ADHD = social exclusion

“I don’t understand. I did everything I could - I asked questions, I smiled, I nodded - but nobody keeps in touch. I’m just so lonely.” I’ve heard this so often from clients of all ages - and it breaks my heart every time.

Adult women report friendships suddenly disappearing, men don’t understand why they can’t make friends at work and kids.. well the kids are not alright.

Studies in the past 20 years looking at the impact of ADHD on friendships in childhood are - to put it mildly - worrying.

In a 2005 study, before treatment (medication, behavioural support and education) 52% of the children with ADHD were rejected by peers, compared to only 14% of randomly selected classmates. Similarly, 56% of children with ADHD did not have reciprocal friends (defined as having at least one of their top two friendship nominations reciprocated), compared to 32% of classmates… wow. And even though medication definitely showed improvements with teachers and parents, the social relationships remained just as bad.

Does this mean ADHD kids never have friends? Of course not - but generally, they struggle to make and retain friends. This means they miss out on a lot of the social experiences that add to our social skills and add to our network of future friends… When we are excluded time and time again, we tend to anticipate that rejection and ‘give off signals’ that others detect - and exclude us even faster. It seems to be connected to ‘delinquent’ behaviour - as well as anxiety and depression. It’s not fair, it’s not kind but is it different for adults?

Studies do seem to show adults with ADHD struggle with maintaining relationships with neurotypical people - both stigma and difficulty communicating, so more masking, might mean that we are not seen as ‘authentic’ or ‘reliable’. Adults seem to find online communities helpful to understanding their symptoms and developing coping skills but a major drawbacks is sharing misinformation and difficulty managing online communication - there’s a reason that RSD is one of the first things that pops up on Google..

Instead of going through all the negative effects of social exclusion and isolation - what can we DO about it?

The two main elements affecting how we interact with other humans are

• executive functions and especially

• emotional regulation

social connection is important at all ages.

So any strategy, scaffolding or education we can do that will support either of those will start to make a difference.

5 ways to support executive functions & emotional regulation - at any age!

1. Grow your Self-Awareness:

   take the time to get to know your strengths and your challenges. If you know ahead of time that you’re a blurter or you tend to say things impulsively, practice with family or even yourself.

2. Practice self-regulation:

   Using ADHD friendly techniques, connecting with your body and knowing what makes YOU feel better is key - when we feel well regulated (in an appropriate state for our circumstances) we are less likely to react in a way that makes you feel bad. When we feel better, we make friends more easily.

3. Externalise time:

   We are all prone to losing track of hours - but sometimes weeks go past and we forget to reply or feel bad we haven’t.. and friends feel hurt and move on. Make time visible in your preferred way. I use a giant blackboard for family AND a daily Planner Pad - this helps me see time passing regularly but you might use an app or online calendar or journal.

4. Cultivate your joy:

   This is one that applies to all humans, of any neurotype. We like to be around people who feel good in their skins and who appreciate their own quirks and strengths - that might be difficult to start with but it will pay dividends. Not least because it will scare off the energy vampires who feed on our need for approval and the people who only want us to conform.

5. Create your life vision:

   Do you find yourself doing things that make other people happy but that you find sap your energy? Are you staying on a path that leaves you feeling stressed and permanently on edge? Maybe it’s because you’ve not had time to work on what lights YOUR brain up, what makes YOUR heart sing and what restores YOUR soul.

It might sound a bit ‘fluffy’ but without the last one, it’s going to be more challenging to identify those friendships you’re willing to put the time in for - and to attract those people who respond to your joy and vision the way that moths flutter up to a lamp at dusk.

ADHD might not be a superpower in the way some people want it to be - but it CAN, with a bit of time and support - mean that you’re the flame and not the moth, when it comes to friendships.

I’m creating small, focused coaching groups (for now) that will work on all of these and more. I’ve found that even my most outwardly successful clients struggle with social exclusion, in one way or another. Some have got to a place where it isn’t a problem - but perhaps they don’t want their child to have to ‘tough it out’ the way they did. Others would love to feel less like they’re on the outside, all the time.

If you’d like to learn more, have a look at my group coaching page - first program begins late October 2023.

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Warmly,

Katherine

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Further reading:

Matthews T, Danese A, Wertz J, Ambler A, Kelly M, Diver A, Caspi A, Moffitt TE, Arseneault L. Social isolation and mental health at primary and secondary school entry: a longitudinal cohort study. J Am Acad Child Adolesc Psychiatry. 2015 Mar;54(3):225-32. doi: 10.1016/j.jaac.2014.12.008. Epub 2014 Dec 24. PMID: 25721188; PMCID: PMC4733108.

Ginapp CM, Greenberg NR, Macdonald-Gagnon G, Angarita GA, Bold KW, Potenza MN. The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study. SSM Qual Res Health. 2023 Jun;3:100223. doi: 10.1016/j.ssmqr.2023.100223. Epub 2023 Feb 1. PMID: 37539360; PMCID: PMC10399076.

Will, GJ., van Lier, P.A.C., Crone, E.A. et al. Chronic Childhood Peer Rejection is Associated with Heightened Neural Responses to Social Exclusion During Adolescence. J Abnorm Child Psychol 44, 43–55 (2016). https://doi.org/10.1007/s10802-015-9983-0

Harwood, V. (2010). The New Outsiders: ADHD and Disadvantage, Chapter 3, in Graham, L.J. (Ed). (De)Constructing ADHD: Critical guidance for teachers and teacher educators. New York: Peter Lang, 119-142.

Abrams, D., Weick, M., Thomas, D., Colbe, H., & Franklin, K. M. (2011). On-line ostracism affects children differently from adolescents and adults. The British Journal of Developmental Psychology, 29, 110–123.

DeWall, C. N., Masten, C. L., Powell, C., Combs, D., Schurtz, D. R., & Eisenberger, N. I. (2012). Do neural responses to rejection depend on attachment style? An fMRI study. Social Cognitive and Affective Neuroscience, 7, 184–192

Somerville, L. H., Heatherton, T. F., & Kelley, W. M. (2006). Anterior cingulate cortex responds differentially to expectancy violation and social rejection. Nature Neuroscience, 9, 1007–1008.

Bagwell CL, Molina BS, Pelham WE, Hoza B. Attention-deficit hyperactivity disorder and problems in peer relations: predictions from childhood to adolescence. Journal of the American Academy of Child and Adolescent Psychiatry. 2001;40:1285–1292.

Hoza B, Mrug S, Gerdes AC, Hinshaw SP, Bukowski WM, Gold JA, Kraemer HC, Pelham WE, Jr, Wigal T, Arnold LE. What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder? Journal of Consulting and Clinical Psychology. 2005;73:411–423.