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Why do individuals with ADHD have trouble maintaining friendships? 

Author: Phoebe Carter, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

ADHD can make forming and maintaining friendships more challenging, not because someone lacks interest, but because symptoms affect communication, emotional regulation, and follow-through. According to NHS guidance, difficulties with attention, impulsivity, and hyperactivity can lead to missed cues, interrupted conversations, or forgotten plans, moments that friends may misunderstand if they don’t know the person has ADHD. 

Why friendships can be harder to sustain 

Friendships rely on steady communication, emotional awareness, and shared expectations. NICE notes that ADHD can cause functional impairment in social relationships because inattention, impulsivity, and emotional dysregulation affect how someone interprets interactions and responds in the moment. 

The Royal College of Psychiatrists highlights that adults with ADHD often struggle with organisation, remembering commitments, and managing emotional reactions; all of which influence how friendships are maintained over time. 

Common ADHD-related challenges that affect friendships 

Communication difficulties 

People may drift off mid-conversation, talk over others, or forget to reply to messages. These behaviours are usually unintentional, but without context can appear careless. The NHS notes this is one of the most common social challenges in ADHD. 

Missing social cues 

Children and adults with ADHD may find it harder to pick up on tone, facial expressions, or signs of discomfort. This can lead to misunderstandings, something that NICE identifies as a frequent cause of relationship strain. 

Emotional intensity 

Emotional responses may be quicker or stronger, which the WHO links to conflict, withdrawal, or oversharing. These reactions can confuse friends or cause tension if not explained. 

Peer rejection and instability 

Research published in BMJ and the Journal of Attention Disorders (JAD) shows higher rates of peer rejection, fewer stable friendships, and more bullying in children with ADHD patterns that can impact social confidence into adulthood. 

Forgetfulness and inconsistent follow-through 

Adults commonly describe forgetting arrangements, losing track of plans, or responding only when reminded. Even though these behaviours stem from executive-function differences, they can make friends feel unimportant if ADHD isn’t understood. 

Masking and burnout 

UK charities such as Mind and ADHD UK report that trying to “act neurotypical” to fit in can be exhausting. When masking breaks down; for example, under stress, sudden shifts in behaviour may confuse friends. 

What can help friendships thrive? 

Clear communication, realistic routines, and shared expectations can make a big difference. Understanding that symptoms drive behaviors, not lack of interest, often helps friendships become more resilient. 

Supportive interventions like behavioural coaching or emotional-regulation tools can also help. Services such as Theara Change offer skills-based support for improving social connection. 
For diagnostic clarity or treatment pathways, private options like ADHD Certify provide assessments and medication reviews within UK standards. 

Takeaway 

ADHD can make maintaining friendships more challenging because symptoms affect communication, cue-reading, emotional reactions, and follow-through. These behaviours can easily be misunderstood but with awareness and support, friendships can become stronger, more trusting, and more sustainable over time. 

Phoebe Carter, MSc
Author

Phoebe Carter is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Applied Psychology. She has experience working with both children and adults, conducting psychological assessments, developing individualized treatment plans, and delivering evidence-based therapies. Phoebe specialises in neurodevelopmental conditions such as autism spectrum disorder (ASD), ADHD, and learning disabilities, as well as mood, anxiety, psychotic, and personality disorders. She is skilled in CBT, behaviour modification, ABA, and motivational interviewing, and is dedicated to providing compassionate, evidence-based mental health care to individuals of all ages.

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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