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When most people think about attention-deficit/hyperactivity disorder (ADHD), they picture visible behaviours such as fidgeting, restlessness, or difficulty sitting still.
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When most people think about attention-deficit/hyperactivity disorder (ADHD), they picture visible behaviours such as fidgeting, restlessness, or difficulty sitting still. While these outward signs are common in children, many adults with ADHD describe something far less visible but equally disruptive: mental or inner restlessness.
This internal experience is often overlooked, yet it can significantly affect focus, sleep, decision making, and emotional wellbeing in everyday life.
Restlessness is generally defined as an inability to remain still, calm, or settled. In ADHD, this can show up physically through:
However, in adults, restlessness often becomes more internalised. Mental restlessness may involve:
Many adults with ADHD describe this as a feeling of having “too many thoughts at once” or struggling to quiet their mind, even when they want to focus or relax.
Inner restlessness appears to be closely linked to mind wandering. Thoughts may drift away from the task at hand, often without conscious awareness, making sustained attention more difficult.
This can lead to:
Over time, repeatedly acting on impulsive thoughts or struggling to maintain focus may contribute to regret, stress, or reduced confidence, which in turn can increase vulnerability to anxiety or low mood.
In children with ADHD, restlessness is usually more visible. It may appear as:
By adulthood, this outward hyperactivity often becomes less obvious. Instead, many individuals experience an internal version of the same restlessness.
One explanation for this shift relates to the development of executive functions. As children grow, they gradually learn to internalise behaviour. Actions that were once physical, such as speaking aloud or acting impulsively, may become mental processes over time.
For example:
In ADHD, delays in executive function development may mean that restlessness remains external for longer before eventually becoming internalised.
Mental restlessness is thought to be linked to differences in brain networks associated with attention and self-regulation, particularly areas within the prefrontal cortex.
Research also suggests a possible connection with the brain’s default mode network. This system is involved in daydreaming and spontaneous thought. In ADHD, it may be less effectively regulated, leading to increased mind wandering and difficulty staying focused on goal-directed tasks.
Although inner restlessness is not always visible to others, it can interfere with daily functioning in several ways:
Living with a constantly active mind can also make it harder to relax or feel present in conversations and social situations.
The good news is that inner restlessness in ADHD is treatable. Approaches that may help include:
ADHD medications are often effective in reducing both physical and mental symptoms, including racing thoughts and distractibility.
CBT programmes designed for adults with ADHD can support:
Mindfulness techniques may help some individuals slow down mental activity and improve awareness of shifting attention.
A combined approach that includes medication alongside behavioural strategies often provides the most effective symptom management.
Mental restlessness may be less obvious than childhood hyperactivity, but it can be just as disruptive. Recognising it as part of ADHD rather than a personal failing can help individuals seek appropriate treatment and develop practical coping strategies.
With the right support, it is possible to reduce the impact of inner restlessness and improve focus, emotional wellbeing, and day-to-day functioning.
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