Procrastination is a sign of ADHD

ADHD and friendship

ADHD and social relationships: Due to their frequent otherness and because they often have difficulties regulating their behavior, those affected tend to fall into the roles of outsiders

For people with ADHD are Friendships and relationships with other people are usually just as important as they are for neurotypically developed people. The often described otherness[1] and the often social nonconformities and abnormalities of those affected are often associated with problems that make lasting relationships difficult. Friendships between ADHD sufferers are therefore often short-lived, both in childhood and adolescence and in adulthood.[2] Decisive for the relationship competence, especially with increasing age, is less whether and how different the person concerned is in his behavior in general; Rather, it is particularly important among young people and adults whether and how disruptive or immature the behavior of others is perceived. Above all, severe symptoms (all symptoms from the cluster are affected) and accompanying comorbidities such as depression[3] or personality disorders[4], can significantly impair social skills and lead to loneliness, from which those affected suffer.

ADHD sufferers are often loners and avoid groups because they are not good at handling group dynamics or because the increased incidence of stimuli in group situations overwhelms them and quickly overloads and exhausts them. If the acute overload does not indicate disinterest or a need to withdraw from the social situation, then at the latest the socially uncontrolled behavior threatens to lead to the person concerned being avoided by others.

More often than neurotypical people, those affected are also victims of exclusion from the group and bullying in kindergarten, school, university or at work.

If those affected find connection to people who they can accept with their idiosyncrasies, the surrounding social environment has a stabilizing effect and the affected are not overwhelmed or decompensated for the most part and permanently, they can, however, prove to be loyal and interesting friends and partners with integrity. Against this background, there seems to be a direct correlation between symptomatic severity and the quality and quantity of social life. See also: ADHD and strengths.

Relevance of friendships for those affected

ADHD sufferers long for a stable social environment that they largely accept for who they are. If those affected feel accepted and accepted, it can be observed that the ADHD symptoms as well as the secondary disorders also improve beyond the respective social context, which again highlights the role of the psychosocial influencing factor in the etiology.

Especially with adult sufferers who have few resources in their own family, extra-family relationships in addition to the partner play an important role. However, this is not only the case with ADHD sufferers, but with almost everyone.

Problems in adolescents and adults

Depending on how pronounced the symptoms are in the individual, the symptom cluster can consist of a lack of concentration (low level of attention and attention span, lack of stimulus filtering, rapid overload), impulsiveness (emotional overreactability, impatience, aggressions, emotional instability) and possibly hyperactivity (strong motor urge to move , Restlessness) go hand in hand with social problems. Due to the increasing pressure to conform with increasing age, this becomes more and more stressful for those affected, as they are more and more required to adapt socially and, if necessary, to suppress their own needs and character traits in order not to attract negative attention.

For those affected, their own behavior is natural and in line with their natural need to express themselves emotionally. In social situations, this can lead to misunderstandings and create a high level of suffering on the part of those affected. This becomes clear in the following examples, which are broken down using the respective symptoms from the symptom cluster:[5]

Lack of attention, poor working memory

  • If a person concerned cannot follow conversations for a long time, the impression arises that he is not interested in the conversation partner, work colleague, etc.
  • If the person concerned is overloaded and withdraws from the social situation, the impression can arise that he / she does not like the interaction partner or is not interested
  • If the person concerned disregards the needs of the counterpart or the group because he has not kept verbal or non-verbal agreements, the impression arises that he has a bad character, is selfish or ignorant
  • Delays due to a lack of sense of time give the impression of low appreciation
  • Only incompletely or incorrectly perceived verbal or non-verbal statements of other people lead to misunderstandings and have a high potential for conflict, especially in combination with impulsive reactions of the person concerned
  • Incomplete or selective memories of the content of a conversation (including chat content, for example) have potential for conflict
  • Gaps in memory, which are to be bridged by compensatory confabulations, make those affected appear untrustworthy, so that outsiders turn away.

Impulsiveness and emotional overreactivity

  • Behavior of the person concerned that is perceived as impulsive and attacking by outsiders does not have to be meant by the person concerned, but is to be understood as an increased temperament. The resulting misunderstandings can easily escalate the conflict.
  • Those affected often tend to process information divergent and to give answers that are out of context
  • Impulsive reactions, which can include hostility, personal insults or even physical assault, can also break long-standing friendships in a short period of time or lead to people turning away from acquaintances or peers at an early stage
  • Outsiders react to behavior without distance, which the person concerned does not regulate even after non-verbal or verbal cues, with aversion or clear demarcation, which hurts the person concerned
  • Affected people encounter incomprehension and displeasure from those around them if they cannot hold back with inappropriate / inappropriate statements in certain situations
  • If those affected feel that they have been treated unfairly, they tend to be right-wing and possibly also to power struggles that are not relevant in terms of content.

Motor hyperactivity

  • A permanent urge to move is perceived by outsiders as annoying and irritating
  • A pronounced need to communicate (logorrhea) is perceived as disturbing, self-centered or self-important and leads to social exclusion

Not all of the features mentioned occur in all ADHD sufferers, and the examples are not limited to ADHD. However, the combination of the specific symptom complex occurs more frequently in ADHD sufferers than in the general population. The perception as to whether the behavior patterns mentioned as an example are perceived as disturbing is always subjective and dimensionally dependent on their frequency and severity.

Secondary comorbidities significantly broaden the range of problems in the social context. In particular, depression with negative self-concepts, personality disorders (histrionic, antisocial, self-insecure, dependent, narcissistic, emotionally unstable, etc.)[6] as well as dependency diseases have a strongly reducing effect on the social skills of the person concerned and also have a reciprocal effect on the overall problem and symptoms.

Problems in children

The above problems in adolescents and adults are similar to ADHD-related social difficulties in children. These can be transferred qualitatively to the child's context. However, it is often more difficult to adapt behavior in therapy or training, since children are even less reflective than adults and cannot yet assess the cause / effect relationship of their behavior well.

Children and younger adolescents with ADHD are also at risk of stigma if their peers, for example other children in kindergarten or classmates, know about the diagnosis. Children and adolescents diagnosed with ADHD are clearly at risk of being excluded from the group due to the stigma attached to the ADHD diagnosis.[8]See also: stigma and ADHD.

Social isolation

To compensate for their dysfunctional basic assumptions and behavior patterns, people with ADHD often develop pronounced procrastination or avoidance behavior at an early stage, which very often relates to social situations. While the tendency towards social avoidance in kindergarten and school age shows itself in the refusal to attend daycare or school, adults withdraw into the apartment and avoid situations in which their social skills could be put to the test. In general, situations are avoided in which there is a possibility (even a small one) of remaining unsuccessful, of being embarrassed or of feeling uncomfortable. This dysfunctional compensation complex leads to a mutually reinforcing conglomerate of problems: on the one hand, those affected become lonely, on the other hand, negative social experiences increase due to the negative basic assumptions and expectations and intensify social fears, up to pathological social phobia.

See also: Coping in ADHD.

Developing friendships for people with ADHD

The social interaction patterns of ADHD sufferers are basically as heterogeneous as those of the general population. In some areas, however, there are special features that can be observed more often in practice in people with ADHD. There are those affected who can become enthusiastic about new people particularly quickly and who lapse into idealizations when they get the impression that they share a particularly high level of similarities with the new acquaintance. As a result, outsiders feel overwhelmed and set themselves apart, which unsettles or hurts those affected and possibly leads to impulsive confrontation. In this way, relationships that have germinated and which actually had good potential can break off again just as quickly. Attribution patterns from people with narcissistic personality disorder or narcissistic personality components must be clearly differentiated here: While the initial idealism of narcissistic personalities usually changes to a diametrical devaluation, in the long term this gives way to disappointment, hurt and feelings of guilt in those affected with pure ADHD.

On the other hand, those affected can meet new acquaintances with particular suspicion or pessimism, especially if they have already had numerous negative experiences with social exclusion or bullying. Because they are often unable to adequately assess how others feel about them, even in the early stages of the friendly relationship they would like to have discussions that go far beyond the usual non-verbal and verbal signals. This, too, often overwhelms the other person, leaves a strange impression and creates a need for demarcation in others.

Those affected appreciate it very much and clearly notice when a "behavior slip" or emotional outburst is not chalked up - even if they themselves often criticize the behavior of others. Tolerating behavioral errors is behavior that those affected are not used to - It is all the more surprising for them if they are not scolded, marginalized or punished for it.[9]

Friendly interaction with people with ADHD

Friendships with people with ADHD can be enriching and interesting and have an unusually friendly character. Shared experiences with those affected can be unpredictable and unconventional, and common activities often take paths that could not previously be foreseen. This sometimes leads to experiences that are not necessarily desirable from the outset - it has been proven, for example, that the risk of accidents in people with ADHD is significantly higher[10] (see also: ADHD and road traffic). In retrospect, however, it is not uncommon for anecdotes to emerge that are unparalleled and that can provide topics of conversation years later.

Still, friendly relationships with those affected are not always easy to manage. People who do not know or do not know enough about ADHD and its typical symptoms can experience the syndrome-typical behavior of their friends as irritating or unpleasant. In a friendly context, therefore, there are some aspects that can be clarifying for friends of those affected (see also: Psychoeducation). Below is a selection of exemplary tips that can be helpful in individual situations:

  • Those affected are often not aware of incomprehensible behaviors and inappropriate reactions or answers. Check back (if possible, not reproachfully) if you cannot understand the behavior (see also: Divergent thinking)
  • Do not value behavior that appears to you as transcendent as disrespect, but as an expression of disruption. Talk to the person concerned about their behavior in a one-on-one conversation and tell them (ideally with the help of evaluation-free I-messages)[11] with how you experience his behavior and how you feel about it
  • In general, you should try to take as little personal behavior as possible when you feel inappropriate. Many behaviors that are barely comprehensible to outsiders or initially seem superfluous are often part of a (often unconscious) coping scheme that may have an important compensatory function for the person concerned
  • If the friend with ADHD reacts impulsively or aggressively, try to stay calm yourself if possible so as not to aggravate the situation further. If necessary, give the person affected the opportunity to calm down or, if necessary, to withdraw
  • In ADHD, impulsive is very often not synonymous with aggressive: Observe, for example, in a situation in which the person concerned is upset, whether it is just a superficial echo or actually an aggressive and emotionally charged form of expression
  • Do not enter into power struggles and try to avoid punishing those affected by ignorance or disregard. Those affected find it particularly considerate and appreciative when their counterpart tries to be restrained, as this is a regulatory effort that costs them a lot of strength and overcoming
  • Do not take spontaneous withdrawals from your presence personally. People with ADHD are quickly overexcited, especially in group situations; the sudden withdrawal also represents a coping mechanism to compensate for the current overexcitation
  • If you know that your friend is struggling with less stimulating or quiet pursuits and activities, try to plan accordingly in a compromise manner
  • Try to understand that your friend would rather do things with you than with your friends and acquaintances. Many people find group situations uncomfortable and confrontational. Nevertheless, you can always offer joint ventures with others, as the social threat and overwhelming feeling of the person concerned can be subject to fluctuations depending on the daily form.
  • If you have the impression that your boyfriend seems to be making fun of himself at your expense and you find this annoying or indifferent, try to ignore this if possible or talk about the behavior in private. Make it clear to your friend that you are bothered. Avoid “countering with the same coin”, as those affected often feel overly sensitive and react accordingly impulsively, so that the original teasing can suddenly develop into an exchange of deep injuries.

The advice given does not imply that you should or must tolerate any kind of misconduct without limits. Rather, in order to maintain their own health, friends and relatives are required to set personal boundaries within the necessary and appropriate framework and to make them clear and to demand their respect. ADHD cannot be an immunization against any behavioral criticism or a universal excuse for any wrongdoing. Rather, they represent exemplary examples that can lead to misunderstandings and conflicts with those affected in many situations.If outsiders understand that numerous behavioral aspects of those affected are part of the spectrum of symptoms or a disorder-related coping strategy that should not be viewed as an expression of personal aversions or disrespect, it is usually less difficult to maintain composure in the corresponding situations and without conflict or further escalation to proceed with the agenda.

Decreased inhibition of behavior in response to emotional signals

Various studies have shown that children and adolescents as well as adults with a diagnosis of ADHD react less sensitively to emotional irritation from other people - for example from teachers or caregivers.[12] This means that people with ADHD do not react sufficiently to negative feedback from others and, for example, continue unwanted or disruptive behavior until an emotional "super stimulus" is sent - for example a screaming teacher or a partner (in ), who seeks the run in desperate anger (and slams the door behind her). Once the time has come, those affected know that they did not behave adequately or as expected - but they do not know when the exact point in time was when the other person perceived the behavior as cross-border. It is therefore very important for those affected that you communicate very clearly - verbally - to them if you do not agree with a behavior.

Avoid stigma

Stigmata are often associated with ADHD, which are characterized by socially sometimes very negative attributions and implications. While a significantly higher understanding and more social support can still be expected for physical disabilities and limitations in society, mental disorders and problems are often considered to be "homemade", less stressful or - as in the case of ADHD - even non-existent. generalized as a "lazy excuse".[13] In addition, there are implications such as crime, "bad children", "dream baby" or "solo entertainer". These stigmata often affect those affected lifelong from childhood, may imply identity conflicts and make the subject of ADHD a sore point. As a friend or relative It is therefore advisable to find out whether the person concerned would like to be seen in connection with ADHD at all. While some people with an ADHD diagnosis attribute the label to neutral or even extremely positive (see also: Self-Esteem Distortions) and experience positive reinforcement, others avoid self-labeling and would rather be seen as people with individual strengths and weaknesses than as "ADHD people".

Ultimately, in connection with the ADHD label, there is also a risk of abuse that should not be underestimated, even in a friendly context, for example with regard to one-sided blame. Regardless of the individual character profile, especially in the event of a conflict, there is a risk of incorrect and unjust attributions, such as "quarrelsome" and similar attributions, which are often stereotypes in connection with ADHD. Comments such as "You probably don't have your ADHD under control again!" or "You are so angry again - did you not take your pills again?" would be an example of the abusive and stigmatizing use of the ADHD diagnosis in the event of a conflict, in which the person concerned is misused as a projection surface reduce the self-efficacy expectations of those affected and nurture negative beliefs, for example that the affected person has no chance of being a "dear child" or a loving, considerate partner without medication.

Even remarks that seem harmless at first, such as "Our little ADHD monster is causing a stir again", "Fidgety Philip has his five minutes again" or "That is just typical of our little dream baby" are also capable of children and young people If necessary, to emotionally invalidate, stigmatize and negatively disturb the development of one's identity over the long term.[14]

See also: Stigmatization as well as ADHD in society and self-perception of people with ADHD.

How ADHD Sufferers Can Make Friends

It is important for those affected (through self-observation and therapy)[15] to learn to become aware of their syndrome-related difficulties and to be able to regulate them accordingly. You need to understand that most other people are likely to perceive differently than they do themselves and try to interpret the meanings of verbal and nonverbal signs correctly. An important factor in terms of impulsiveness is also the expectation of the relationship and the problem of the inability to defer needs (Adronitis)[16]: Relationships take time to develop. Personal similarities can form a good foundation for a friendship, but are more a prerequisite for such than that they can say anything about the already existing solidity of the relationship. This only develops after some time in the course of shared experiences, experiences and conversations. Equally important is the development of a realistic self-assessment and perception and perception of others.

Particularly in the case of severe symptoms and accompanying disorders, it is very difficult or even impossible for those affected to make new friends, as personal resources are (currently) lacking. The focus should be on the treatment in order to improve the symptoms on the spot, so that, for example, as part of cognitive behavioral therapy or training (e.g. impulse control training)[17] one can gradually work on social skills. Specialized coaching can also help to optimize certain behavioral patterns and to reframe perceptual styles. Medication cannot improve individual behavioral deficits, nor can medication alone improve social skills. As a therapy component, however, medicinal flanking can be supportive, especially in the case of severe symptoms, and in particularly severe cases it can even be a prerequisite for successful therapeutic treatment of the areas concerned.

Furthermore, in multimodal therapy, the focus is on conveying sensible patterns of compensation:[18] The habitual avoidance behavior should give way to positive self-attributions and self-efficacy expectations that enable cognitive restructuring by enabling positive experiences. The aim was to convey to those affected that openness to new friendships and a differentiated view of the good in other people are meaningful and enriching.

Ultimately, those affected should carefully weigh up when the right time is to inform new acquaintances about their own particularities and the sometimes associated difficulties and whether this is necessary at all. By explaining how you are affected, misunderstandings and conflict situations can be prevented. In addition, knowledge of the specific characteristics of the person affected can make an important contribution to stabilizing the friendly relationship, so that it is also possible for people with ADHD to make and maintain long-term, valuable friendships.

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