Why does low frustration tolerance harm ADHD friendships? 

For many adults with ADHD, small frustrations can feel overwhelming. Waiting for a reply, coping with plans that change, or managing misunderstandings may trigger irritation or withdrawal that seems out of proportion to the situation. This low frustration tolerance often leads to tension, hurt feelings, or distance within friendships. According to NICE guidance NG87 (2025), emotional impulsivity and difficulty managing frustration are recognised as core features of adult ADHD that can affect social, family, and work relationships. 

The reasons lie partly in how the ADHD brain processes emotion. Research from PLoS ONE (2023) found that adults with ADHD often rely on emotional suppression rather than healthy cognitive reappraisal. This means frustration builds internally until it bursts out as irritation, followed by guilt or self-blame. Neuroimaging studies suggest that the prefrontal cortex, which helps regulate emotion, communicates less effectively with the amygdala, the brain’s emotional centre. This makes it harder to pause before reacting or to let go of minor annoyances. 

How low frustration tolerance affects friendships 

Friendships rely on patience, empathy, and repair after conflict. When frustration tolerance is low, everyday stressors such as someone being late, forgetting a message, or offering feedback can be interpreted as rejection or disrespect. The Royal College of Psychiatrists’ Good Practice Guidance (CR235, 2023) notes that adults with ADHD may struggle with anger, irritability, and rejection sensitivity, which can lead to impulsive comments or abrupt withdrawal during conflict. Over time, this can create cycles of misunderstanding where both friends feel unheard or criticised. 

The NHS Devon Partnership ADHD and Relationships Booklet (2024) explains that emotional overreactions often mask exhaustion or overstimulation. Simple strategies like taking a “time-out,” practising mindfulness, and using reflective listening can help de-escalate tension. Therapies such as Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT) are shown to improve frustration control and communication by teaching reappraisal and problem-solving techniques. Mindfulness and compassion-focused approaches also support emotional recovery after a difficult interaction. 

Key takeaway 

Low frustration tolerance is not a personality flaw but part of ADHD’s emotional regulation profile. Evidence from NICE, RCPsych, and NHS sources shows that structured therapy, mindfulness, and partner or peer education can help people with ADHD manage irritation more effectively. By learning to pause, reframe, and communicate openly, adults can protect their friendships and build stronger, more understanding social connections. 

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.