Treating Adult ADHD with DBT
Living with ADHD can feel like having a superpower that does not come with an instruction manual. One minute you’re hyper-focused on a project. The next, a dozen unrelated thoughts pop up to distract you. Things slip through the cracks. If this sounds like you, you’re not alone. ADHD is part of how we navigate the world for so many of us. For us LGBTQ+ folks, managing mental health can come with extra challenges. Fortunately, there’s a therapy tool that might help you: Dialectical Behavior Therapy (DBT).
Originally developed for treating Borderline Personality Disorder, DBT has been found to be effective for working with ADHD too. In fact, one study out of Sweden breaks down exactly how DBT words to help manage the symptoms of ADHD, and capitalize on the strengths it gives you. In this article we’ll get into how DBT works and how it can help you work with your ADHD mind.
Origins of DBT
Dialectical Behavior Therapy (DBT) was created by Dr. Marsha Linehan in the 1990s. She originally designed DBT as a treatment for people with intense emotions who had difficulty regulating them. As a therapy, it’s designed to target distress tolerance, impulse control, and building a life worth living. Over the years, DBT’s has been tested as a therapy for other mental health issues. Those include depression, anxiety, chronic pain, and our topic today—ADHD. At its core, DBT is about using practical skills to navigate emotional intensity and get a handle on managing your habits, two of the hallmarks of ADHD.
Four Core Skills of DBT
DBT focuses on four main topics. They are widely applicable to people looking to improve their emotional and mental well-being. Here’s a quick breakdown of these topic areas and how they relate to ADHD:
Mindfulness: This is the foundation of DBT, and it’s all about being present and aware of your world. For people with ADHD, mindfulness is how you help manage distractions and stay grounded. It’s also how you release any judgments you have about the way your brain naturally works.
Distress Tolerance: This skill involves coping with crisis in healthy ways. ADHD can often make stressful situations feel overwhelming. In fact, it’s exhausting. With some distress tolerance skills, you have options for staying in control and preventing impulsive reactions.
Emotion Regulation: This area helps you understand and manage your emotions better, so that you don’t feel like emotions run your life. Emotional dysregulation is common in ADHD. Learning to manage them is crucial for long-term mental health.
Interpersonal Effectiveness: This topic is about improving how you communicate and manage relationships. ADHD can sometimes lead to miscommunication or impulsive interactions. Isolation is common, as is rejection sensitivity: the idea that abandonment or rejection hits you extra hard. These skills help build and strengthen your connections with others.
Understanding ADHD in a Queer Context
ADHD doesn’t just make mean problems with focusing. In fact, it’s an entire spectrum of things that impact your daily life. For example, you might be incredibly gifted at retaining information and lose track of time doing activities you love. You might find it hard to concentrate or get tasks organized. Some of the most common ADHD experiences are impulsivity, forgetfulness, and difficulty regulating emotions. Sometimes, it feels like you’re constantly trying to keep your head above water while treading water on too many things at once.
For LGBTQ+ people, ADHD can look a little different. We’re up against a double bias. Many people in the queer community already face societal pressures, discrimination, or stigma about their sexuality and gender identity. People who are neurodivergent are often told that the way their brains work is a problem; that they are the “odd one out” or don’t belong. Stigma against both of these communities can make for a confusing childhood and teenage years.
Treatments for ADHD
One of the most common ways to treat ADHD is with medication. Typically, the symptoms of ADHD can be well-maintained using medication. The difficulty lies in remembering to take it consistently- and sometimes, with accessing medication in the first place. With so many people in the United Stated living without reliable healthcare, and with shortages of many medications, accessibility is a major issue.
There are several different types of therapies that work well with ADHD as well. Often, the best treatment option is a combination of medication and therapy. Neurofeedback and cognitive training can be helpful as well.
How DBT Helps with ADHD Symptoms
In the research on how to treat ADHD, one of the most interesting studies came out of Sweden. A group of researchers there tested whether DBT is helpful in managing ADHD symptoms, with really exciting results! (Well, exciting if you’re like me and love therapy studies. It’s the little things!)
The article they published gets into detail about why and how DBT addresses ADHD. They broke their pool of 51 participants down into two groups, with one of them receiving DBT skills training, and the other a casual, discussion-based group therapy. The results they got are encouraging! People who got the DBT therapy reduced their ADHD symptoms, as you might expect. Additionally, the people who got the DBT “reported better ability to cope with their ADHD-related problems after finishing the treatment.” And on top of that, the participants in the skills training group “would recommend the group more often to a friend with ADHD” than the people in the discussion groups .I’ll break down the skills they taught in the rest of this article. Or, you can read the full study here: “Reduced ADHD symptoms in adults with ADHD after structured skills training group: Results from a randomized controlled trial.”
Mindfulness for ADHD
Mindfulness is the cornerstone of DBT, and for people with ADHD it can help you break the cycle of getting swept away by distractions or emotional reactions. The ability to stay present in the moment is a cognitive skill, and the mindfulness trainings and homework assignments you get with DBT help you build that skill.
In the study from Sweden, people getting the DBT treatment were taught about the neurobiology of ADHD, and how exactly their time management and concentration are impacted. In developing a deeper understanding of how ADHD brains function, the participants learned how to work with those cognitive styles. For example: the mindfulness skill of nonjudgmentalness can help to reframe symptoms of ADHD from “problems” to the more neutral “ways of being” or “habits.”
Mindfulness exercises can also help improve concentration over time. Simple practices like mindful breathing or body scans can create a stronger connection between your mind and body, which is essential when ADHD makes it hard to stay grounded.
Emotion Regulation
If you have ADHD, you know that emotions can come on fast and strong. You might go from calm to irritated in a matter of seconds or feel completely overwhelmed by frustration. DBT’s emotion regulation skills teach you how to recognize, label, and manage your emotions more effectively.
The study in Sweden paid particular attention to the emotion of sadness and depression, which can come up commonly for people with ADHD. The group leaders brought in a psychiatrist to discuss symptoms of depression, and how how medication can address some of those issues. The participants were invited to discuss their expectations or experiences of medical treatment, and how it impacted their mood symptoms. By reflecting back on their emotion management, the people in the study deepened their understanding of what skills had been most helpful to them.
For example, instead of reacting impulsively to a situation, you might use DBT skills to take a step back and ask yourself, “What am I feeling right now, and why?” Understanding your emotional triggers allows you to respond with intention instead of reacting in the heat of the moment.
Distress Tolerance
Distress tolerance skills are all about getting through tough moments without making them worse. For someone with ADHD, this could be during an emotional crisis, a stressful work deadline, or a difficult conversation. Rather than impulsively quitting a project, saying something you regret, or feeling paralyzed by anxiety, DBT offers tools like radical acceptance and self-soothing to help you manage the moment.
These tools give you a way to handle the stress and discomfort of daily life without being reactive. Instead of acting on a whim, distress tolerance helps you pause, reflect, and choose healthier ways to cope.
For people with ADHD, impulse control can become a major issue. This can be a positive and a source of strength as well, as with spontaneity and creativity. One skill that is taught in DBT, the STOP skill, can be a huge help in giving you the space to consider the options before you act. When you master this one, you make a huge difference in your ability to ride out urges and impulses, as difficult as they can sometimes be.
Interpersonal Effectiveness
ADHD often comes with challenges in relationships, whether that’s with friends, partners, or coworkers. Rejection sensitivity dysphoria, or RSD, is one common experience that many people with ADHD live with. Interpersonal effectiveness skills in DBT helps you navigate these concerns. The focus is on improving your communication, setting boundaries, and getting your needs met in healthy ways. For instance, if you tend to forget commitments or interrupt others during conversations (a common ADHD behavior), these skills teach you how to express yourself more clearly and listen more effectively.
Building stronger relationships with the people around you can make your life feel more stable, reducing the emotional chaos that often comes with ADHD. Additionally, DBT can help address the impact of ADHD on self-respect. In fact, in the study from Sweden, the participants and their significant others were both brought into the group therapy, to help practice some new skills.
Therapist’s Perspective
Working with a DBT-trained therapist can be incredibly helpful. They can guide you through the process, personalize the skills to your ADHD, and provide support when things get challenging. If therapy isn’t accessible for you, there are great DBT workbooks and online resources that offer self-guided ways to start learning.
If you’re looking for a DBT therapist, start by seeking out LGBTQ+-affirming professionals. Many therapists specialize in ADHD or queer mental health and can tailor treatment to your needs. Websites like Psych Today or local LGBTQ+ community centers often have directories for finding therapists who align with your values.
DIY DBT
There are plenty of self-help resources to get you started with DBT. There is an ADHD- centric DBT workbook called The Neurodivergent Friendly Workbook of DBT Skills that can be one excellent resource. Also, apps like "DBT Diary Card and Skills Coach" can provide valuable guidance. Consider joining an LGBTQ+ ADHD support group, either locally or online. Connecting with others who share similar experiences can reduce feelings of isolation and offer a sense of community.
Conclusion
DBT offers practical, accessible tools for managing ADHD, especially when emotional regulation, impulsivity, and focus are major challenges. By practicing DBT skills, you can create more stability in your daily life and feel empowered in your mental health journey. Whether you choose to work with a therapist or explore self-help resources, DBT can be a powerful tool for ADHD—and the best part is, you don’t have to do it alone. Reach out, get support, and take control of your mental health in a way that feels right for you.