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Why do I feel like I’m underperforming ADHD? 

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Updated
ByMy Patient Advice
Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Many adults with ADHD describe a painful sense of “not living up to their potential.” Despite intelligence, creativity, and driving, they often find it hard to stay organised, meet deadlines, or follow through on goals. According to NICE guidance (NG87), ADHD affects the brain systems that regulate attention, planning, memory, and emotion, all essential for consistent performance at work and in daily life. 

Discover if you have ADHD

Why ADHD can make you feel “behind” 

A 2023 review in the Journal of Attention Disorders found that untreated ADHD in adults is linked to wide-ranging difficulties in employment, education, relationships, and wellbeing. Inattention, disorganisation, and executive-function problems, rather than lack of motivation, are key reasons for this functional impairment. 

According to the Royal College of Psychiatrists, adults often present with a lifelong pattern of inconsistent performance. Many achieve high in bursts but struggle to sustain momentum, leading to self-blame and the mistaken belief that they are “lazy” or unreliable. 

A 2024 umbrella review in Frontiers in Psychiatry also found that adults with ADHD have higher rates of low self-esteem and self-stigma, often because of repeated criticism, missed opportunities, and burnout from overcompensation. 

The self-esteem and stigma loop 

Low confidence can deepen the impact of ADHD. A 2024 study using the Rosenberg Self-Esteem Scale found that adults with ADHD consistently rated themselves lower than peers. Researchers suggested that stigma, perfectionism, and negative feedback reinforce the feeling of underperforming, even when individuals are doing their best in systems not built for them. 

Psychoeducation and strength-based therapy can help break this loop by reframing struggles as executive-function challenges, not character flaws. NICE recommends a holistic approach that combines medication (where indicated) with CBT-style skills training, coaching, and occupational support to rebuild confidence and functioning. 

Rebuilding confidence and performance 

Practical NHS and Trust resources, such as Lothian’s Self-Help Pack and ELFT’s ADHD Support Pack, recommend: 

  • Breaking tasks into small, visible steps 
  • Using planners and reminders to externalise memory 
  • Scheduling planning time daily rather than weekly 
  • Body-doubling or working alongside someone for accountability 
  • Celebrating small wins instead of only focusing on outcomes 

Workplace adjustments under the Equality Act 2010, like clear task lists, flexible scheduling, and supportive feedback, can also help adults with ADHD to perform more consistently and feel valued. 

Reassuring takeaway 

Feeling that you are “underperforming” with ADHD is not a personal failure; it reflects how ADHD shapes attention, time, and motivation. According to NICE and RCPsych, combining treatment, structured support, and self-compassion can help you rediscover your capability and confidence. With the right tools, you’re not underperforming; you are uncovering how you work best. 

Victoria Rowe, MSc
Author

Victoria Rowe is a health psychologist with a Master’s in Health Psychology and a BS in Applied Psychology. She has experience as a school psychologist, conducting behavioural assessments, developing individualized education plans (IEPs), and supporting children’s mental health. Dr. Rowe has contributed to peer-reviewed research on mental health, including studies on anxiety disorders and the impact of COVID-19 on healthcare systems. Skilled in SPSS, Minitab, and academic writing, she is committed to advancing psychological knowledge and promoting well-being through evidence-based practice.

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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