Why Do People with ADHD Feel Guilty About Mistakes?

PostedOctober 30, 2025

UpdatedNovember 5, 2025

ByMy Patient Advice

Author: Harriet Winslow, BSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

People with ADHD often experience intense guilt following mistakes, which is linked to emotional dysregulation, impulsivity, and low self-esteem. This guilt can be especially challenging, as it tends to persist long after the mistake has occurred. This blog explores why individuals with ADHD feel guilty about mistakes and how their neurodevelopmental traits contribute to these emotional responses.

The Role of Impulsivity and Emotional Dysregulation

Impulsivity and emotional dysregulation are core features of ADHD that contribute to heightened guilt. A 2024 study by Marques et al. found that emotion dysregulation mediates the link between impulsivity and guilt in ADHD. Children, in particular, experience strong feelings of remorse after impulsive actions but often struggle to regulate or resolve these emotions, leading to chronic guilt and negative self-perception (Frontiers in Psychiatry, 2024).

Additionally, rejection sensitivity—the tendency to overreact to perceived social disapproval—further amplifies guilt. Research by Liu et al. in 2024 found that self-criticism and poor emotional regulation heighten guilt after mistakes, as individuals with ADHD often struggle to separate their behaviour (“I did something wrong”) from their self-worth (“I am bad”) (Acta Psychologica, 2024).

Guilt vs. Shame in ADHD

Guilt in ADHD is typically more task-focused, related to specific actions like forgetting or interrupting. However, due to poor emotional regulation, this guilt often escalates into shame, which is more global and involves negative feelings about the self. A 2024 review by Zaccari et al. explained that excessive guilt in ADHD often transforms into shame because of the brain’s inability to manage negative emotional states, leading to long-lasting emotional distress (Frontiers in Psychiatry, 2024).

Clinical Recommendations for Addressing Guilt

Effective treatment approaches for guilt in ADHD focus on emotional regulation and self-compassion. Cognitive behavioural therapy (CBT) and mindfulness-based therapies are especially helpful for addressing guilt-driven distress. A 2024 study by Petrocchi et al. showed that compassion-focused therapy (CFT) and mindfulness interventions reduce self-blame and improve emotional regulation by helping individuals view mistakes through a lens of self-kindness rather than self-criticism (PMC, 2024).

The NICE guidelines for ADHD treatment also emphasise addressing guilt and self-stigma through psychoeducation and behavioural interventions that focus on emotional well-being and self-esteem (NICE NG87, 2025).

Conclusion

Guilt in ADHD is a complex emotional response rooted in impulsivity, emotional dysregulation, and low self-esteem. Addressing this guilt through therapy, such as CBT, mindfulness, and compassion-focused interventions, can help individuals reframe their self-perception, manage emotional reactions, and improve overall emotional health. Clinicians are encouraged to integrate these approaches into ADHD treatment plans to alleviate guilt and support healthier emotional regulation.

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.