Collective Trauma and the Clinician With ADHD
We are living in prolonged collective trauma while being expected to function as if we are not.
and clinicians with ADHD are carrying a unique and under-acknowledged load.
Violence against innocent people.
Discrimination written into policy and practice.
Threats to safety that no longer feel abstract.
Misinformation that erodes trust.
Institutional betrayal by systems meant to protect.
None of this is new. What is different is the degree to which we are constantly exposed to it, visually, emotionally, relentlessly, while still being asked to show up to work, care for others, and regulate ourselves as if this does not matter.
Our bodies and brains were not designed to move back and forth between witnessing violence, scrolling past it, and then being expected to focus on productivity, wellness routines, or the next meeting. And yet, this is where many of us are.
For clinicians and helpers, this creates a particular kind of tension that pulls at ethics, emotions, the body, the mind, and relationships all at once. For clinicians with ADHD, the difficulty shifting between these demands can be especially draining and overstimulating.
I see this tension daily in my work, and I feel it in my own nervous system as well.
This blog is written for clinicians and helpers who support people with ADHD, and who may also live with ADHD themselves. Perhaps you have noticed that you cannot do everything at once anymore, that tools which once helped feel less reliable, or that you are carrying more guilt or shame than in the past. If so, that makes sense .The details differ, but the feelings often overlap.
What follows is an attempt to speak plainly about what many are navigating, without sanitizing it and without offering easy answers.
TL;DR
We are living through ongoing collective trauma while being required to function as if we are not. Clinicians are carrying ethical strain, emotional overload, and mounting cognitive fatigue. For clinicians with ADHD, these pressures often collide with emotional intensity, executive functioning challenges, and guilt about not doing enough. These reactions reflect prolonged stress, moral injury, and systemic harm.
Ethical care right now depends on naming reality, resisting simplification, and finding ways to live and work that do not require denial or result in collapse.
Is it ethical for clinicians to stay neutral during violence, discrimination, and collective trauma?
This is a question many clinicians are wondering, whether or not it is spoken aloud.
Mental health training often emphasizes neutrality, non-imposition of values, and careful boundary keeping. Those principles matter. At the same time, much of that training has been shaped by the beliefs and safety of a few, not by the full complexity of the communities clinicians now serve.
As violence, discrimination, and threats to safety continue, many clinicians are finding that neutrality no longer feels like an ethical position. What once seemed like professionalism can begin to feel like distance, or silence, or an inability to name what clients are already living with.
Clinicians are not outside of collective trauma. We are inside it.
We sit with fear, grief, and anger in the therapy room.
We work with clients directly impacted by violence or discrimination.
We are warned against being too political and against being silent.
We are encouraged to advocate, but not too visibly.
We are asked to remain steady while the ground keeps shifting.
Ethical practice does not require constant commentary or performative outrage. It does require honesty about what is happening. When violence, discrimination, or systemic harm go unnamed, therapy can begin to feel disconnected from lived experience.
There is a real difference between ethical care and false neutrality, and many clinicians are feeling that tension sharply right now.
How does collective trauma interact with ADHD traits like emotional intensity, getting stuck in thought loops, and sensory overwhelm?
Collective trauma affects everyone, but it does not land the same way for everyone.
For people with ADHD, certain traits can make prolonged exposure to harm especially difficult to absorb. Emotional intensity means feelings arrive quickly and linger. Difficulty disengaging from distressing material means that once something captures attention, it can replay again and again. Sensory overwhelm means constant alerts, images, and information tax the nervous system. Moral sensitivity means injustice is not simply noticed, it is felt deeply.
Many people with ADHD describe getting stuck in thought loops. Headlines replay. Worst-case scenarios multiply. Connections form faster than the nervous system can integrate. Clinically, this may resemble rumination. Functionally, it often looks like paralysis, knowing something matters while feeling unable to move.
This reflects how an intensity-wired nervous system responds to unresolved threat. When guilt and shame enter the picture, questions like “Why can’t I handle this better?” or “Why am I not doing more?” the load grows heavier.
Why does executive functioning become so unreliable during prolonged periods of stress and uncertainty?
Executive functioning does not operate on its own.
Planning, prioritizing, initiating tasks, and regulating attention depend on a sense of relative safety and predictability. Prolonged stress steadily wears both down.
During extended uncertainty, many people notice worsening time blindness, difficulty holding onto positive experiences or future plans, all-or-nothing thinking, and swings between over-functioning and shutdown.
For clinicians with ADHD, this can feel especially unsettling. You may understand what is happening intellectually and still feel alarmed by how unreliable your brain feels compared to earlier stages of your life or career.
This is the nervous system redirecting energy toward vigilance and meaning-making. Expecting yourself to function as you once did, without accounting for this strain, often adds another layer of pressure rather than relief.
How are clinicians supposed to support clients while living inside the same collective trauma?
This is where many clinicians begin to feel burned out, or even break, even if it is not visible from the outside.
We can’t CBT or deep breath our way out of this collective trauma.
Supporting clients during collective trauma means holding intense fear, grief, anger, and uncertainty while navigating ethical constraints, limited resources, and conflicting expectations about what clinicians should or should not say. It happens within systems that often underfund, undervalue, or restrict care, and alongside ongoing stigma that mental health work should be quiet, contained, or apolitical.
For clinicians with ADHD, this strain can show up in particular ways. Many bring real strengths to this work: hyperfocus, high energy, creativity, deep empathy, and the ability to think flexibly in moments of complexity. These qualities can make clinicians with ADHD especially effective in crisis and deeply attuned to clients’ emotional worlds.
At the same time, those same strengths can carry a cost. Hyperfocus can turn into overextension. High energy can mask exhaustion. Creativity can be drained when there is no room for recovery. Many clinicians with ADHD push themselves to keep going, using their strengths to compensate long after their nervous systems are depleted.
The truth is more complex than either story allows.
Supporting clients during collective trauma does not require pretending you are untouched or endlessly resilient. It requires acknowledging your humanity and finding ways to practice that make sustainability possible, not just survival, for both you and the people you serve.
How do you keep living your life, finding joy, and making plans without abandoning your values?
This question is often heavy with guilt.
It can feel difficult to honor your own desires, the needs of people you love, and a sense of responsibility to a hurting world at the same time. Many clinicians with ADHD wrestle with whether enjoying life is selfish, if taking time to rest limits time for advocacy, or how to plan when the future feels unstable.
There are no clean answers, but there are anchors.
Moments of joy do not erase awareness.
Rest does not cancel care.
Engagement does not have to be constant to be meaningful.
Self-compassion supports ethical practice rather than weakening it. So do sleep, nourishment, movement, and connection. Sometimes that looks like stepping outside, turning off the scroll, or sitting quietly with a pet that does not need you to explain yourself.
Advocacy does not take one form. Sometimes it is loud. Sometimes it is quiet. Sometimes it is sustained. Sometimes it is limited by capacity. Often it is imperfect. Doing something, however small, is different from doing everything.
It can feel deeply uncomfortable to hold a desire to act with integrity alongside the reality of being human with limits. And yet, limits are part of what makes continued care possible.
In closing
This moment is complex. There is no universal script for how to live or work through prolonged collective trauma, especially for clinicians with ADHD.
If you feel more strained, more conflicted, or more exhausted than usual, that often reflects awareness rather than failure.
Ethical practice right now is not about perfect answers. It is about resisting simplification, easing shame where possible, and allowing ourselves to remain human in the presence of real emotion.
Nothing about finding this hard means you are failing at your work, or your clients.