Hsp and add

Why Highly Sensitive People Have ADHD

What Is Hypersensitivity?

Hypersensitivity — also known as being a “highly sensitive person” (HSP) — is not a disorder. It is an attribute common in people with ADHD. Symptoms of hypersensitivity include being highly sensitive to physical (via sound, sigh, touch, or smell) and or emotional stimuli and the tendency to be easily overwhelmed by too much information.

What’s more, highly sensitive people are more likely to suffer from asthma, eczema, and allergies. “It’s good in some situations and not in others,” says psychologist and psychotherapist Elaine N. Aron, Ph.D., author of The Highly Sensitive Person. She believes knowing that you have hypersensitivity is important. As with ADHD, being aware of it makes you realize that you’re not alone.

What Are the Signs and Symptoms of Hypersensitivity?

After I told my younger sister, Melissa, about my ADHD diagnosis, we reminisced about our childhood. “If there were family arguments, we would think it was something little, but, for you, it was huge,” said Melissa. “Something that I considered a minor spat, you felt was monumental and earth-shattering.” It wasn’t until I was 48 that I recognized what caused me to be a drama queen: I was born with ADHD and hypersensitivity.

I first learned about the genetic nature of hypersensitivity by reading Scattered (#CommissionsEarned), by Gabor Maté, M.D., a physician and psychotherapist. “People with ADHD are hypersensitive,” says Maté. “That is not a fault, it is how they were born. It is their inborn temperament.” When I read Aron’s The Highly Sensitive Person (#CommissionsEarned), I finally recognized this sensitivity in myself. According to Aron, 15 to 20 percent of the population is born with a high level of sensitivity.

“When you know that you are highly sensitive, it reframes your life,” says Aron. Knowing that you have this trait will enable you to make better decisions. “Sensitive people have to live differently in order to be comfortable.”

[Self-Test: Could You Have Sensory Processing Disorder?]
[Additional Resource: Sensory Processing Disorder Symptom Test for Children]

Clinicians working with people with ADHD view hypersensitivity, both physical and/or emotional, as a common comorbid condition. “[People with ADHD] often are hypersensitive in one of the sensory domains: sound, touch, or smell,” says Ned Hallowell, M.D., author of Driven to Distraction (#CommissionsEarned). “My daughter with ADHD will only wear cotton, she won’t wear wool.”

I discovered that my longtime habit of fidgeting with my hair was due to hypersensitivity. I dislike the feel of hair strands tickling my face and neck, so I bunch it up in a knot. Before long, it feels like someone is driving her knuckles into my skull, just where I’ve knotted my hair. So down it comes. Then back up. And so on, throughout the day.

Other sensitivities include sounds and visual stimuli — flashing lights and moving objects. Studies suggest that those with ADHD also suffer more from asthma, eczema, and allergies — conditions of hypersensitivity — than those without ADHD.

What Is an Example of Hypersensitivity?

Prior to discovering my hypersensitivity, I perceived my overly emotional responses as a character flaw. My mom would say, “Why can’t you get on an even keel?” As a child, I didn’t have an answer. This added to my already-low self-esteem.

“Recognizing their high sensitivity can help people stop feeling bad about themselves,” says Aron.

[Free Download: Could It Be Sensory Processing Disorder?]

A friend, Denise, diagnosed with ADHD at age eight, had a similar childhood to mine. “My parents would say, ‘You need to toughen up. Don’t be so sensitive. Don’t be so influenced by what others think about you,'” says Denise. “I still find, as an adult, that if I’m fighting with peers, I immediately take their words and gestures to heart. I’m too quick to accept the nasty things they may be saying about me.”

Denise is sensitive to environmental noise. “I need to get into a forest or a quiet place every once in awhile to calm myself down. I am also overwhelmed by the constant flow of information we are bombarded with these days.”

Psychologist and ADHD coach Michele Novotni, Ph. D., says she sees higher levels of physical sensitivities and emotional reactivity in her ADHD clients than in the general population. She told me about a client whose manager made an unkind, unfair remark at work. A person without ADHD may have let the words bounce off of him, but her client, who has a high level of sensitivity, ended up in tears.

Novotni suggests that it is the tendency of people with ADHD to feel overwhelmed that leads to their hypersensitive reactions. This, in turn, contributes to their difficulty in coping emotionally. Take the routine of going to work in the morning, for example. Most people get out the door without forgetting anything, ready with a game plan for the day. Someone with ADHD, who can’t sort tasks and prioritize, feels tired and overwhelmed by the time they get to work.

“Some of my clients tell me that socializing is work,” says Novotni. “So if you think about the things that most people do for recreation as being work, you probably won’t have the resiliency to cope with other things that come down the pike. ”

Why People With ADHD Often Have Hypersensitivity

“Just as we have trouble filtering what goes out,” says Hallowell, who has ADHD himself, “we have trouble filtering what comes in. I can’t back this up with research, but in my clinical experience, and in my own life, it seems that we tend to let things get to us. We take on the experiences of others very quickly, like the insect on the leaf that takes on the color of the leaf.”

Maté explains that, if individuals with ADHD are born with a high level of sensitivity, it takes less stimulation for them to feel more overwhelmed, especially in distracting environments and dynamic conversations. Plus, the more sensitive we are, the more likely we’ll feel pain. “Emotional pain and physical pain are experienced in the same part of the brain,” he says.

Many of us have discovered positive things about living with ADHD, and a high level of sensitivity may also be used to our advantage. But like ADHD, hypersensitivity must be managed and controlled to let the positive aspects — creativity, empathy, and depth of perception — shine through. I’ve learned to do this, and so can you.

How to Treat Hypersensitivity

How do I cope successfully with my hypersensitivity? By following these simple strategies:

Honor your sensitivity. Don’t make yourself do things that are difficult. As much as possible, choose situations that suit your temperament. Highly sensitive people need more time than others to process the events of the day. Before you overload yourself by going out in the evening, take a few minutes to consider if you can handle more stimulation or you’ve met your limit for the day.
Step back. Allow yourself your emotional reaction to a situation, but consider that there may be other interpretations. Pause for reflection and take some deep breaths to calm down. Analyze the situation and re-evaluate it.
Block it out. To avoid sensory overload and anxiety, always have earplugs and a headset with you to block out noise.
Tone it down. If crowds and noise are problems, find venues that are quieter and less populated — a smaller grocery store instead of a major chain, for example, or a small doctor’s office located in a home instead of a large group practice at a hospital.
Reduce extraneous stimulation. Say ‘no’ nicely to things that have overwhelmed you in the past, that you don’t have to do or just don’t want to do. Identify your limits and implement them when you’re overwhelmed.
Make sure you’ve had enough sleep: Rest or take a nap before facing a situation that will be highly stimulating or after an intense one to regroup.
Use relaxation methods: Meditate, pray, or do some yoga to strengthen your ability to cope with day-to-day challenges by practicing feeling calm and learning how to recreate this sensation.

[Read This Next: Why You Feel Rejection So Intensely]

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Sensory Processing Sensitivity vs. ADHD

What is Sensory Processing Sensitivity?

Sensory processing sensitivity (SPS), or environmental sensitivity (ES), is a biologically-based trait characterized by increased awareness and sensitivity to the environment. A highly sensitive person — whether child or adult — processes sensory stimuli and information more strongly and deeply than do others. Individuals with SPS express these characteristics:

Deeper cognitive processing
More attention to subtleties
Greater emotional reactivity
Pausing before acting
Greater awareness of environmental and social stimuli, including the moods and emotions of others

What Does It Mean to Be a Highly Sensitive Person?

Researchers of various disciplines – from psychology, sociology, human development, biology, and more – have long recognized differing sensitivity levels among individuals. Dr. Elaine Aron, a clinical research psychologist who coined the term “the highly sensitive person” in her 1996 book (#CommissionsEarned), also developed a now widely used scale that measures responses to different stimuli. According to the scale, some markers of highly sensitive people (HSPs) include:

Needing to withdraw (privacy from stimulation)
Being easily overwhelmed by bright lights, strong smells, loud noises, clothing materials, and other stimuli
Being affected by other people’s moods
Feeling annoyed or overwhelmed when asked to do too many things at once
Becoming nervous when observed performing a task
Sensitivity to caffeine

A Highly Sensitive Child Scale is also available and used. This scale divides behaviors into three distinct components of SPS. Discomfort with loud noises, for example, is associated with a low sensory threshold. Nervousness when having to do multiple tasks in a short amount of time is linked to ease of excitation. Responding to pleasant stimuli, like music, scent, and scenery, is associated with aesthetic sensitivity.

[Hypersensitivity Is Real: Why Highly Sensitive People Have ADHD]

Is Sensory Processing Sensitivity a Disorder?

SPS is not a disorder, but rather an innate trait. It should not be confused with sensory processing disorder (SPD), wherein the brain has difficulty organizing and processing sensory stimuli. SPS, in comparison, is not associated with dysregulation, but with awareness, depth of processing, and needing time to process information and stimuli.

Sensory Processing Sensitivity: Prevalence and Origins

Early studies estimate that 20 percent of the population may be “highly sensitive. ”¹ Researchers sometimes refer to highly sensitive people as orchids, given the flower’s responsiveness to changes in its environment. Less sensitive people, on the other hand, are referred to as dandelions.

More recent research, however, suggests that there may be three groups of sensitive people². About 40 percent of people in this framework fall into a moderately sensitive group (tulips). Low-and high-sensitive individuals each make up about 30 percent of individuals. Research appears to be pointing to sensitivity as a continuum rather than having definitive categories. This theory encourages considering environmental factors in tandem with biology when studying how sensitivity manifests (genetic research suggests, for example, that about 50 percent of sensitivity is heritable³).

[Read: “My Socks Feel Weird!” Morning Help for the Highly Sensitive Child]

Sensory Processing Sensitivity and the Brain

Recent research points to unique neural activity among highly sensitive people.

Our 2014 fMRI study found that the anterior insula, a part of the brain associated with emotional processing and visceral sensations (like the gut feelings that often accompany empathy), shows higher activation in highly sensitive people⁴. The study, in part, had participants look and react to images of partners and strangers experiencing a range of positive and negative emotions.

The highly sensitive participants who looked at happy images of their partners, furthermore, had more brain activation in areas related to bodily sensations. Seeing a partner smile, or reflecting on a partner’s happiness, led to greater activation in the ventral tegmental area (VTA), a key dopamine area of the brain also associated with motivation, energy, feelings of euphoria, and reward. Seeing sad images of their partners activated areas of the brain linked to cognitive processing, reflective thinking, and perspective.

In another study⁵, we found that highly sensitive individuals who also reported a positive childhood experience showed even greater VTA activity after seeing positive images. In response to negative images, these individuals, interestingly, showed activation in areas associated with self-regulation and cognitive processing. VTA activity, meanwhile, showed decreased activity in response to negative images for those with negative childhood experiences.

Sensory Processing Sensitivity and ADHD

Sensory processing sensitivity and attention deficit hyperactivity disorder (ADHD or ADD) do overlap in some ways. Both are characterized, in part, by emotional reactivity and overstimulation. The risk for anxiety and mood disorders is greater, especially if a sensitive person experienced a negative childhood. ADHD and SPS can also impact interpersonal and academic performance. They are, however, inherently different.

ADHD is a neuropsychiatric disorder characterized by inattention, hyperactivity, and/or impulsivity. Sensory processing sensitivity, meanwhile, is proposed to be a biological temperament trait observed in people who are more sensitive to environmental and social stimuli. A child with ADHD, for example, may display impulsivity in response to an overwhelming environment, but a sensitive child would more likely pause and reflect before taking action.

Brain activity also delineates the difference between the two. ADHD is associated with less activation in cognitive processing areas that impact self-regulation, attention, and inhibition. With SPS, there is actually more activation in these areas, along with depth of processing and empathy.

Sensory Processing Sensitivity Interventions

Despite overlapping characteristics, it is possible to have SPS and ADHD. For individuals with ADHD who suspect SPS, it is important to consider the extent and length of responses to stimuli, as well as the aforementioned core characteristics of SPS (like being reflective, more empathetic, and careful to act), especially as they may have manifested in childhood. Interventions can include:

Taking the Highly Sensitive Person Scale, also available on the LoveSmart app
Keeping calm and comfortable environments
Decreasing sugar and caffeine intake
Engaging in activities that build resilience, self-esteem, and self-regulation (e. g. meditation, yoga, and talk-therapy)

The content for this article was derived from the ADDitude Expert Webinar “Why Are You So Sensitive? Understand How Sensory Processing Sensitivity Affects the ADHD Brain” with Bianca Acevedo, Ph.D., which was broadcast live on November 18, 2020.

Sensory Processing Sensitivity: Next Steps

Self-Test: Sensory Processing Disorder (SPD) in Adults
Read: “I’m a Sensitive Woman:” ADHD Sensory Overload in Adults
Watch: Are You Hypersensitive?

View Article Sources

¹ Boyce, W. T., & Ellis, B. J. (2005). Biological sensitivity to context: I. An evolutionary-developmental theory of the origins and functions of stress reactivity. Development and psychopathology, 17(2), 271–301. https://doi.org/10.1017/s0954579405050145

² Lionetti, F., Aron, A., Aron, E.N. et al. Dandelions, tulips and orchids: evidence for the existence of low-sensitive, medium-sensitive and high-sensitive individuals. Transl Psychiatry 8, 24 (2018). https://doi.org/10.1038/s41398-017-0090-6

³ Assary, E., Zavos, H.M.S., Krapohl, E. et al. Genetic architecture of Environmental Sensitivity reflects multiple heritable components: a twin study with adolescents. Mol Psychiatry (2020). https://doi.org/10.1038/s41380-020-0783-8

⁴ Acevedo, B. P., Aron, E. N., Aron, A., Sangster, M. D., Collins, N., & Brown, L. L. (2014). The highly sensitive brain: an fMRI study of sensory processing sensitivity and response to others’ emotions. Brain and behavior, 4(4), 580–594. https://doi.org/10.1002/brb3.242

⁵ Acevedo, B. P., Jagiellowicz, J., Aron, E., Marhenke, R., & Aron, A. (2017). Sensory processing sensitivity and childhood quality’s effects on neural responses to emotional stimuli. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 14(6), 359–373.

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IgG antibodies to heat shock protein (HSP-60) Chlamydia trachomatis

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MAINPACK INDUSTRIAL HSP-12 Stapler

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