Bendy Bodies, ADHD Brains: Connecting the Dots
Joint hypermobility may be the common thread between ADHD and a host of physical health problems.
We have all seen that novice contortionist who delights in doing splits, wrapping their legs behind their head, or bending their knee joints backward to make us squirm. Here are two more mind-and-body-bending facts: Nearly 80% of female adults with ADHD are hypermobile and individuals with ADHD are four times more likely to be hypermobile than their neurotypical peers.
You might be thinking, What on earth does ADHD have to do with being bendy? New research suggests that hypermobility, a condition in which the joints have an unusually large range of motion, may be a common thread binding neurodivergence to a range of physical health problems.
Joint hypermobility is the result of a genetic difference in connective tissue. It can cause anxiety, brain fog, varicose veins, irritable bowel syndrome, and more.
Understanding the interconnectedness of these seemingly disparate symptoms and problems can be transformative, particularly for people seeking a diagnosis and treatment.
Hypermobility Spectrum Disorders (HSD)
Hypermobility does not always cause problems; in fact, it may be advantageous, as it is with gymnasts and ballet dancers. Ten percent of hypermobile people, however, suffer from a Hypermobility Spectrum Disorder or hypermobile Ehlers-Danlos syndrome (hEDS). These conditions cause the connective tissue to become floppy, leading to fatigue, headaches, gut issues, autonomic dysfunction, anxiety, and poor proprioception (the body’s ability to sense its own position and movements in space). The joint instability of these conditions often leads to pain, subluxations, dislocations, and injury.
[Self-Test; Am I Hypermobile?]
Hypermobility and Dysautonomia
HSD/hEDS weakens connective tissue in muscles as well as veins, disrupting the autonomic nervous system’s ability to circulate blood. After a large meal, for instance, blood pools in the gut, making it harder for the body to pump blood back to the heart. Consequently, those who have either condition may feel dizzy, lightheaded, and have heart palpitations. These are also symptoms of postural orthostatic tachycardia syndrome (POTS), which is characterized by an excessive increase in one’s heart rate upon standing or sitting up.
A recent study of neurodivergent adults found a strong link between hypermobility, dysautonomia (when the nervous system doesn’t function properly), and pain. Neurodivergent participants reported significantly more POTS symptoms and musculoskeletal pain than their non-ADHD peers, and hypermobility seemed to be the common denominator for neurodivergence and dysautonomia/pain.
Our autonomic nervous system is also in charge of managing our fight-or-flight response. When this part of our nervous system works differently, mental health problems, including anxiety, are likely to develop.
[Watch: “The Surprising Association Between ADHD & Inflammation”]
Hypermobility and Anxiety
In the late 1990s, researchers discovered that 70 percent of patients with anxiety disorder were hypermobile, compared with just 12 percent of control subjects. Patients with anxiety were at least 16 times more likely to have joint laxity.
This arresting finding prompted my research team to examine the brin structure of hypermobile people through functional and structural MRIs. We found differences in structure and activity in the amygdala, responsible for fear and emotion processing, as well as differences in the insula, which interprets sensory and emotion perception, and self-awareness (known as interoception). These patterns confirmed the high levels of anxiety and difficulties with interoception reported by hypermobile patients. The differences in brain structure we observed were similar to those seen with ADHD and autism.
Another study of roughly 8,000 adolescents found that hypermobile teems were at least three times more likely to have an anxiety or depressive disorder. Dysautonomia (such as POTS) seemed to be linking the conditions.
Some researchers posit that hypermobility and neurodivergence may be inherited as a pair. Gene studies have likewise shown links between hypermobility and ADHD, as well as chronic pain and fatigue. While further research is needed to understand the precise mechanisms that link this disparate web of conditions, it’s clear they are closely intertwined.
HSD and hEDS Symptoms
Hypermobility spectrum disorders may include any of the following symptoms:
HSD and hEDS Treatment Options
Because HSD/hEDS symptoms vary widely, treatment is highly personal and customized. Regardless of the approach, all comorbidities, including ADHD and dysautonomia, should be treated.
Exercise
Physical therapy, occupational therapy, and exercise, particularly Pilates, can strengthen core muscles, leading to improved function and proprioception as well as reduced pain and injury. When your core is stronger, you’re less likely to have widespread pain, especially in the neck, back, or shoulders. Be careful not to over-exert yourself during exercise, as hypermobility can increase the risk of injury.
Adjusting your posture and movement can be helpful, especially for people with ADHD, who may hyperfocus in a less-than-ergonomic position. Ask yourself, “How am I studying/working? Am I hunched over a laptop? Is my chair the right height?”
Medication
- For pain: NSAIDS/acetaminophen, lidocaine patches
- For anxiety: Antidepressants
- For muscle spasm: Anti-spasm agents (baclofen or tizanidine)
A Puzzle of Pain, Fatigue, and Flexibility
Studies show that 80 percent of people with fibromyalgia and/or chronic fatigue syndrome are hypermobile; the severity of hypermobility predicts the severity of these comorbidities.
- Fibromyalgia is a chronic condition that causes pain and tenderness throughout the body, as well as fatigue, memory problems, and anxiety.
- Chronic Fatigue Syndrome causes extreme fatigue, memory problems, dizziness, and pain. It can last for six months or longer.
Joint Hypermobility and ADHD: Next Steps
- Watch: “Why Chronic Pain is So Common Among Neurodivergent Youth“
- Read: Hypermobility Often Misdiagnosed as Mental Illness
- Free Upcoming Webinar: “Movement As Medicine – How Music, Movement, and Dance Transform the Neurodivergent Brain“
This article was derived from the ADDitude ADHD Experts webinar, “How Joint Hypermobility Links Neurodivergence, Chronic Pain, Inflammatory Disorders, and Anxiety” [Video Replay & Podcast #560] with Jessica Eccles, Ph.D., which was broadcast on May 29, 2025.
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.
