Why do I have trouble understanding social cues with ADHD?

PostedDecember 22, 2025

UpdatedDecember 30, 2025

ByMy Patient Advice

Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

If you sometimes miss hints, interrupt at the wrong time, or worry you have misread a situation, you are not alone. According to NICE guidance on ADHD (NG87), social and emotional difficulties are recognised as part of ADHD and should be considered in assessment and treatment, not mistaken for a lack of empathy or care.

Recent reviews show that adults with ADHD may process social information more slowly or less consistently than others, especially under pressure. This reflects differences in attention, working memory, and emotional regulation, not poor social awareness or intent (Frontiers in Psychology 2022).

How ADHD affects social understanding

A 2022 systematic review found that adults with ADHD recognised most facial emotions accurately but took longer to respond and were less precise with complex or negative expressions, such as fear or sadness. Researchers describe this as a difference in social-cognitive efficiency; the brain works harder to decode tone, facial expression, or context while managing distractions.

Emotional dysregulation can also make social situations feel intense or confusing. A PLOS One review confirmed that adults with ADHD often experience faster, stronger emotional shifts, which can amplify reactions or make it harder to stay calm when reading social cues (PLOS One, 2023).

ADHD vs. autism and why the distinction matters

Some people wonder if missing cues means they might also be autistic. While overlap exists, studies show the mechanisms differ. Adults with ADHD tend to struggle more with timing, attention, and context, whereas autistic people often have broader and more consistent challenges interpreting social meaning (Frontiers in Psychiatry 2023). NICE notes that both conditions can affect social functioning and recommends clinicians consider autism where appropriate, but also treat social impacts of ADHD (NICE NG87 context).

What helps

NICE advises that adults who need non-medication support should be offered a structured psychological intervention focused on ADHD, often CBT-based (NICE NG87 recommendations). CBT and coaching can improve self-awareness, communication, and emotional regulation, helping people pause before responding, asking for clarification, or checking assumptions.

Peer groups and psychoeducation programmes also help adults recognise unhelpful patterns, such as over-sharing or masking, and practise explicit communication strategies (PMC10399076). For many, ADHD medication makes it easier to focus, notice cues, and apply these learned strategies (PMC 2025).

Takeaway

Having trouble with social cues when you have ADHD is not about indifference; it is about neurocognitive load. With greater awareness, structured support, and the right tools, most adults find that social interactions become less exhausting and far more rewarding.

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.