Why does shame lower motivation in ADHD? 

Shame can be a powerful and disabling force in adults with ADHD, often leading to decreased motivation and difficulty following through on tasks. For many, the constant feeling of “not being good enough” or “too flawed” can create a cycle of avoidance, procrastination, and low self-worth. These emotional barriers are more than just temporary feelings, they have deep roots in ADHD’s emotional dysregulation and executive function challenges. 

According to NICE guidance NG87 (2025), emotional dysregulation, shame, and guilt are recognised features of adult ADHD that significantly impact motivation and goal-setting. The guidance recommends structured psychological interventions such as CBT, mindfulness, and Compassion-Focused Therapy (CFT) to help manage these emotional responses and restore task engagement. 

The Royal College of Psychiatrists’ Good Practice Guidance (CR235, 2023) similarly identifies low self-esteem and emotional lability as key factors contributing to poor motivation and procrastination in ADHD. When adults with ADHD repeatedly experience failure or mistakes, these negative experiences often become internalised as shame. This shame, in turn, reduces self-efficacy and makes it even harder to initiate or sustain tasks. 

How shame interferes with task initiation 

Shame is not only an emotional experience but also a cognitive one. The brain’s reward pathways, particularly those involving dopamine, are significantly impacted by the emotional dysregulation common in ADHD. As described in a 2024 study in Frontiers in Psychiatry, emotional dysregulation directly affects task initiation and persistence, with shame suppressing dopamine release, which is essential for motivation and focus. The resulting lack of motivation often becomes a self-perpetuating cycle, failure to act reinforces shame, and the shame makes it harder to act in the future. 

Therapies such as CBT and CFT, which focus on challenging self-critical thoughts and fostering self-compassion, can break this cycle. NHS Talking Therapies recommends these approaches to help ADHD adults reframe their experiences and address the underlying shame that inhibits action. 

Key takeaway 

Shame is a significant motivator of avoidance and procrastination in ADHD. However, evidence from NICE, RCPsych, and NHS sources shows that CBT, CFT, and mindfulness interventions can help rebuild self-esteem, improve emotional regulation, and restore motivation. By addressing shame directly, adults with ADHD can begin to break free from the cycle of self-doubt and move towards greater task engagement and emotional resilience. 

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.