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Why do ADHD people struggle to maintain long-term friendships? 

Author: Avery Lombardi, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Maintaining long-term friendships can be difficult for individuals with ADHD due to symptoms such as impulsivity, emotional dysregulation, and working memory issues. According to Berkshire Healthcare NHS (2024), emotional volatility and distractibility can make friendships feel like a “rollercoaster,” leading to misunderstandings, frustration, and a lack of consistency. These challenges often result in inconsistent communication, forgetting plans, and emotional outbursts, all of which create strain on relationships. 

The challenges of emotional regulation and impulsivity 

As described by RCPsych (2024), ADHD often co-occurs with anxiety and rejection sensitivity, which further hinder relationship stability. Impulsivity and emotional overreaction can result in anger or withdrawal, leading to feelings of guilt and social avoidance. These emotional swings, combined with ADHD-related forgetfulness or inattention, often lead to friends feeling neglected or misunderstood. 

Strategies for maintaining friendships 

NICE NG87 (2025) recommends using psychoeducation, CBT, and structured routines to help individuals with ADHD better manage their emotions and improve their social skills. Tools such as reminders, planning, and mindfulness can help reduce misunderstandings and provide more consistent communication with friends. 

Key takeaway 

People with ADHD often struggle to maintain long-term friendships due to emotional dysregulation, impulsivity, and inconsistent communication. However, with the right support, including CBT and structured interventions, individuals with ADHD can develop stronger, more stable relationships.  

For further support, services like ADHD Certify provide ADHD assessments and medication reviews for adults. 

Avery Lombardi, MSc
Author

Avery Lombardi is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Psychology. She has professional experience in psychological assessment, evidence-based therapy, and research, working with both child and adult populations. Avery has provided clinical services in hospital, educational, and community settings, delivering interventions such as CBT, DBT, and tailored treatment plans for conditions including anxiety, depression, and developmental disorders. She has also contributed to research on self-stigma, self-esteem, and medication adherence in psychotic patients, and has created educational content on ADHD, treatment options, and daily coping strategies.

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. 

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