I used to think autism meant headbanging or stimming in obvious ways. I didn’t see myself in the stereotypes, and I definitely didn’t think it explained my chaos. But then came TikTok.

It started innocently enough. Like many people, I downloaded the app during the pandemic to see what the fuss was about. The algorithm didn’t take long. Almost instantly, my For You page was filled with chaotic, rainbow-haired women my age talking about ADHD and autism. Women who looked like me. Women who were me.

I didn’t even have to search. They just appeared — video after video of people with the same explosive personality traits, the same sensory issues, the same thought patterns. The same trauma responses. The same jokes. The same blue hair.

At first, it was comforting. “That’s me!” I’d laugh. “Oh my God — that’s so me!” But then the laughter started to sting.

[Read: “I’m ‘The ADHD Doctor’ on TikTok. Here’s How the App Has Changed Me.”]

One video hit particularly hard. A woman — split-dyed blue and black hair, like mine — left her house to grab blueberries. The timestamp showed it had been over an hour when she came back through the door with five full shopping bags, arms overflowing. Her husband called out, “Did you get the blueberries?” And her face froze in horror. She hadn’t. She’d forgotten the one thing she went out for. I laughed out loud… then felt punched in the gut. Because I had done that exact thing — only with orange juice.

Once the algorithm clocked my reaction, it doubled down. Every time I opened the app, I saw someone like me: brushing their teeth and suddenly realizing the toilet roll needed changed… which led to changing the bin… which led to discovering their toothbrush in the kitchen beside the bin they forgot to empty. These bizarre, tangled thought spirals I thought were unique to me were suddenly just… everywhere.

As my friends discovered the app, my inbox started to fill with more versions of myself — daily scenarios acted out by strangers who looked like me, always with the same message: “This is so you.” People even said it in person: “You know that girl — the one who’s basically you on the Internet,” when they were talking about an AuDHD video.

And that’s when it hit me. I wasn’t special. I was one of thousands. Millions, even.

Weirdness as Identity, Stolen by TikTok

All my life, I’d felt weird, different. I had clung to that as a form of identity. Even when it hurt, even when I felt alone, I had accepted my quirks as mine. But TikTok held up a mirror I hadn’t requested — and in that mirror, I saw not one reflection, but hundreds. Thousands. My traits, once mine alone, were playing out on screens all over the world. It felt like I’d been cloned and scattered across the Internet.

That realization spiraled into a strange grief. I was relieved to have answers for my lifelong struggles, yes. But at the same time, I was grieving the person I thought I was. I had worn my difference like armor — if I couldn’t blend in, I’d be the loudest, weirdest one in the room. I didn’t realize how much of my identity hinged on feeling like the only one.

Seeing “me” reflected back so often, in so many strangers, made me feel exposed. Invisible, even. Was I just ADHD sprinkled with some autism — another neurodivergent stereotype of blue hair and mandalas? Had anything about me ever been unique?

I Don’t Need to Be One-of-a-Kind

For weeks, I found myself torn. I kept scrolling through these videos that made me laugh, cry, and feel understood. But they also made me feel hollow. Like my sense of self had dissolved. I started snapping the app shut, unable to face the steady stream of doppelgängers.

And then one night, I looked at my son — this messy, brilliant little boy who shares many of my quirks — and something shifted.

If I can see myself everywhere… maybe that means I was never alone.

Maybe there’s comfort in that.

Maybe I’m not a diluted version of a stereotype, but a real, whole person who happens to be neurodivergent — like so many others. And maybe that’s not a bad thing. Maybe it’s a blessing. Maybe I can see the humor in this — the light in myself by seeing it in others like me.

Because if I can find myself in all of these strangers, then maybe he will, too.

Maybe he’ll grow up seeing himself everywhere and never feel the kind of loneliness I felt as a child.

Maybe the weird won’t feel weird at all. That’s all I can hope for.

These days, I still fall into the TikTok rabbit holes. I still see my reflection in strangers. But now I feel a little more grounded. A little more grateful. I’m learning to let go of the need to be “one of a kind,” and embracing the strange, beautiful truth that we are never as alone as we think.

I may not be the only blue crayon in the box — but I’m still here, coloring outside the lines.

AuDHD in Women: Next Steps

• Read: TikTok Is My Therapist — The Dangers and Promise of Viral #MentalHealth Videos
• Read: ADHD, Autism, and Neurodivergence Are Coming Into Focus
• Read: “5 Unique Features of AuDHD in Women”

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I worry the person I’m talking to will doubt I’ve really got it or mistake my revelation for a declaration of specialness.

I get why they might hear it that way. Some people do seem to center their identity around their neurodivergence and I understand that too. Endless flying-kicks to the ego inflict deep and lasting wounds and there’s a screw-you joy in shouting from the rooftops that you like who you are and have finally found your squad.

For me though, ADHD is only part of who I am. I’m different from the people I know who have it and they are different from each other as well. I don’t want others to hear those four little letters and put me in an ill-fitting box.

But that probably makes it all the more pressing that I push through the cringe and crack on with my disclosure.

There are loads of reasons why I feel I should talk about ADHD.

[Read: The ADHD Myths That Hurt Us Most]

1. To Explain That It’s Like an Iceberg

Public perception of ADHD is still negative and narrow: we’re chaotic, annoying and devoid of common sense. We bash things with sticks all day long and talk over each other non-stop. The stereotype overlooks inattentive attributes completely and defines us largely by what we lack and by our most conspicuous traits.

A lot of people with ADHD wouldn’t stand out in a crowd though, especially if they’re female. We’re skilled at concealing our inner struggles behind a slick-but-exhausting performance of normal.

The little quirks we do exhibit can look trivial or amusing to the casual observer, but they’re often the tip of a giant iceberg that quietly threatens to capsize our lives.

Being open about ADHD lets me dig into the detail of the many different ways it can manifest and how much is hidden from view. I like being part of that conversation and I think I have a duty to share what I know.

[Read: 3 Defining Features of ADHD That Everyone Overlooks]

2. To Help Friends Understand Themselves Better

It’s no accident that my account of lifelong symptoms often chimes with the person I’m talking to. ADHD people attract each other, after all. When someone recognizes themselves in my experience, they’re usually keen to learn more and some have gone on to pursue diagnosis, either for themselves or their children.

My own ADHD journey began when a friend shared a podcast that resonated so much it brought me to tears. Finding out my more troublesome traits were part of a pattern and not random failings as a human helped weaken the grip that shame sometimes has on me and which can wreak more havoc than the condition itself.

Talking about ADHD feels worth the discomfort when it helps get the message to people like me who need to hear it most.

3. To Take the Sting out of Stigma

Even if a person does not relate to my story of quiet dysregulation and self-sabotage, my willingness to be vulnerable can lead to reciprocal sharing.

Laying bare my own battles almost always results in chats about what others find difficult.

I used to worry that being honest would make me feel weak, but I’ve found that the opposite is true. I feel braver and stronger when I open up and it gives other people permission to do likewise.

4. To Make Working Life Easier

When I first got my ADHD diagnosis, I didn’t want to tell my employer. I was scared I’d be seen as incapable and worried the condition would be used to sweep real workload issues under the carpet.

I’m so glad I did come clean though. It made it easier to ask for accommodations, even informal ones. Small changes to my role and teaching hours have made me calmer and more productive and I feel like my managers have my back.

Conversations I have at work about ADHD soon turn to the things I excel at too and the stuff my colleagues find easy. That’s great for collaboration. If my workmate gets off on the gristle-chewing torment of detailed yearly planning, they can knock themselves out with their color-coded spreadsheets while I save my energy for bringing fresh, last-minute ideas when plans get upended as they so often do.

5. To Remind Us That Everyone Is Weird

Sceptics scoff when they hear how many people are being diagnosed with ADHD. But I’m surprised they’re surprised by the stats. It’s not uncommon and everyone is different. I thought we knew that by now.

I don’t see the rise in cases as proof of rampant overdiagnosis or the fragility of entire generations. I view it as long-overdue acknowledgement that the uniform, manmade and neurotypical-centric requirements of modern life are extremely hard for a lot of people to meet.

Reading about ADHD helped me pinpoint what I find tough and examine why that might be. But talking about ADHD to people who don’t have it opened my eyes to the many things others can struggle with – unforeseen changes, recognizing feelings, encountering buttons, for example. It gives me the chance to acknowledge that I know it’s not all about me.

I don’t feel special for having ADHD. I feel fortunate that my particular brand of weirdness fits into an established and well-researched cluster. Not everyone is that lucky.

6. To Assuage the Fear of Labels

Diagnosis has helped me a lot. I talk to myself more kindly now and am learning to soothe my nervous system when I need to persevere.

My ADHD label is not a shield behind which I intend to cower, emerging only to hurl rotten eggs and expletives at people who insist I do boring jobs. It’s a framework for understanding myself better so that I can capitalize on my strengths and work on the tough bits with greater insight and practical strategies.

7. To Make It So Normal It’s Boring

Talking about ADHD feels awkward. I still feel embarrassed when I bring it up. But I need to chuck my truth out there and have faith that if enough of us do the same, the stereotypes will melt away and at some point, someone like me will be able to mention their common difference to zero frowns or pigeonholing.

One day, I hope, ADHD will be a boring shortcut to explain how I function and what I do best.

Maybe by then everyone will have their own punchy acronym to help me understand them better as well. I might interrupt them to ask for more detail, but I promise I will never roll my eyes.

Explaining ADHD: Next Steps

• Read: 10 Ways ADHD Can Hide in Plain Sight
• Read: Coping with the Stigma of ADHD
• Read: Who Do You Tell About Your ADHD?

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A staggering 78% of ADDitude readers say they’ve been gaslit by a provider, according to a poll of 194 respondents conducted during a February 2026 webinar with Jennifer Fraser, Ph.D., titled “Medical Gaslighting: When Willful Ignorance Causes Doctors to Dismiss Your ADHD Concerns.”

Is there a difference between gaslighting and provider ignorance? What makes people with ADHD susceptible to gaslighting? It is possible to resist gaslighting and heal from past experiences of self-doubt?

Fraser addressed these questions in her webinar and provided evidence-based strategies to protect from future gaslighting while healing from past dismissals. Whether you’re seeking an ADHD diagnosis or advocating for better treatment, these three takeaways will help you find your voice at the doctor’s office.

1. Whether It’s Gaslighting or Ineffectiveness, the Result Is the Same

One definition of gaslighting says it is a form of psychological or emotional abuse that involves lying, manipulation, and challenging a person’s reality to gain control over them. Another says it is the act or practice of grossly misleading someone, especially for one’s own advantage.

These definitions suggest that not every dismissive doctor is engaging in intentional gaslighting. Many physicians are unfamiliar with new ADHD research, including studies about how it presents in historically overlooked populations (e.g., women, people of color, older adults). Still, the damage may be done regardless of intent.

“Regardless of whether the gaslighting is intentional or you are being misdiagnosed… it still is going to make you feel off-kilter,” Fraser explained. “It’s going to make you question yourself, question your own reality.”

That said, a doctor who lacks knowledge but remains curious can become a partner in your care.

2. ADHD Creates Unique Vulnerabilities to Gaslighting

People with ADHD often arrive at a doctor’s office already questioning their reality. Negative messaging around their symptoms — often misinterpreted by others as character flaws — and pressure to adhere to neurotypical standards of functioning create deep self-doubt. When a doctor questions a patient’s story or suggests that what they believe to be ADHD symptoms are actually depression, anxiety, or something else, it compounds self-doubt.

Women may be especially susceptible to medical gaslighting, as science has historically focused on male bodies, leaving providers with significant knowledge gaps. Women also tend to mask symptoms, and are frequently told they can’t have ADHD because they weren’t diagnosed as children or they’re “too successful” to have it.

3. You Can Protect Yourself from Gaslighting

From sharpening your senses to learning to trust your gut, you can train your malleable brain to resist gaslighting through daily practice, Fraser said. To help you learn to trust your gut, for example, you can develop your emotional vocabulary, which will help you articulate your experiences with more precision.

To learn more about how to spot gaslighting, defend against it, and effectively advocate for yourself, watch the full webinar at additu.de/022426.

Medical Gaslighting and ADHD: Resources

• Free Download: How to Talk to Your Doctor About Medical Research
• Read: “Medical Gaslighting Convinced Me That I Didn’t Have ADHD”
• Read: A Clinicians’ Guide to Better Patient Communication

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The steep out-of-pocket costs of ADHD care today — on average, more than $8,500 per child and $4,700 per adult annually — are driving families to ration medication, delay or skip medical appointments, and forgo interventions they rely on to function well, according to ADDitude magazine’s new Cost of ADHD Diagnosis & Treatment survey.

Of the 1,970 survey respondents, about 25% cited out-of-pocket medical costs as a limiting or determining factor in accessing ADHD care; 21% said ongoing care is not covered by their insurance, and 16% said their ADHD medication costs are not covered at all.

“I just go without medication when I run short of money,” said one mother. “My adult child has skipped doses to be able to pay for her psychiatrist, and this has brought a lot of unsavory people into her life.”

“I never take my clinician-recommended dosage because I can’t afford it,” said another. “We are paying out-of-pocket for medication, so our kids don’t take it on weekends or vacations,” another mother commented.

[Free Report on Out-of-Pocket ADHD Costs]

ADDitude asked survey participants how they are covering or reducing the cost of ADHD care. Here’s what a few people said:

“I’ve had to take disbursements from retirement accounts to pay for psychotherapy.”

“I have two jobs at this point.”

“I switched jobs to one that is closer to home. I now bike to work. I also joined a nearby affordable community center pool. I swim and arrive at work already having exercised and feeling refreshed.”

“I’ve split the cost of ADHD coaching with another client.”

“It’s hard to pay premiums and pay for doctor visits and maintain a household.”

[ADDitude Directory: Find Affordable Care Near You]

Uneven Insurance Coverage

About half of the people surveyed said their health insurance plan partially paid for an ADHD evaluation for themselves, another adult in the household, or their child(ren). More than one in four said their insurer paid nothing toward evaluation and diagnosis; one in five said those costs were covered completely.

Many of the survey participants expressed frustration about rising health care costs — 10% said their ADHD care costs exceeded 10% of their income — and voiced deep anxiety about potentially steeper hikes and even less coverage in 2026.

The High Cost of Prescription Meds

One-quarter of survey respondents said they reluctantly switched medications because insurers dictated cheaper alternatives or covered prescriptions only partially or not at all, or because the cost of their preferred drug increased substantially.

A significant number said they had to meet their deductible, which was typically more than $1,000, before insurance would cover medication costs.

When asked if their health insurance plan covered the medications they take for ADHD:

• 19% said their prescriptions were fully covered
• 65% said their prescriptions were partially covered
• 16% said their insurer did not cover their prescriptions

Medications Covered

Regarding the medications covered:

• 32% said their insurance covered generics only
• 1% said their insurance covered brand names only
• 35% said generics and brand names were covered
• 32% said they weren’t sure

Types of Providers

Pediatricians and developmental pediatricians were the most common medical professionals seen for ongoing ADHD care (63% for children). Other providers include:

• 62% psychiatrist
• 50% other therapist or counselor
• 50% primary care provider
• 31% psychologist
• 9% occupational therapist
• 6% neurologist

Many survey respondents lamented about the shortage of psychiatrists and the impact of presumably less experienced providers who dismissed their symptoms of adult ADHD.

“I worked with an online provider to get my diagnosis because it was cheaper and quicker.”

“I had to see several different practitioners because they believed I couldn’t have ADHD as an adult since I was never diagnosed as a child.”

Finding Providers Who Take Insurance

The odds of finding a psychiatrist or therapist who accepts your insurance plan are becoming slimmer by the day.

One in four ADDitude survey respondents said that at least one of their medical providers has stopped accepting their health insurance. They voiced worry over a shrinking pool of affordable psychiatrists and therapists.

This provider shortfall was also documented in an investigation by ProPublica, which found that hundreds of mental health providers nationwide have stopped accepting insurance plans in recent years. They blamed insurance network practices that forced providers to chase down payments that were meager or late, and some reported that their services were denied coverage altogether.

The providers also criticized insurers for increasingly interfering with patients’ treatment, sometimes denying it, or pushing generic prescription medications that were cheaper but not optimal.

As the availability of mental health providers who take insurance continues to worsen, ADDitude survey participants shared their experiences.

“This has happened throughout my child’s life. His occupational therapist left the insurance network, his psychiatrist left, my therapist left, our family primary care provider left.”

“It took almost two years to find and start seeing a new therapist. The wait list was nine months long.”

“My psychiatrist is semi-retired and takes cash only. I have not found a new one who will follow my treatment plan, which was working great.”

“I had to call around and ask a bunch of psychiatrists, and it was such a pain. They think that you’re seeking medication when you just want appropriate care. It took me six months to find someone new.”

“I was referred to a nurse practitioner from a psychologist about nine months ago because the practice said my insurance didn’t reimburse them enough. I chose to stay with the practice, rather than start somewhere new, and now I pay out-of-pocket.”

ADHD Medication Cost: Next Steps

• Free Download: What to Ask Before Starting ADHD Medication
  
• Read: These Prescription Assistance Programs May Help You Save Money on ADHD Medication
• Read: How Does Health Insurance Work? A Primer for Patients with ADHD
• Watch: “Cracking the ADHD Medication Maze: How to Get, Afford, and Refill Your Prescriptions With Minimum Hassle”

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The United States is the only first-world nation that does not provide basic health care to all its citizens. The roadmap to universal health care exists and public opinion largely supports it. However, health care is so incredibly profitable for American insurance companies and political campaigns that proposed reforms are practically guaranteed to fail time and time again.

Health insurance companies use the worst possible system to fund patient care. The only way to perpetually increase the profits demanded by shareholders is to deny legitimate claims or otherwise create obstacles that prevent or delay payments to providers. This system does not incentivize efficient care; it disincentivizes delivering care altogether.

How Insurers Dictate Physician Care

In the 1980s, as technology made the delivery of care more efficient, insurers sought ways to increase profits. This was largely accomplished by obstructing the delivery of care or denying care outright – and it changed physician behavior. If a clinician knew that a prescription for the cheapest immediate-release ADHD medication  would be approved swiftly and without question, but a superior and more expensive time-released formulation would be contested or denied, the clinician would prescribe the insurance-preferred medication, even if it were not what was in the best interest of the patient.

In Colorado, where I live, a majority of private mental health practitioners no longer accept any insurance plans largely because the insurance companies don’t pay parity rates or pay for care that was pre-authorized. It can take months for insurers to pay claims.

These insurance company practices have made access to patient care difficult, if not nearly impossible. In Colorado, few clinicians have the training and experience necessary to adequately manage ADHD in children and adults. If a patient cannot find an experienced clinician and access good care, they stop running up clinical office and pharmacy charges — a win for the insurance company and its profits, and a loss for people who go untreated.

[Download: The Soaring Cost of ADHD Care]

For every practicing clinician who still deals with insurance, there are likely one to two people in their office who do nothing but fight to get their legitimate claims submitted and paid. This extra cost gets passed on to the patient in the form of higher out-of-pocket costs at the point of service.

Being obstructive and slow to pay claims is profitable in other ways, The longer the insurance company can hold onto billions of dollars of premiums, the more investment interest those premiums will earn. Insurers also know that people with mental health conditions are much less likely to appeal a denial of care.

Life is hard enough for people with an ADHD nervous system. They can become overwhelmed by the intentional complexity and obstruction of legitimate care, A single complaint by a patient to a lawmaker or regulator is rarely noticed. A million complaints could start a revolution.

[Read: Bottom Line – Reduce the High Cost of ADHD Treatment]

Jumping Insurance Hurdles

What can patients do to fight insurance abuses?

• Contact your federal and state representatives about the problems you are having with your insurance company.
• Report issues with your insurer to your state’s Department of Insurance and copy your governor’s office.
• Report complaints about your insurance company to your human relations department, which chooses employee benefits.
• When a claim is denied, immediately demand a peer-to-peer review between your clinician and the company’s medical directors.

How can practitioners advocate for their patients?

If you are fighting to get your clients the best care you can provide (not the cheapest care that the insurance company can force you to provide), you must be aggressive. Each time you contact the insurance company, keep a log and do the following:

• Ask for a phone number to re-establish contact if the call is dropped.
• Get the person’s full name and professional licensure. Find out in which state they are licensed in case you want to make a complaint about practicing outside the scope of their license or for obstruction of appropriate care.
• As you get passed from person to person, ask each one for their credentials and what gives them the training, knowledge, and experience to make decisions about your patients’ care. How many people with ADHD have they diagnosed and treated in the last five years?

William W. Dodson, M.D., has been a board-certified adult psychiatrist for more than 27 years. He does not accept insurance.

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During this time, I was diagnosed with autism and ADHD. I wasn’t expected to show up to work or social gatherings due to the pandemic, and that left more space to focus on drawing — something I did for up to 10 hours a day. I made my own schedule, added physical therapy to reduce my chronic pain, adapted my clothing and home to better suit my needs, and engaged in my special interest full time, all of which deepened my relationship with myself.

[Read: ADHD & the Interest-Based Nervous System]

“The illustration I created for the cover of this issue was inspired by movement and repetitive movement, something that autistic people do as a form or regulation and communication. To me, the illustration shows a person spinning in their own world, and I wanted to illustrate the feeling of vestibular movement.”

I started to draw on the computer and eventually moved to an iPad, which allowed me to create works at the speed of my thoughts and impulses. As I began to truly understand my autism, I was able to find a path to the art of illustration.

A friend recommended that I try illustrating articles in magazines and newspapers, and that really sparked my interest. It felt like a perfect way to combine my love for drawing scenes and for creatively telling a story.

[Read: On the Awesomeness of ADHD Creativity]

I also began posting my works online. Viewers’ reactions to my work gave me the confidence to approach retail stores and pitch my designs for greeting cards and prints, and to create more art around storytelling. An art director saw my work at a bookstore and hired me for my first editorial assignment.

All the hours I spent on my special interest helped to develop my skills and allowed me to fully dedicate myself to illustration – and get paid for it. My style is expressive, bold, and moving – a lot like me.

Emcie Turineck, an artist in Montreal, Canada, created the artwork that appears on this issue’s cover.

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Living with a compulsive need to please others and avoid conflict can be emotionally exhausting. With ADHD in the mix, self-esteem and communication skills can also suffer.

To achieve a healthier balance in your relationships, follow these seven steps.

1. Identify Root Causes

People-pleasing behaviors often stem from fear of rejection, low self-esteem, or past experiences in which you felt emotional safety hinged on accommodating others.

Perhaps you felt you had to fulfill your parents’ demands, no matter how unhealthy, or risk harsh punishment and emotional upheaval. Maybe you experienced rejection from your parents, peers, and other adults whose standards felt impossible to reach. A therapist can help you explore and understand the root causes of your people-pleasing behaviors and develop solutions for overcoming them.

[Read: How ADHD Impacts Sex and Marriage]

2. Set Boundaries

Self-respect grows from setting healthy boundaries and prioritizing self-care. This doesn’t mean you care less about your family; it means you care enough about yourself to make sure your needs are being met. Start with minor requests, learn to say no, and express your desires.

3. Speak Up

Have an honest conversation with your husband and family. Express your desire to change, A supportive partner will understand and help you with this transition. Effective communication can also prevent misunderstandings.

4. Reframe Thoughts

Many compulsive people-pleasers harbor negative thoughts and self-criticism. Are your fears based on proven facts or speculation? Cognitive behavioral techniques can be particularly helpful in reframing negative thinking patterns.

[Webinar Replay: Stop People Pleasing! Halting the Cycle of ADHD Self-Doubt, Perfectionism and Procrastination]

5. Practice Assertiveness

Being assertive means expressing your thoughts, feelings, and needs directly and respectfully. This can be challenging if you’re used to avoiding conflict, but there are many books, workshops, and therapies to help you build these skills. Participating in role-playing scenarios with a therapist or trusted friend can also help.

6. Embrace Self-Compassion

Be kind to yourself as you work through these changes. It’s normal to make mistakes and revert to old patterns occasionally. Instead of beating yourself up, acknowledge your progress and remind yourself that change take time.

7. Prioritize Mutual Respect

Healthy relationships are built on mutual respect and understanding. When you and your husband contribute equally to the relationship, it creates a more satisfying partnership and reduces the pressure to constantly please.

Breaking free from the cycle of pleasing people and avoiding conflict is not easy, but with patience, self-awareness, and support, it’s possible.

Stephanie Sarkis, PhD., is the author of Healing from Toxic Relationships: 10 Essential Steps to Recover from Gaslighting, Narcissism, and Emotional Abuse.

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Circadian health interventions may improve ADHD symptoms for a significant group of individuals with attention deficit disorder, according to a new perspective review published in Frontiers in Psychiatry.¹ For some, circadian misalignment may play a role in ADHD pathophysiology, and targeted circadian interventions may supplement ADHD treatment for these individuals, concluded the study’s authors following a review of existing research.

Another narrative review in PLOS Mental Health explored the neurobiological mechanisms of psychiatric conditions including depression, anxiety and ADHD, and the bidirectional relationship they have with sleep. That research also found that sleep is an essential element of symptom management for these disorders.²

“Sleep disturbances, including insomnia, hypersomnia, and circadian misalignment, are highly prevalent and clinically significant across various psychiatric disorders. Sleep problems are transdiagnostic features, impacting diagnostic presentation, prognostic trajectories, and underlying pathology,” the authors of the PLOS review write. “Sleep is a tractable factor in mental health, offering a potent intervention leverage point.”

Circadian Rhythm Disorder and ADHD

The authors of the Frontiers in Psychiatry review, Brandon Luu, M.D., and Nicholas Fabiano, M.D., point to several established facts linking circadian rhythm dysfunction to ADHD, including:

• 73-78% of people with ADHD have delayed sleep-wake cycles.³
• Cortisol rhythms, especially in the morning, are decreased and delayed in ADHD patients.⁴Another recent study that investigated the association between morning cortisol variability and ADHD through genomic approaches found ADHD and cortisol levels reflect “a complex interplay involving arousal regulation.”⁵
• Dim-light melatonin onset (DLMO) occurs 90 minutes later in adults with ADHD, and 45 minutes later in children with ADHD, compared to controls.⁶ A study conducted by J.J. Sandra Kooij, Ph.D, found that, in neurotypical populations, melatonin is secreted at 9:30 p.m. (leading to an estimated 11:30 p.m. sleep onset), whereas melatonin is secreted at 11 p.m. for people with ADHD.⁷

Kooij explored her research in detail during her recent ADDitude webinar titled, “How Sleep Disorders Impact Every Aspect of Life with ADHD.

“Each of us has an internal clock that determines our sleep rhythm. This clock, located in the mid-brain, is heritable and it starts ticking in childhood.” she said. “Because it directs the rhythms of all bodily organs, it has far-reaching influence.”

Luu, who has ADHD himself, writes about his personal connection to this research in his newsletter. “When I started implementing circadian interventions for sleep optimization, my ADHD symptoms improved noticeably. When I began digging into the literature, I was struck by how strong the link was, and by how little attention circadian-based interventions have received in ADHD treatment discussions.”

Chronotherapy Interventions

The Frontiers in Psychiatry review found that circadian-targeted interventions, including melatonin supplementation and bright light therapy, both of which advanced DLMO, improved sleep as well as ADHD symptoms.

Melatonin Supplementation

• A small study found that taking 0.5 mg of melatonin nightly moved up melatonin onset by 88 minutes and reduced ADHD symptoms by 14% for adults.⁸
• For children, taking 3-6 mg nightly moved up DLMO by 44 minutes.⁹ After several weeks of melatonin use, 71% of parents reported improvements in behavior and 61% noted improvements in their children’s mood.

Bright Light Therapy

• A pilot study found that, for adults with ADHD, two weeks of bright light therapy in the morning (10,000 lux lamp) advanced DLMO by 31 minutes.¹⁰
• Another small study found that, during winter months, bright light therapy offered particular benefit for individuals with ADHD.¹¹

Multimodal Approaches

While not specific to those with ADHD, multimodal behavioral approaches have resulted in advancement of sleep-wake phases for those with late chronotypes.

• In one study, the multimodal behavioral approach lasted three weeks and involved consistent earlier wake time, morning light exposure, restricted nighttime light exposure, avoiding naps and caffeine in the late afternoon and eating late at night. The intervention group shifted their DLMO, wake time, and peak cortisol time by approximately 2 hours; self-reported depression scores decreased by 58% and stress scores by 40%.¹²

A Low-Risk Adjunctive Approach to Addressing ADHD

“The safety profile, accessibility, and potential for synergy with existing treatments make circadian interventions an attractive addition to the ADHD treatment,” write Luu and Fabiano, who propose that individuals with ADHD receive routine screening for sleep or circadian disturbances, so that potential delayed sleep phase disorder can be more easily identified and addressed.

“This is not a universal cure for ADHD, but a potential adjunctive approach,” Luu writes. “While the evidence is still emerging, these interventions are generally low risk, offer broad health benefits, and are relatively easy to implement.”

Sources

¹Luu, B., & Fabiano, N. (2025). ADHD as a circadian rhythm disorder: Evidence and implications for chronotherapy. Frontiers in Psychiatry, 16, 1697900. https://doi.org/10.3389/fpsyt.2025.1697900

²Hyndych A, Koval K, Dzeruzhynska N, Mader EC. Sleep and psychiatric disorders: Bidirectional interactions and shared neurobiological mechanisms. PLOS Ment Health. 2025;2(12):e0000531. doi:10.1371/journal.pmen.0000531

³Wajszilber D, Santiseban JA, and Gruber R. Sleep disorders in patients with ADHD: impact and management challenges. Nat Sci Sleep. (2018) 10:453–80. doi: 10.2147/nss.s163074

⁴Baird AL, Coogan AN, Siddiqui A, Donev RM, and Thome J. Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels. Mol Psychiatry. (2012) 17:988–95. doi: 10.1038/mp.2011.149

⁵Ramos, J. K. N., Grevet, E. H., Junger-Santos, I., Ciochetti, N. P., Bandeira, C. E., de Araujo Tavares, M. E., de Oliveira, V. F., Vitola, E. S., Rohde, L. A., Grassi-Oliveira, R., da Silva, B. S., Dotto Bau, C. H., & Rovaris, D. L. (2025). Shared biological pathways linking ADHD and cortisol variability are related to externalizing behaviors. Psychoneuroendocrinology, 181, Article 107587. https://doi.org/10.1016/j.psyneuen.2025.107587

⁶Lunsford-Avery JR, Scott H, and Kollins SH. Editorial Perspective: Delayed circadian rhythm phase: a cause of late-onset attention-deficit/hyperactivity disorder among adolescents? J Child Psychol Psychiatry. (2018) 59:1248–51. doi: 10.1111/jcpp.12956

⁷Van Veen MM, Kooij JJS, Boonstra AM, Gordijn MCM, and Van Someren EJW. Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia. Biol Psychiatry. (2010) 67:1091–6. doi: 10.1016/j.biopsych.2009.12.032

⁸van Andel E, Bijlenga D, Vogel SWN, Beekman ATF, and Kooij JJS. Effects of chronotherapy on circadian rhythm and ADHD symptoms in adults with attention-deficit/hyperactivity disorder and delayed sleep phase syndrome: a randomized clinical trial. Chronobiology Int. (2020) 38:260–9. doi: 10.1080/07420528.2020.1835943

⁹van der Heijden KB, Smits MG, Van Someren EJW, Ridderinkhof KR, Gunning WB., et al. Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia. . J Am Acad Child Adolesc Psychiatry. (2007) 46:233–41. doi: 10.1097/01.chi.0000246055.76167.0d

¹⁰Rybak YE, McNeely HE, Mackenzie BE, Jain UR, Levitan RD, et al. An open trial of light therapy in adult attention-deficit/hyperactivity disorder. J Clin Psychiatry. (2006) 67:1527–35. doi: 10.4088/jcp.v67n1006

¹¹Wynchank DS, Bijlenga D, Lamers F, Bron TI, Winthorst WH, Vogel SW, et al. ADHD, circadian rhythms and seasonality. . J Psychiatr Res. (2016) 81:87–94. doi: 10.1016/j.jpsychires.2016.06.018

¹²Facer-Childs ER, Middleton B, Skene DJ, and Bagshaw AP. Resetting the late timing of ‘night owls’ has a positive impact on mental health and performance. Sleep Med. (2019) 60:236–47. doi: 10.1016/j.sleep.2019.05.001

You’ve been reading about new research developments in ADHD, and you want to discuss them with your medical provider, but you fear they will dismiss or challenge you.

This ADDitude Patient Resource can help. Use the following tips and scripts to prepare for and confidently initiate a productive conversation with your provider about ADHD research and news.

In this download, you will learn:

• How to begin the conversation in a proactive way
• How to acknowledge that clinicians are inundated with new research
• How to prepare for a conversation with your provider
• And more!

The Upside Down Is My Normal

When 12-year-old Will Byers goes missing from the fictional town of Hawkins, Indiana, in 1983, his family and friends don’t realize that he’s actually right there beside them. He’s just in an alternate dimension called the Upside Down, which parallels the real world. The Upside Down is a colder version of home, a world of intense electrical storms, strange bloodthirsty creatures, and darkness.

Living with ADHD is a lot like being in the Upside Down. I’m amongst people in the real world, but they don’t see what’s in my dimension. While others go smoothly from Point A to Point B, I have fog, toxic quicksand, and squelching monsters that keep me from moving freely.

Stuck in a Loop

“Stuckness” appears throughout the show. Sure, there are the characters who become stuck in the Upside Down. But the Upside Down itself is also stuck. Even as time in the show’s world moves ahead, the Upside Down stays in 1983. Then there’s the mother of Eleven (a young girl with psychokinetic abilities) who is stuck in a catatonic state, caught in a mental loop that replays the events leading to her daughter’s kidnapping.

If my ADHD brain had a dial, “stuck in a loop” would be its default setting. It cycles endlessly through memories of childhood starring young me as a brilliant, shining disappointment. This loop replayed with intensity after I was diagnosed with ADHD in my 20s. I experienced my memories with a fresh set of eyes, mourning all the time I struggled socially and emotionally without understanding why. I become enmeshed in the loop less often these days, but it remains a constant presence.

☁️ Read: Getting Unstuck from the Cloud of ADHD Stuck-ness

The Mind Flayer

The powerful, massive, spider-like monster of the Upside Down — the show’s antagonist for most of its run — can connect to and command surrounding creatures and entities even as they venture outside the alternate dimension.

Sometimes, living with ADHD feels like living with a creature that’s flaying my body and mind. It tears through my brain, causing symptoms and challenges I’d rather bypass. But sometimes my ADHD acts like a living, breathing partner. Like when it drives me into hyperfocus and allows me to be extremely, but selectively, productive.

Vines and Tunnels

When Will becomes possessed by the Mind Flayer, he begins to erratically draw a series of tunnels and vines. His drawings, initially dismissed, are later discovered to be a map of the Upside Down growing beneath the town. The tunnels twist and turn, and the vines have minds of their own.

ADHD thinking patterns can operate like the vines and tunnels of the Upside Down. One thought gives birth to another, growing out of hand, spreading until I burn out. Or, without warning, a thought can stop. A brilliant idea becomes a dead end, abandoned.

💡 Read: The True Value of ADHD Side Quests, Rabbit Holes, and Tangents

Who’s In Your Party?

The teen protagonists of the show call themselves the Party, borrowing from a Dungeons & Dragons term for an allied group of players. The party and the entire town unite to confront the forces besieging their home.

When no one else knows I’m drowning, even those closest to me, I remind myself that the Upside Down is invisible. I need to let them know it’s trapped me. When I do, I have faith they’ll show up and help me fight every scary monster. When we feel broken, we can heal together.

Life is better with a Party.

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For example, studies are virtually non-existent on how gender identity affects ADHD symptoms and presentation. Do transgender individuals with ADHD experience symptoms not fully reflected in the Diagnostic and Statistical Manual of Mental Health Disorders? Are they more or less likely to experience significant difficulty with emotional regulation, sleep disturbances, racing and disorganized thoughts, and heightened stress and anxiety related to executive dysfunction?

We do not have these answers, but we do know that ADHD treatment improves more than a person’s ability to focus and calm down.

ADHD and Hormonal Therapy Considerations

Individuals receiving gender-affirming hormone therapy should receive ongoing clinical care to monitor the impact of hormones on ADHD symptoms and treatment. In some cases, elevated testosterone levels can increase the hyperactive/impulsive traits of ADHD and induce more pronounced risk-taking behaviors, emotional reactivity, and impatience. Estrogen therapy can increase the ADHD traits of emotional intensity and dysregulation.

The periodic adjustment of gender-affirming hormone therapy and its impact on ADHD medication efficacy must be tracked carefully; otherwise, a previously therapeutic ADHD treatment regimen may become frustratingly ineffective.

In my clinical practice, providing adaptive ADHD care – adjusting ADHD medications to account for changes in hormone therapy and connecting transgender patients to non-pharmacological resources such as therapy or support groups – has resulted in improved emotional regulation, decreased anxiety, and less symptom variability. Some of these individuals have been able to decrease their reliance on other medications, such as antidepressants or mood stabilizers.

If you’re a transgender individual with ADHD struggling to find care, contact your insurance provider for a list of affirming doctors, then check to see if those professionals list transgender or LGBTQ+ care in their specialties. You might also find a provider in your state who offers telehealth visits. Make sure the provider you choose has experience with ADHD and gender diverse care.

Tiffany Gishizky, DNP, PMHNP-BC, is a board-certified psychiatric nurse practitioner at Mindpath Health in Napa, California.

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Q: “Every time I try to talk about ADHD to my friends or family, they tell me that I shouldn’t label myself. They point to my life achievements and say that if my ADHD were that bad, I wouldn’t have survived in corporate America and so on. It seems as if they get triggered when I talk about my ADHD. It leaves me feeling invalidated and like I have no one in my corner.”

This sounds like a very difficult situation. Whether your loved ones are judging you or trying to reassure in their own way (as in suggesting that you’re doing better than you think), their approach has left you feeling unseen.

ADHD Is More Than Most Know

People who react negatively to “ADHD” often don’t understand what it entails. And in a time when labels are discussed frequently on social media, some people who would be otherwise compassionate may be skeptical or dismissive of what you’re trying to say about your life with ADHD.

Free Webinar with Dr. Saline: Helping Kids (and You) Navigate Unfair Treatment and Tough Relationships

Your loved ones may come around if you explain that the label is helpful for you because it captures experiences — including challenges — that you thought were unique to you but point to a biologically based condition.

Detail Specific Challenges

Try describing the particular areas of your life that ADHD impacts most. Whether you struggle with emotional regulation or time management, framing ADHD in terms of concrete challenges can make it easier for others to understand. Over time, they may come to see what ADHD really is – a condition that affects executive functioning, the brain processes that allow us to plan, organize, prioritize, control impulses, focus, and manage our lives. We all have executive functioning strengths and challenges, but for people with ADHD those challenges are usually more severe and can cause problems regularly.

Find Neurodivergent Support

Your journey to managing ADHD is personal and valid, irrespective of others’ opinions. While support from loved ones is valuable, I also urge you to connect with neurodivergent peers who know what it’s like to walk in your shoes. There are tons of online communities where neurodivergent people share advice, strategies, and validation. These groups can help normalize your experiences and remind you that you are not alone.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

What you’re describing are the negative self-defeating default mindsets many of us with ADHD have endured most of our lives. The negativity stems from criticism doled out by caregivers, teachers, and others who refused to understand or accept our ADHD-related impairments in childhood. It grows worse when we compare ourselves to neurotypical peers who seem to do with ease the things we find so difficult.

Everyone makes mistakes, and judging ourselves harshly won’t motivate us to do better. It often achieves the opposite. To break this pattern, start by paying close attention to the first signs of self-criticism. Then stop yourself and try these healthier mindset shifts – along with corrective actions – to reach your goals.

How to Silence Your Inner Critic

• Always late? This pattern will not change unless you build a plan to support the goal of punctuality. Instead of chastising yourself, think about the conditions that could make you tardy – like heavy traffic, or sneaking in one more task before leaving, misjudging how long that task will take (thank you, time blindness), and then rushing to your destination. The next time you have an appointment, remind yourself of these variables.
• Beating yourself up after a slip-up? Instead of telling yourself you’re not good enough, or wondering why you even bother, say to yourself: “Hey, buddy, you’re trying.” Negativity only reinforces our belief that we don’t measure up and hobbles our future performance. After a setback, acknowledge what went wrong and how you can do better next time. Be gentle and give yourself credit for trying.
• Forget to do a chore, like drying the kids’ laundry or picking up groceries? Instead of berating yourself, practice self-acceptance and self-compassion by saying something like, “I am a valuable and loving person.” Then set yourself up for success next time. Put reminders in your phone or on notes around your house.

Turning down the volume on your inner critic takes practice. Be aware of signs that self-criticism is about to emerge, and deliberately shift your inner dialogue toward empathy and compassion – and take the steps necessary to do better next time.

Alan P. Brown, B.SC., AAC, is the creator of the ADD Crusher ^TM virtual coach video/audio program for teens and adults with ADHD.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

However, Likes and Shares are not an indicator of accuracy, according to a recent study in PLOS ONE. For example, less than half of the information shared in immensely popular ADHD TikTok videos (which have garnered nearly half a billion views) aligns with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).² Most ADHD TikToks perpetuate lies or half-truths.

ADHD inaccuracies don’t just permeate social channels; they also appear in podcasts, newspapers, TV shows, and beyond. Misleading information threatens to oversimplify symptoms, to worsen stigma, and to promote unsafe interventions.

So, where can people turn to find trusted and useful ADHD resources? We asked ADDitude readers to share their recommendations, and here is what they told us.

ADHD Experts

“I turn to professional publications and professionals trained to treat ADHD, like Russell Barkley, Ph.D., and Tracey Marks, M.D.  NOT TikTok! Anyone with a login can make claims, and it’s problematic.” — Vanessa

“My go-to resources are the Attention Deficit Disorder Association (ADDA), Russell Barkley, Ph.D., Ari Tuckman, Psy.D., Jessica McCabe, and Daph Chan of SuperSkills ADHD. Chan’s work focuses on nervous system regulation, which is something I’ve found is overlooked in other places.” — Rachel, California

“I observe and listen to students, parents, teachers, researchers, and thinkers such as Andrew Huberman, Ph.D., of the Huberman Lab.” — Kent, Georgia

“I trust ADDitude webinars, Russell Barkley, Ph.D.’s books and YouTube channel, information from Roberto Olivardia, Ph.D., and William Dodson, M.D., LF-APA.” — an ADDitude reader

“Kathleen Nadeau, Ph.D., and John Ratey, M.D., are trusted sources of information. I don’t like sources that are overly positive and say that ADHD is a ‘gift’ or a ‘superpower.’ I don’t mind reframing it like that, but I need advice that sees my situation in a real-word context.” — Carol, Virginia

“The late Chris Zeigler Dendy’s publications and past webinars have been invaluable and validating.” — an ADDitude reader

“I subscribe to the Attention Research Update newsletter from David Rabiner, Ph.D. The ADHD reWired podcast is great as well. Other than that, I do a lot of my own research using information by medical professionals.” — Natalie, Pennsylvania

“I follow Sasha Hamdani, M.D.” — Caroline, United Kingdom

ADHD Podcasts

“I like the Neurodivergent Insights podcast.” — Tiffany, Kansas

“I like podcast hosts and authors Tracy Otsuka, JD, LLM, AACC, ACC, and Lindsey Mack (Lindsey Mackereth, MA, LPCC, LADC).” — Michelle, Mississippi

“I listen to Emily Kircher Morris, host of The Neurodiversity Podcast, and Seth Perler, a self-proclaimed ‘executive function nerd.’” — Marty, Maryland

“I enjoy Alex Partridge’s ADHD Chatter podcast.” — an ADDitude reader

“The ADHD Women’s Wellbeing podcast with Kate Moryoussef has taught me a lot.” — Vicki, England

YouTube

“I love Russell Barkley, Ph.D.’s work and his YouTube channel. The way he lands his points really sits well with me — and sticks.” — Vicki, England

“I like the How to ADHD YouTube channel.” — an ADDitude reader

Books

“I read pretty much every book that I can find that comes out on ADHD, and I judge whether they are trustworthy based on their sources. I always trust the resources my psych nurse recommends.” — Emily, Washington

“I refer to authors with first-hand experience of living with ADHD. I also love that so many therapists now practice from a place of personal solutions and suggestions.” — Christina, South Carolina

“I listen to audiobooks. Women with ADHD (#CommissionsEarned) by Annie M. Henderson was particularly good.” — an ADDitude reader

“I read books by reputable authors such as James Kustow, BMedSci, BMBS, MRCPsych.” — an ADDitude reader

Journals and Studies

“I tend to search PubMed for abstracts, new and old.” — an ADDitude reader

“Peer-reviewed journals, credible health sites, health practitioners, and service providers are my sources.” — an ADDitude reader

“I trust medical journals, other people with ADHD, and my psychiatrist and therapist.” — an ADDitude reader

Personal Sources

“My sources are mainly physicians who treat ADHD and can explain it well, but also adults and teens who have it, and parents of kids with ADHD.” — Sue, Michigan

“My most trusted and useful sources of information on ADHD are learning from my kids’ experiences.” — Sarah, Canada

ADDitude

“I have seen my psychiatrist for more than 24 years, and I have learned more from ADDitude than I have from my doctor. ADDitude has introduced me to new ways of thinking and understanding my mental health. When there are ADDitude webinars, I do my best to attend each one, even if it doesn’t pertain to me, because I learn something that I can relate to every time.” — Christine, Texas

“I am not one to seek out too much information, and being diagnosed so late, I don’t know what I don’t know. ADDitude brings issues to life for me and, if I need more, I can research specific things. Thank you.” — Sue, Idaho

“ADDitude has been an absolute game-changer for me. I love that I get a variety of topics very regularly and that exploring one leads to another (and another!). I follow a breadcrumb trail that has led to so much of my growing understanding of ADHD. I also love the webinars for more in-depth information.” — Caroline, Manchester

“ADDitude has also been instrumental in providing information that has helped our family plan and strategize. These sources also help me keep my physicians from demonizing me and my children.” — an ADDitude reader

All of the Above

“Your Kids Table (Alisha Grogan, MOT, OTR/L), The OT Butterfly, (Laura Petix, MS OTR/L), Seth Perlman and TEFOS (The Executive Function Online Summit), Edward (Ned) Hallowell, M.D., Jessica McCabe, Penn and Kim Holderness, Roxanne and Richard Pink, and Tracy Otsuka.” — Marivic, Washington

“My most trusted and useful sources of information on ADHD are a mix of professional resources and lived experience. I find ADDitude magazine itself incredibly helpful — the articles, webinars, and personal stories give both practical strategies and validation. I’ve also gained so much from Roxanne and Richard Pink through their books, podcast, and videos. Their content is relatable and filled with practical, real-life strategies. I regularly listen to The ADHD Adults podcast on YouTube and the ADHDAFpodcast on Spotify, both of which have helped me understand the science, humor, and day-to-day realities of living with ADHD. Combining expert information with shared lived experiences has given the most balanced and realistic understanding of ADHD.” — Debbie, United Kingdom

ADHD Resources: Next Steps

• Free Download: Fight Misinformation with These 11 Facts About ADHD
• Read: Myths and Truths About ADHD
• Read: 30 ADHD Books You Need to Read

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹Leveille, A. D. (2024). “Tell Me You Have ADHD Without Telling Me You Have ADHD”: Neurodivergent Identity Performance on TikTok. Social Media + Society, https://doi.org/10.1177/20563051241269260 (Original work published 2024)

²Karasavva, V., Miller, C., Groves, N., Montiel, A., Canu, W., Mikami, A. (2025) A double-edged hashtag: Evaluation of #ADHD-related TikTok content and its associations with perceptions of ADHD. PLOS ONE. https://doi.org/10.1371/journal.pone.0319335