Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can present in both children and adults. ADHD can cause difficulties in everyday functioning and educational or professional work. Although it is not officially a diagnosable condition, paralysis is a common symptom of ADHD, making it very difficult for people to complete or begin tasks [2].

What is ADHD paralysis?

ADHD paralysis is the term given to a symptom of ADHD in which a person feels unable to function due to feeling overwhelmed by a task, frozen by indecision, or overloaded with information and thoughts.

ADHD paralysis can cause people to struggle with tasks, schoolwork, or professional work, causing an inability to focus, thereby delaying the start of a task. It may also result in incomplete tasks that have been started, but the person feels unable to finish, or shifting tasks when attention is diverted elsewhere midway through a task [2].

People with ADHD may experience different symptoms within their condition. Hence, there may be many causes of ADHD paralysis, such as low self-esteem and worry causing a delay due to fear of failure; disorganization, causing an inability to prepare and begin a project; or poor memory, causing difficulty in formulating and retaining necessary information [3].

Types of ADHD paralysis

Mental paralysis

Mental paralysis occurs when someone feels overwhelmed or overloaded with information and struggles to process this information [2]. They might then freeze or crash, feeling completely unable to do anything as they are unsure where to start or how to utilize the information.

For example, someone may be experiencing several thoughts and emotions at once, such as feeling worried about a project, excited about an upcoming party, and sad about the death of a pet. All these thoughts and emotions will feel overwhelming, causing difficulties in making sense of and managing them, thereby feeling stuck [4].

Choice paralysis

Choice paralysis occurs when someone faces several choices and struggles to decide. They may feel that there are too many choices and begin to overthink each choice, unable to conclude which option they should choose [5].

For example, looking at a menu with numerous options may cause choice paralysis. A person may start overanalyzing the options, considering every possibility and outcome, worrying that they will make the wrong choice and regret their decision, thereby feeling unable to come to a decision.

Task paralysis

Task paralysis occurs when someone faces a task or several tasks that feel uninteresting, difficult, or overwhelming, and they feel unable to begin. This can cause them to freeze, procrastinate, or find their thoughts drifting elsewhere, intentionally or unintentionally avoiding the task [2][6].

For example, a parent asks their child to tidy their room full of clothes, toys, and trash. The child sees this task as overwhelming, struggling to know how or where they should begin, and instead stands looking at their room for a long time without moving or goes to play with their toys in a different room.

Symptoms of ADHD paralysis

People who experience ADHD paralysis may experience symptoms such as [7][8]:

  • Poor time management
  • Finding it difficult to listen to information
  • Inability to make decisions
  • Lack of mental clarity, or ‘brain fog’
  • Becoming easily distracted
  • Regularly overanalyzing or overthinking situations or choices
  • Inability to act on or begin tasks
  • Finding it difficult to prioritize information and tasks
  • Often losing a train of thought
  • Regularly switching between tasks
  • Mood swings
  • Emotional outbursts and frustration
  • Regularly zoning out or thoughts drifting off-topic
  • Feeling frozen, physically or mentally

Is ADHD paralysis the same as procrastination?

Procrastination refers to a delay or postponement in action and is something that most people have experienced at some point in their lives. Often, this may be caused by feeling too tired, lazy, or forgetful to begin or complete a task successfully or having poor time management [9].

However, while sporadic procrastination is common in the general population, someone with ADHD may experience chronic or repeated procrastination. Studies have shown a much higher prevalence of procrastination in people with ADHD, despite this not officially being a symptom in the DSM-5 [6].  

Three types of procrastination that are very common for people with ADHD to experience, either alone or in combination, depending on their presenting symptoms [6]. Although ADHD paralysis and chronic procrastination are not necessarily the same thing, they appear closely related [10].

  • Decisional procrastination: it can be common for people with ADHD to delay decision-making, which can be linked to ADHD paralysis as a result of feeling overwhelmed or overloaded with information.
  • Arousal procrastination: people with ADHD may experience a desire for regular excitement and mental stimulation, which may cause procrastination as a way to create this thrill, by delaying tasks until the last minute.
  • Avoidant procrastination: people who experience ADHD paralysis often feel overwhelmed by tasks or choices, which may be due to a fear of failure or showing their flaws in imperfect work, thus avoiding commencing a task.

How to manage ADHD paralysis

Managing symptoms of ADHD can be best helped by gaining a diagnosis from a professional and receiving appropriate treatment in the form of medication or therapy. Various types of therapy can help to reduce ADHD paralysis, such as [3][11]:

  • Psychotherapy: psychotherapy can help to manage the underlying feelings that may be causing paralysis, such as fear of failure, anxiety, low self-esteem, and frustration, and provide the skills to develop a more positive attitude toward approaching challenging tasks or decisions.
  • Behavioral therapy: behavioral therapy, including cognitive behavioral therapy (CBT), can help develop practical skills, positive coping strategies in response to feeling overwhelmed, and ways to alter negative thoughts and associated behaviors.
  • Family therapy: symptoms of ADHD, including paralysis, can cause frustration and disappointment for the person with the diagnosis and for their family and loved ones. As such, family therapy can be a helpful way to discuss and manage these feelings and to develop a better understanding and management of the symptoms of ADHD.

Other valuable skills and techniques to manage ADHD paralysis include [2][8]:

  • Routine or schedule: having a set time to do certain things can make it easier to begin or complete tasks and reduce overwhelming feelings by having the dayplanned out.
  • Organizing belongings: having a set place for certain things can help with getting started on a task, as it can prevent searching for lost items or feeling anxious about preparing for a task.
  • Writing lists: writing lists of thoughts, tasks, and plans can help to prevent feeling overloaded with information, be useful for planning and scheduling, and can help with processing feelings individually.
  • Breaking down tasks: approaching tasks can be daunting, which can result in paralysis and delays, so breaking a big task down into several smaller tasks can help to make the project feel less intimidating, require shorter periods of concentration, and result in more rewarding feelings of achievement, as each item can be ticked off when completed.
  • Rewards: rewarding or treating yourself after completing tasks can help to positively reinforce proactive behavior and help starta task as there is something to look forward to.
  • Accountability buddy: it may be useful when completing tasks to have someone with you who can prompt you to focus, prevent distractions, or help make uninteresting tasks feel more

Resources:

  1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC: American Psychiatric Association. Retrieved from https://doi.org/10.1176/appi.books.9780890425596
  2. Attention Deficit Disorder Association. (2022). ADHD Paralysis. ADDA. Retrieved from https://add.org/adhd-paralysis/
  3. Niermann, H.C., & Scheres, A. (2014). The Relation Between Procrastination and Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) in Undergraduate Students. International Journal of Methods in Psychiatric Research, 23(4), 411–421. Retrieved from https://doi.org/10.1002/mpr.1440
  4. ADHD Aware. (n.d). ADHD Symptoms. ADHD Aware. Retrieved from https://adhdaware.org.uk/what-is-adhd/adhd-symptoms/
  5. Elosúa, M.R., Olmo, S.D., & Contreras, M.J. (2017). Differences in Executive Functioning in Children with Attention Deficit and Hyperactivity Disorder (ADHD). Frontiers in Psychology, 8, 976. Retrieved from https://doi.org/10.3389/fpsyg.2017.00976
  6. Ferrari, J., & Sanders, S. (2006). Procrastination Rates Among Adults With and Without AD/HD: A Pilot Study. Counseling and Clinical Psychology Journal, 3(1), 2-9. Retrieved from https://www.researchgate.net/publication/276354426_Procrastination_Rates_Among_Adults_With_and_Without_ADHD_A_Pilot_Study
  7. Volkow, N. D., & Swanson, J. M. (2013). Clinical Practice: Adult Attention Deficit-Hyperactivity Disorder. The New England Journal of Medicine, 369(20), 1935–1944. Retrieved from https://doi.org/10.1056/NEJMcp1212625
  8. National Institute of Mental Health. (Reviewed 2022). Attention-Deficit/Hyperactivity Disorder.NIMH. Retrieved from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
  9. Orellana-Damacela, L.E., Tindale, R.S., & Suarez-Balcazar, Y. (2000). Decisional and Behavioral Procrastination: How They Relate to Self-Discrepancies. Journal of Personality and Social Behavior, 15, 225-238. Retrieved from https://ecommons.luc.edu/cgi/viewcontent.cgi?article=1026&context=psychology_facpubs
  10. Klingsieck, K.B. (2013). Procrastination: When Good Things Don’t Come to Those Who Wait. European Psychologist, 18(1), 24-34. Retrieved from https://doi.org/10.1027/1016-9040/a000138
  11. Centers for Disease Control and Prevention. (Reviewed 2022). Treatment of ADHD. CDC. Retrieved from https://www.cdc.gov/ncbddd/adhd/treatment.html