Find a therapist to help with ADHD

Polyvagal theory links autonomic states to ADHD perceptions and behaviors.

Emotional contagion heightens ADHD awareness and stress.

Managing dorsal vagal collapse involves rest and activities for regulation.

Polyvagal theory, introduced in 1994 by psychologist Stephen Porges, highlights the role of the autonomic nervous system in regulating our health and behavior. Our lived experience of engaging with the world is impacted by external environmental cues, internal physical sensations, and relational experiences (e.g., an impression of connection, safety, and trust between individuals). Neuroception is our body's unconscious surveillance system that shifts us into one of three autonomic states needed to respond to a situation: rest-and-digest (social and safe), fight-or-flight (mobilization), or shutdown/collapse (immobilization).

The ventral vagal state is associated with a sense of safety and calm. When we are grounded in our ventral vagal pathway, we are at our greatest capacity for connection. The following vignette is a commonly reported ADHD perception associated with feeling grounded in a ventral vagal state of safety and homeostasis (i.e., characterized by feeling grounded, mindful, curious, and collaborative).

"When I am in a ventral vagal state of regulation, I have a baseline of energy to enjoy doing what I love. I rediscover my love of learning and creativity. I have an urge for social engagement. I feel present in the moment. I feel hopeful."

"When I am in a ventral vagal state of regulation, I have a baseline of energy to enjoy doing what I love. I rediscover my love of learning and creativity. I have an urge for social engagement. I feel present in the moment. I feel hopeful."

Sympathetic mobilization activity increases when you are stressed, physically active, or if there is a perceived threat. Many of the mechanisms required to intuitively tune out environmental distractors, control impulses, and sustain attention are dysregulated in ADHD. Neurodivergent people are susceptible to emotional contagion (the tendency to absorb, catch, or be influenced by other people's feelings) and can distinguish very subtle clues that others would not. This can be an overwhelming experience that can lead to a hypervigilant, alarmed state (i.e., the body's sympathetic nervous system is activated). The following vignette depicts commonly reported ADHD perceptions associated with a perpetual state of exhaustion and chronic levels of stress.

"When I am experiencing a heightened state of anxiety (mobilization) I feel a sense of urgency, like time is running out. I worry about what needs to be done and I feel distressed by my to-do lists. I experience survival mode thinking and an overwhelming sense of responsibility. I am hyper-focused on productivity, often at the expense of my own needs."

"When I am experiencing a heightened state of anxiety (mobilization) I feel a sense of urgency, like time is running out. I worry about what needs to be done and I feel distressed by my to-do lists. I experience survival mode thinking and an overwhelming sense of responsibility. I am hyper-focused on productivity, often at the expense of my own needs."

If the sympathetic system is too aroused, dorsal vagal activation triggers your body to move into a state of shutdown. The autonomic state of a dorsal vagal collapse helps to protect against life threat by immobilizing (in this state, the parasympathetic system is activated). During immobilization, our metabolism slows down, our heart rate and breathing slow, and blood pressure drops, which can present as fatigue and brain fog.

The following vignette depicts commonly reported ADHD perceptions associated with a state of collapse.

"When I experience an autonomic state of a dorsal vagal collapse, I compare myself to others. I feel like I have been left behind and I don't measure up. I feel like the world is an overwhelming place. I psychologically withdraw and detach. I can't see my way out. I experience hopelessness and I feel lost in a spiral of existential thinking (e.g., what is the meaning of life, who am I connected to, what is my purpose). I feel fatigued, numb, and I experience brain fog. I need to sleep more than usual."

"When I experience an autonomic state of a dorsal vagal collapse, I compare myself to others. I feel like I have been left behind and I don't measure up. I feel like the world is an overwhelming place. I psychologically withdraw and detach. I can't see my way out. I experience hopelessness and I feel lost in a spiral of existential thinking (e.g., what is the meaning of life, who am I connected to, what is my purpose). I feel fatigued, numb, and I experience brain fog. I need to sleep more than usual."

Polyvagal theory describes a physiological and psychological understanding of our autonomic nervous system and depicts a pathway for shifting in and out of different states. We can activate out of shutdown by engaging in activities that are regulatory (e.g., meditation, yoga, spending time in nature), rhythmic (e.g., listening to music, dancing, exercising), involve movement, and/or connection (e.g., enjoying the calming presence of my dog and reaching out for support from loved ones).

Find a therapist to help with ADHD

Environmental factors play a significant role in determining our ability to regulate our nervous system. For neurodivergent people, this is especially important. Neurodiverse minds need to rest and recharge. There are many different types of rest, including sensory, creative, emotional, and social rest. Adults with ADHD are acutely aware of their differences energetically, physically, emotionally, and mentally, giving them a remarkable view of the world.

© Psychology Today