Feel Like You’re “Flunking” Treatment? You’re Not. (And You’re Also Not Alone.)

We know that ADHD symptoms respond best to a multimodal treatment plan that includes medication plus helpful interventions ranging from mindfulness meditation to exercise to brain training. These complementary supports can help curb symptoms and enhance well-being for many individuals with ADHD. All of that is very good news.

But if you’ve tried some of these ADHD interventions with limited success and ended up feeling like you “failed” at treatment, rest assured that you did not -— and you’re not alone in feeling this way.

In ADDitude’s recent treatment survey, we asked 11,000 readers about their experiences with 10 different kinds of treatments for ADHD, from medication to meditation. Readers shared what worked and what didn’t, plus stories of how painful the process of finding effective treatment can be, especially for those with rejection sensitive dysphoria (RSD), perfectionism, or feelings of shame.

“I felt as though I flunked mindfulness because I couldn’t pay attention for that long!” said one ADDitude reader. Another shared: “I felt like I was failing in talk therapy when I couldn’t talk in straight lines or remember what I had just said.”

Robyn, an ADDitude reader in Canada, simply said, “I always feel like I’m failing.”

[Read: ADHD and the Epidemic of Shame]

Feelings of Failure, Easily Triggered and Intense

Many people are quick to blame themselves when supplemental therapies don’t work as rapidly or as well as they’d hoped. This instinct has everything to do with the wiring of the ADHD brain, explains Tamar Rosier, Ph.D., in the ADDitude article, “Silence Your Harshest Critic — Yourself.”

“Neurotypical people have prefrontal cortexes that act like a butler. ‘Sir,’ the butler calmly says, ‘your keys are on the table.’ Or ‘Madam, you must leave now if you want to be on time,’” Rosier explains. “Instead of a tranquil butler, individuals with ADHD have an angry neighbor threatening them with his shoe. ‘If you lose your keys again,’ he yells, ‘I’ll throw this at you!’”

Zak, an ADDitude reader in Florida has experienced this first-hand: “My doctor is still working with me to get the meds correct and I feel at times it’s my fault; that I am the one whose body is not adjusting.”

[Download: 2024 Scorecard of ADHD Treatments]

For many, these feelings of falling short or failing to meet expectations are amplified by RSD, which triggers intense emotional sensitivity and pain, explains William Dodson, M.D., LF-APA in “How ADHD Ignites Rejection Sensitive Dysphoria.” “For people with RSD, these universal life experiences are much more severe than for neurotypical individuals. They are unbearable, restricting, and highly impairing.”

This description resonates with ADDitude reader Calvin in Florida. “When I have tried things like mindfulness, exercise, or therapy, I have not had success and I just felt awful,” Calvin says. “I thought mindfulness might help to end the snow-piercer-like train that lives in my head, but instead I felt like a child unable to do a simple concept.”

In addition to the neuroscientific factors that play a role in triggering feelings of failure, a long history of negative experiences exerts a powerful force, says J. Russell Ramsay, Ph.D., ABPP, clinical psychologist.

“Adults with ADHD are often more susceptible to feelings of failure and defeatism when undertaking new endeavors,” Ramsay explains. “This is likely due to past experiences with setbacks, which often result in criticisms. This, in turn, makes adults with ADHD sensitive to the first signs that something seems to not be going well.”

Clinical psychologist Sharon Saline, Psy.D., agrees, adding: “These past struggles resemble a thousand paper cuts per day and accumulate over time into larger wounds which leave sensitive scars. Feelings of shame and not measuring up haunt folks and make it tougher to try new things.”

How to Reframe Feelings of Failure

Experts agree that to optimize treatment for ADHD, trial-and-error is essential. The “error” part of that process can be demoralizing, but it is critical. To discover interventions that work, you’ll have to try ones that don’t — and knowing that from the get-go can be helpful.

“It is important to normalize setbacks as a part of the process of establishing new habits. It is rarely, if ever, a straight line,” Ramsay says. “Reframing a new habit as a challenge or as an experiment is important, as is setting up realistic expectations.”

“I have a hard time planning and sticking to a good regular habit, like exercise and mindfulness meditation. I used to get so aggravated with myself, and feel helpless,” says an ADDitude reader. “My therapist has taught me to not make a big deal of it and simply get back on track.”

Fine-tuning the therapies, lifestyle changes, and medications that best address your particular constellation of symptoms — and dealing with the emotional fallout of that process — is hard work, make no mistake. You can make that hard work a little easier by being kind to yourself, says Saline.

“Treat yourself with compassion, understanding that change usually involves forward motion along with some backsliding,” Saline urges. “Stumbling, regrouping and trying again is part of living for everybody—ADHD or not.”

 Fear of Failure & Treatment: Next Steps

• Read: You Are Worthy of Self-Compassion – How to Break the Habit of Internalized Criticism
• Read: “My Fear of Failure Becomes Paralyzing Perfectionism”
• Free Resource: Understanding Rejection Sensitive Dysphoria

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