ADHD and: Shame

Many women with ADHD often feel like they’re constantly fighting against a wave of shame. Whether it’s trying to meet demands at work or in the household, the emotional strain is often hidden beneath the surface.

In this episode, Dr. Monica Johnson explores the unique struggles women with ADHD face in managing shame. Watch as she offers strategies to help ADHD women foster healthier lives.

We love to hear from our listeners. Email us at podcast@understood.org.

Related resources

• ADHD and women

• ADHD and emotions

Timestamps 

(00:58) What is shame?

(01:44) How shame affects women with ADHD

(05:11) How to reduce shame

Episode transcript

Dr. J: Imagine this. You're at home staring at a pile of laundry that just keeps growing larger by the day. The guilt of not keeping up weighs heavily on you, and you can't shake the feeling that other people see you as lazy or disorganized. Or maybe you've been out with friends trying to enjoy the moment, but you can't help but feel like you're always one step behind in the conversation.

If these moments resonate with, you know that you're not alone. Many women with ADHD face the burden of shame. This is "ADHD and," where we talk about everyday life and ADHD. I'm your host, Dr. J. I'm a psychologist who works with those with ADHD. Today we're talking about ADHD and shame.

(00:58) What is shame?

Shame is an emotion that's characterized by feelings of inadequacy, unworthiness, or humiliation. And it's often tied to the perception that you violated some societal or personal standard. Unlike guilt, which focuses on specific behaviors. So, like, "I did something bad," shame encompasses the entire self. So, for instance, "I am bad." It arises when an individual feels exposed, judged, or disconnected from others due to real or perceived shortcomings.

Shame has profound psychological effects influencing thoughts, emotions, and behaviors. Let's talk about some of them and how they relate to women with ADHD.

(01:44) How shame affects women with ADHD

The first thing I'll mention is negative self-perception. Shame fosters a pervasive sense of being fundamentally flawed or unworthy, which can have a negative impact on your self-esteem or self-image. Let's say that you constantly forget to reply to emails at work. One of the things that can happen is you may tell yourself that "I'm so incompetent. I'm never going to succeed." And over time, you just see yourself as fundamentally flawed instead of recognizing the role of ADHD in your challenges.

The second thing I'll mention is social isolation. Individuals experiencing shame often feel unworthy of connection, which can lead to withdrawing from relationships or social interactions. After interrupting friends during conversations, Mia feels really ashamed. And as a result, she starts to distance herself and not go to social events. When in actuality her friends miss her and value her company.

The third thing that I'm going to mention is emotional dysregulation. Shame can lead to intense feelings of anger, sadness, or anxiety. It is also linked to self-critical thoughts and rumination. Khushali loses her keys for the third time in a week and feels incredible anger and shame towards herself. She ruminates about how irresponsible she is and struggles to calm down, which leads to being paralyzed by her emotions.

The fourth thing is avoidance behaviors. People may attempt to avoid shame through several methods. It could be procrastination, substance abuse, self-sabotage, or even perfectionism. After being criticized at work for missing a deadline, Cassidy begins to avoid starting new tasks altogether, which only makes her situation worse.

The fifth thing that I'm going to mention is impaired relationships. Shame often manifests as defensiveness, anger, or withdrawal, which can strain your relationships. The inability to seek support or communicate effectively perpetuates feelings of disconnection. Rachel's partner confronts her for repeatedly forgetting to pick up groceries. She feels ashamed and reacts defensively, accusing her partner of being overly critical, which only escalates the conflict and leads to more strain in the relationship.

Number six is reduced motivation. While guilt can motivate reparative action, shame can inhibit changes by creating a feeling of helplessness or unworthiness. Gina misses a job interview because she mismanaged her time. Instead of engaging in problem-solving strategies, she gets overwhelmed by shame and starts thinking, "What's the point? I'm just going to mess it up again anyway," and stops applying for new jobs.

Yeah, so all of this is to say that shame is a beach. It's a nice sunny day with your toes in the sand. Or more representative, it's the worst sunburn you've ever had while being pummeled by tsunami-level waves. You want to be on fire while simultaneously drowning? That's shame. But don't you worry. We can at least downgrade it to stepping on a pointy shell while walking on the beach. I'm going to give you a few ideas on how to begin reducing shame.

(05:01) How to reduce shame

Number one is to practice self-compassion. Act kindly towards yourself during moments of shame. Replace harsh self-criticism with understanding and acceptance. This doesn't mean to use your ADHD as a rationale for why you can't do something or to make your ADHD someone else's responsibility.

For example, Lisa is a woman with ADHD and she frequently forgets appointments and feels ashamed of being unreliable. Instead of berating herself, she practices self-compassion. She says to herself, "My ADHD makes this hard, but forgetting doesn't make me a bad person. I can use reminders to help myself."

This is different from simply accepting that you're never going to be on time because you have ADHD or requiring your environment to just accept that you're always going to be late. Lisa knows that keeping an appointment is hard when you have ADHD and that it's important to figure out ways to improve her ratio of kept to missed appointments. Both things can be true at the same time. I'll also add that requesting support from your environment when it's needed is also an act of self-compassion.

Number two is to reframe negative beliefs. You want to challenge and reframe core beliefs that trigger shame. This could be replacing "I'm unworthy" with "I made a mistake, but I'm still worthy of love." For example, after being criticized at work for missing a detail in a report Jingwen tells herself, "This doesn't mean I'm incompetent. I bring creativity and energy to the team and I can work on improving my focus."

One of the things that I like about this example is that Jingwen highlight an inherent strength that she has and sees the mistake as something that can change over time. That's the type of thinking that leads to managing ADHD and shame more effectively. Share feelings with a trusted friend or a support group. Human connection reduces feelings of isolation that amplify shame.

Number three is to seek social connection. Jasmine joins a support group for women with ADHD. Sharing her experiences of feeling lazy helps her to realize that she's not alone and that ADHD is a valid challenge and not a personal failing. What I have to say here is get off the internet. I know that sounds funny coming from a doctor that you know through the Internet, but the majority of your connection to others shouldn't be through a computer screen. It should be with people that you can actually talk to.

Social media is a sinkhole that will mimic a weighted blanket. Social media allows you to be looked at. Human connection allows you to be seen. One is junk food and the other is a lifesaver. Choose sunlight over blue light every single time.

Number four is to practice mindfulness. Stay present with your emotions without judgment. Accept shame as a passing experience rather than a permanent state. I know you've heard it before, but there's a lot of robust research that shows that mindfulness is good for you, and there's a thousand different ways that you can do it. So, you're going to hear me talk about it a million different ways.

For example, Diana feels overwhelmed by shame after forgetting to pay a bill. She takes a few minutes to engage in deep breathing and acknowledge her feelings without judgment. This helps her to regain focus to address the situation at hand. So, instead of spending the next hour mentally punishing herself for making a mistake, she actually is able to take that time and to focus on problem-solving strategies. As I tell my patients all the time, "Don't cry over spilled milk. Mop it up and pour a new glass."

Number five is to engage in somatic practices. To drive home mindfulness-related actions, I'm going to talk about body-based practices like yoga, body scans, and progressive muscle relaxation. All of these strategies can help to release the physical tension in the body linked to shame.

Missy is the mother of two young and beautifully rambunctious children. She notices that she holds a lot of tension in her body and has a lot of frustration throughout the week when dealing with her kids. She begins a yoga routine that includes grounding poses to help her release physical tension and to relieve a lot of the frustration that gets built up throughout the week. This practice allows her to be more present and less frustrated when she's interacting with her children.

And here's my Dr. J. personal tip: If you can't afford the price of a yoga studio, use YouTube. There's lots of yoga videos that range from ten minutes to 90, so there's no reason to not engage in this as a practice. One of my favorites is Yin Yoga, and I do this nearly every week.

Number six is to engage in value-based actions. Align your actions with personal values to counteract feelings of shame that are connected with societal expectations. Despite struggling with time management, Anita decides to volunteer to help with the organization of a charity event because she values giving back. She focuses on tasks that align with her strengths, such as brainstorming ideas and interacting with the participants.

Instead of holding back from life, meet yourself where you're at and get started. Being able to contribute in ways that align with your values and play to your strengths will help you in reducing shame. It also provides you with opportunities to challenge yourself in your weaker areas. Over time, you can get to a level of competence or find a workaround for most things in life.

Number seven is seek professional help. As my patients often say, "Life be lifing." When that's the case, you can always do it all on your own. You may have to seek professional assistance, even if it's only for a limited period of time. If you have insurance, whether that be commercial Medicare or Medicaid, check with your carrier to find in-network providers. You can also find organizations that provide low-cost or sometimes even free services like community mental health centers, teaching hospitals, and college counseling centers.

At my practice, we offer lots of sliding scale in order to provide increased access to care. We have virtual skills training groups that are available to people in at least 40 or more states in the U.S. It's not always an easy process to get health care, and you may have to go on some waiting lists. I think it's worth the effort because you're worth the effort.

That's it for today. Thanks so much for joining me on this episode of "ADHD and." If you enjoyed this episode, I highly recommend our episode on ADHD and imposter syndrome, where I talk about how imposter syndrome is closely linked to ADHD. I give tips for overcoming self-doubt and quieting your inner critic. Don't forget to subscribe to our channel for more content like this, and I'll catch you on the next episode of "ADHD and."

This show is brought to you by Understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. Learn more at Understood.org.

"ADHD and" it's produced by Tara Drinks and edited by Alyssa Shea. Our video producer is Calvin Knie. Ash Beecher is our supervising producer. Briana Berry is our production director. Neil Drumming is our editorial director. Our audio engineer and music composer is Justin D. Wright. Our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. And I'm your host, Dr. J.