Does ADHD guilt lead to over-apologising in relationships? 

Feeling guilty is something most people experience occasionally, but for many adults with ADHD, guilt can become a constant companion. It often shows up as self-blame for things like forgetting plans, interrupting others, or struggling to keep up with responsibilities. This emotional pattern can lead to excessive apologising in relationships, as individuals with ADHD may fear letting others down or being misunderstood. 

According to NICE guidance NG87 (2025), emotional regulation is now recognised as a key part of ADHD management, alongside focus and impulsivity. NICE highlights that psychological support should include help for managing frustration, anger, and guilt, particularly when these emotions affect relationships. The guidance also recommends partner or family psychoeducation, helping those close to someone with ADHD understand that emotional overreactions and self-blame are part of the condition, not a character flaw. 

The Royal College of Psychiatrists (CR235, 2023) notes that chronic guilt and shame often develop when adults with ADHD internalise criticism from years of being told they are lazy, careless, or unreliable. Over time, this can lead to low self-esteem and over-apologising as a defence mechanism. Many people with ADHD apologise quickly to prevent rejection or to restore peace in a relationship, even when they are not at fault. 

Understanding guilt and emotional regulation in ADHD 

Guilt in ADHD often stems from emotional dysregulation, a difficulty in managing and recovering from strong emotions. Studies such as Frontiers in Psychiatry (2024) show that adults with ADHD have reduced communication between the prefrontal cortex (which controls emotion) and the amygdala (which generates emotional reactions). This makes emotional pain and guilt feel more intense and longer-lasting. 

Research from PLoS ONE (2023) found that adults with ADHD are more likely to use emotional suppression rather than healthy reappraisal techniques, meaning they hold in guilt rather than resolving it. This can make them more prone to overthinking, people-pleasing, and apologising excessively, especially after a perceived mistake or misunderstanding. 

The RCPsych CR235 Report (2023) emphasises that cognitive behavioural therapy (CBT) and compassion-based therapy can help improve emotional awareness and reduce self-blame. By learning to identify when guilt is disproportionate, individuals can replace habitual apologising with more balanced communication and self-compassion. 

Key takeaway 

ADHD-related guilt and over-apologising are part of a wider emotional regulation challenge rather than personal weakness. Evidence from NICE, RCPsych, and recent psychology research shows that structured therapy, compassion-based interventions, and partner-inclusive education can help adults with ADHD manage guilt, reduce over-apologising, and build more understanding and resilient relationships. 

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

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.