ADHD And The Paradox Of Worry

Living in the 'Now', But Stuck in 'What If'

Apr 19, 2025

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You’ve probably heard it said: ADHD is a "here and now" brain. We're known for impulsivity, acting in the moment, being distractible by the present stimulus—shiny objects and all things new.

But what about the chronic overthinking, the doom spirals at bedtime, the way some of us can worry about one offhand comment for three days straight? Isn’t that anxiety and isn’t anxiety about the future?

So, if ADHD keeps us in the now, why do so many of us get stuck in what if?

Let’s explore the neuropsychology behind this paradox—and how it can be both understood and softened.

Time Perception and Emotional Weight

Time blindness is often described as one of the most defining features of ADHD—and it doesn’t just mean forgetting what time it is. Clinically, time blindness refers to the brain's impaired ability to perceive, estimate, and organise time (Barkley, 2006). Dr. Russell Barkley, a leading researcher in ADHD, describes it as a fundamental deficit in the brain’s "temporal horizon," meaning we struggle to look ahead or reflect back in useful, structured ways.

What does that look like in real life? Time becomes either urgent or invisible. There is no gentle unfolding. We're either in fire-alarm mode or floating in a timeless fog where we think we have 'plenty of time'—until we suddenly don’t and the fog becomes smoke, setting the fire-alarm off again!

Pair that with emotional dysregulation—another under-discussed core feature of ADHD (Shaw et al., 2014)—and it’s no wonder our thoughts can spiral. The emotional brain takes over. We’re no longer solving, we’re soothing. Or at least trying to.

We worry not because we're great at thinking ahead, but because our nervous system is hijacked by emotion, and our working memory can’t hold a stable enough picture to contextualise or soothe it easily.

Hyperfocus Turns the Now Into a Laboratory

Here’s where things get more interesting. People with ADHD are often painted as chaotic or short-sighted, but in the right conditions—particularly during hyperfocus—we can be incredible problem-solvers. Something that often requires some degree of future awareness - a further paradox.

Hyperfocus isn’t just intense attention—it’s a neurochemical tunnel into full cognitive and emotional immersion. During hyperfocus, the ADHD brain stops scanning widely and instead drills down deeply, often into something emotionally or intellectually engaging.

Pattern recognition: ADHDers often think laterally and associate ideas in nonlinear ways. In hyperfocus, this ability is enhanced, making it easier to spot patterns and anticipate multiple outcomes.
Scenario generation: The ADHD brain can run future simulations rapidly, especially under emotional charge. While this might look like anxiety, it’s often an intense form of adaptive planning, not fear—unless we convince ourselves it’s fear, and then it becomes it. Or if others label it that way, we can take that on ourselves to avoid rejection.
Divergent thinking: We often organise information unconventionally, which allows for outside-the-box problem solving. What looks like chaos from the outside can be creative genius from within.

This helps explain how an ADHD brain that struggles with “next week” can still imagine twenty different ways a social interaction might go—within seconds. It’s a matter of what activates us, not what’s missing. Think of it like this: not all cars run best on the same fuel. A high-performance sports car might stall or misfire on regular petrol—it needs something more refined, more reactive, to do what it’s built to do. The ADHD brain is kind of like that. It doesn’t always respond to slow, steady pacing or long-range planning—but give it the right conditions, the right emotional spark, and suddenly it’s firing on all cylinders. Fast. Focused. Fluid. It’s not that the engine’s broken. It’s that the fuel has to match the design.

The Role of the Default Mode Network

One of the most compelling neurological findings about ADHD in recent years revolves around the Default Mode Network (DMN). This brain network is responsible for self-referential thinking—daydreaming, reflecting, imagining the future, and rehashing the past. It’s what’s active when we’re “off task.”

In neurotypical brains, the DMN typically deactivates when we need to focus on a task. But in ADHD brains, research shows it often stays overactive or poorly regulated (Castellanos et al., 2008). This can lead to intrusive thoughts, difficulty sustaining attention, and those endless loops of “I can’t believe I said that thing in 2014.”

So even if we appear present, a part of our brain might be busy spinning stories in the background—replaying awkward conversations, jumping ahead to worst-case scenarios. It’s not a moral failing—it’s a neurological quirk. But it’s also one that can be softened with awareness, structure, and nervous system support.

This means the ADHD brain can feel like a tug-of-war between acting without foresight and overthinking without grounding. This can create social threat.

Threat Detection and Rejection Sensitivity

Social Threat, is where Rejection Sensitive Dysphoria (RSD) often comes into play. RSD isn’t a formal diagnosis, but it’s a term that captures something deeply familiar for many people with ADHD: the intense emotional pain experienced from perceived criticism, disapproval, or exclusion (Brown,2009).

ADHD affects the prefrontal cortex, which is the part of the brain responsible for regulating impulses, managing executive functions, and—critically—inhibiting emotional overreaction. When this area doesn’t function optimally, it’s much harder to down-regulate intense emotional responses. So when someone with ADHD perceives even subtle criticism or exclusion, their brain may interpret it as a threat—and respond accordingly.

This doesn’t mean they’re overreacting; it means the brakes aren’t fully working. Studies (Shaw et al., 2014) have shown that children and adults with ADHD demonstrate higher emotional reactivity due to weaker cortical regulation.

Neuroimaging studies have shown that people with ADHD often display heightened activity in the amygdala, which is the brain’s emotional alarm system. When this part of the brain is hyperactive, it can magnify social cues into perceived threats—leading to strong emotional responses even to neutral or ambiguous stimuli (Posner et al., 2011).

So a delayed text reply? Not just a delay—it’s perceived as evidence of rejection.

From a nervous system perspective, social connection helps regulate us. ADHD brains tend to rely more heavily on external structure and emotional cues to stay regulated (think co-regulation). When we perceive disconnection, the brain panics—not only emotionally, but physiologically. RSD is essentially the nervous system's way of bracing for social abandonment, which it equates to threat. If you think of this when we roamed in tribes, abandonment could equate to death - we remember this! - it’s encoded in the hardware.

People with ADHD have challenges with working memory (Working memory is the brain’s mental sticky note—used to hold and manipulate information in the moment so we can problem-solve, plan, and regulate emotions), meaning we struggle to hold onto context in the moment. But paradoxically, we may hold onto emotional memories with disproportionate weight, especially if they haven’t been processed or resolved.

So even a mild criticism from years ago can come rushing back as if it just happened. Not because we're ruminating on purpose, but because our brain files emotional threats in the “check this forever” folder. This is a protective adaptation - one that made sense in the past, but now just needs to dial down a little.

When we feel even the hint of social threat, the amygdala (our brain’s smoke detector) lights up. And if the prefrontal cortex—the rational, self-regulating part of our brain—is under-functioning (as it often is in ADHD), we’re left without the inner resources to calm down the alarm.

So we get stuck in loops: scanning conversations, prepping for failure, anticipating rejection just in case. It’s not overreacting. It’s overprotection. And knowing that can be the first step in softening the spiral.

Even though ADHD often impairs executive function, our threat response system can be very active—and worry becomes a form of “doing something” and can be an expression of hyperactivity.

The Emotional Time Loop

Because we have difficulty with memory and forecasting, the ADHD brain often doesn’t know when something is over.

So we:

Worry as a way to keep track of things.
Ruminate because we didn’t get closure.
Try to predict to avoid making the same mistake again.

It’s less about foresight and more about emotional bookmarking.

So What Can We Do?

Understanding the root of ADHD worry helps us meet it with more compassion. Here are a few pathways forward:

1. Externalise Time and Safety

When we try to hold everything in our heads—especially vague fears, timelines, or lingering to-do’s—our ADHD brains tend to short-circuit. Externalising worry gives it a container, and signals to the nervous system that it’s been acknowledged.

Step-by-step:

Step 1: Set a timer (5–15 minutes) and write down everything you’re worried about. Don’t censor. Let it pour out.
Step 2: When the timer ends, close the notebook or file. You’ve honoured the worry—you don’t need to carry it now.
Step 3: Use a visual cue (like a sticky note or symbol on your phone) that reminds you: this worry has been seen.
Step 4: Try a grounding activity like stretching, holding a warm mug, or rubbing your feet on the floor to anchor your body back in safety.

This process turns spiralling into something finite, physical, and manageable—without needing to solve every single thing in one go.

2. Name the Nervous System State

Instead of trying to logic your way out of worry, ask:

What’s my body trying to protect me from right now?

When you name fear, you often calm it. You interrupt the worry loop with felt safety instead of forced control.

3. Use Micro-Planning Instead of Broad Forecasting

Worry thrives in the unknown. But broad timelines and distant goals can be paralysing.

Focus on “the next step” only.
Limit worry to specific windows (“I’ll think about that Thursday at 4pm”).

So... Are We Future-Oriented or Not?

The nuance is this: ADHDers aren’t inherently bad at thinking about the future—we’re just not naturally future-organised. Our default setting isn’t built around neat timelines or step-by-step forecasting.

But give us urgency, emotion, or meaning, and suddenly we’re ten steps ahead—mapping out scenarios, spotting weak links, playing out outcomes in rapid-fire loops. Sometimes it turns into anxious rumination. Other times, it’s insight, empathy, and creative strategy.

The ADHD brain may struggle to plan calmly for next Tuesday, but we might strategise ten ways a situation could unfold in the next ten minutes—especially if it feels important, personal, or charged.

We aren’t simply “stuck in the now” or “unable to think ahead.” We’re living in a constant oscillation between hyper-present instinct and emotionally-fuelled foresight. Our challenge is learning to recognise the state we’re in—and gently redirect it without shame to where we need it to be. ADHD brains may crave the now, but our hearts carry echoes that we need to extend ourselves some self-compassion for.

Paid subscribers can scroll down to the ADHD Worry Loop Flowchart.

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