How Being an HSP and Having ADHD Collide

ByZylla Black
A highly sensitive man listens to music with his eyes closed

I’m an HSP with ADHD: I can’t, by definition, truly know what it is like to have one without the other. 

I was in second grade. I was taking one of my first ever standardized tests, and I kept getting distracted. It wasn’t that the test was difficult — in fact, I found it quite fun. But the kid across the desk from me was breathing too loud.    

It wasn’t a surprise to my parents that I had trouble with noises. I had always been overwhelmed by loudness and shrillness, prone to headaches, and shy of crowds. But it had never before interfered with my concentration to this magnitude, especially not in an otherwise quiet room.

After some tests, the doctors came back and diagnosed me with attention-deficit disorder (ADD). It couldn’t be attention-deficit/hyperactivity disorder (ADHD), oh no, she wouldn’t be doing so well in school if it were that, and she’s so good at sitting still! But try this Ritalin and see if it helps.

My mother asked me if the Ritalin was working. After a thoughtful moment, I turned to her and said, “Well, the humming stopped.” After a few panicked moments, she figured out that I was referring to the small electrical noises and light buzzings of life in the modern world. She, on the other hand, had never noticed they were even audible.

It also gave me migraines, though, so I went off the medication and powered through. I thought I just had some specialized condition where I lacked the normal filters on my hearing. After all, it couldn’t be ADHD.

Fast forward about two decades, and I heard the term “HSP” for the first time — which stands for highly sensitive person. I looked at the list of traits: one or several senses keener than average (check); deeply empathetic and easily overwhelmed by others’ emotions (check); deep processing and seemingly wise beyond experience (double check). And the list went on… 

Well, that explained it! I just “have” HSP, I thought… Because I couldn’t possibly have ADHD, right? I was a graduate student, I’d been in several healthy long-term relationships, and, honestly, I hated moving around. 

But learning more about ADHD proved me wrong.

What Is ADHD?  

ADHD is commonly thought to be characterized by an ongoing pattern of inattention and/or hyperactivity-impulsivity. Symptoms may include having trouble focusing, hyperactivity (extreme restlessness), and being impulsive (making decisions before thinking about long-term consequences). While anyone could, theoretically, exhibit these symptoms, in people with ADHD, it tends to happen often and negatively impacts the quality of their life, whether it’s at home, school, work, or what have you.

Although some people are not diagnosed until adulthood, symptoms of ADHD often begin in early childhood, though children may not be properly diagnosed or even misdiagnosed. Treatment may include therapy and/or medications, and other mental health conditions may accompany the ADHD.

What Is Sensitivity?

Being sensitive does not mean what society has led most people to believe. Instead of being a “weakness,” it’s a healthy personality trait and an innate part of our temperament. So we can say that everyone is sensitive to one degree or another; some of us just are more so, with up to 30 percent of the population counting as highly sensitive people. This means that nearly 1 in 3 people are more sensitive to stimuli both physically (to lights, sounds, textures, etc.) and emotionally (to the feelings, social cues, and facial expressions of those around them). 

The sensitivity trait is associated with many strengths, from empathy and creativity to being a deep thinker and having a “Spidey-Sense” (amazing intuition) about things that help HSPs pick up on little nuances others may miss. The more you explore the many positive traits of sensitive people, the more you can see just how many strengths the trait produces. So rather than seeing sensitivity as a weakness, it can be seen as the true gift that it is. 

However, when looking at it alongside ADHD, things can get a bit confusing, as some of the traits overlap.     

ADHD vs. High Sensitivity   

I’ve seen a lot of confusion about the overlap of various neurodiverse conditions, like ADHD. One thing they all seem to involve is some level of sensitivity more than the average person. When you’re a highly sensitive person, you have sensory processing sensitivity (SPS) and get overstimulated from many types of stimuli (from fabrics to sounds to people’s emotions, to name a few). ADHD causes sensitivity, too, but in its own way — and this is important when we differentiate the two.

In the scientific world, you won’t find high sensitivity in the Diagnostic and Statistical Manual of Mental Disorders, a publication by the American Psychiatric Association (APA), because being an HSP is not a disorder. However, being highly sensitive may be more common than you think, as was indicated above.

Meanwhile, ADHD appears in only approximately 4-5 percent of the population, though that number may be slightly underreported due to the gross misunderstandings about the condition, especially as it differs by gender. ADHD is not characterized by a deficit of attention or physical hyperactivity, but by executive dysfunction, decreased working memory, and increased lateral thinking. Or, to be less technical, difficulty exerting focus where we want to focus, distractibility, and an affinity for narrative.

Little research has been done on the similarities between being an HSP and having ADHD. In fact, Dr. Aron initially assumed that being an HSP was the direct opposite of having ADHD. It’s not hard to imagine how one might come to that conclusion. If all you know of ADHD is the inability to focus (the seemingly opposite of deep processing) and hyperactive stimulus-seeking behavior (the seemingly opposite of being extremely sensitive to stimuli), it seems like a natural conclusion to make. 

In fact, the very first study of the overlap in people with SPS and ADHD was conducted just last year. It found a positive correlation between the two, suggesting that people with both conditions are more common than we may think. The characteristics of each have enough in common to create a lot of confusion. 

Many traits overlap: 

  • Sensory overload
  • Emotional overload
  • Creativity
  • Intuition

HSPs are known for their: 

  • Deep processing
  • Need for alone and quiet time 
  • Deep connections over superficial ones
  • Empathy and picking up on little things

In people with ADHD, they commonly experience:

  • Lateral thinking
  • Impulsivity
  • Hyperfocus
  • Being easily distracted

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The majority of the characteristics of being an HSP also appear in people with ADHD, but not always the reverse. Now everyone’s personal experience will be different, of course. For one thing, my deep processing as a sensitive person happens to be stronger by far than any ADHD impulsivity, and that isn’t going to be the case for everyone.

But one thing I find people often overlook when talking about ADHD is that stimulants work differently on the ADHD brain. The chemistry is simply different. It’s common for ADHD brains to process caffeine as a soporific, and harder stimulants, like Ritalin or Adderall, are such an effective treatment for ADHD because they allow the brain to narrow its focus. If non-ADHD brains are given stimulants, it does not have the same effect, often leading to jitters, hyperactivity, or worse.    

So the fact that Ritalin worked for me, even if I didn’t like it, is a sure sign to me that I do, indeed, have ADHD. (That, and the fact that espresso makes me want a nap!)

But SPS medical sensitivity leads to heightened effects of many drugs, and that, I find, is also very me. I don’t need a shot of espresso to knock me out: a single chocolate-covered espresso bean will do the trick. I’m extremely reactive to small amounts of any effective drug, and I often have to watch carefully for unusual side effects.

My body knows that I am an HSP, as well as someone who has ADHD — and it reacts accordingly. It isn’t just “all in my head,” for all the neurodivergence and mental differences are mostly, technically, in my brain.

Being an HSP with ADHD

I am a highly sensitive person: I map my world by emotions and I connect deeply with others (if I connect at all). Yet I also have to be careful with what I let myself take in, or I weep for the state of the world. High-pitched sounds and strong smells — chemical sensitivity — easily overwhelm me and often lead to migraines…

…and I have ADHD. I am writing this article while listening to music, because I often cannot focus if there isn’t ambient noise. I cannot memorize anything by rote, and I have 20 browser tabs open, five major projects I’m working on, and three books I’m actively reading. I have absolutely no sense of time, and my working memory… well, let’s just say that’s what my various lists are for.

I hyperfocus (an ADHD symptom) on reading and on playing soothing, beautiful video games (things that appeal to my HSP traits). I can’t, by definition, truly know what it is like to have one without the other. Who would I be if the high-stimulus environments of things like basketball games, to which I was frequently taken to as a child, hadn’t routinely ended in massive, overwhelming pain from the noise of the crowd? What would my ambitions be like if my quick, lateral thinking and storytelling skills didn’t merge with my empathy and deep processing to drive my desire to educate and reform?

This is who I am. Maybe it’s who you are, too. In any case, embrace it. 

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Zylla Black is an HSP with ADHD, anxiety, and depression. She’s also a writer, an artist, an ex-academic with two Masters degrees, and a YouTuber. You can find her work here. She/they.