Many people can relate to feeling anxious in social settings. The idea of getting up in front of a group of strangers to give a presentation might make your skin crawl, for instance. Or maybe group gatherings feel stressful and nerve-wracking for you.
As a therapist for anxious millennials, many of my clients experience some level of nervousness in when it comes to being social. It’s fairly common to get overwhelmed in social settings, especially with a group of people you don’t know well or who you don’t feel particularly safe with.
But if you have a persistent, unshakeable fear of being judged by others and it interferes with your life, you might have social anxiety. And as it turns out, the relationship between social anxiety and ADHD is stronger than you might think.
Social anxiety is an intense fear of being scrutinized or judged in a social setting. It can prevent you from showing up in certain places or events, feeling connected to your community, and making friends. It can also lead to increased mental health issues like anxiety, depression, and isolation. And ADHD has been linked to higher rates of social anxiety.
Before you panic, let me reassure you: social anxiety is not a life sentence. If you have both ADHD and social anxiety, you can still live a fulfilling life with lots of beloved connections and support. I’ve seen it with my own eyes – many of my clients have gone from years of struggling and feeling misunderstood to facing their fears, engaging more in their communities, and feeling like they belong.
The reasons for the connection between the two haven’t been well studied. But here’s what I can tell you from my years of working with clients with ADHD and anxiety: the outside stigma and internal self-judgment associated with ADHD can greatly increase a person’s anxiety levels, including social anxiety.
One reason ADHD increases social anxiety is that people with ADHD are often ridiculed from an early age for being lazy, spacey, flaky, overly energetic, or just generally different from others. When you’ve heard things like this throughout your life, of course it’s going to impact the way you engage with the world. And if you’ve frequently known judgment for the way you show up in social settings, it makes sense that you would try to avoid those settings at all costs.
Another reason for the relationship between ADHD social anxiety is the tendency of ADHD brains to mask their symptoms. “Masking” refers to the way people with ADHD (or any other neurodivergent trait) will try to be like everyone else around them and pretend not to be neurodivergent. They act like they aren’t struggling, which means they often don’t reach out for help and end up feeling even more alone and unworthy. This leads them to internalize their shame, frustration, and confusion for feeling like things are harder for them than for everyone else.
Many people with ADHD mask unconsciously as a way to feel safer and more accepted in the world. Women in particular seem to be quite adept at masking their symptoms in public settings. But this is a problem, in part because masking is exhausting. It takes a lot of energy to pretend everything is fine when it’s not. It can lead to overwhelm and feelings of inadequacy. And it can reinforce the message that unless you’re masking, you’re not worthy of social connection or love.
There’s no easy answer to the question “can ADHD cause social anxiety?”
People with ADHD are indeed more likely to also struggle with anxiety disorders, including social anxiety. But I’d argue that ADHD itself doesn’t cause anxiety – it’s the stigma and lack of understanding surrounding ADHD that does.
ADHD itself is simply a different way of brain functioning. It’s inherently neutral. There’s nothing wrong or bad about it. But because it doesn’t align with our society’s parameters for productivity and “normal functioning,” it’s characterized as a problem.
Growing up being judged and belittled by people who didn’t understand you can wreak havoc on your sense of safety in social settings. The message you’ve heard reinforced over and over may be: there is something wrong with you. You’re different. You’re not good enough. Just do better. As a result, it might feel like everyone everywhere is judging you all the time.
Treatment for social anxiety and ADHD takes time and patience. It often involves changing some of the core beliefs you have about yourself and others, which can feel daunting. That’s why it’s so important to be patient and compassionate with yourself throughout the process.
Here are treatment ideas to help get you started.
Inserting yourself into scary social situations might sound like stupid advice, but it can be hugely helpful. You’ll likely feel better than you expected, or at least it probably won’t be as horrible as you’re imagining. This shift in perspective provides you with evidence that you can handle social settings. It provides you with proof you’re not broken, and that people aren’t judging you as much as you think they are. The more proof you gather, the more you boost your sense of belonging, self-esteem, and worthiness.
The key is to start slow and small. Going from being a homebody 24/7 to attending a massive block party might be a great recipe for a panic attack. Instead, try something that feels manageable and doable.
For instance, maybe your social anxiety prevents you from making eye contact with people outside your home. Commit to making friendly eye contact with at least one person whenever you leave your house. The more you practice small and manageable behaviors, the more confidence you’ll build overall.
ADHD and social anxiety are both overwhelming things to have to navigate separately, let alone together.
Support can look a lot of different ways. Consider talking to your friends about your ADHD and social anxiety so they know how to best support you. Telling them about your experiences and fears can help them show up for you in a way that makes you feel loved, seen, and understood.
It can also be really helpful to seek therapy from someone who specializes in both ADHD and anxiety – like me. I understand the unique challenges you face and how to overcome them. Seeking support via therapy can help you feel seen, validated, and empowered.
If you want support managing your social anxiety and ADHD, I’m here to help. We’ll come up with coping strategies to manage your ADHD, and you’ll learn tools and skills to overcome social anxiety.
Together, we’ll help you shift negative self-beliefs, old patterns of behaviors that no longer serve you, and the fears that keep you stuck.
I’m ready if you are. Reach out today to get started.
Danielle is an anxiety therapist and perfectionism coach. She specializes in helping busy millennials dial down their anxiety and ADHD, so they can perform at their best. Danielle has been featured on Apartment Therapy, SparkPeople, Lifewire, and Now Art World. When Danielle isn't helping her clients, she's playing video games or spending time with her partner and step children.