What Is ADHD? How Does It Relate to Attachment?

Attachment theory and ADHD are topics that most of us wouldn’t think to associate with each other. Yet, attachment disorders and ADHD are strongly linked, meaning that an insecure attachment style has the potential to worsen ADHD symptoms – even in adulthood. However, understanding how attachment can influence ADHD and vice versa can help us to figure out the best ways to manage both conditions. 

The ability to pay attention is an important skill that most of us take for granted. It is similar to highlighting text in a workbook; we focus on the specific details that we’ve spotlighted while tuning out the other less important information. This ability to “highlight” is essential. We only have a limited amount of attentional resources, so we need to use them in the best way possible for us to make sense of our world. 

Paying attention allows us to focus, learn, stay safe, and create and maintain social bonds. Yet, for some of us, paying attention is one of the most difficult tasks.

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that impacts how we feel and behave, as those with it can seem restless, struggle with concentrating, and can be impulsive.

An Introduction to ADHD

Most cases of ADHD are diagnosed in children when they start to attend school and are required to focus their attention in formal environments. For this reason, it was historically acknowledged as a childhood-specific disorder. However, more recently, research demonstrated that children with ADHD don’t just “grow out of” their symptoms. In fact, according to The National Institute of Mental Health, approximately 4.4% of adults have ADHD.

In contrast to the difficulties with hyperactivity and impulsivity that children with ADHD tend to encounter, adults with the condition are more prone to a lack of mental focus, memory problems, and restlessness.

What’s more, a later diagnosis may mean that strategies were never put in place to manage the symptoms of ADHD. Consequently, these symptoms can have a serious effect on people’s quality of life, relationships, and careers unless measures are taken to manage them. 

Plus, The Attachment Project is not choosing to just randomly deviate into developmental disorders. There’s a strong association between attachment theory and ADHD. Of course, we’re not suggesting that everyone with ADHD will have an insecure attachment style. Still, the connection does lead to the question of whether treating ADHD as attachment deficit hyperactivity disorder in some instances could help some people optimize positive changes in their behaviors, outlook, and relationships. 

For these reasons, in this article, we will cover:

• What ADHD is
• The different types of ADHD
• What causes ADHD?
• How ADHD and attachment theory connect
• ADHD attachment issues

What Is ADHD?

ADHD (attention deficit hyperactivity disorder) is one of the most common disorders in childhood – it affects approximately 11% of children and roughly 5% of adults. This level of frequency is due to ADHD’s lack of specificity to a particular population, socio-economic class, or place – it can affect anyone, anywhere. The primary problems for people with ADHD are around focusing attention, impulsivity, and organization. Yet, although the symptoms of ADHD are mostly behavioral, it’s important to recognize that ADHD is neither a mental illness nor a behavior disorder. Rather, it is a developmental impairment that affects how we manage our emotions, thoughts, and actions. 

Similar to all other developmental disorders, ADHD starts in childhood, and more males tend to report symptoms than females. However, just because more males than females have an ADHD diagnosis doesn’t necessarily mean that males are more prone to it. Males may just present more outward symptoms, so, therefore, many women may go undiagnosed. 

There is somewhat of a myth that everyone with ADHD must have hyperactivity and problems with focusing. Yes, this is the case for some, but ADHD looks a little different for everyone who has it. There are three different subtypes of ADHD, and each one influences behavior differently.

Check also our content on Neurodiversity and Attachment!

The Types of ADHD

The DSM-V and American Psychiatric Association (APA) have classified ADHD into three distinct subtypes based on the different presenting symptoms experienced by those with it.

ADHD Inattentive Type

Although we might often associate ADHD with hyperactivity, many people who have ADHD don’t experience overactive or impulsive behaviors. Instead, they may struggle with issues of inattention, distractibility, and slow information processing. Such individuals might appear bored or daydreamy; they often have issues with following instructions and listening actively. This form of ADHD might come across more common in females than males. 

People with ADHD inattentive type may:

• Make careless mistakes at work
• Overlook or miss details
• Appear not to listen when other speak to them – their minds are elsewhere
• Have trouble maintaining attention 
• Seem disorganized – are messy, late to work or appointments, and struggle to meet deadlines
• Lose focus during tasks and often fail to finish them
• Find themselves distracted by unrelated thoughts 
• Forgetful in tasks like paying bills, completing chores, correspondence

ADHD Hyperactive-Impulsive Type

Someone with this form of ADHD will experience traits of hyperactivity and impulsivity. Yet, they may also encounter symptoms of inattentiveness. Hyperactive-impulsive individuals may have difficulties with sitting still, may seem impatient, speak inappropriately, act disruptively, and grapple with quiet activities. As children, hyperactive-impulsive types may be a disruption in school. They are likely aware of this fact, but still, struggle to control it. As adults, they may have more control over their issues, but they may still have difficulties consistently managing their overactivity and impulsiveness.

People with ADHD hyperactive-impulsive type may:

• Struggle to sit still – they fidget or squirm
• Feel restless and need to dispel energy in inappropriate situations – such as walking about during meetings
• Seem constantly “on the go” and difficult to keep up with
• Have difficulty waiting their turn in line
• Speak excessively and cannot wait for their turn to speak – they interrupt others frequently

ADHD Combined Type 

Some people with ADHD may not fit into either the inattentive or hyperactive subgroups exclusively. Instead, they may manifest symptoms of both interchangeably. It’s likely that most people with ADHD fit into the combined subtype. Thus, strategies for managing behavior should consider both the hyperactive and inattentive traits – which can make treatment difficult. 

What Causes ADHD?

There has been an age-old argument regarding the exact cause of ADHD. And, despite how common it is as a disorder, professionals in the area are still being debating its origins. This is probably because genetics, neurobiology, and environment might all influence the presence of ADHD. In fact, our environment may play a greater role in ADHD development than most people might think. For instance, how our caregivers responded to our needs during our formative years may have influenced whether we express ADHD symptoms. 

Interestingly, in recent years, the number of ADHD diagnoses has increased. This further leads experts in the field to wonder whether or not ADHD is being over-identified or if it’s sometimes confused with the symptoms of attachment deficit hyperactivity disorder. 

ADHD and Attachment Theory

Attachment theory proposes that caregivers who are attentive and responsive to their child’s needs allow them to form a sense of security. From the child’s perspective, this means that they feel safe enough to explore their world with confidence because they see their caregivers as sensitive and protective. 

ADHD and Attachment Theory start to connect based on ADHD’s links to hyperexcitability, difficulty focusing, and impulsivity. All of these traits which can be challenging for a caregiver to manage in everyday scenarios and could potentially interrupt the quality of the bond that the caregiver and child form. Furthermore, caregivers’ sensitivity regarding how they manage their children’s behaviors forms the basis of a secure attachment bond. Yet, the needs of children with ADHD are greater than those without. This can affect how well caregivers are able to meet their child’s needs. Perhaps for these reasons, the findings of many different studies have found that many people with ADHD tend to display behaviors that resemble those of the insecure attachment styles. 

So, the question now is whether attachment issues cause ADHD, or is it the presence of ADHD that leads to an insecure attachment? Moreover, how can a secure or insecure attachment style influence the lives of those with ADHD?

ADHD and Insecure Attachment

Insecure Attachment Can Enhance ADHD Traits

The secure attachment style typically goes together with a positive outlook, healthy levels of self-esteem, and the ability to focus for long periods of time. What’s more, secure attachers are typically willing and enthusiastic to persevere with difficult tasks. In contrast, the insecure attachment style links to lower levels of positivity and self-esteem, inattentiveness, hasty behaviors, and a lack of drive to persevere with difficult tasks. In light of this information, it’s not surprising that a secure attachment style may lessen the impact of ADHD on the lives of those with it. However, it is also likely that an insecure attachment style may negatively impact or enhance people’s ADHD traits. 

In fact, research has demonstrated that adults with ADHD had a much greater chance of having an insecure attachment style than the rest of the population. 

Insecure Attachment of Caregivers Predisposed Their Children to ADHD

Fascinatingly, attachment theory may have implications for whether or not someone develops ADHD before they are even born. In a review of twenty-nine different studies that examined how attachment may affect ADHD, results showed that if a primary caregiver had an insecure attachment style, then it was more likely that their child would develop ADHD.

What’s more, if a child is biologically predisposed to having ADHD, their caregiver’s attitude and levels of warmth towards them may predict whether or not they actually develop ADHD attachment issues.  

Moreover – similar to children with insecure attachment styles – people that grew up in households where caregivers struggled to manage their negative emotions (such as in the case of mood disorders like depression) appear to be more likely to develop ADHD. These findings tie in with attachment theory’s stance that a caregiver’s sensitivity and attentiveness to their child’s needs creates a strong bond. But it also suggests that this bond can potentially lessen the risk of developmental disorders. 

Of course, although parenting styles can influence whether a child develops ADHD, it can be somewhat of a chicken and egg scenario; although the way a caregiver responds to their child’s needs can influence the child’s behavior, the child’s challenging behaviors can also impact how caregivers’ relate to their child. 

ADHD and Attachment Issues 

By this stage, it seems pretty evident that ADHD and insecure attachment commonly occur in tandem. But how can having an insecure attachment style affect how someone manages the symptoms of their ADHD? 

Insecure attachers are less psychologically robust 

To begin with; it’s likely that attachment styles could serve as a protective factor for people with ADHD. Unfortunately, adults with ADHD are more prone to depressive and anxious symptoms. However, if these people have an insecure attachment style, then they are less likely to be psychologically robust (compared to secure attachers). For example, those high in attachment anxiety and ADHD are more at risk of emotional distress. Interestingly, this effect wasn’t present for people with high attachment avoidance. 

Insecure attachers struggle with emotion regulation

What’s more, people with ADHD are prone to strong, negative moods and feelings, which they often struggle to manage. This difficulty with regulating emotions is also commonly experienced by people with the anxious and disorganized attachment styles. Moreover, people with the disorganized attachment style often struggle with paying attention and managing their emotions. So there’s a clear association between how disorganized attachment could impact the symptoms of ADHD. 

Implications for ADHD from Attachment

Essentially, the findings from research suggest that the quality of the bond between a child and their caregiver should be assessed in association with ADHD symptoms by professionals, as treatment may need to focus on forging security in their relationships.  

However, it is also important to note that some children may display ADHD-like behaviors in an attempt to elicit the response that they want from their caregivers. Some insecurely attached children and adults may thus be misdiagnosed with ADHD in their aim to prompt the attentive reactions that they want from their loved ones. 

Yet, overall, understanding the link between ADHD and attachment theory may allow us to take a more personalized approach to how we may manage our ADHD symptoms. 

Final Thoughts on ADHD and Attachment Theory

Even in light of all of the information discussed in this article, it’s still unknown whether ADHD influences the development of an insecure attachment style, or whether an insecure attachment increases the likelihood of ADHD. It’s highly possible that both conditions impact each other mutually – if one develops, then there’s a greater risk of contracting the other. Therefore, if ADHD symptoms emerge at an early age, then it’s wise to treat them as early as possible in an attempt to avoid interruptions to the attachment bond. 

Alternatively, for adults with a confirmed insecure attachment style and ADHD, it may be best to consider behavioral strategies that encompass emotional healing in order to cope with both the symptoms of ADHD and an attachment deficit. Our article: “How to Manage Your ADHD Based on Your Attachment Style,” includes techniques designed to help manage the mood, organizational, and performance difficulties that people with either or both of these conditions may encounter regularly. 

However, if you’re struggling to manage your ADHD symptoms and insecure attachment style, then it’s important to consult your health care professional for guidance on therapy, medication, or a possible combination approach. 

References 

Cavallina, C., Pazzaglia, C., Ghiglieri, V., & Mazzeschi, C. (2015). Attachment and parental reflective functional features in ADHD: enhancing the knowledge on parenting characteristics. Front Psychology.

Clarke, L., Ungerer, J., Chahoud, K., Johnson, S., & Stiefel, I. (2002). Attention Deficit Hyperactivity Disorder is Associated with Attachment Insecurity. Clinical Child Psychology and Psychiatry, 7(2), 179-198.

“Data & Statistics.” Centers for Disease Control and Prevention. Ed. Center for Disease Control. Centers for Disease Control and Prevention, 14 Feb. 2017. Web. 14 Mar. 2017.

Harold, G. T., Leve, L. D., Barrett, D., Elam, K., Neiderhiser, J. M., & Natsuaki, M. N. (2013). Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry, 54(10), 1038–1046. 

Kissgen, R., & Franke, S. (2016). An attachment research perspective on ADHD. Neuropsychiatry, 30, 63-68.

Kordahji, H., Ben-David, S. & Elkana, O. (2021). Attachment Anxiety Moderates the Association Between ADHD and Psychological Distress. Psychiatric Quarterly, 92, 1711–1724. 

Storebø, O., Rasmussen, P., & Simonsen, E. (2013). Association Between Insecure Attachment and ADHD: Environmental Mediating Factors. Journal of Attention Disorders, 20(2).

https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd