It was fairly easy to stomach an ADHD diagnosis when I was 15. It gave me a scapegoat for my disorganized thoughts, messy room, and the anxiety that amplified the sound of synthetic basketball shorts shaking against someone’s knee during a standardized test. But one thing I couldn’t foresee was how my sexual behavior, identity, and ability to communicate intimacy would be directly tied to my disorder. Upon diagnosis, I tried managing it with Adderall and Concerta—both common medications for ADHD—and I experienced debilitating side effects with both. Since then, I manage it with natural stimulants and a great deal of patience. But it hasn’t been easy.
According to studies from the Mayo Clinic and ADHD educator Gina Pera, ADHD can cause restlessness during sex, hyperactive movement, an inability to relax, hypersensitivity to touch, sexual impulsiveness, struggles with prioritizing sex over other activities, and a reluctance to initiate sex. These can manifest in a variety of ways for each person; the key is learning to manage them.
Dealing With Distraction
For me, initiating sex at all sometimes comes with a heavy amount of bargaining, regardless of how high my sex drive is on a given day. I’m constantly trying to manage the tasks or errands that lose priority during sex, because no matter how trivial the task may be, it demands a fraction of attention until it’s taken care of. This makes it hard to forget about returning a phone call or prepping dinner when trying to devote your attention to someone else intimately.
Experiencing distraction during partnered sex isn’t unique to me. “My ADHD definitely presents as an inability to focus during sex with a partner, so if a distracting thought pops into my head, it makes it all the harder to re-focus on the task at hand,” said 24-year-old Izzi from L.A. “A distracting thought could be anything from ‘Wow they’re so beautiful’ to ‘Oh that tickles!’ which may seem like no distraction at all, but my thoughts can spiral in milliseconds with no return in sight.”
I couldn’t reach an orgasm during partnered sex without having a visual aid playing on loop in my head.
Izzi also sometimes fixates on making their partner climax. “If I slip into a hyper-focus on trying to relax or on helping my partner climax, I could lose my own ability to do just that in a reasonable amount of time,” they said. “When letting go of climax-oriented sex, there is nothing wrong unless you have the desire to cum, which can make this is a frustrating process.”
Relying on Visual Anchors
When I was younger, I was more vocal about sex than my peers. I took an interest in porn at an extremely young age. I often was looking for some sort of sexual stimulus in the form of a movie, website, or a long chat with someone who could match my fixation and horny compulsions on a conversational level.
This fixation on sex conditioned me to feel completely unable to reach an orgasm during partnered sex without having a visual aid playing on loop in my head. I started engaging in partnered sex at 17, and it initially came as a huge surprise that—while I wanted to be physical with my partner, and I knew I felt sexually aroused—I couldn’t reach an orgasm without a visual in mind. This led to a lot of confusion as to what my sexuality was, making me question why it was that I could feel so deeply about my partner but not fully give myself to them during sex because my mind had to fixate on an external scenario that they weren’t a part of. Now that I have a stronger understanding of my own ADHD, I recognize that I was relying on porn because it helped quiet the scattered thoughts that I was worried would take me out of the moment, and it served as a clear path to completing the task at hand: an orgasm.
Last year, I reached out to sex educator Lola Jean for some insight on how I could manage these fantasies and help me remain in the moment. Her response was that this is a normal, knee-jerk compulsion for having relied so heavily on visuals during climax-oriented sex. She suggested incorporating my partner and myself into those fantasies; if I can’t finish without them, try to become part of them.
“I love to embrace my ADHD and use it as my superpower. I think in my sex life it helps me relax and be more creative with myself and my partners.”
This sometimes means fantasizing about an erotic video but re-casting it in my head so that my partner and I are the actors. Other times, it means visualizing whatever we’re physically doing from the perspective of a voyeur. This allows me to see what’s happening from every angle as opposed to trying to rely only on sensation and a limited POV. I’ve found this has given me a much stronger sense of agency when engaging with my partner, as these visuals work to lock my attention onto the moment and help to create a more engaging sexual experience than what I was once accustomed to.
Learning to Accept ADHD Symptoms—And Even Appreciate Them
While some may find their symptoms to be a set of hurdles, others have found liberation because of them. M from Chicago has learned to embrace their ADHD since going off their medication after 14 years. While on the meds, M had a hard time feeling sexual, but after they went “cold turkey,” they started to enjoy sex more and could achieve orgasm more easily.
“I love to embrace my ADHD and use it as my superpower,” they told me. “I think in my sex life it helps me relax and be more creative with myself and my partners. I’ve found a lot of comfort in rope play and BDSM. I think it gives a sense of security and a physical manifestation of the medication I was on for so long, without inhibiting my sex drive.”
As for me, I’ve come to understand that relying on visuals is not an indication that I’m not attracted to my partner. They merely serve as an anchor for my thought processes, allowing me to focus on the moment because—once derailed—it becomes exceedingly difficult to lock back in again. Similar to the Adderall and coffee I’ve used to manage ADHD in the past, these fantasies are not distractions; they’re stimulants. They help me stay on track, not drift out.
It can feel daunting trying to seek explanations for a behavior that you don’t fully understand. But it helps to find a community of people who have been dealing with similar issues, because learning through shared experience and seeking the tools to embrace my ADHD—as opposed to trying to subvert it—has helped me develop a deeper, more autonomous sexual practice. Bottom line? Fostering an open dialogue can lead to a stronger sense of solidarity, control, autonomy, and shared experience.