How does hyperactive-impulsive ADHD affect sibling relationships?

PostedSeptember 16, 2025

UpdatedSeptember 17, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Living with a sibling who has hyperactive ADHD can shape family dynamics in significant ways, often testing patience, fairness, and emotional balance. The impulsivity, restlessness, and intense emotional reactions associated with the hyperactive-impulsive ADHD subtype can lead to frequent conflicts, attention-seeking behaviours, and misunderstandings between siblings. While ADHD therapy aims to reduce symptoms and improve behaviour, it’s equally important to address the emotional needs of the entire family.

Siblings may feel overlooked, frustrated, or confused by the unpredictable behaviour of their brother or sister. At the same time, the child with ADHD may struggle to form stable connections due to poor executive function or difficulty managing impulses. This dynamic can strain bonds and lead to lasting resentment if not handled with awareness and support.

Strategies to strengthen sibling relationships

Here’s how families can support healthier, more empathetic sibling interactions:

Incorporate family-based therapy options
Working with a therapist who understands both ADHD and family systems can provide tools to resolve conflict and foster understanding.

Practise mindfulness as a family
Simple breathing exercises or guided moments of stillness can help reduce emotional reactivity, for both the child with ADHD and their siblings.

Give each child dedicated attention
Set aside one-on-one time to ensure siblings without ADHD feel seen and valued, reducing feelings of imbalance.

Teach empathy and emotional awareness
Use calm moments to explain hyperactive ADHD in age-appropriate ways, encouraging siblings to express how they feel and what they need.

When managed proactively, ADHD therapy can ease behavioural challenges and help restore harmony between siblings. Visit providers like ADHD Certify for holistic treatment plans that include family dynamics and emotional health.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Hyperactive‑Impulsive ADHD .

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve 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 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.