ADHD makes burnout more likely, but recognising the signs early can help you take back control. Photo / 123rf
People with ADHD are more susceptible to burnout, a debilitating condition that can cause serious issues – but there are ways to treat it
Not only will most people with ADHD have experienced burnout at least once, it is often what leads someone to an ADHD diagnosis in the first place.
ADHD burnout occurs when the typical ADHD traits – taking on too much, over-committing and over-extending, juggling too many plates, and trying to please too many people – combine and come crashing down.
The phrase ‘burnout’ was first coined in the 1970s and describes a state of total exhaustion brought on by work-related pressure. Anyone can fall victim, but studies have shown that workaholism correlates strongly with ADHD, making those who have it especially vulnerable. So what strategies can help?
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition. It affects the way the brain functions. The symptoms vary depending on the individual but, in general, people with ADHD have trouble with attention, organisation, time management and self-control.
They may also exhibit hyperactivity and impulsivity, which can be disruptive to their daily lives. Diagnosis can only be done by a medical professional, and for ADHD to be diagnosed, symptoms must be present in two or more settings, such as at home, school or work, or in other activities. Symptoms must also interfere with, or reduce the quality of, social, school, or work functioning.
“Very simply, it’s when the common features of ADHD, added to the stresses and strains of the workplace and modern life, lead to the loss of the ability to function,” says Dr Heidi Phillips, a GP, ADHD specialist and the Royal College of General Practitioner’s clinical advisor for neurodiversity.
“ADHD burnout isn’t just exhaustion, it’s complete overwhelm. It’s the feeling of being a hamster on a wheel and you can’t take one more step. It’s the point where something has to change.”
“The symptoms can be very individual and depend on the person and how far along they are in the cycle,” Phillips says.
“You might be at the point where you are aware that you’re not managing anymore and you need help. Or you might be past that point and you can hardly find the energy to get out of bed.”
The key features of ADHD can easily lead to a place of overwhelm and exhaustion, says Jo Desborough, a neurodiversity coach at advocacy service Unblocked Thinking. “ADHD affects executive function, which is what helps us plan and organise, prioritise tasks and manage our time.
“If you’ve prioritised everything and nothing, underestimated how long it will take and now you’re distracted and procrastinating, too, the stress and pressure will be building up. You may have managed it all at first but when you come to burn out, your reserves are gone.”
People with ADHD can often take on too much at work partly as a result of ‘rejection sensitive dysphoria’, an emotional dysregulation where failure or rejection causes severe emotional pain. People with ADHD may have had a lifetime of being told to ‘try harder’, they may have been labelled ‘lazy’ or ‘stupid’ in the classroom, so there is often a very strong drive to ‘people please’ and achieve more.
“You don’t want to let anyone down, you might be really driven by the need to prove yourself, so you over commit and find it very difficult to say ‘no’,” Desborough says.
“From childhood on, someone with ADHD often relies on routines initially supplied by parents and teachers and other structures that provide a kind of scaffolding that includes self-care like meal times, bedtimes, winding down times, spaces for exercise or rest,” says Phillips.
“As a working adult, if you’re taking on too much and struggling to get it all done, that self-care often gets cut away.
“You don’t have time for exercise, you’re sending emails at 3 in the morning when you should be asleep – and you can’t sleep anyway because you can’t switch off. You’re not scheduling meals and when you do open the fridge, there’s nothing in it because you haven’t had time to buy anything, so you eat rubbish.”
It’s a vicious cycle, Phillips says. “The more depleted you are, the less energy you have for self-care and the worse you feel.”
“The first step to recovery is to understand what’s happening and why.
“Knowing what ADHD burnout is, especially if you’ve been through it before, and recognising it in yourself is really important. The experience might be different for everyone – or it might be that you have family, friends or trusted colleagues who know you well and can point it out without judgment.”
“Start by allowing yourself three tasks to complete today,” says Phillips. “Depending on where and how you are, that might be to get up, shower and eat well – or it might mean that out of the 20 things on your work to-do list, accept that you’re not going to do 17 of them. Most importantly, try to do one at a time – don’t multi-task.”
“Accept help from family and colleagues, work out where the gaps are and where you’re struggling – the areas that you can’t do so well and that are adding to your exhaustion - and delegate or ask for help,” says Phillips.
“If you’re in a position to do this, try to put support in place full-time.” That might mean employing a cleaner, an accountant, or a virtual assistant, if doing so means you can remove the overload.
Many people with ADHD are hyper-sensitive to sensory stimulation and if you’re experiencing burn-out, it’s important to create the calmest conditions possible. Be aware if you are being distracted by surrounding stimuli – loud noise, a crowded workplace, strobe lighting – and find a way to remove yourself or the distractions. “Step out of social media, switch off your notifications, use your out-of-office reply,” Phillips says.
“If your ADHD is controlled by medication and you’ve been functioning well, then suddenly you’re not, it’s important to look at everything that might explain why.
“Talk to your GP. If you’re a woman, look at your hormone cycle and where you are in it. Are there any patterns? Could this be menopause related? Does your ADHD medication need to be changed?”
ADHD can occur unexpectedly, but there are ways for people with ADHD to mitigate the risk and take steps to prevent it from happening.
“Noticing your own early warning signs is one of the biggest gifts,” says ADHD coach Clare McNamara. “It can be highly nuanced. You might be more fidgety, or forgetting a lot of things, or you’ve lost a love for a particular activity. Notice the small pieces of information which show if the pressure is building.”
“Understand what you find easy and hard, the best, most productive times of day for you, and how you work best, then try to build a framework that fits,” says Desborough. That framework should include good sleep hygiene and healthy habits.
“An ADHD coach can really help with this. Check in with yourself at the end of each day. How are you managing? What have you got coming up – not just at work but family obligations, social calendar, difficult dates? Be aware of any challenges and have a plan in place.”
“It sounds so simple but understanding why you people please and agree to take on too much can help you set better boundaries,” says Phillips. “Do you define yourself by the praise you get from others? Are there other areas where you could get that energy and fulfilment that aren’t work-related – like a hobby?”
If you suffer from ‘time blindness’, learn to routinely over-estimate how long tasks will take – some people need to double it.
“A regular exercise that you enjoy can really help,” says McNamara. Research has found that even 10 minutes of regular exercise can improve executive function, promote dopamine release and reduce impulsivity for people with ADHD.
Although many people with ADHD find it difficult to ‘do nothing’, Desborough recommends finding a restful activity – for example, painting, journalling, knitting, Lego - that allows you to slow down, ‘switch off’ and clear the mind.
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