It’s nine in the morning and you’re sitting at your desk, ready to work on a crucial task. But no matter how hard you try, you just can’t get going. You feel stuck and don’t know why.

Your internal voice says you’re lazy, but it’s not like you’re enjoying this. Getting the task done would feel so much better!

This is ADHD task paralysis and it can be an extremely distressing symptom.

But what causes ADHD paralysis? Can you do anything about it?

What Causes ADHD Paralysis?

ADHD paralysis is not caused by a lack of motivation. In fact, you may have felt extremely motivated before it came time to act. It’s not necessarily connected to the difficulty of the task, either. 

Another way of understanding ADHD paralysis is as a struggle with task initiation – the ability to start the task. It can occur even when you have been interrupted while doing a task and need to get going again.

But why do people with ADHD feel overwhelmed by task initiation?

Executive Dysfunction

A person’s executive functioning refers to their ability for processing information, planning, decision-making, impulse-control, and using working memory. The developmental issues caused by ADHD lead to executive dysfunction, causing deficits in each of these areas.

Research in neuroscience has backed this up. The part of the brain responsible for executive function, the prefrontal cortex, shows reduced activity in people with ADHD.

Task initiation therefore requires a lot more energy as the person has to make up for the deficits in executive functioning. In other words, it doesn’t just feel harder to get started, it actually is harder.

Perfectionism 

A related factor is a sense of perfectionism many people with ADHD have. This emerges from the frequent experience of not meeting expectations even when they think they have done everything ‘right’.

Let’s say the person needs to organize an event. They believe it needs to be perfect but don’t know what ‘perfect’ is. Success seems impossible and the fear of failure replaces the motivation to try.

Time Blindness

The recognition of time blindness as a symptom has vastly contributed to the understanding of ADHD. Time blindness refers to the struggle to measure time. It is difficult to envision the future, which makes it tough to plan for the day, let alone a week or a year.

This leads the person to be uncertain of whether they have enough time to get everything done, adding to the sense of overwhelm and anxiety at the core of ADHD paralysis.

Emotional Dysregulation 

People with ADHD also struggle with emotional regulation. Everyone experiences difficult emotions, however, people with ADHD lack the ability to regulate those emotions.

This is due to a combination of hyperactivity in the amygdala, which plays a role in emotional responses, and the imbalance of neurotransmitters such as dopamine, serotonin, and norepinephrine, all of which regulate a person’s mood.

As such, difficult emotions are heightened, making it challenging to focus on a task and increasing the sense of feeling overwhelmed. Motivation, which is driven in part by mood, is quickly drained.

How to Get Out of ADHD Paralysis

The discussion of ADHD paralysis itself might seem overwhelming. However, understanding it as a symptom of ADHD can actually provide a lot of relief. 

Oftentimes, people with ADHD internalize their paralysis as a personal failing, especially if teachers or parents called you ‘lazy’ during your childhood. Knowing that it is a symptom of a disorder can help diminish the shame.

Here are a few ways to treat ADHD paralysis: 

Medication

Medication is not a panacea for the symptoms of ADHD but it can make a huge difference. Stimulants such as methylphenidates (Ritalin, Concerta) and amphetamines (Vyvanse, Adderall) can provide an immediate boost in focus during the day, helping both with task initiation and completion.

Non-stimulants like Atomoxetine (Strattera) provide a more subtle but longer-term improvement to focus.

Antidepressants that help process neurotransmitters like serotonin and dopamine can also improve the mood of people with ADHD, lowering another barrier to task initiation.
Medication works differently for different people. A psychiatrist can help you find the most suitable medication, but it may take time to settle on the right option.

ADHD Coaching

An ADHD coach is a person who specializes in training people with ADHD to use skills to better manage areas affected by executive dysfunction. These include strategies like time blocking and goal setting.

ADHD coaching can be very helpful in dealing with ADHD paralysis. However, it is important to note that most ADHD coaches are not licensed therapists. They are therefore not necessarily equipped to help with emotional regulation and your health insurance is unlikely to pay for their services.

Therapy for ADHD Paralysis

Individual therapy is a great way to start treatment for ADHD paralysis. Your therapist will give you evidence-based strategies to identify and break down the anxious thoughts that contribute to it. This practice gradually makes tasks feel less overwhelming, revealing a path out of paralysis.

Different kinds of therapy provide excellent tools for emotional regulation. The strategies provided by cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) in particular are very effective for people with ADHD.

Your therapist will also work with you to identify ways to complete tasks that play to your strengths. For example, they may help you break tasks up into smaller steps, making those steps more stimulating, and introducing creativity into their completion.

Once you’ve built skills to help with task completion, task initiation no longer takes as much energy. You can come unstuck and get through the ADHD paralysis.

Octave has dozens of therapists who can meet your unique needs.