Is It ADHD Or Dysregulation? Here's How They're Different & Why It Matters
ADHD (Attention Deficit Hyperactivity Disorder) is a brain difference that creates symptoms such as working memory struggles, overwhelm, distractibility, and poor time management skills (often called executive dysfunction). Much of the current narrative suggests that if you have ADHD, these symptoms simply come along with it. Because you’ll have this brain for the rest of your life, it is what it is.
The only thing to do is cope the best you can. Get out those water wings—as long as you don’t drown, you’re good. The trouble with our current understanding of ADHD is that the studies done on the ADHD brain don’t account for the likelihood that people with ADHD are also dysregulated. This oversight causes us to attribute our symptoms of both dysregulation and ADHD to one thing: the brain we were born with. Our struggles can feel inevitable and, frankly, hopeless.
We try so hard to stay afloat, but it can feel like a heck of a lot of work for very little reward. But once we know that both ADHD and dysregulation are contributing to our struggles, there is a lot we can work on to see profound improvement.
When we look at the symptoms of ADHD and the symptoms of dysregulation, many overlap:
- Anxiety
- Avoiding or procrastinating on tasks
- Difficulty concentrating
- Dissociating or zoning out
- Emotional dysregulation
- Extreme sensitivity to sounds, smells, textures, or sights
- Feeling fidgety or restless
- Irritability
- Lashing out
- ADHD paralysis
- People-pleasing
- Racing mind
- Trouble falling asleep or staying asleep
- Sensitivity to criticism
It makes sense that we would place the blame on our ADHD. But here’s what I’ve noticed: We attribute all of the symptoms we experience to the ADHD brain when in reality, dysregulation is contributing a lot of fuel to the symptom fire. When we are not aware of the reason for the symptoms, we cannot treat them effectively.
What does it mean to be dysregulated?
Dysregulation means your nervous system is out of balance—too activated, too shut down, or rapidly shifting between the two, often swinging from one extreme to the other. Being dysregulated can get us stuck in fight-or-flight. This is a primal survival mechanism that evolved to help us react quickly to life-threatening situations.
But, our biology hasn’t caught up with the modern world, where many of us spend our waking hours sitting at a desk or doing school pickups. We’re safe at our desk or in our parked car while being stuck in a perpetual state of looking for danger, as if we are still living in the elements, watching out for predators. This response to mental stressors doesn’t mean you think you’re in danger. It means your nervous system and subconscious don’t know the difference between the psychological stress of a long to-do list and the imminent, life-threatening danger of being chased by a bear.
When you are dysregulated, the problem is that most of the time your body thinks these mental stressors are life-threatening risks. One major stipulation I’m assuming as we move forward is that you are typically (hopefully always) in a physically safe space, which I recognize isn’t true for everyone. What I mean by “safe” in the context of this book is that for many of us living in the twenty-first century, we’re generally not at risk of losing our lives when we’re at the laundromat, fixing dinner, or preparing a PowerPoint for work.
But when we’re dysregulated, we live as if we are. In the face of danger (or perceived danger), our systems react in four different ways: FIGHT, FLIGHT, FREEZE, FAWN
- Fight We confront the threat.
- Flight We escape the threat.
- Freeze We become “paralyzed” or immobile.
- Fawn We appease the threat by accommodating the aggressor.
Fight can look like:
- Lashing out at a partner
- Being snappy with everyone
- Cursing at drivers who cut us off
- Irritability
- Impatience
When you’re in fight mode, your nervous system believes this: “What’s happening to me is life-threatening. I need to fight if I’m going to survive. So I’m fired up. I’m fierce; I’m defensive. My survival depends on it.”
Flight can look like:
- Avoiding work until the night before it’s due
- Avoiding confrontation or uncomfortable conversations, meaning a lot of loose ends out there
- Doing easier tasks to convince yourself that you’re being productive to avoid the tasks that are dysregulating
- Scrolling, spending, substance use, or any activity that allows you to escape discomfort and soothe yourself
When you’re in flight mode, your nervous system believes this: “I’m at risk, so I need to avoid this situation at any cost. I’ll check out mentally or I’ll check out physically. To preserve my own life, I have to get the hell out of here.”
Freeze can look like:
- Needing to pee for thirty minutes, but you’re not getting up to use the bathroom
- Getting trapped doomscrolling
- Being stuck in “paralysis,” like a deer in the headlights
- Thinking for forty-five minutes about needing to shower instead of getting up and doing it (or deciding not to do it)
- Thinking you must pick the exact right thing to do first, so you wind up doing nothing
When you’re in freeze mode, your nervous system believes this: “If I engage with this perceived threat, I could die. And so I’m going to lie low. If I don’t move, I’ll survive. By freezing in this way, this threat won’t see me.”
Fawn can look like:
- Never saying no when asked to do something
- Preemptively doing all the things that make those around you happy
- Thinking you need to do extra to “earn your keep”
- Being overly concerned with what other people think
- People-pleasing not having fun unless everyone else is
When you're in fawn mode, your nervous system believes this: “I feel inferior, and I don’t want people to know and kick me out of the group. Getting kicked out of the group is life-threatening. So I’m going to make myself valuable to everyone. I’ll make sure everyone else is happy at any cost, so I can stay safe.”
There’s a tendency to believe that fawning is more acceptable than fighting or freezing. We think fawning is “just being nice,” but is it? Who are we doing it for? I know we’re kind, loving people, but we’re not fawning to be nice; we’re doing it to protect ourselves. There is absolutely no shame in this (there is no room for shame in regulation work). Just be wary of normalizing fawning behaviors because they’re actually an indicator that you’re dysregulated.
Thank goodness for our ability to kick into fight-or-flight. This alarm system is a helpful one—just not when it’s going off all the time. When we’re dysregulated, it means we experience one of these four alarm systems—fight, flight, freeze, or fawn—at times when we simply don’t need to. We may gravitate to one of these or exhibit all four under different circumstances. When we’re stuck in any of these dysregulated states, it makes our ADHD symptoms worse.
The following has been excerpted from The Simple Guide to ADHD: The Secret to Finding Balance, Getting Things Done, and Enjoying Your Life (Jenna Free; Harper Collins Celebrate, 2026.)