When the Brain Won’t Settle: ADHD, Alcohol, and the Ache for Escape
For many adults with ADHD, the path to understanding their neurodivergence is paved with missed cues, misunderstood behaviours, and deeply internalized shame. Long before there is a diagnosis, there is the lived experience: the misplaced homework, the forgotten names, the racing thoughts, the bubbling frustration, and the ache of never quite getting things right, no matter how hard one tries. Amid this lifelong friction, alcohol often enters the scene quietly, wrapped in social ritual, adolescence, or curiosity. But for many neurodivergent individuals, it quickly becomes more than just a weekend indulgence. It becomes a coping mechanism, a shield, a salve for a nervous system that never truly feels settled.
The ADHD brain, wired for novelty, reward, and stimulation, is also prone to emotional volatility, sensory overload, and chronic restlessness. This unique wiring, often misunderstood as laziness, carelessness, or moodiness, creates a deep, chronic mismatch between internal experience and external expectation. Daily life can feel like trying to play a game where the rules keep changing, and you're always one step behind. For individuals unaware of their diagnosis, the result is often relentless self-blame. Humans with ADHD learn to mask, to hustle, to overcompensate, and to survive. But survival is not the same as peace. Over time, the weight of unmet needs, executive dysfunction, rejection sensitivity, and persistent overstimulation can culminate in one urgent desire: to shut it all off, even briefly.
Enter alcohol. It offers what feels like relief, slowing the mental churn, numbing the sharp edges of shame, loosening the grip of anxious thought loops. In a world that rarely grants ADHD brains permission to rest or be messy, alcohol becomes the shortcut to stillness. But the cost is high. What begins as a coping tool can easily slide into dependency, especially for those whose impulsivity, emotional dysregulation, and interoceptive challenges (difficulty recognizing internal cues like hunger, thirst, or intoxication) make moderation difficult. And because ADHD is so often undiagnosed, especially in women, BIPOC individuals, or those assigned female at birth, what looks like “just drinking too much” is often a signal of something deeper: a brain that has never truly been understood, supported, or affirmed.
The Unseen Link: ADHD and Alcohol Use
While the co-occurrence of ADHD and Alcohol Use Disorder (AUD) is well documented, it remains under-discussed in public discourse. According to clinical research, up to 43% of individuals with ADHD will develop an AUD in their lifetime, and approximately 20% of adults with alcohol dependence meet criteria for ADHD, a number believed to be underreported due to underdiagnosis, especially in women and marginalized groups (Kronenberg et al., 2014).
But beyond the statistics lies the question: Why? What makes the ADHD brain more susceptible to patterns of risky drinking and substance use?
The answer begins with executive function.
Executive Function as a Daily Battleground
Executive functioning refers to a suite of cognitive processes that help us plan, initiate, sustain, and shift attention. It allows us to regulate our behavior, manage time, prioritize tasks, and resist unhelpful impulses. In ADHD, these abilities are often impaired, not due to lack of intelligence or care, but due to neurological differences in how the brain organizes, motivates, and maintains effort.
Living with impaired executive function means navigating life in a constant state of friction. Individuals may know exactly what they need to do, whether it’s paying a bill, preparing for a meeting, or remembering to pick up groceries, and yet be unable to initiate the action. This dissonance between intention and action is not only frustrating; it can be deeply distressing.
Over time, this chronic struggle with the basic demands of adulthood leads many individuals to question their worth. Why can everyone else “just do it,” while they remain stuck in a loop of procrastination, disorganization, and perceived laziness? The gap between internal desire and external ability becomes a source of profound self-criticism.
This is where alcohol can quietly slip in, not as a thrill-seeking behavior, but as an escape hatch.
The Ache for Ease: Why Alcohol Feels So Good (Until It Doesn’t)
Many clients report that drinking initially helped them feel calm, focused, or free from the constant noise in their heads. For those whose days are shaped by chaos, forgetting appointments, misplacing keys, emotionally overreacting to perceived criticism, alcohol offers a temporary stillness.
It slows the world down. It masks the fear of failure. It numbs the shame of being “too much” and “not enough” all at once.
But it’s a false balm. Alcohol impairs memory, executive functioning, and sleep, all of which are already compromised in ADHD. It may offer short-term relief, but it ultimately amplifies the very issues it seeks to soothe. The aftermath, missed responsibilities, emotional dysregulation, relational tension, feeds back into the ADHD shame spiral.
And thus, the cycle begins: self-doubt, followed by avoidance, followed by more drinking to cope with the fallout.
Rejection Sensitivity and the Hidden Wounds
A crucial, yet often overlooked, part of this dynamic is Rejection Sensitive Dysphoria (RSD), a phenomenon commonly experienced by those with ADHD. RSD is not a formal diagnosis, but it refers to the intense emotional pain triggered by real or perceived rejection, criticism, or failure.
For someone with ADHD, a minor correction at work or a friend canceling plans can feel like a personal betrayal. These experiences can provoke disproportionate emotional reactions, deep shame, anger, or withdrawal, and reinforce negative self-beliefs.
When compounded over time, these moments of rejection carve deep grooves in the psyche. A missed deadline isn’t just an inconvenience, it’s proof that one is unreliable. A forgotten birthday becomes a sign of being a “bad friend.” With each perceived failure, the need for self-soothing intensifies.
Alcohol becomes one of the easiest, most accessible methods of numbing those feelings.
Adults with ADHD often share that drinking helped them not feel the sting of letting people down, of being misunderstood, or of never quite measuring up. For those who never received affirming narratives about their brains, alcohol became a stand-in for acceptance, however temporary.
Masking, Misunderstanding, and Missed Diagnoses
For many adults, the road to an ADHD diagnosis is long, winding, and often obscured by misunderstanding especially for those socialized as women or assigned female at birth (AFAB). Rather than being disruptive or hyperactive, many internalize their symptoms. They learn to cope through masking over-preparing, over-achieving, people-pleasing, and suppressing their natural tendencies in order to meet the expectations of a neurotypical world.
This masking is exhausting and unsustainable. But because it “works” on the surface, their ADHD goes unnoticed dismissed as stress, anxiety, or perfectionism. Emotional outbursts are labeled dramatic. Executive dysfunction is mistaken for laziness. And the intense inner turmoil? Often chalked up to “just being sensitive.”
This diagnostic invisibility is not benign. It delays access to support and treatment for years, sometimes decades. And during that same span of time, alcohol and substance use often become common self-regulation tools socially acceptable ways to calm a restless brain, mute rejection sensitivity, or take the edge off emotional dysregulation.
By the time many individuals receive an ADHD diagnosis, they’ve already internalized deep shame. They believe they are the problem. They see their struggles as personal failings rather than symptoms of a misunderstood neurodevelopmental condition.
Healing Begins With Understanding
For many adults with ADHD, especially those diagnosed later in life, the path to healing begins not with medication or therapy, but with understanding. After years of confusion, misdiagnosis, or internalized shame, receiving a diagnosis can feel like unlocking a part of oneself that was always there but never named. Many individuals recall spending decades believing they were lazy, broken, emotionally unstable, or simply “not trying hard enough.” They pushed harder, worked longer, masked their struggles, and still found themselves overwhelmed, disorganized, or emotionally reactive. The realization that these lifelong challenges stem from a neurodevelopmental condition, and not a moral failing, can be profoundly transformative. It reframes their history with clarity and compassion.
This shift in understanding creates space for both grief and relief. Grief for the years spent misunderstood, for the coping strategies that led to harm, and for the missed opportunities that came from struggling without support. Relief in knowing that their brain works differently, and that difference is real, valid, and worthy of support. In this new light, behaviors like impulsivity, procrastination, substance use, emotional reactivity, or social withdrawal begin to make sense. Alcohol, for example, is no longer seen as a failure of character but as a desperate attempt to self-regulate in a world that offered no other tools. With this insight, people begin to replace shame with curiosity, blame with context, and punishment with compassion. They realize they were doing the best they could with the nervous system they had, and that better tools and support are now possible.
Understanding becomes the foundation of change. When people stop fighting their brains and start learning how to work with them, everything begins to shift. They explore new strategies for emotional regulation that don’t rely on numbing. They build scaffolds for executive functioning, not to “fix” themselves but to support their unique processing style. They begin to name their needs more clearly, set boundaries, and find community with others who see and understand them. This is the essence of neuroaffirming recovery, not forcing oneself to conform to neurotypical expectations, but creating a life that honours the way one’s brain is wired. Healing begins here, not through force or shame, but through the quiet, powerful act of self-recognition.
Toward a Neuroaffirming Model of Recovery
Recovery from alcohol use disorder in the context of ADHD is not about willpower, it’s about understanding the brain’s needs. It’s about recognizing the legacy of shame and misattunement and gently untangling it.
For some, this includes:
ADHD-informed therapy or coaching
Medication support to manage core symptoms
Structure-building to improve executive functioning
Trauma and attachment work to address rejection sensitivity
Somatic practices for nervous system regulation
Peer support from neurodivergent-led spaces
And for many, the journey is not linear. There are stumbles. There are moments of forgetting. But there is also growth, and growing clarity.
Final Reflections
Not everyone with ADHD will struggle with alcohol, but for those who do, understanding the why matters more than judgment ever will. Substance use is rarely just about the substance. It’s about what came before: the quiet, chronic overwhelm of a brain constantly overstimulated or under-stimulated. The years of being told to “try harder” without being taught how. The loneliness of feeling out of step with peers, family, or even your own goals. For many late-diagnosed individuals, alcohol entered the picture not as rebellion, but as relief, a socially sanctioned way to slow the world down, blur the noise, or silence the shame. In this context, drinking isn’t a failure. It’s information. It tells us something was too much for too long, and the system tried to adapt.
Recovery, then, cannot be reduced to abstinence or compliance. It is not about becoming someone else, but finally being allowed to be yourself. It means shifting from a model of punishment to one of permission: permission to feel, to fall apart, to learn, and to rebuild. Recovery for neurodivergent individuals must be flexible, trauma-informed, and rooted in affirmation. It must honour the unevenness of progress, the complexity of healing, and the reality that what looks like “backsliding” may in fact be an old strategy resurfacing in a moment of overwhelm. Recovery isn’t linear, but it is possible.
When we adopt a neuroaffirming model of care, we begin to hold space for nuance. We understand that resilience grows not from denying our needs but from finally meeting them. The individual who once turned to alcohol to survive can now turn to tools, supports, community, and a deeper sense of self. They can begin to imagine a future where regulation comes from rhythm, not repression. Where relationships are built on understanding, not masking. Where their brain is not a burden to manage, but a difference to embrace. And in that future, healing doesn’t mean erasing the past, it means weaving it into a new story, one where hope is grounded not in perfection, but in presence.