Why Do I Struggle with Prioritising Tasks? 

Finding it hard to decide what to do first, even when everything feels urgent, is a common experience for people with ADHD. According to the Royal College of Psychiatrists’ guidance, this difficulty stems from challenges with executive functioning, the set of mental processes that help us plan, organise, and manage time effectively. 

How ADHD Affects Prioritisation 

Executive functions act like the brain’s “control centre.” When these processes are impaired, as described by Nottinghamshire Healthcare NHS Foundation Trust, it becomes harder to judge which tasks are most important or when to start them. Many people experience what is sometimes called “task paralysis,” where competing demands create mental overload and delay action. This is not laziness; it is a recognised part of ADHD’s neurological profile. 

The Brain Science Behind It 

Research published in Frontiers in Psychology (2025) shows that ADHD is linked to differences in the prefrontal cortex and dopamine-based reward systems areas responsible for focus, motivation, and working memory. Reduced dopamine signalling can make it harder to weigh long-term priorities against immediate rewards. This helps explain why short, stimulating tasks may feel easier to start than complex or open-ended ones. 

Support That Can Help 

NICE guidance (NG87) and the RCPsych recommend a mix of medication, coaching, and cognitive-behavioural therapy (CBT) to support executive function. Medication can improve attention regulation, while structured behavioural strategies, such as timeboxing, visual planners, and breaking tasks into small, clear steps, can make prioritising more manageable. According to the Cleveland Clinic and Mayo Clinic, techniques like setting firm “by-when” goals or saying tasks aloud can help anchor focus and reduce procrastination. 

Private ADHD services, such as ADHD Certify, also provide assessment and post-diagnostic support for adults seeking structured care and medication reviews in line with NICE standards. 

Takeaway 

Struggling to prioritise tasks is not a personal failure; it is part of how ADHD affects the brain’s executive control systems. With the right mix of treatment, structure, and understanding, it’s entirely possible to regain a sense of clarity and control over your day. 

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.