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How can I handle performance reviews with ADHD? 

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

Performance reviews can be challenging for anyone, but for adults with ADHD, the mix of feedback, pressure, and self-evaluation can trigger anxiety or self-doubt. According to NICE guidance (NG87), adults with ADHD benefit from structured, collaborative reviews that emphasise clear expectations and written feedback rather than spontaneous discussion. Predictability and preparation are key. 

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Why feedback can feel harder with ADHD 

Research shared by the Royal College of Psychiatrists (CR235) and UKAAN shows that adults with ADHD are more prone to feedback on sensitivity and self-critical thinking during reviews. This may stem from difficulties with emotional regulation and rejection sensitivity, sometimes described as RSD (Rejection Sensitive Dysphoria). Research by PubMed (2020) found that CBT-based emotional regulation training can help reframe feedback, turning evaluations into learning opportunities rather than threats. 

Practical ways to prepare 

Evidence from NHS Sussex’s Neurodiversity Guidance and Mayo Clinic recommends planning ahead. Ask for: 

  • Written agendas and a summary of key review points in advance 
  • Shorter, more frequent check-ins instead of one annual review 
  • Time to process feedback before giving a response 

Practising review scenarios with a coach or therapist can also be helpful. Role-playing and scripting calm responses, as shown in PubMed (2024), can reduce stress and improve communication clarity. 

Managing emotional responses 

The Cleveland Clinic highlights the value of mindful pausing and naming emotions during reviews. Simple steps such as taking notes, breathing before replying, or asking to follow up by email can create space between reaction and response. 

If anxiety is high, brief grounding techniques, counting breaths, focusing on a sensory cue, or having a prepared checklist can help maintain composure and clarity. 

Takeaway 

With preparation and the right support, performance reviews can shift from being overwhelming to constructive. NICE and RCPsych both emphasise that structured, compassionate communication supports adults with ADHD to thrive at work. Request written feedback, prepare key talking points, and remind yourself that reviews are not a measure of worth; they are part of your growth and self-advocacy journey. 

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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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