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Why do I have trouble prioritising tasks with ADHD? 

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

If you often feel overwhelmed deciding what to do first, even with a clear to-do list, you are not alone. According to NICE guidance (NG87), difficulties prioritising tasks are a key part of ADHD. These challenges stem from how ADHD affects executive function, the brain system for planning, organising, and managing time. 

Discover if you have ADHD

Executive function and planning 

Executive dysfunction is one of the main reasons people with ADHD find it hard to set priorities or stick to plans. NHS evidence highlights that these “thinking skills” planning, organising, and switching between tasks, often work less efficiently in ADHD. According to NICE and the Royal College of Psychiatrists, this can lead to decision paralysis: struggling to decide where to start or how to break tasks into steps. 

Time management and “time blindness” 

Many people with ADHD experience what experts call time blindness, a reduced sense of how long things take or how much time has passed. This makes it easy to underestimate deadlines or focus on what feels urgent rather than what is most important. Recent research confirms that inconsistent time perception and working memory issues combine to make task prioritisation even harder (PubMed, 2025). 

Reward sensitivity and motivation 

Another factor is reward sensitivity, the brain’s natural bias toward instant gratification. NICE and PubMed reviews (2024–2025) show that people with ADHD often find it difficult to stay motivated for long-term or unrewarding tasks. The ADHD brain tends to prioritise what feels interesting or stimulating right now, rather than what is most urgent or necessary. 

Supporting better prioritisation 

Improving task prioritisation is about building external support around how your brain works, not against it. 

  • Use visual planners or time-blocking tools to map tasks clearly. 
  • Try body-doubling working alongside someone to maintain focus. 
  • Break down big goals into short, timed steps with visible rewards. 
  • Consider CBT-based therapy or executive function coaching, which NICE recommends to help with planning and self-regulation. 

Behavioural support services such as Theara Change focus on emotional regulation and task-structuring skills that align with these evidence-based strategies. For diagnostic review and ongoing treatment planning, regulated assessment services such as ADHD Certify can provide clinical support within UK NICE frameworks. 

Takeaway 

Trouble prioritising tasks is not a character flaw; it is a recognised feature of ADHD’s executive function profile. According to NHS and NICE, the right combination of structure, therapy, and self-compassion can make it far easier to decide what matters most and get it done. 

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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