ADHD and Sex: Optimizing Intimacy for the Neurodivergent Brain

By Rami Nijjar

Folks with ADHD are becoming increasingly curious about the impact that neurodivergence has on their dating and sex lives.  And for good reason.  ADHD (attention deficit hyperactivity disorder) a diagnosis characterized by inattention, hyperactivity, and impulsivity, comes with its strengths (creativity, spontaneity, innovation, high energy, and the ability to be hyper-focused when it matters) and its challenges.  Essentially, navigating ADHD means becoming very mindful of one’s internal states (including sexual arousal) and understanding how being over-stimulated and under-stimulated impacts functioning (including sexual functioning).   Over the years I have worked with several individuals with ADHD and couples who are surprised, and then relieved, to know that their neurodivergence is showing up in the bedroom.   Surprised to learn that what they assumed was low desire, sexual anxiety, or the tendency to end up in a big fight – make up sex cycle, is actually a factor of their uniquely sexy brain.  And relieved because, more than half the battle is figuring out the root of the issue, after that point effective strategies are plentiful. 

 A recent review of the literature, folks with ADHD showed that they have more sexual desire, masturbate more frequently, and have less sexual satisfaction and more sexual dysfunction, such as issues with arousal, erectile function, and orgasm.  Which means that folks with ADHD are more likely to seek out sex or sexual play, and less likely to enjoy it. How frustrating!

 Why is this?  Well, as aforementioned,  managing ADHD often means getting really good at finding the sweet spot between over-stimulation and under-stimulation – as either state can lead to disinterest, a strong emotional response, anxiety, and/or a range of other cognitive, emotional or physiological outcomes.  Sex poses a particular challenge because good sex is often about being present and attending to sensations as they come up.  For some folks with ADHD, there can be moments where there is too much stimulation (touch, sounds, smells, tastes) happening at once, leading them to become emotionally activated and less present.  For other folks, ADHD can lead to becoming under-stimulated during sex – sex play starts to feel routine and habitual – leading the mind to wander and arousal to wane.

 This is not bad news!  It just means that folks with ADHD can use their strengths, such as creativity, innovation, focus, and the ability to be spontaneous, to help them have the sex lives they desire.   With the right mix of self-awareness building, key strategies, and communication, good sex is possible for everyone.

 Here are some helpful strategies for approaching sex through a neurodivergent lens:

 Be Mindful:

 Yet again, mindfulness shows us how effective it is in helping us navigate life challenges.  As with any change process,  self-awareness is key to helping those with ADHD meet their unique needs in and out of the bedroom.  Mindfulness is the process of becoming present with an accepting attitude,  and observing what is there.  Once we know what is arising for us, it becomes so much easier to work with it (rather than against it, which is what we do by default when we are not mindful). When it comes to sex, mindfulness helps folks with ADHD start to notice the sensations (physical, mental, emotional, etc.) related to their own sexual response.  It also helps them either attend to stimulation (touch, taste, sounds, smell, sights) to help them become more stimulated and aroused.  Or, conversely, to attend more to sensations that will help them become grounded when they are overstimulated (noticing breath, finding calm sensations in the body). 

 Use self-compassion to target shame and negative beliefs about the self

 Just as mindfulness can help the kick start the therapeutic process, self-doubt and self criticism halts it.  For folks with ADHD, shame around sexual and relationship difficulties can make it hard to learn new responses.  Which makes total sense, no one likes the feeling like they are not connecting with their partner, or often getting themselves in trouble for just being themselves (i.e. having a hard time with time management, communication, and coping with boredom).  Self-compassion is often called the antidote to shame, as it helps us treat ourselves with kindness, embrace our quirks and neurodiversity, and create healthy (and sexy) behaviours.  In fact, over the years of working with folks on their sex lives, I have started to believe that self-compassion is not just the antidote to shame, but also a powerful aphrodisiac! Self compassion is sexy. Check out our mindfulness and self compassion resources here.

 Get curious about the context and stimulation that works for you:

 For folks with ADHD, knowing what environments and sexual stimulation works for you is important.  Paying attention to the context (i.e. time of day, room of the house, time of week) and the stimulation (i.e. erogenous zones, pressure, texture and temperature associated with touch, lingerie, visual stimulation, etc.) that helps folk with ADHD get an stay in a zone of optimal sexual stimulation, can make all the difference in one’s sex life. 

Also using your mindfulness skills to become present with stimulation and also know what your own signs of being over-stimulated and under-stimulated. 

 Communicate ! :

 Sex is everywhere and nowhere all at once.  Most folks are having or have had sex, either with themselves or others, however it is a topic that we very rarely speak about, unless it is going well.  As they say, silence feeds shame, so the less we talk about something that is confusing, the more we end up internalizing the challenge and blaming ourselves (or others) for it.  Communicating about sex with your partner, or through a therapist if it feels awkward to navigate the conversation together at first, helps to normalize challenges and get you both on the same page.  Some keys to positive sexual communication when you have ADHD include, starting by talking about what is working and what you like and making request based on that information. Getting curious, focusing on the positive, and making requests all help you communicate about sex and your ADHD.

 For help navigating ADHD and sex, book an appointment with one of our skilled therapists in Vancouver or Montreal.