Decision-Making

What's the deal with

Decision-Making

and ADHD?

Decision-making is the cognitive process of selecting a course of action from multiple alternatives. For individuals with ADHD, decision-making can be a particularly challenging aspect of daily life due to difficulties with executive functioning, impulse control, and emotional regulation. These challenges can impact everything from minor daily choices to major life decisions.

“When it isn’t clear what is urgent, the signals can all sound the same, and we often just get stuck. Decision paralysis is a common experience for those of us with ADHD. When we try to narrow down our choices, a process that relies on convergent thinking, our divergent-thinking brains often keep handing us more options to choose from, and we can end up overwhelmed.” — Jessica McCabe, How to ADHD: An Insider's Guide to Working with Your Brain

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What it looks like:

Decision-making challenges in ADHD can manifest in various ways:

Difficulty weighing pros and cons of different options
Tendency to make impulsive decisions without considering consequences
Analysis paralysis: becoming overwhelmed by too many options
Procrastination on important decisions
Difficulty prioritizing when faced with multiple choices
Emotional decision-making rather than logical reasoning
Second-guessing decisions after they've been made
Struggles with long-term planning and decision-making
Difficulty making decisions under time pressure
Tendency to seek excessive input from others before making decisions
Challenges in following through on decisions once they're made

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The science:

The difficulties with decision-making in ADHD are closely linked to the neurological differences associated with the condition:

Brain activity: The prefrontal cortex, a part of the brain responsible for skills like planning and reasoning, is often underactive in individuals with ADHD. This can make it much more difficult to analyze options choose between them.
Brain chemicals: Dopamine is a brain chemical involved in motivation and reward. Dopamine levels are often low in people with ADHD, impacting how people weigh risks and rewards and make choices about how to proceed.
Emotional dysregulation: Many individuals with ADHD struggle with emotional regulation, which can lead to emotionally-driven decision-making, impulsivity, or avoidance.
Working memory deficits: Working memory is a mental process or skill which allows you to hold information in your mind while you manipulate it, like using a piece of scratch paper to solve a math problem. In people with ADHD, working memory is often impaired, making it difficult to hold multiple options in the mind and compare them against each other at the same time.

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References:

https://add.org/adhd-paralysis/

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.519840/full

https://journals.sagepub.com/doi/10.1177/1087054718815572

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What you can do:

Journaling: It can be helpful to “brain dump” before starting the decision-making process in order to externalize your thoughts and emotions. It’s a great way to clear your mind and also prepare for creating mind maps, pros/cons lists, or other strategies.
Use visual aids or decision-making frameworks: Tools like pros/cons lists, decision matrices, decision trees, or mind maps can help you visualize options and outcomes.
Set decision deadlines: Give yourself a specific timeframe to make decisions to avoid analysis paralysis. Telling someone about the deadline can help you stick to it.
Use the "10/10/10" rule: Consider how you'll feel about the decision in 10 minutes, 10 months, and 10 years to gain perspective.
Break down complex decisions: For major decisions, break them down into smaller, more manageable choices, and work on decision-making in shorter chunks of time.
Limit options: When possible, narrow down choices to prevent overwhelm.
Use "if-then" planning: Create specific plans for implementing decisions to improve follow-through.
Have a regular decision-making time: Identify the times of the day when you feel most alert, focused, and relaxed. Use this time for more complex decision-making.
Separate “decision-time” from “doing-time”: Leaving decision-making to the moment you need to act on the decision can be too mentally taxing. Instead, try to make as many small decisions in advance as you can. Choosing what to buy at the grocery store in advance is a simple example of this.
Self-care: Ensuring you get enough sleep, regular exercise, and regular meals is especially important for people with ADHD, as these things increase dopamine levels in the brain.
Habits and routines: Consistently performing actions or tasks in the same way or at the same time reduces the mental effort or cognitive load required to initiate or complete them. In essence, you’re eliminating as many decisions as possible from your day.

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Go deeper:

Conquering Decision Fatigue

Emotional Regulation and ADHD

Setting Goals, ADHD-Style

Impulsivity in Action: Why ADHDers Struggle with Response Inhibition

https://www.understood.org/en/articles/adhd-and-analysis-paralysis

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Attention Dysregulation

Emotional Regulation

Lateness

Impulsivity

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