Rethinking ADHD: Beyond Symptoms, Toward Story, Sensitivity, and Support
- Nicole Pitt
- May 13
- 12 min read
Reflections from Gabor Maté and Terry Matlen’s webinar
Author: Nicole Pitt, MSW, RSW, Psychotherapist
ADHD is often described as a problem with attention.
After recently attending Rethinking ADHD: From Origins to Healing, featuring Dr. Gabor Maté and Terry Matlen, I found myself returning to a question I often ask often in my work:
What if attention is only the surface?
What if beneath the distraction, impulsivity, emotional intensity, forgetfulness, tuning out, restlessness, or overwhelm, there is a nervous system trying to adapt?
The webinar explored ADHD through a wider lens, including sensitivity, stress, development, relationships, women’s experiences, medication, addiction, family systems, and healing. A personal perspective that deeply resonates with personal understand of people, behaviour, stress, sensitivity, and emotional pain. The webinar expanded and deepened this lens, offering more language for patterns often witnessed in practice.
That widening of the lens also showed up in another meaningful way: access.
An ASL interpreter was available during the webinar, and as a social worker, psychotherapist, and ASL-English interpreter, I noticed that immediately and was elated. Accessibility is not separate from mental health care. It is part of it. When education is designed so more people can participate, reflect, learn, and belong, we are already practising a more attuned and inclusive way of working.
In many ways, that connects directly to the heart of this reflection. Whether we are talking about ADHD, family stress, women’s experiences, disability, Deaf and hard-of-hearing access, or emotional safety, the question is similar:
What conditions help people feel supported enough to show up fully?
Before I go further, I want to be clear: this reflection is not medical advice, diagnostic assessment, medication guidance, or a replacement for individualized care. ADHD is complex and multifactorial. This post is written through a trauma-informed, relational, developmental, and nervous-system-informed lens.
A reflective watercolour-style image of a woman surrounded by notes, calendars, reminders, and a glowing brain illustration, symbolizing ADHD, mental clutter, executive functioning, overwhelm, and the deeper nervous system story beneath attention.
A Diagnosis Describes a Pattern. It Does Not Tell the Whole Story.
A diagnosis can be useful. It can help people access support, understand patterns, and name struggles that may have been misunderstood for years.
But a diagnosis does not explain everything.
ADHD may describe challenges with focus, impulse control, emotional regulation, restlessness, follow-through, task initiation, forgetfulness, sensory overload, or tuning out. What it does not automatically tell us is how those patterns developed, what intensified them, what the person has been carrying, or what kind of support helps them feel safer and more capable.
It does not tell us about temperament, sensitivity, birth order, family stress, grief, trauma, gender expectations, school experiences, sleep, hormones, culture, or the emotional environment a person developed within.
Even children raised in the same home can have very different experiences. Parents are not the same version of themselves with every child. One child may arrive when parents are anxious and learning. Another may arrive when the family is more tired, financially stretched, grieving, or under relationship strain. Each child also brings their own temperament and sensitivity, which can evoke different responses from the adults around them.
That is not blame.
That is context.
And context matters.
Sensitivity Is Not the Problem
One idea that stood out was the importance of understanding sensitivity.
Many people with ADHD traits are highly responsive to their environments. They may feel deeply, notice more, react strongly, create vividly, intuit quickly, and struggle when the world becomes too loud, fast, demanding, or emotionally charged.
That sensitivity can make stress more overwhelming. It can also make supportive environments especially powerful.
ADHD is often described through what is difficult: distractibility, impulsivity, forgetfulness, disorganization, emotional intensity, or restlessness. Those challenges are real. But sensitivity itself does not have to be treated as a flaw.
Sensitivity without enough support can become overwhelm.
Sensitivity with support can become creativity, empathy, intuition, curiosity, passion, and aliveness.
That is a more compassionate place to begin.
Children Develop Inside Relationships
Children do not develop in isolation. They develop inside relationships, homes, schools, communities, cultural expectations, stress levels, and nervous systems that are either supported or stretched thin.
This is where attunement matters.
Attunement is not perfect parenting. No parent, teacher, therapist, or caregiver is emotionally available every second of every day. Perfection left the building somewhere around the first spilled snack cup.
Attunement is the repeated experience of being emotionally met. It is the child feeling:
“I am seen.”
“I am safe enough.”
“My feelings make sense.”
“Someone can help me hold this.”
Children are not just looking for a smiling face. They are looking for a responsive one.
When parents are overwhelmed, exhausted, unsupported, grieving, anxious, financially strained, or carrying their own unresolved pain, it becomes harder to stay emotionally present. Not because they do not care. Because stress pulls the nervous system into survival.
Children feel that. They feel tone, tension, distance, anger, distraction, and emotional absence. They also feel warmth, repair, steadiness, playfulness, and connection.
This is not an argument for permissive parenting. Children need limits, structure, leadership, and adults who can hold boundaries. But boundaries land differently when they come with connection rather than humiliation, threat, or constant correction.
No blame does not mean no responsibility.
It means shame is not the tool we use to create change.
Behaviour Is Often Communication
When children act out, they may be expressing something they do not yet have the words to say.
Behaviour can become a kind of Morse code.
A child’s actions may be communicating overwhelm, disconnection, fear, frustration, shame, sensory overload, tiredness, or a need for closeness. That does not mean adults should excuse harmful behaviour. Hitting, yelling, running, refusing, or hurting others still requires limits and support.
But we can hold the boundary while also listening for the message.
Instead of only asking, “How do I stop this behaviour?” we can also ask, “What is this behaviour trying to tell me?”
That shift matters.
When we respond only to the behaviour, we may control the moment but miss the child. When we respond to the message underneath, we create more space for connection, regulation, and growth.
Even if the behaviour is loud.
Even if the moment is messy.
Even if the child cannot yet explain what they need.
We can still stay curious.
Tuning Out, Opposition, and Attention-Seeking
This relational lens changes how we understand several behaviours often connected to ADHD.
Tuning out is not always laziness or lack of caring. Sometimes it is protection. When a child cannot escape stress, make sense of what is happening, or regulate the amount they are carrying, the brain may disconnect. That spacing out can be the nervous system’s way of saying, “This is too much.”
Opposition also deserves curiosity. A child saying “no” is not automatically a disorder. Saying no is part of developing a sense of self, preference, autonomy, and personal will. If we never learn how to say no, our yes does not fully belong to us.
Of course, intense oppositional behaviour can be very hard on families and may require skilled support. But even then, we need to ask relational questions:
What is this child resisting?
Where is there too much pressure?
Where has connection been strained?
Does this child feel guided or controlled?
Does this child feel safe enough to follow?
Attention-seeking behaviour also needs a wider lens. Sometimes a child who is “looking for attention” is actually looking for connection. Children need positive attention before behaviour has to shout.
That does not mean rewarding harmful behaviour. It means recognizing the need while holding the limit:
“I will not let you hit.”
And:
“I can see you need me.”
Both can be true.
Children Swim in Stress
One image that stayed with me is that children swim in parental stress like fish in the sea.
That may sound heavy, but I do not hear it as blame. I hear it as a reminder that parents need support too.
Parents are raising children while working, paying bills, managing relationships, navigating school systems, carrying grief, facing burnout, and often trying to parent differently than they were parented. Many are doing this with far less community support than families were ever meant to have.
When children are stressed, their bodies may speak first. Stomach aches, headaches, sleep struggles, clinginess, irritability, shutdown, defiance, impulsivity, and emotional explosions can all be ways a nervous system communicates overload.
The goal is not to blame the parent or pathologize the child.
The goal is to ask:
What is this child’s body responding to?
What is the family system carrying?
Where has stress interrupted connection?
What support would help everyone breathe a little easier?
Sometimes one of the most effective ways to support a child is to support the adults around them.
Reconnection Is a Daily Practice
Modern family life often separates parents and children for long stretches of the day. Many parents work because they have to. Many families rely on childcare because survival requires it.
So the answer is not shame.
The answer is intentional reconnection.
When children have been away from us all day, they may need to be collected again. Not immediately questioned, corrected, rushed, or redirected into the next task. Collected.
Seen.
Welcomed back into relationship.
That might look like a warm greeting, eye contact, a snack together, a silly ritual, ten minutes of undistracted play, a walk, a screen-free meal, or a bedtime check-in.
Children are not the same every day. We need to keep getting to know them.
Play belongs here too. Not as a reward after the “real work,” but as part of development itself. Play supports emotional processing, movement, problem-solving, connection, creativity, and regulation. Sometimes the most therapeutic thing a child needs is not another lecture. It is a safer relationship, a slower adult, a playful moment, or a boundary delivered without threat.
A parent who can pause and say, “I’m too angry to respond well right now. I’m going to take a minute, and we will come back to this,” is not failing.
They are modelling regulation.
ADHD in Women: The Silent Struggle
Terry Matlen’s discussion of women with ADHD was especially powerful.
For many women, ADHD has not looked like the stereotype. It has looked like masking, over-functioning, comparing, apologizing, perfectionism, emotional labour, and holding it together in public while falling apart in private.
Many women with ADHD spend years wondering why daily life feels so hard.
Why am I late again?
Why can I work so hard and still feel behind?
Why do I forget what I just walked into the room to do?
Why does dinner feel like an Olympic event with knives?
Why do I feel everything so deeply?
Why does everyone else seem to manage life so easily?
Girls and women are often missed because ADHD may show up less as visible hyperactivity and more as daydreaming, disorganization, internal restlessness, emotional overwhelm, talking too much, being too quiet, missing social cues, or working intensely to compensate.
Many women are not suddenly becoming ADHD.
They are finally being seen.
Hormones, Overwhelm, and the Invisible Load
For women, ADHD also needs to be understood across the lifespan.
Symptoms may shift around menstruation, pregnancy, postpartum, perimenopause, and menopause. For some women, perimenopause can make lifelong ADHD traits much harder to ignore. For others, hormonal changes, sleep disruption, anxiety, low mood, or brain fog may look like ADHD on paper.
This is why a more holistic assessment matters.
Not “it’s just hormones.”
Not “it’s just ADHD.”
Better questions are needed.
What changed?
When did symptoms begin?
Were attention and regulation struggles present earlier in life?
Is sleep disrupted?
Is anxiety, depression, trauma, burnout, caregiving stress, or sensory overload part of the picture?
Women also carry an enormous invisible load: the meal planning, remembering, organizing, scheduling, emotional managing, birthday tracking, school form finding, and household air traffic control.
For women with ADHD, this can become a daily source of self-criticism. The issue is not that women are failing. The issue is that many are trying to function inside expectations that were never designed with their nervous system, capacity, or humanity in mind.
Rejection Sensitivity and Sensory Overload
Many women with ADHD describe intense emotional pain around perceived criticism, rejection, disappointment, or disapproval. This is often discussed as rejection sensitive dysphoria, or RSD. I use the term carefully because it is not a formal diagnosis in the same way ADHD is, but the experience is very real for many people.
It can sound like:
“She seemed annoyed. Did I do something wrong?”
“They didn’t text back. They must be upset with me.”
“My boss corrected one thing. I’m terrible at my job.”
“My friend sounded different. Maybe I’m too much.”
Sensory overload can also be part of the picture. A mall, grocery store, sports arena, workplace, school event, or family gathering can become a full-body sensory storm: lights, noise, smells, crowds, movement, decisions, and social cues all piling up at once.
Support can be practical.
Go during quieter times. Wear headphones. Play soft music. Use sunglasses indoors if needed. Choose soft, breathable clothing. Leave when the nervous system has had enough.
Comfort is not laziness.
Sometimes it is regulation.
ADHD, Coping, and Addiction
Another important theme is the overlap between ADHD and addiction.
ADHD can involve challenges with impulse regulation, emotional intensity, motivation, reward, and the ability to pause before acting. Addiction often lives in similar territory: the place where a person knows something is hurting them, but still reaches for it because it offers relief, stimulation, escape, comfort, or a break from emotional pain.
For some people with ADHD, substances or behaviours may become a form of self-medication. This can include alcohol, nicotine, cannabis, cocaine, methamphetamine, gambling, pornography, shopping, scrolling, food, risk-taking, or constant novelty.
Not always. Not for everyone. But often enough that the overlap deserves attention.
The question is not only, “How do we stop the behaviour?”
It is also:
What pain is this behaviour soothing?
What need is it meeting?
What has this person been trying to regulate alone?
What would help them feel alive without self-destruction?
Food deserves extra care in this conversation because we cannot simply stop eating. Food is survival, culture, comfort, memory, family, and daily life. When food becomes compulsive, shame rarely helps. Curiosity does.
What is this behaviour doing for me?
Is it calming anxiety, filling emptiness, offering comfort, distracting me, or giving me a short burst of reward?
The deeper clinical question becomes: what is the behaviour trying to solve, and how can we help the person meet that need in a healthier way?
ADHD and Relationships
ADHD can affect romantic relationships too.
Not because someone with ADHD is childish. Not because their partner should become the parent. But unsupported ADHD can create patterns that slowly strain the relationship.
One partner forgets. The other reminds. One avoids. The other manages. One shuts down. The other escalates. One misses the task. The other carries the mental load.
Over time, the relationship can slide into a painful parent-child dynamic. The partner carrying the “parent” role may feel exhausted, resentful, lonely, and overly responsible.
The partner being managed may feel judged, controlled, ashamed, defensive, or never good enough.
Then both people become more stressed.
And stress often makes ADHD symptoms worse.
Love is not enough if the system is unfair. Support is not support if it quietly turns one partner into the household project manager, therapist, parent, and unpaid crisis response team.
The goal is not blame.
The goal is adult-adult responsibility, clearer systems, repair, boundaries, and support.
Medication: Helpful Tool, Not the Whole Answer
The medication conversation needs nuance.
Medication can help. For some people, stimulant medication may feel like the first time the mind has ever been able to sit down. Not sedated. Not erased. Calm enough to focus. Calm enough to choose. Calm enough to access skills that were already there but buried under noise.
But medication is not the whole answer.
Medication may support functioning, but it does not replace therapy, environmental support, stress reduction, sleep, movement, nutrition, self-esteem work, parenting support, classroom accommodations, relationship repair, or nervous system regulation.
For children especially, medication should never send the message:
“You need medication to be good.”
“You need medication to be loved.”
“You need medication so adults can tolerate you.”
Children need to be part of the conversation in age-appropriate ways. We need to ask how medication feels inside, not only whether the child looks easier to manage from the outside.
Do you feel calmer?
Do you feel more like yourself?
Do you feel flat?
Can you still play, laugh, imagine, and feel?
Medication can be one tool.
It should never be the whole room.
Neuroplasticity: The Hope Section
The brain is not fixed.
Neuroplasticity means the brain can change, adapt, reorganize, and build new pathways in response to experience.
This does not mean healing is quick, simple, or magical. It means the nervous system is responsive. And that matters.
If stress, disconnection, pressure, and overwhelm can shape development, then support, safety, connection, movement, play, rest, creativity, and responsive relationships can also shape development.
The same applies to adults.
Adults can learn new patterns. Parents can develop new responses. Families can create new rhythms. Relationships can repair. Nervous systems can become more flexible.
The work is not to shame the past.
The work is to create better conditions for growth now.
So What Helps?
For children, we can ask what helps them feel safe, connected, understood, and supported. What kind of structure helps without shaming? Where do they need more movement, play, sleep, connection, or adult support? Where are we responding to behaviour but missing the message?
For adults with ADHD, we can ask what the nervous system needs. What stressors are making symptoms worse? Which relationships are draining? Where is life running on constant pressure? What helps this person feel regulated, grounded, connected, and capable?
Support may include therapy, medication assessment when appropriate, movement, nutrition, sleep, meditation, breathwork, reduced screen overload, nature, relationship repair, environmental changes, executive functioning supports, and deeper self-esteem work.
Many people with ADHD carry shame because they have been measured by what they finished, remembered, organized, achieved, or followed through on.
But genuine worth is not earned through productivity.
You are not valuable because your inbox is clean.
You are not worthwhile only when your house is tidy.
You are not lovable only when your brain cooperates on command.
You have value because you exist.
Final Reflection
What I appreciated most about this webinar was the invitation to widen the lens.
To look beyond behaviour without ignoring behaviour.
To honour diagnosis without reducing people to diagnosis.
To recognize medication as one possible support without making it the whole answer.
To understand sensitivity, stress, relationships, family systems, women’s experiences, addiction, shame, and healing as part of the larger story.
At Waves Psychotherapy, this is the lens I continue to value: compassionate, curious, trauma-informed, neurodiversity-affirming, relationship-focused, and rooted in the belief that people are more than their patterns.
A diagnosis can open a door.
But healing begins when we listen to the story underneath.
Even if the story is complicated.
Even if the path is not linear.
Even if healing begins with simply asking a better question.
If you are a woman recognizing yourself in these words, a parent trying to understand your child’s behaviour, or an adult wondering whether ADHD, stress, trauma, hormones, or burnout may be part of your story, therapy can offer a space to slow down and make sense of it all.
At Waves Psychotherapy, I support clients in exploring nervous system patterns, emotional regulation, self-esteem, parenting stress, relationship dynamics, and the deeper stories underneath diagnosis.
Waves Psychotherapy
Deep Healing, Genuine Growth, and Empowered Living
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