Why do people with ADHD often have social anxiety?

PostedNovember 19, 2025

UpdatedNovember 21, 2025

ByMy Patient Advice

Author: Harriet Winslow, BSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Living with ADHD can be challenging enough, but for many, it also comes with the added difficulty of social anxiety. Research shows that people with ADHD are significantly more likely to experience social anxiety disorder compared to the general population. This overlap is often linked to how ADHD affects emotional regulation, attention, and social confidence. Understanding this connection can help individuals, families, and clinicians identify the right mix of support and treatment to improve quality of life (NHS, 2025; PubMed, 2025).

Understanding the link between ADHD and social anxiety

Many studies estimate that around 20–32% of people with ADHD also live with social anxiety disorder, highlighting a strong and well-documented link (RCPsych, 2023; PubMed, 2025). According to NHS guidance, symptoms such as impulsivity, forgetfulness, and restlessness can make social interactions feel unpredictable or stressful. These experiences can build up over time, reinforcing fear of embarrassment or rejection.

How ADHD symptoms contribute to social anxiety

Core ADHD traits like impulsivity, inattention, and rejection sensitivity can make it harder to read social cues and maintain confidence in conversations. Emotional dysregulation may cause someone to overreact to criticism or misinterpret neutral feedback as negative, which increases avoidance and self-doubt. Studies from PubMed (2024) and the Mayo Clinic (2024) show that this emotional sensitivity is one of the strongest predictors of social anxiety among adults with ADHD.

What guidance recommends

Both NICE guidance NG87 and NHS advice recommend screening for social anxiety as part of ADHD assessments. A person-centred plan that includes CBT, psychoeducation, and ADHD-focused coaching has been shown to improve self-regulation and reduce avoidance (BMJ, 2025). In some cases, a combination of stimulants for ADHD and SSRIs or SNRIs for anxiety may be prescribed with close clinical supervision.

Peer support and gradual exposure to social situations also play an important role. Multi-agency care and coaching services can help individuals develop confidence and coping strategies in real-world settings (RCPsych, 2023).

Key takeaway

Social anxiety is common among people with ADHD, but it can be effectively managed with understanding, therapy, and the right clinical support. Combining behavioural strategies with medication where appropriate helps build lasting confidence and reduces avoidance, allowing individuals to reconnect with others and thrive socially.

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.