By Dr Gisele Caseiras
Psychodynamic Psychotherapist working with adults, adolescents and families in London
https://likeminds.london/dr-gisele-caseiras/

Introduction

Children and teenagers with ADHD are often described in terms of attention difficulties, impulsivity, or hyperactivity. However, the emotional experience of living with ADHD can be just as significant. Many young people who struggle with ADHD symptoms also experience anxiety, low self-esteem, and sometimes depression or persistent low mood. Psychological support can play an important role in helping them understand these experiences and develop a more confident sense of themselves.

The emotional experience of ADHD

Many young people with ADHD might grow up receiving frequent feedback about their behaviour. They may hear that they are distracted, disorganised, impulsive, or not trying hard enough. Over time, repeated experiences of difficulty in school or social situations can shape how they see themselves.

From a psychodynamic perspective, ADHD does not only affect attention or behaviour. It can also influence how a young person experiences themselves in relation to others. School life, friendships and family relationships often involve comparisons with peers. When a young person repeatedly feels that they are struggling in ways others are not, they may begin to internalise the idea that something is wrong with them.

This experience can contribute to anxiety and shame. Some young people become highly self-critical, while others may withdraw from situations where they anticipate failure or embarrassment. During adolescence, when questions of identity and belonging become particularly important, these feelings can sometimes contribute to low mood or depression.

These difficulties are often visible at school, where problems with concentration, organisation or impulsivity can affect academic confidence and relationships with teachers and peers.

Why neuroscience matters

Neuroscience research helps explain why these patterns occur. ADHD is associated with differences in the development and functioning of brain systems involved in attention, planning, impulse control and emotional regulation. These areas of the brain continue to mature throughout childhood and adolescence, and in young people with ADHD this development may occur at a different pace.

Understanding ADHD in this way can be very helpful for both young people and their families. When behaviour is understood in terms of brain development rather than personal failure, it often reduces blame and self-criticism. A young person may begin to see that their difficulties are not a sign that they are lazy or incapable.

The role of the GP

For many families, the GP is the first professional they approach when they are concerned about ADHD. GPs play an essential role in recognising symptoms, guiding families through the assessment process and discussing treatment options, including medication when appropriate.

Medical care and educational support are key components of ADHD management. At the same time, psychological support can help address the emotional experiences that often accompany ADHD. When medical, educational and psychological approaches work together, young people are more likely to feel supported both practically and emotionally.

How therapy can help

Psychotherapy can offer young people a space where their experiences can be explored rather than simply managed. In therapy, the young person does not need to perform or keep up with expectations. Instead, they can begin to think about the feelings that may sit behind their behaviour.

Psychodynamic therapy focuses on understanding emotions that may not always be easy to name. For example, a young person with ADHD may feel frustrated or angry about struggling in ways their peers do not. At the same time, they may also feel ashamed or worried about disappointing others. When these feelings remain unspoken, they can increase anxiety.

Talking about these experiences within a therapeutic relationship can help young people develop a more compassionate understanding of themselves.

Early understanding can also be protective. If negative experiences accumulate without being reflected upon, some young people may begin to internalise critical views of themselves. These beliefs can influence important decisions later in life, affecting confidence, relationships and educational opportunities.

Therapy can help young people recognise these patterns earlier and develop a more balanced sense of identity.

Looking beyond difficulties

ADHD is often discussed primarily in terms of challenges. Yet many young people with ADHD are also creative, energetic and capable of thinking in flexible and original ways. As young people begin to understand their minds better, these qualities can become easier to recognise and build upon.

Over time, the therapeutic relationship can support the development of a more stable sense of self. Instead of defining themselves primarily through criticism or failure, young people can begin to see themselves in a fuller and more realistic way.

For many adolescents, this shift can be transformative. Feeling different does not need to mean feeling inferior.