"Why Do I Even Bother?" — How Failure Affects ADHD Self-Esteem
Failure is a familiar and sickening feeling for everyone. The missed deadline, the poorly-constructed flatpack furniture, and the bad grade at school are all common setbacks in everybody's lives.
For those of us with ADHD, that feeling of failure can be crippling. We seem to fail more often, receive more negative feedback as a result, and have a harder time dealing with the negative emotions surrounding failure.
That kind of powerful negative feedback can have lasting behavioural and emotional consequences:
Avoiding trying anything new or challenging.
Trying so hard to do something perfectly that it causes burnout.
Feeling that anything less than perfect just isn't good enough.
Experiencing pervasive guilt, shame, or inadequacy.
Deferring responsibility (e.g. asking others to make decisions).
Do any of those sound familiar?
Understanding Our Trouble With Failure
Failure hurts for everyone, of course. But for those of us with ADHD, it hurts more frequently, more seriously, and with greater hits to our self-esteem than for neurotypicals. There are several reasons for this:
People with ADHD tend to fail a lot more than neurotypicals due to executive function deficiencies.
People with ADHD often see neurotypicals doing the same things seemingly easily and wonder why they can't.
People with ADHD often receive far more negative messages from a young age than neurotypicals.
People with ADHD tend to suffer with RSD, making them more sensitive to those negative messages and to their perceived failure compared to neurotypicals.
Let's examine each of these in turn.
We Fail More Often
Many of us have experienced a lifetime of struggle against our limited executive functions, meaning that failure is far more commonplace than it is for our neurotypical peers. We tend to be physically clumsier, meaning that accidents happen more often (I can't tell you how many things of my husband's I have managed to break over the years). We're prone to missing deadlines and details, leading to unfinished projects and poor performance at school and work. We tend to have problems following instructions, missing key steps or doing them in the wrong order.
All kinds of executive function issues can cause failure in our everyday lives. This means that we've failed many more times than the average neurotypical, and we know it. We see those around us being able to do the same things successfully, and assume it's just us being stupid or careless.
We Fail More Seriously
Some of these failures can be life-changing or even life-threatening. Our impulsivity can lead us down dangerous or self-destructive paths, and our limited ability to understand consequences in the moment can mean we make decisions that seem completely boneheaded in hindsight. People with ADHD are more prone to substance abuse problems, serious accidents, unplanned pregnancies, impulsively quitting jobs, and more.
These kinds of major failures can make us feel as though we are seriously flawed, or even that we're fundamentally a bad person. We look at these serious mistakes in hindsight and can hardly believe we would do something so reckless. Sometimes it's as if an entirely different person did that incredibly stupid thing, not us. Why is it that we are capable of understanding the consequences after the fact, but not in the moment?
For most of us with ADHD, moments of extreme impulsivity come at times of heightened emotional stimulation — a "hold my beer" moment — the exact times when most people's prefrontal cortex kicks in and tells them, "perhaps this isn't such a great idea?"
But the ADHD prefrontal cortex is impaired, especially in moments of emotional arousal. This means that in the exact moment we need it most, our prefrontal cortex is completely ineffective at helping us see the consequences of our actions.
We Receive More Negative Feedback
Leading ADHD experts estimate that by age twelve, children with ADHD have received 20,000 more negative messages from their parents, teachers and peers than children without the condition. A 2015 study found that children whose parents held critical views of their children as people (as opposed to merely criticisms of their undesirable behaviour) showed more severe and persistent ADHD symptoms into their teenage years.
This is a negative feedback spiral familiar to many of us with ADHD; our ADHD symptoms cause friction and criticism, and this in turn worsens the symptoms, which creates more criticism, and so on.
We're More Sensitive to Rejection
We experience more frequent, serious failures, and receive more negative feedback about them, but we're also likely to be much more sensitive to the criticism we receive. Rejection Sensitive Dysphoria (RSD) is commonly found alongside ADHD, meaning we are generally far more sensitive than neurotypicals.
Criticism can feel like a form of rejection for many of us with ADHD. We frequently interpret criticism about our behaviour or actions as criticism about us as people, and that kind of criticism feels exactly like rejection. For example, if we make a mistake at work and our boss points it out, we can easily interpret that as a personal criticism rather than a professional constructive criticism.
It's so hard for us to tell the difference, in fact, that it's easy for us to miss actual workplace bullying due to our tendency to internalise the bully's behaviour, instead believing that it is our perceived "defectiveness" that is the problem. We are also more likely to become a victim of gaslighting — a form of psychological abuse where someone makes you question your perception of reality, your memories, or your sanity.
It can also go too far the other way, and we interpret even minor, innocuous, professional criticism as an attack on us personally. In turn, this creates self-doubt and impostor syndrome — the belief that you are not as competent as others perceive you to be.
What Can We Do About It?
As we have seen, those of us with ADHD tend to take massive hits to our self-esteem, and it starts from an early age. This is compounded for the undiagnosed, because there is no explanation for why our failures are more commonplace, nor for why other people find the same things so easy, so it's taken as a character flaw or personal failing rather than as a neurobiological difference. Thankfully, there are a few things we can do to make this easier on ourselves.
Understand ADHD Better
Often it helps simply to understand more about why these failures happen, and how the reactions of ourselves and others to those failures can affect our self-esteem. If we can understand the mechanisms at work, we can rationalise them.
Understanding our lack of an effective prefrontal cortex can allow us to be more forgiving of our silly, impulsive mistakes, since now we understand that we lack the usual "control mechanism" available to neurotypical people.
Understanding that our executive function is the underlying cause of our distractibility means we can be more forgiving of that detail we missed in a project at work, and not some personal failing that could have been overcome if we had "just tried harder".
Understanding that Rejection Sensitive Dysphoria might be making us feel unnecessarily hurt by comments from a work colleague helps us to avoid internalising well-meaning, constructive criticism. This then allows us to examine and learn from the criticism rather than feel hurt by it.
Practice Positive Self-Talk
Receiving so many negative messages over a lifetime gives our self-esteem a real battering, and we have no control over what other people say to us. But whilst we can control what we say about ourselves, often we join in with the critical messages, internalising the negative comments of others and echoing them. This isn't healthy!
It can be very helpful to practice positive self-talk. The next time you find yourself saying something like, "How could I have been so stupid," try saying, "Well, it appears my brain made me come unstuck a bit." You don't have to try to sugar-coat it — if it was a bad mistake then it was a bad mistake, and there's no getting away from that — but you don't have to make it about you.
You are human, and therefore imperfect. Everybody makes mistakes, and although you may well make more than the average person, it's really important to remember that this is due to a neurobiological difference and not a personal failing. You are trying very hard with fewer resources than most. Would you criticise someone on crutches for finding it hard to walk?
Talk to yourself as if you would talk to a friend or loved one going through the same. Offer yourself comfort and advice. If you find yourself being self-critical, counter with an immediate and opposing viewpoint as you would for a friend.
Get the Support of Loved Ones
ADHD isn't just frustrating for us, it's also difficult for those around us, especially when they want to help but can't understand why we are the way we are. But when our loved ones understand us better, they can support us better.
For example, if your spouse is frustrated because you have a hard time staying on top of chores, and they feel as if they're the housemaid whilst you're just being lazy (yes, this is me speaking from personal experience!), they might express that frustration by nagging you to get the chores done. This may work for neurotypical brains, but the ADHD brain will likely respond with even more resistance to the chores, along with a side of guilt for good measure.
When your spouse is able to understand that your inability to do the chores results from a neurobiological difference and not from laziness, they can start to work with you to help accomplish the tasks you're struggling with.
Since they now know that nagging won't work, they can start to help you in other ways. If you are able to work together to determine exactly what you have difficulty with — and also where your strengths lie — you can come up with strategies that help you to take on those tasks more successfully.
This kind of support from family and loved ones helps immensely, both for the person with ADHD and for the family and friends of that person. Primarily, it facilitates understanding and empathy between ADHD and non-ADHD brains that deal with the world in very different ways.
Therapy and Medication
Therapy is a very effective treatment for ADHD, especially when used in conjunction with medication. There are many different forms of therapy available, and many are also useful in treating comorbid conditions commonly found alongside ADHD, such as conduct disorder, oppositional defiant disorder, anxiety, and depression.
Cognitive behavioural therapy, or CBT, is a form of psychotherapy that was originally developed for mood disorders. It changes negative patterns of thinking by challenging and addressing "cognitive thoughts" — spontaneous interpretations of events which often come loaded with the unfounded negative assumptions we've built up over a lifetime.
Talk therapy can help adults with ADHD with the struggles we often face with issues stemming from longstanding patterns of underachievement, failure, academic difficulties, job turnover, and relationship conflict. Individual talk therapy can help us deal with this emotional baggage, including low self-esteem, feelings of embarrassment and shame experienced as a child and teenager, and resentment at nagging and criticism received from peers, family and authority figures.
Medication can also be very beneficial to those of us with ADHD.
MANDATORY DISCLAIMER: I am not a doctor! It's important to consult with a qualified medical professional to discuss anything relating to medication use, including but not limited to starting, stopping, altering dosage or changing medication.
Medication can boost the production and/or uptake of the neurotransmitters we naturally lack in our brains, allowing different areas of the brain to communicate more effectively with each other. It's rather like lubricating the gears in a machine, allowing it to run more smoothly.
Because medication works by boosting neurotransmitters — the lack of which underpins all of ADHD — medication is a very good way of treating the broadest spectrum of ADHD symptoms quickly and effectively.
Recent scientific research has supported significant improvements in emotional stability in both adolescents and adults. When the different areas of the brain are able to communicate effectively, it allows for more controlled responses to stressful emotional situations; the areas of the brain that modulate and regulate our responses are given a chance to communicate their information, rather than be drowned out by our overactive instinctive reactions.
In short, therapy and medication can allow us to mitigate the effects of our limited executive functions, meaning that — with practice — we will begin to make mistakes less often and less seriously. It also allows us the space to control and modulate our responses to situations, leading to fewer meltdowns, reduced impulsivity, and boosted self-esteem.
If you take only one piece of information from this article, let it be this: Be kind to yourself. Even if it doesn't feel like it, remember that you are valid, you are worthy, and you are deserving of kindness. Forgive your mistakes and try to learn something positive from them, rather than berating yourself. It will likely be your most important step towards living well with ADHD.