often occurs when watching movies and in my husband’s career. As an advertising executive, I believe it give him a big leg up in understanding his clients and target markets. But it has also caused him severe problems with personal bondaries with co-workers and those he manages. Thanks for the fascination article.

    1. And thanks for reading and your comment, J.

      I love the discussion this has sparked! So interesting.


  48. HI LuAnn,

    Thanks for sharing your story. Yes, that’s very interesting about the 7R repeater allele, eh? That it confers more empathy among women but not among men.

    Autism expert Simon Baron-Cohen has done some interesting research on what he calls the systems-empathy polarity, with extreme systems being autism. He calls autism “extreme male syndrome” and points out the problems when one is all systems but little empathy.

    Conspicuously lacking, at least to me, was the problem with extreme empathy and little systems (in other words, more of a “extreme female” syndrome). Empathy can run amok, leading to too much self-sacrifice, sometimes to the point of endangering health and welfare.

    I think adding ADHD to high empathy would create a challenge just as you describe: poor boundaries.

    Helping others is a noble aspiration. It’s also highly rewarding, if not monetarily than in the connection it brings. At least that’s how I feel about it. I am very rich in connection. But then, there’s the balance, right…taking care of ourselves so we can continue to have something to give. 🙂

    Take care of yourself!

  49. Truly a fascinating article, thanks for writing and posting it! I have a much stronger appreciation and understanding for my son’s struggles now. Penny Williams, in her comments above, took the words right out of my mouth. My (ADHD, possible Aspergers) son, 16, has always exhibited a big heart and kindness towards others. He is very sensitive so I have always said he has a lot of empathy, when perhaps what I should be saying is that he shows a lot of compassion. He does have impaired perspective-taking abilities which causes misunderstandings when he mis-interprets the underlying intent of another’s words or actions. He has paid a huge price in the loss of friendships over the years due to this lagging skill. I wonder if this is something that can be learned and acquired over time with the correct interventions and practice or is a person blind to cognitive-empathy forever like someone who was born color-blind? I suppose we will not truly know if all the years of therapy and social skills training has paid off until that frontal lobe completely matures.

    1. Hi Shannon,

      I’m very happy that my article has helped you make the connection for your son.

      My own husband presented a similar situation: being kind-hearted but sometimes acting in ways that were anything but. Then being down on himself, disappointed in himself, and entirely dejected.

      I definitely think there are things your son can learn. But also, as i wrote, the medication really can help many people with ADHD to “access” their innate empathy, and to better use it in relationships. Reciprocity, cooperation, turn-taking…these can all be problems for people with ADHD, no matter how empathic. So, the more he is able to strengthen his Executive Functions in this area, the more his kind heart will jibe with his actions.

      There is a great book by psychologist Michele Novotni, written for people with ADHD: What Does Everyone Else Know That I Don’t. Check it out on Amazon.

      Also, you might want to read autism expert Simon Baron-Cohen’s book, The Essential Difference.

      Good luck!


    2. Thanks for your return comments and reading recommendations Gina, I will look into these books. BTW, Methylphenidate XR combined with Strattera has made a world of difference in targeting my sons ADHD symptoms.

    3. Hi Shannon,

      Glad to hear it. For my husband, too (except Concerta).

      Seeing the positive changes that my husband has made in his life fuels my energy to help others make similar changes. Healthier, happier, more fulfilled in his career. What’s not to like!


  50. Hello Gina,
    I’m a bit confused about your stance on empathy and ADHD – in this article you’ve stated “That, enhanced dopamine transmission often enhances the innate ability of people with ADHD to feel and act with empathy.”, yet you go on to write “Consider this excerpt from my book, Is It You, Me, or Adult A.D.D.?, where I name “low empathy” as one of three common ADHD-related deficits that can derail relationships: …”

    Am I missing something? Thanks in advance for setting me straight on this.

    1. Adding to my previous post: your use of “innate” is where my confusion lies – do you consider empathy to be innate in ADHD, as you’ve stated?

      Thanks again.

    2. Hi Deborah,

      Sorry, I was unclear. I was trying to be concise, and these are complex subjects.

      What I mean is that empathy is not a human constant. It is a highly individual trait. Humans have it in varying degrees.

      Some people with ADHD might be into the autistic spectrum, and so their “innate” empathy might be lower than average. Some people with ADHD might be very high in empathy, but ADHD symptoms interfere with the expression of it.

      But no, I do not– and there is no evidence to support — that people with ADHD have higher degrees of empathy than the rest of the population.

      As LuAnn points out, in the genetic study I cited, some women with the 7R repeater allele (which has an association to ADHD but is found in other people, too) were found to have more empathy than women without this genetic mutation. But the men were found to have less.

      In general, I view people with ADHD as I do everyone else: as individuals, with their own unique personalities.

      I find no sense in dumping 10-30 million people (in the U.S. alone) into some kind of simplistic category. Hardly seems fair, or logical.


    3. Hi Deborah,

      I understand your confusion, and I tried to be more clear in my response to your other comment.

      The bottom line: Even people with ADHD who have innate empathy (that is, the brain-based capacity for empathy, which is variable among all humans) might not be able to access it.

      ADHD symptoms such as impulsivity, hyperactivity, distractibility, etc. can interfere with the type of “new brain” reflection that lets them process such “higher-order” capacities such as empathy. And ADHD symptoms can also interfere with the “actions” associated with empathy.

      One simple example: 20 years into marriage, a husband begins medication treatment for his ADHD. That day, he notices his wife’s eyes are streaming tears as she chops onions in the kitchen. He says, “Here, let me do that for you, honey.” She about fell on the floor, as he hadn’t displayed such empathy toward her since their courtship.

      I write about this in more detail in the book.


  51. My two adolescent sons and I all have ADHD and we are all hyper-empathetic. It is painfully too easy for us to walk a mile in another’s shoes. It often impairs our lives and creates debilitating anxiety. My boys have especially noticed this at school. Where other teenagers may need to be shocked out of apathy (for example, when learning about the holocaust or WW1), they must shield themselves from too much detail because they will become drawn in so deeply and will be tortured by their level of empathy.

    My eldest son has actually noticed an ability to have a healthier detachment since he has been taking Concerta. The empathy is still there, but he seems more able to step back and not be drawn in so deeply. I always attributed this to his tendency to be overly emotional and sensitive, a common trait with ADHD.

    I am wondering if this hyper-empathy could be more associated with OCD, which we all also have. Interesting.

    1. Oh wow, Lori. Thank you for sharing your and your boys’ experience.

      It harkens to LuAnn’s, another commenter.

      The fact is, whether we have high empathy or low empathy, we function best in life when we are more capable of MANAGING that quality.

      With high empathy, we need to create boundaries and structures so that we can remain emotionally and physically healthy, taking care of ourselves.

      With low empathy, we need to learn actions that help us to stay connected to others. (And there are plenty of people with ADHD who are low empathy, too.)

      ADHD presents challenges in self-regulation; that is the core. So, it makes sense that your son is better able to regulate his emotions, with Concerta on board.

      As for your question about OCD and hyper-empathy, I haven’t heard of any such association. In the scenario you describe, I’d wonder if it is more the OCD quality of being overcome by obsessive thoughts that is more the problem. And that would be separate from your high empathy. If that makes sense. In other words, someone with OCD could also be low empathy and could become obsessed about how the world doesn’t do enough for him/her. 🙂

      Thanks for writing.

    2. You may all be level 1 “invisible end” of the Aspergers spectrum. I’m level 1 ASD, ADHD, the works. Comes with Hypersensitivity and “sensory amplification,” as my psychiatrist calls it. Meds like clonidine or guanfacine are great for this. Also, an ADHD med can decrease sensitivity but might take trying different ones. Everything EXCEPT Vyvanse made me MORE sensitive–but Vyvanse has made me WAY less sensitive.

  52. I have always been frustrated by the fact that my 8 year old ADHD son has seemed to lack empathy and acts self-centered. It has been difficult to understand because my two older children (from a different father) have always been the exact opposite. Now, I’m understanding that, to some extent, this is not his fault or mine. I’ve blamed myself, thinking I’ve done something wrong even though he’s been in counseling and I strive to expose him to and discuss with him situations in which we could/should show empathy. I just wish there was something more I could do to help him. Thank you for this article. It has relieved some of the guilt I feel and helped me understand what’s happening with my son. Hopefully, continued research will result in some practical ways to help ADHD children and adults relate more sensitively with others.

    1. Hi Mary,

      Yes, it’s so important to know that many of our “human” qualities aren’t evenly distributed. And, empathy is one of them. Even though you are mother to all three children, the different fathers (“genetic donors”) can of course make a huge difference. But the same can happen with the same biological parents: it’s a roll of the genetic dice.

      Of course, there’s a role for parents to play in teaching the “behaviors” of empathy, in drawing out capacities. But some children definitely will have an easier, or a harder, time with it.

      But if your son has ADHD, the good news is that medication treatment might enhance his capacity for empathy. So, we already have good knowledge about this.


  53. I have the ability to understand and identify emotions. It is so strong in my members of myself and family members that I call us empathic. We are great at sales.
    My ability to take the perspective of another person was groomed in law school. Perhaps our rigidity hinders seeing other’s perspectives or it is not as strong in my family.

    1. Very interesting, Angela. I had never thought of law school as an exercise in perspective-taking, but that makes perfect sense.

      In that case, it might be fostering “cognitive empathy” but not “emotional empathy” — a slightly different creature.


  54. g,
    Love your new site!

    One interesting additional point that connects empathy and executive function – from my halcyon days as a youth studying psychoanalysis back in the early 70’s:

    Empathy is a higher order function, more evolved with effective PFC activity than sympathy. Why? Sympathy indicates a certain subjective, feeling level, ability to emotionally reach across the room and identify with the pain of another. The only problem for those practicing sympathy is that, more often than not, they only take that first identification step, and too often get stuck in the other person’s pain. They can’t leave, and become emotionally lost over there.

    Empathy, on the other hand, requires good PFC Executive Function, with a metacognitively active two step process: 1. Trial identification with the other, and 2. Return to one’s full self for objective management of the other’s challenges. Good next-step advice doesn’t often arise from sympathy, but does often arise from empathetic considerations more objectively managed outside of a purely emotional reaction.

    Fairness required objectivity.

    These activities arise from good PFC activity on an objective level, thus supporting this interesting report.
    Thanks for sharing.
    Dr Charles Parker
    Author: New ADHD Medication Rules

    1. Hi Chuck,

      Thank you SO much for that clear explanation.

      That’s how I understand it as well, but obviously didn’t explain it as clearly as you have!


    2. Dr. Parker, thank you for your description of the two-step process. I don’t think I’ve ever heard it described quite this way, but I can immediately apply this to situations in my life that were confusing, but now make sense. This is very good insight. I think if more people understood this, they might be more patient with people who seem very naive and unable to return to their original state in order to be useful to the other person. It also explains why some people who might be considered cold or detached might actually be simply more practical in solving the problem because, while they have tender feelings, they also have the ability to compartmentalize in order to remain productive.

    3. Exactly, Jenni.

      This kind of information can help us distinguish between what someone “feels” and what someone “does” — and help to bridge any gap.


    4. That is probably the best explanation of the difference I’ve seen. Thanks for sharing! The fact that it’s still relevant shows how solid it is too.

  55. Dan Wheatley

    I was also wondering if this could be a problem with regulating empathy? In a case of to much at times for situations that don’t seem to merit this? I’ve just started reading “Smart but Stuck” by Dr.Thomas E Brown and I’m amazed that emotions and ADHD are just now being recognized. Thanks ,Dan Wheatley

    1. Hi Dan,

      Absolutely, I think it can be an issue with self-regulation, which Dr. Barkley maintains is the core of ADHD-related challenges.

      There might be too much empathy or not enough empathy — the challenge is, like Goldilocks, finding the “just right.”

      This kind of calibration of higher-order thought requires a strongly functioning prefrontal cortex.

      Thanks for writing,

  56. This was an interesting article because I was diagnosed with ADHD at the age of 17 and 16 years later, I am still filled with empathy. I have had medication management on and off over the years as well. I have worked with children in schools with ADHD, Aspergers, and I am currently a Masters level clinician for drug and alcohol counseling. Empathy has always played a role in my life- I deeply feel the emotions and connect with others. In my field, I have learned to manage empathy and I am excited to see future research about helping addiction. In my relationships, I feel and try to fulfill the emotional needs of my partner, but do not or cannot recognize my own. And sometimes I feel really overwhelmed- flooded- and i want to retreat! Thank you for this article.

    1. Hi Leslie Anne,

      As you describe yourself, you are exactly the person I had in mind when I read psychologist Simon Baron-Cohen’s fascinating book, The Essential Difference.

      As I wrote in another comment reply, he talks about the hazards of what he calls being “extreme systems.” That is, having a high aptitude for science, math, the “hard sciences,” but little aptitude for empathy, reading facial expressions, etc.

      High systems/low empathy people can be rewarded greatly in society (engineers, scientists, architects, computer software engineers, etc.), but their relationships and sense of human connection often suffers. Sometimes they don’t care, though!

      But I was reading the book, thinking…okay, where is he going to talk about the problems with “high empathy/low systems” — that is, the people who feel too much for others (mostly women, but not always) and lack the “systems” ability to engineer their lives, their money, their work life, etc. That is a great risk, too.

      Perhaps because Baron-Cohen is an autism researcher, he wasn’t as focused on that. But there’s a very real cost, as you describe.

      I wish you the best in sorting out your own emotions (which might not be as “interesting” to you, eh?) and taking care of yourself.


  57. What a huge light bulb moment. I created a nickname for the behavior that goes with it, a long time ago. Save the world syndrome. I have been obsessed with justice and fairness my entire 45 years of life. Have been ADHD aware for 20 plus years but is never ceases to amaze me how much new there is to learn to go along with it. This information is very helpful for myself and my 11 year old mini me. THANK YOU!
    This also contributes to my own psychology experiment I love to study. Red mind-Blue mind. It is mostly biology folks! 🙂

  58. I am an ADHD adult, this was a very interesting study, and a realistic one, the more I read the more it became obvious, because looking back before my medication days…., I always wondered why people found me distant or didn’t like me some of the time. I have always been kind and I am often thoughtful, but I did lack empathy…..but since being on my medication, I have seen a change concerning my empathic side. ….so I need to blurt out …..I feel so bad for my kids I raised before my medication days.

    1. Hi Jean,

      I imagine that was quite the puzzle for you—and could have turned you off to the whole idea of “other people.”

      If they didn’t see as the person you felt you were (kind and thoughtful), then it would be easy to conclude: to heck with them!

      The world is confusing enough, especially in our first few decades of life. That would seem to have added another layer of confusion.

      I’m glad you have some answers now.


  59. I can document at least three generations of ADHD/ADD in my family and I can see the empathy-deficit as explained in your article. What’s more, the less understanding of ADHD there is, the less empathy!

    It is often difficult to elicit empathy from our children or to suggest to them our empathy with whatever is going on with them.

    The lack of empathic response and the rejection of empathy leads often to a painful break in connections in our wide-spread and disjointed times, making connections even more tenuous.

    Luckily medication helps! Recognition, understanding and acceptance are difficult to acquire as to ADHD/ADD. Your article makes empathy easier to “learn”! Thanks!

    1. Thanks so much, Ted.

      I debated if I should take time out of my work to write this post.

      Knowing that it makes a difference for you and others means a lot.


  60. HI Penny,

    I’m glad you found the information helpful.

    Yes, it’s tricky to see how one who might be tender-hearted or have a kind nature might not necessarily be empathic.


Leave a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

[advertising; not endorsement]
[advertising; not endorsement]
Stay in Touch!
Ride the ADHD Roller Coaster
Without Getting Whiplash!
Receive Gina Pera's award-winning blog posts and news of webinars and workshops.
P.S. Your time and privacy—Respected.
No e-mail bombardment—Promised.
No Thanks!