Living with ADHD can be like navigating life in fast-forward. Thoughts race, impulses can take the lead, and the battle to master time management is forever looming. While these traits often bring creativity and spontaneity, living in a world designed for neurotypical people can also sometimes make maintaining close relationships – whether with a partner, within the family, or with friends – particularly challenging.
If you or someone you love has ADHD, you may be familiar with:
- Miscommunications that lead to frustration
- Forgetfulness that causes unintentional hurt
- Impulsivity that sparks conflicts
- Difficulty regulating emotions
- Struggles with consistency in relationships
- Anxiety and depression
These patterns can create tension and make meaningful connections harder to sustain. However, psychotherapy offers a way to navigate these challenges and build stronger, more fulfilling relationships.
This article explores how therapy can help people with ADHD develop greater emotional awareness, improve communication, and create deeper, more lasting bonds with the people who matter most.
How Does ADHD Affect Relationships?
We are all interconnected, and this means ADHD involves more than just trouble focusing, it affects how people interact and connect. All my clients with ADHD describe ways their neurodivergence causes difficulties in their relationships, with their partner, their wider family, their friends, their colleagues.
I hear people with ADHD describe their partner’s irritation with things they do or forget to do. I hear about their reputation at work for being late or unreliable. Others are regretful because they have lost friends whose messages they forgot to answer. I hear clients feeling anxious or depressed because they put in a huge amount of effort to get things right, but still they have these problems. They tell me about the exhausting levels of masking and covering up they do to fit into a neurotypical world. In all these examples, functional challenges have led directly to relational and emotional challenges.
While there are also reasons to celebrate your ADHD, studies confirm that individuals are much more likely to experience relationship difficulties, with up to 58% of adults with ADHD reporting significant challenges in romantic relationships (Barkley, 2017).
Common struggles can include:
- Emotional dysregulation (difficulty managing emotions during conflicts)
- Focussing on immediate relationships, followed by waning attention
- Difficulty remembering commitments, leading to frustration
- Impulsive reactions that can cause misunderstandings
Psychotherapy provides a supportive space to unpack these challenges and develop skills for more balanced, rewarding relationships.
What is Relational Psychotherapy?
Relationally focussed psychotherapy is a form of talking therapy that focuses on the way past and present relationships shape thoughts, emotions, and behaviours. As the therapy progresses, understanding and insight emerges about repeating patterns in a client’s relationships. All of us carry an internal working model of relationships and often find ourselves repeating patterns in our dealings with other people. As with many therapies, an equally important element is the healing capacity of a positive and collaborative relationship between the client and the therapist. In summary, relationship psychotherapy emphasises:
- Understanding interpersonal patterns
- Exploring emotional responses in relationships
- Strengthening self-awareness and self-compassion
- Developing healthier communication habits
By working with a therapist, clients gain insight into how their relationships impact their well-being and learn strategies to foster more meaningful connections and develop their relational skills.
How Psychotherapy Helps Clients with ADHD
1. Enhancing Emotional Awareness and Regulation
People with ADHD can often experience intense emotions that can be overwhelming. They can find it difficult to self-regulate their emotions, particularly under stress, such as when they feel criticised or when there are too many demands on their attention. They sometimes need longer to gather their thoughts and work out a response or a plan. This can be difficult for all of us, but it is even harder for an individual with ADHD.
Psychotherapy helps clients:
- Identify emotional triggers in relationships
- Develop coping strategies to manage emotional outbursts
- Recognise and communicate their emotions more effectively
- Practice mindfulness techniques to stay present
By reducing impulsivity and becoming more aware of their emotional responses, clients can reduce conflicts and strengthen emotional intimacy with loved ones.
2. Improving Communication and Active Listening
Miscommunication is a major source of tension in relationships. Psychotherapy helps individuals with ADHD:
- Recognise unhelpful communication patterns (interrupting, tuning out, reacting impulsively)
- Develop active listening skills to stay engaged in conversations
- Build curiosity about how their communications are being understood
- Use structured techniques (such as repeating key points to ensure understanding)
- Express needs and boundaries clearly
These strategies foster healthier, more open dialogue with partners, family members, and friends.
3. Addressing Low Self-Esteem and Fear of Rejection
ADHD also affects an individual’s relationship with themselves. The symptoms of ADHD often lead to low self-esteem and sometimes feelings of shame. People with ADHD may be forgetful, frequently late, or find it difficult to absorb information. They may have been told they are lazy or should try harder.
Sometimes people with ADHD become sensitised to conflict and have a strong emotional response to perceived criticism or rejection. This can lead to:
- Avoiding difficult conversations out of fear of conflict
- Feeling unworthy or inadequate in relationships
- Over-apologising or people-pleasing to gain approval
- Finding it difficult to make decisions because of self-doubt and fear of getting it wrong
Therapy helps clients work through these fears, reframe negative self-perceptions, and build confidence in their ability to maintain healthy relationships. Therapy can also:
- Normalise their struggles in the context of ADHD using psychoeducation (including podcasts such as ADHD Ahwa!)
- Recognise the enormous amounts of effort they are already putting in
- Encourage self-compassion when mistakes happen
- Provide realistic hope that their relationships can be more stable and secure
By acknowledging the role of ADHD in disrupting close relationships despite best efforts, therapy can help clients be kinder to themselves when relationship difficulties occur.
4. Developing Consistency and Trust in Relationships
ADHD often makes consistency a struggle, leading to missed plans, forgotten commitments, or difficulty following through on promises. This can put strain on relationships with those around us. Individuals with ADHD are often very engaged with the person in front of them and find it easy to give them all their attention, however they can find it hard to hold the same person in mind when they are not with them. This can lead to ruptures when others feel forgotten or ignored. Psychotherapy supports clients in:
- Identifying patterns of inconsistency and their impact on relationships
- Following practical strategies for reliability that do not rely on just trying harder (such as establishing structure and routine)
- Prioritising realistic changes that will be significant for those close to them
- Building trust through small, meaningful actions
By developing more reliable habits, individuals with ADHD can strengthen their relationships and reinforce trust over time.
The Role of the Therapist
A therapist specialising in relationally focussed psychotherapy provides a safe, nonjudgmental space where clients can:
- Explore past relationship patterns and how they influence present behaviour
- Receive constructive feedback on interactions with others
- Learn practical strategies for emotional regulation and communication
- Practice relationship-building skills in a supportive environment
While ADHD can present unique relationship challenges, psychotherapy offers a roadmap to more meaningful, lasting connections. By enhancing emotional regulation, improving communication, and addressing self-esteem issues, individuals with ADHD can develop deeper bonds with those they care about.
If you or a loved one is struggling with relationship difficulties due to ADHD, consider seeking out a therapist trained in working with a relational perspective. With the right support, healthier, more fulfilling relationships are within reach.
Useful resources
ADHD Aha! (2021-2025) (podcast), www.understood.org/en/podcasts/adhd-aha
Barkley, R. A. (2017).Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed.). Guilford Press
