Why is Getting Started So Difficult with ADHD?

written by Dr. Liz Nissim, posted on Psychology Today

Do you or your child, teen, or young adult struggle with ADHD? If you answered yes, then you know that getting started can be the hardest part of getting a task or assignment done. Getting started is also known as initiation, and it is a genuine challenge. It’s not about being lazy or lacking motivation, but rather a true struggle that is linked to how the ADHD brain processes time, motivation, and execution.

If you’re a teenager, young adult, adult with ADHD, or a parent who is raising a child with ADHD, the struggle with initiation can be very frustrating and is often misunderstood.

What Is Initiation?

Initiation is the ability to begin a task or activity independently. For people with ADHD, there’s a gap between wanting to start and actually starting. This is not caused by a lack of desire, but rather by neurological differences that affect dopamine regulation. Dopamine regulation impacts time perception and prioritization, which are the precursors to initiation, or getting started (MacDonald, Kleppe, Szigetvari, Haavik, 2024).

What does that end up looking like?

• Feeling “stuck” even when you know what you need to do and how to do it.
• Staying away from tasks that feel or look too large or boring, or that will take a long time.
• Needing an absolute deadline or that “last-minute rush” to actually get things done.
• Getting overwhelmed by having to make decisions.
• Not knowing how or where to start.

This can result in procrastination, low self-esteem, and a cycle of shame. From the outside, it looks like nothing is getting done. On the inside, there is a battle being fought.