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ADHD and Risk of Self-Harm

Attention Deficit Hyperactivity Disorder or ADHD for short, is a neurodevelopmental difference in the way the brain functions. There are three underlying sets of symptoms that people with ADHD experience, which are inattentiveness, hyperactivity and impulsivity. People with ADHD can experience some or all of these symptoms, which can be mild, moderate or severe (see ‘What is ADHD?’ for more information). 

Research indicates that adults with ADHD face a significantly increased risk of suicidal behaviour. Studies suggest that people with ADHD are around five times more likely to attempt suicide compared to those without ADHD. Among women with ADHD, approximately one in four reports having made at least one suicide attempt, while men are statistically more likely to die by suicide. There is also a higher incidence of accidental death for people with ADHD.

Risk due to Impulsivity

Impulsivity, which is a core feature of ADHD, can contribute to these risks. In some situations, people may act quickly on distressing thoughts without pausing, leading to unplanned or impulsive behaviours. It is important to remember that thoughts of self-harm or suicide are often temporary, even though they may feel overwhelming in the moment. With time and support, these feelings can lessen and pass. Low mood leading to symptoms of depression are also a central part of suicidal thoughts and intent (please see ‘Managing Mood with ADHD’ for more information). 

Factors which may increase vulnerability

The reasons behind increased suicide risk in ADHD are complex and multifaceted. A number of contributing factors have been identified, including:

• Differences in judgement and decision-making, such as difficulties in underestimating the potential risks of making a decision.
• A tendency towards risk-taking behaviours.
• Impulsivity: reacting and responding to intense feelings before having a chance to pause and think more carefully.
• Additional challenges with emotional regulation,
• Involvement with the criminal justice system or difficulties with authority.
• Barriers to engaging with treatment, support services, or self-help strategies
• Lower educational attainment (not linked to intelligence but due to difficulties related to a lack of reasonable adjustments at school to ADHD) which may lead to poor self-esteem and thoughts or worthlessness.
• Exposure to early life adversity or trauma (for example, witnessing domestic violence in childhood).
• Higher rates of physical health problems and difficult life circumstances (such as chronic pain, smoking, or financial hardship).
• Hormonal changes, particularly in women.
• Problems with the ADHD brain use of dopamine, the brains feel good chemical dopamine functions differently in those with ADHD.
• A history of substance use, including alcohol use which can significantly increase risk.
• The presence of other mental health conditions, such as depression or anxiety, which are strongly linked to suicide risk.

Recognising Early Warning Signs

For individuals with ADHD, it is important to stay alert to certain thoughts, feelings, and behaviours that may signal an increased risk of self-harm or suicide. Being able to recognise these early indicators, whether in yourself or someone else, can make it easier to seek support in time.

Some key signs to be aware of include:

• Persistent or recurring thoughts about suicide.
• Talking about wanting to die or expressing intentions related to ending one’s life.
• Some may get the financial or other areas of their life in order.
• Sudden and unexpected increase in positive mood.
• Misuse of alcohol or drugs.
• Feeling like a burden to others.
• Experiencing strong feelings of worthlessness / hopelessness.
• A sense of isolation or not belonging anywhere.
• Ruminating on the past or, common in post diagnosis of ADHD.
• Previous suicide and self-harming attempts.

Looking After Yourself

Using self-help strategies can be an important first step in managing difficult moments. One particularly useful tool is creating a personalised safety plan. The Samaritans website offers a free template that includes prompts to help you reflect on your thoughts, identify warning signs, and outline practical steps you can take if you begin to feel overwhelmed. See ‘help someone create a safety plan’ go to: www.samaritans.org 

It’s a good idea to keep your safety plan somewhere easy to access so that you can refer to it when needed. Sharing it with someone you trust such as a friend, family member, or professional can also be beneficial, as it allows them to better understand how to support you. Having something structured to follow may also help shift your focus during distressing moments.

Seeking professional support

Your local NHS trust has a number of services that can work with you. If you are unable to know where to start, you may want to start by booking an appointment with your GP. If it is the weekend and you need is more urgent, please see below for a range of support to help you, which you can access straight away. 

Urgent mental health support

If you are not in crisis now, it can be helpful to keep a list of support services in a place where you can easily find them. Or program them into your mobile phone. 

These may include:

• See your local GP in first instance
• NHS 111, option 2 for mental health support
• NELFT 24/7 Mental Health Crisis Assessment Hub 
  Telephone: 07926 703715 
  Walk in, Block 8, Goodmayes Hospital, Barley Lane, Ilford IG3 8XJ

Emergency services: Call 999 if you are in immediate danger or need urgent help.

Considering medication

Medication is one possible option, but it isn’t suitable for everyone. It’s important to think about how ADHD affects your wellbeing and daily life. If it seems appropriate, you will be offered an appointment to discuss medication in more detail. It may be found combination of ADHD medication and anti-depressants may be required. However, the adult ADHD service is able to offer other interventions, from more practical help to adapted talking therapies designed with ADHD in mind.

Other Adult ADHD service support

Please consider evidence-based treatments. If your find your inattentiveness, hyperactivity-impulsivity causes significant problems with daily functioning across different areas of your life leading for low mood or depression. You may want to consider:

• Adapt ADHD medication assessment (if not already prescribed).
• CBT for ADHD, available for those with depression and anxiety in your local NHS trust NELFT.
• ADHD coaching, for those who want to focus on practical problems due to inattentiveness.
• Occupational Therapy for developing strategies for work or education.

We have a range of professionals who form the multidisciplinary team who can support you. We offer support from ADHD coaches and specialist occupational therapist, to help with the practical difficulties throughout the diagnosis processes. We have medical staff such as specialist nurses, psychiatrists and pharmacist, who will support you with the diagnosis, and if you decided to take medication. Finally, we have psychology staff, which includes assistant psychologist, practitioner psychologists and cognitive behavioural psychotherapist, to help support you with your mental health needs. The multidisciplinary approach allows the service offer tailored support for your current needs, now and into the future.

NHS Adult ADHD Service and national support

Once accepted onto the adult ADHD service, you will receive an initial triage assessment. At the stage you will have a chance to discuss any concerns about risk to yourself. We can provide you with, if required, more immediate support from our NHS crisis services and mental health wellness teams. Difficult thoughts about harming yourself or ending your life can feel intense, but they are often temporary. With time, support, and the right help, these feelings can change and become more manageable.

National support

Stay Alive app: A suicide prevention resource available to download

CALM (Campaign Against Living Miserably): Visit thecalmzone.net for guidance and support

Papyrus HOPELINE UK – For young people under 35, telephone: 0800 068 4141, and text: 07860 039967

The Listening Place – Suicide Prevention, telephone: 020 3906 7676,

The mix (support service for young people aged 25 and under): 08088084994

The silver line (support for adults over the age of 55): 0800 995 1000