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Why do I struggle with social cues with ADHD? 

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

If you live with ADHD and often feel you “miss the moment” in conversations, you are not imagining it. According to the NHS and Royal College of Psychiatrists, people with ADHD can find it harder to notice tone, facial expressions, or body language, leading to misunderstandings and social anxiety. 

Discover if you have ADHD

Why ADHD affects social cue awareness 

Research shows that inattention, impulsivity, and executive dysfunction all contribute. You might miss subtle cues because your attention shifts quickly or responds too fast before you’ve read the situation fully. Brain imaging studies suggest that ADHD involves differences in regions linked to empathy and emotional regulation, areas that help people interpret others’ intentions and expressions (The Lancet Psychiatry, 2024). 

The emotional layer: rejection and regulation 

Emotional dysregulation and rejection-sensitive dysphoria (RSD) can make social feedback feel painful or confusing. Mind notes that many people with ADHD “mask” or withdraw after feeling embarrassed or rejected, reinforcing loneliness (Mind, 2023). 

What NICE and NHS recommend 

NICE guideline NG87 and NHS advice recommend structured support to build confidence and understanding: 

  • Psychoeducation to explain ADHD’s role in social processing. 
  • CBT or ADHD coaching to practise real-world social skills. 
  • Mindfulness to slow reactions and notice cues at the moment. 
  • Peer and family education to reduce stigma and improve empathy (NICE NG87, 2018). 

Programmes such as Theara Change provide evidence-based coaching focused on emotional regulation and social connection, complementing NHS and NICE guidance. 

Takeaway

 Struggling with social cues does not mean you lack empathy; it means your brain processes interaction differently. With psychoeducation, therapy, and supportive environments, people with ADHD can improve social awareness, strengthen relationships, and feel more confident connecting with others. 

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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