ADHD: how to manage a risky behavior ?

People who struggle with attention-deficit/hyperactivity disorder (ADHD) sometimes engage in risky behavior. Is this behavior sought after for the thrill of the risk, or is the behavior due to impulsivity? Perhaps it is sometimes due to the former, but most of the time, risky behavior is due to struggles with executive functioning skills.

Research has shown that certain skills lag in individuals diagnosed with ADHD. These skills are often tied to working memory, which allows individuals “to plan, monitor, and self-regulate” (Lawson, n.d.). With struggles in working memory, individuals struggle to link past and present, including present consequences for past errors. Decision-making and self-control can suffer (Banaschewski, Coghill, & Zuddas, 2018). This can lead to living in the moment, and therefore, behaviors that appear risky. The important differentiation is that the individuals are not seeking the behaviors for the thrill (Dekkers et. Al, 2021). Rather, individuals with ADHD can engage in potentially dangerous behaviors because their working memories do not allow them to call to mind the potential consequences of these behaviors.

Individuals with ADHD struggle to stop long enough to think before making decisions. This can lead to repeating the same unproductive behavior, as the brain does not have enough time to consider the past before acting on the current impulse (Lawson, n.d.). Holding multiple thoughts and ideas in the brain and processing them takes space and time, and without having these, decision-making suffers (Banschewski, Coghill, & Zuddas, 2018; Sutherby, 2022). It is sometimes even said that individuals with ADHD can act before thinking.

Processing emotions is another area of struggle for individuals with ADHD. Emotions can overwhelm, and in the absence of the ability to stop and think before acting, emotions tend to drive action (Lawson, n.d.). Anxiety can exacerbate symptoms, and anxiety tends to co-exist with ADHD, as individuals with ADHD often have negative social reactions to their decisions. Without strong executive functioning, individuals can get stuck in, and act out of this anxiety (Belsky, n.d.). Behaviors that appear risky may actually be actions done out of fear.

Impulsive behaviors are risky and dangerous. As therapist Robyn Gobbel says, though, “Changing how we see people changes people” (Gobbel, 2021). Conceiving risky behaviors as born out of struggle, rather than thrill-seeking, helps bring attention to the actual deficits that accompany ADHD. Instead of shaming people for their choices, it allows people to support loved ones with ADHD, working on interventions to grow access to working memory, increase time taken to make decisions, and calm anxiety. Are these quick fixes? No, but that is what individuals with ADHD need… for things to slow down. Impulsivity in ADHD is not a character flaw. It is not a personality characteristic. It is a deficit born out of lagging skills. Seen in this light, it is something to work at, and on. Rather than telling people to stop being so impulsive, maybe the question needs to be, “How can I help you develop skills to make better decisions in the future?” This is a person-focused, rather than problem-focused, way to address risk-taking in those diagnosed with ADHD.