ADHD and entrepreneurship: a gift and a burden at once

“At nine in the morning I had three new products in my head. By six in the evening I hadn’t replied to a single message that was actually urgent.”

I hear sentences like this from people who run their own companies, and they are not said with pride. They are said wearily, sometimes with a smile that covers shame. The same person who can see a solution in ten minutes at a meeting that others have missed for three months forgets at home that their daughter had a school performance today. The same mind that got the company off the ground in the first place now undermines it a little every day.

More and more often, the word ADHD comes up. Sometimes the person brings it themselves, because they read a list of signs online and recognised themselves in it. Sometimes a partner, a colleague or an investor says it, half joking. In this post I will try to set out what we actually know about the link between ADHD and entrepreneurship, why it is both a gift and a burden at the same time — and why it shouldn’t become a romantic story about geniuses who never have to clean up after themselves.

What ADHD is — and what it isn’t

ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental condition. That means two things: it begins in childhood, even if it is only recognised at forty, and it is not the result of laziness, bad upbringing or a lack of willpower. In adults it shows mainly as difficulty regulating attention (not an absence of attention), as impulsivity, and as an inner restlessness that in adults is often less visible than in children bouncing around the classroom.

A meta-analysis published in 2009 by Viktória Simon, István Bitter and colleagues estimated that around 2.5 per cent of adults have ADHD. So it is not rare — but nor is it every other person, as you might conclude from social media.

The psychologist Russell Barkley, one of the best-known researchers of the condition, likes to say that ADHD is not a disorder of knowing what to do, but a disorder of doing what you know. People with ADHD usually know perfectly well that they should hand in the report. The difficulty is that the brain doesn’t “switch on” the action until it becomes urgent, interesting or new. What falters here is what we call executive functions — planning, working memory, inhibiting responses, a sense of time.

Why people with ADHD often end up in entrepreneurship

Entrepreneurship researchers have asked whether there are more people with ADHD among entrepreneurs than elsewhere. In 2019 the psychiatrist Michael Freeman and colleagues published a study in which around 29 per cent of the participating entrepreneurs reported that they had or had had ADHD — considerably more than the comparison group. The figure needs to be read with care: the sample was not large, the data were self-reported rather than based on clinical assessments, and the participants were people interested in the topic. But the direction of the finding matches other research.

In 2016 Johan Wiklund and colleagues carried out in-depth interviews with entrepreneurs diagnosed with ADHD. They described choosing their own path partly because routine and rigid structures in employment had stifled them. In their own company they could work on whatever lit them up, and they often found more energy there than ever before. A year later, the same group found in a larger study that impulsivity in particular plays an important role in the link between ADHD and entrepreneurial intentions.

It sounds lovely. But entrepreneurship doesn’t “cure” people with ADHD. It is simply an environment that is sometimes kinder to some of their traits — and less forgiving of others.

One trait, two faces

When people talk about ADHD and entrepreneurship, they often list “superpowers”. I would like to be more precise: these are not two sets of traits, good and bad, but the same traits that turn around in different circumstances.

Hyperfocus — the state in which a person with ADHD works for hours and hours on something that interests them and forgets everything around them — can produce a prototype in one weekend. The same hyperfocus means a partner waiting with dinner, a phone ringing unanswered, and waking up after two days completely exhausted. Researchers who have only recently begun to study hyperfocus in adults with ADHD systematically stress exactly this: it can’t be steered at will. It goes where interest pulls it, not where you need it.

Impulsivity helps when you have to decide quickly amid uncertainty. But the same speed means promises made to a client without consulting the team, hires that weren’t thought through, purchases at two in the morning.

Novelty seeking opens doors that others don’t even notice. At the same time it leaves behind a graveyard of half-finished projects and a team that has learned the direction may change every Monday.

When I say this out loud, people often breathe out. Not because they are off the hook, but because they hear for the first time that their chaos is not proof that they are “really” incompetent. That talent and difficulty are often one and the same thing, seen from two sides.

The price no one sees

From the outside, an entrepreneur with ADHD often looks like someone with incredible energy. From the inside the picture is different. Many describe a constant effort to appear together: writing reminders they then forget to read, working late into the night to catch up, endlessly apologising.

Behind this there is most often shame. Adults whose ADHD was recognised late often heard as children that they were lazy, scatterbrained, that they “could if they wanted to”. That voice does not fall silent with success. It often grows louder: as the company grows, there are more and more things you can forget, and more and more people who will notice. I wrote about how shame shapes the way we see ourselves in Shame: the emotion that whispers “There is something wrong with me”.

The second hidden price is emotional intensity. Researchers, among them Philip Shaw and colleagues, have shown that difficulties with emotion regulation are common in ADHD, even though the diagnostic criteria don’t list them. Criticism from an investor that someone else would sleep off can knock a person with ADHD off balance for a whole week. The enthusiasm is big, and so is the fall.

The third price is paid by those close to them. A partner who takes over everything “boring” — bills, the dentist, birthdays — can slowly start to feel like an employee in their own home. Colleagues who pick up unfinished work get tired. And the person with ADHD feels it, which feeds the shame again.

Why this is not a romantic story

The media often run the story of a famous entrepreneur who had ADHD and succeeded precisely because of it. Stories like this have one big blind spot: we don’t hear from people with ADHD who didn’t succeed, who lost the company, fell into debt or burned out. Statisticians call this survivorship bias.

In 2021 the World Federation of ADHD, in an extensive consensus statement by experts, summarised evidence that ADHD is linked to a higher risk of accidents, financial difficulties, addiction and poorer health. I don’t say this to frighten anyone. I say it because romanticising ADHD takes away people’s right to seek help: if your condition is your superpower, then it is your own fault when it hurts you.

Rather than superpowers, I prefer to talk about neurodivergence — the fact that some brains work differently. Different is not better or worse. But it is different, and that has consequences that need to be taken seriously.

Diagnosis: who makes it and why an online test isn’t enough

An ADHD diagnosis in adults is made by a psychiatrist or clinical psychologist. I don’t make it, and nor can an online questionnaire, an article or this post. A professional assessment includes a detailed conversation about how things showed up in childhood (often with the help of parents or school reports), standardised questionnaires and — very importantly — ruling out other causes.

Attention difficulties are very non-specific. They can be caused by chronic sleep deprivation, anxiety, depression, bipolar disorder, the effects of trauma, the thyroid, or simply prolonged overload. An entrepreneur who sleeps five hours a night and has thirty open loops in their head will have trouble concentrating whether or not they have ADHD.

In Slovenia, the route to an assessment in public healthcare usually goes through your GP, who refers you to a psychiatrist if needed. If, reading this, you thought “that’s me”, it is a good reason to talk to a doctor — but not a reason to diagnose yourself. Self-diagnosis carries two dangers: you may miss something else that needs treatment, or ADHD may become the explanation for everything, including things worth looking at differently.

Decisions about treatment, including medication, are made together with a psychiatrist. It is not a subject on which it would be right for me to advise, nor one you should decide based on the experience of an acquaintance who took something before an important meeting.

What psychotherapy can offer

Psychotherapy doesn’t remove ADHD. But it can help with everything that has built up around it in the years when no one recognised it — and there is often more of that than of the condition itself.

In relational family therapy, in which I am training, we are interested in how a person learns to see themselves within the relationships they grew up in. A child who was always “the one who forgets” at home, “the one who can’t sit still”, internalises an image of themselves as a problem. As an adult they may build a company, lead people and appear in the newspaper — and still feel inside like the boy who forgot his slippers again. That inner image affects how they take criticism, how they respond to their team and how they treat their partner.

A conversation I often hear in a similar form (composite, not a real person):

“Everyone thinks I’m unstoppable. But every morning I start with the feeling that I’ve messed something up again.”
“Who first gave you that feeling?”
“I don’t know … Dad always said I had my head in the clouds. That I’d never amount to anything.”
“And now you run a company.”
“Yes. And I’m still waiting for someone to work out he was right.”

That sentence often overlaps with what I describe in Impostor syndrome: why successful people doubt themselves — except that with ADHD it has an additional, very real basis: things really do slip through. Therapy doesn’t deny those slips, but helps separate the fact (“I forgot the deadline”) from the verdict (“there is something wrong with me”).

Because ADHD affects everyone in the family, it sometimes makes sense for both partners to come to a session. In couples therapy they can talk about how the load has been divided between them, without one becoming “the patient” and the other “the carer”.

For many, it also matters that for the first time they learn to treat themselves with something other than criticism. Research on self-compassion shows that kindness towards yourself is not letting yourself off, but a precondition for learning anything from a mistake at all. More on this in Self-compassion instead of self-criticism: what Kristin Neff’s research shows.

Exercise: a map of one day without judgement

This exercise is not a test for ADHD and not a productivity plan. It is a way of observing, over a few days, how your attention really works, instead of simply judging it. It takes ten minutes in the evening.

1. Write down three moments of absorption. When today were you so deep in something that you lost track of time? What were you doing, with whom, at what time?
2. Write down three moments when something slipped. A forgotten call, a postponed task, something you started and left. Just the fact, no adjectives.
3. Next to each, add what you felt just before. Boredom, tension, tiredness, hunger, dread of the task? It often turns out that “forgetting” follows an unpleasant feeling.
4. Catch the inner voice. What did you say to yourself when you noticed the slip? Write the sentence down word for word — and then rewrite it the way you would say it to a friend who had done the same.
5. After five days, look at the pattern. Not to fix it, but to see it. If it seems important, show it to someone you trust, or take it with you to the doctor.

People are often surprised by how much of their “scattered” day is actually a response to boredom, overload or anxiety. This is information that will also be useful to a professional who may carry out an assessment.

When it isn’t ADHD — and when it isn’t only ADHD

Because this post is about ADHD, you might get the impression that every scattered entrepreneur is neurodivergent. That isn’t true. Entrepreneurship itself creates conditions in which almost anyone would behave as if they had ADHD: constant interruptions, ten roles at once, too little sleep, permanent readiness. When exhaustion builds up over a long time, it can show as forgetfulness and confusion — I describe this in Burnout is not laziness: signs your nervous system is asking for a break.

The reverse is also true. If a person has ADHD, it doesn’t mean that everything happening to them is ADHD. They may also have depression, anxiety or problems with alcohol — and all of these are more common in adults with ADHD. A diagnosis can be a relief, but it mustn’t become an excuse that closes the conversation about everything else.

And one more limit: this post is not about how to run a company. Whether you need a different organisation, an operations partner or a new managing director is not a question for a psychotherapist. My question is how you are in the midst of all this — and what happens to you when things go wrong.

If English is the language you feel most at home in, you are welcome to write to me; I work with English-speaking clients too.

What to remember

• ADHD is a neurodevelopmental condition estimated to affect around 2.5 per cent of adults — not laziness and not a character flaw.
• Research suggests ADHD is more common among entrepreneurs, but the data are limited and need to be read with care.
• The same traits — hyperfocus, impulsivity, novelty seeking — are both a gift and a burden, depending on the circumstances.
• A diagnosis is made by a psychiatrist or clinical psychologist; treatment is decided with a doctor, not on the basis of an online test.
• Psychotherapy doesn’t remove ADHD, but it can help with the shame, the relationships and the self-image that have built up over the years.