For some women with ADHD, people-pleasing is more than just being nice. It’s a way to cope with feeling overwhelmed or misunderstood. In this episode, Dr. Monica Johnson breaks down what people-pleasing looks like in women with ADHD. Find out how this coping mechanism can impact your life. And learn helpful strategies to stop people-pleasing and live a healthier life.
For some women with ADHD, people-pleasing is more than just being nice. It’s a way to cope with feeling overwhelmed or misunderstood.
In this episode, Dr. Monica Johnson breaks down what people-pleasing looks like in women with ADHD. Find out how this coping mechanism can impact your life. And learn helpful strategies to stop people-pleasing and live a healthier life.
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Timestamps
(00:00) Intro
(00:39) What does people-pleasing look like in ADHD?
(2:48) Why ADHD leads to people-pleasing
(4:31)The hidden costs of people-pleasing
(7:10) Tips for managing people-pleasing
For a transcript and more resources, visit the MissUnderstood: ADHD in Women page on Understood.org.
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(00:00) Intro
Dr. J: Here's a question you might not have asked yourself: What if your people-pleasing isn't just a personality quirk, but actually a coping mechanism? For women especially, ADHD often hides behind a mask of being agreeable, helpful, and overly accommodating. This is "ADHD, And," where we talk about everyday life and ADHD. I'm your host, Dr. J. I'm a licensed psychologist who works with people with ADHD. Today, we're talking about ADHD and people-pleasing.
(00:39) What does people-pleasing look like in ADHD?
Dr. J: So what does people-pleasing look like when ADHD is involved? People-pleasing isn't just about being nice. In ADHD, it often shows up as a survival strategy, shaped by a nervous system that is sensitive to rejection, a brain that chases rewards to keep momentum, and executive functions that make conflict resolution and planning feel like an impossible task. Here are some examples:
The first is saying yes fast and regretting later. The intention is generous. The time/energy math hasn't been done yet. And prospective memory, which is remembering to remember, and time estimation is difficult with ADHD. So declining in the moment is hard.
Number two is over-apologizing and over-explaining. If you've gotten a lot of negative feedback growing up, things like, "Oh my God, you forgot again," or, "Why can't you just," dot-dot-dot, you know what I mean, fill in the blank for your lived experience. If you've had those things happen, you may preemptively apologize to avoid more criticism.
Next is perfectionism as camouflage. And I'm not talking about the classic meticulous kind, but the, "let me over-deliver so nobody notices when I'm late to the appointment or I forget something." That can look like staying up until 2 a.m. polishing something that was good enough hours earlier.
Number four is conflict avoidance. When you're flooded, some folks default to people-pleasing to get the stress to stop. It's less a personality trait than an immediate nervous system down-regulation move.
And lastly, role-shifting in different spaces. Women with ADHD often mask their symptoms, overcompensating with warmth, helpfulness, and emotional labor because assertiveness risks stereotypes. For example, the whole trope of "angry Black woman."
(2:48) Why ADHD leads to people-pleasing
Dr. J: Now let's get into why ADHD turns up the volume on people-pleasing.
First is emotional dysregulation and rejection threat. Many people with ADHD experience big, fast emotions and a heightened sensitivity to criticism. Generally speaking, research shows greater irritability and difficulty recovering after negative cues for people with ADHD. Avoiding disapproval can quickly become the path of least resistance.
Number two is reward and punishment learning differences. ADHD brains are more responsive to immediate rewards than delayed rewards. So a quick, "Thank you, you're awesome, you're a lifesaver," has much more of an impact than motivating someone over the long-term benefits of a boundary. So what happens is "yes" becomes your default.
Number three is executive function load. Saying no requires forecasting, prioritization, and emotion management, three things that are already heavily taxed in ADHD. So in the moment, "yes" simply feels easier.
And lastly, I want to talk about social history. Many patients have a long trail of micro-failures. So these are things like missed deadlines or forgotten birthdays and grew up being labeled as lazy or inconsiderate. People-pleasing can be a repair strategy. For example, if I'm extra helpful, you'll see my heart and not my mistakes.
(4:31) The hidden costs of people-pleasing
Dr. J: People-pleasing might feel like you're keeping the peace, but it's actually costing you. Let's break it down because these habits have likely been quietly depleting you for years.
Number one is emotional burnout. When you're constantly prioritizing other people's needs over your own, your emotional reserves get tapped out. ADHD brings a higher baseline of emotional intensity and a slower recovery after stress. People-pleasing piles on chronic micro-stress. Every "yes" that should have been a "no" is a little betrayal of the self. Over time, this leads to irritability, resentment, and maybe even low-grade depression. Not because you don't love people, but because you've been loving them at your own expense. My mother always had a great saying that I use in my life: "I love you. I don't love you to death." This is all to say that there are times where it makes sense for you to be number one on the call sheet.
Number two is suppressed anger and resentment. When you can't express what you truly feel, whether it's because you're afraid of being labeled as difficult or because you literally didn't realize you had a choice, anger doesn't just disappear. It sits in your body, sometimes leaking out as passive-aggressive comments, procrastination, or physical symptoms. For women, there's the added tension of stereotype threat. Being assertive can be misread as aggressive, which makes suppressing feelings feel safer, even though it's costly.
Number three is increased ADHD symptoms. Ironically, people-pleasing can worsen ADHD challenges. Overcommitting leads to overload, which makes it harder to focus, plan, and remember things. This means more mistakes, which can trigger more self-criticism, which can push you right back into overcompensating and saying yes to prove yourself. It's a very vicious cycle.
Number four is physical health strain. Chronic stress from overextending yourself keeps cortisol levels elevated. Long-term, this is linked to poor sleep, immune suppression, higher blood pressure, and weight changes. Basically, your body starts to file formal complaints.
Number five is boundary breakdowns in relationships. People-pleasing may feel like it's keeping your relationship smooth, but it often builds hidden tension. Over time, others may expect constant availability or start taking your yeses for granted. Meanwhile, you feel unseen or undervalued because they're responding to the role you play, not your actual needs. This is how some ADHD folks end up in relationships, partnerships, or work relationships that feel lopsided and draining.
(7:10) Tips for managing people-pleasing
Dr. J: Now let's share some effective strategies. I talk a lot about kindness and what it really means with my patients. So a common question that I get is, what is the difference between kindness and people-pleasing? Kindness respects both people's needs. People-pleasing quietly sacrifices yours. Did you consider yourself, what you have going on, or what your needs are prior to agreeing? If not, you're probably doing some form of people-pleasing.
Now, it would be selfish to only consider your needs. Depending on the situation, you may consider someone else's needs more, equally, or less than your own. If my close friend lost a parent and needed me for support, then it's likely I'm going to drop everything, even if it's inconvenient for me or it requires some level of problem-solving. However, if I were truly busy and my friend wanted me to take them to the airport, but they have other reasonable options, I may say no in that instance because it makes more sense for me to prioritize myself and my work. You want to start practicing being kind over people-pleasing.
Next is to pre-decide your default nos. So I want you to write out a few rules that you can follow under stress that match your system. For example, I have a rule where I don't hang out after work unless I have advanced notice or it's a special occasion. The reason I have this rule is I'm extremely introverted, and I work in a profession where I spend my entire day talking with and helping other people. After work is very precious to me, and I definitely prioritize my needs so I can prioritize my patients the following day. Pre-decisions reduce working memory demands and make in-the-moment boundaries much easier.
Number three is to use a pause script. And what I mean by that is you want to train some one-liners that can buy you some time. An example of this is, "Let me check in with my bandwidth, and I'll get back with you tomorrow."
The next one is to lead with body regulation first. So when you feel a physical urge to fix it or agree, treat it like a craving. Go for a walk, do some paced breathing, anything that kind of slows down your response. Emotion regulation works better before you speak than after you've over-committed.
Next is behavioral experiments. So try one small no, collect data on what actually happens, and then follow up with yourself. What this means is when you do the small no, pay attention to how others responded and how long did it take for the discomfort to go away.
Lastly is values over vibes. So what I want you to do is identify your values. For example, you may have a value around reliability, rest, or equity. Anytime you're about to say yes, check those requests against your values. If yes would violate rest and equity, for example, it's a value-based no. And values have better staying power than mood.
And I can't say this enough: When you're a people-pleaser by default, there is no such thing as a no without guilt. When you're first practicing these behaviors, they will always come with guilt. That doesn't mean that you shouldn't say no. It simply means that you're having an emotional reaction that doesn't necessarily fit the facts of the situation. Make sure to have compassion for yourself when you have that guilt because it will pass.
That's it for this episode of "ADHD, And." What's a people-pleasing habit that you're trying to break? Let me know in the comments. And if you enjoyed today's episode, check out our episode on "ADHD and Imposter Syndrome," where I break down how imposter syndrome is closely linked to ADHD and give tips on how to overcome and silence your inner critic. Thanks so much for joining me on this episode of "ADHD, And," and I'll see you next time.
"ADHD and" is produced by Tara Drinks, with video by Calvin Knie. The show is edited by Alyssa Shea.
Our theme music was written by Justin D. Wright. Andrew Rector provides production support.
Briana Berry is our production director. Neil Drumming is our editorial director.
For Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Jordan Davidson.
And I'm your host, Dr. J.