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The ADHD-Pain Link in Women

Oct 22, 2024

As an adult woman navigating life with ADHD, you’re probably familiar with the challenges of managing attention, focus, and impulse control. But what if, on top of all that, you’re also dealing with chronic pain?

The combination of ADHD and chronic pain can create a unique set of struggles that many women face but few understand. At the heart of these challenges is something called the Default Mode Network (DMN) — a key player in how the ADHD brain works, and a factor that can make managing both ADHD and chronic pain even more difficult.

In this post, we’ll dive into the science behind the DMN, how it works in the ADHD brain, and why understanding it could hold the key to better managing your symptoms of both ADHD and chronic pain.

The Default Mode Network (DMN)

The Default Mode Network is a group of brain regions that becomes active when your mind is at rest — when you’re not focused on a task, and instead might be daydreaming, mind-wandering, or thinking about yourself.

In a typical brain, the DMN shuts off when you switch to a task that requires focus or attention. This allows your brain to concentrate on external activities like working, reading, or solving problems.

However, for individuals with ADHD, especially women, this switch between the DMN (resting mode) and task-focused networks often doesn’t happen as smoothly. The DMN can remain overactive, even when you’re trying to focus, leading to distractions, mind-wandering, and difficulty sticking to a task.

How does the DMN Impact Women with ADHD?

Women with ADHD tend to face a unique set of challenges because ADHD symptoms in women often differ from men. While men might exhibit more hyperactive behaviors, women with ADHD are more likely to struggle with inattention, emotional dysregulation, and internal distractions — many of which are linked to the DMN. Do any of these sound familiar to you?

Mind-Wandering and Distractibility: The overactivity of the DMN makes it harder to turn off daydreaming or self-referential thoughts when trying to focus on a task. You may find yourself thinking about unrelated worries, past experiences, or future plans when you’re supposed to be concentrating on something else.
Procrastination: Women with ADHD often procrastinate, not because they don’t want to get things done, but because switching from rest mode to focus mode is a challenge. The DMN’s overactivity keeps you stuck in rumination and daydreaming, making it hard to start tasks.
Difficulty Staying on Task: Even when you finally start working, the DMN can creep back in, pulling you away from the task at hand. This leads to difficulties with sustained attention and productivity.

For women, this often comes on top of the societal expectations to multitask and balance multiple roles, such as caregiving, professional responsibilities, and managing the home — all of which can further exacerbate ADHD symptoms and mind-wandering.

ADHD, the DMN, and Chronic Pain

If you live with both ADHD and chronic pain, you might find that the two conditions seem to feed into each other, making life even more challenging. Here’s how the DMN might be contributing to both:

DMN and Pain Perception: The DMN is linked to self-referential thinking — thoughts about yourself and your body. When you’re in pain, your brain often becomes hyper-aware of those sensations, and the DMN can heighten this awareness, making you focus more on the pain.

Example: Have you ever found yourself constantly thinking about how much your back hurts while trying to work or do daily activities? That’s the DMN keeping your brain focused on the pain, even when you want to focus on other things.

Emotional Dysregulation: Both ADHD and chronic pain can cause emotional ups and downs. When your DMN is overactive, it can lead to rumination — constantly thinking about the pain, how much you haven’t accomplished, or worrying about your future. This can contribute to feelings of depression or anxiety, which are common in both ADHD and chronic pain.
Distraction from Discomfort: For some, chronic pain and ADHD lead to impulsive behaviors or self-medicating to escape the discomfort. When your mind is constantly bouncing between pain awareness and distraction, the DMN’s activity can make it difficult to stay present in the moment, worsening both the pain and your focus.

Managing ADHD and Chronic Pain by Addressing the DMN

Understanding how the DMN affects your ADHD and pain management can help you develop strategies to reduce its negative impact. Here’s how you can take the DMN into account and regain control:

1. Time-Blocking and Structured Routines

One of the biggest challenges for women with ADHD is managing distractions. By using time-blocking techniques, you create structured periods for focused work and rest. This method can help reduce the intrusion of the DMN during task-focused times by providing boundaries that your brain can follow.

Tip: Try the Pomodoro Technique, where you work for 25 minutes, take a short break, and repeat. During the break, allow your DMN to activate, but when it’s time to work again, refocus on the task.

2. Mindfulness to Counteract the DMN

Mindfulness exercises can help increase awareness of when your DMN is taking over, especially during moments of pain or distraction. Practicing mindfulness regularly trains your brain to come back to the present moment and gently refocus on your current task, reducing the negative impacts of both ADHD and chronic pain.

Tip: Start with short mindfulness sessions (even 5-10 minutes) to calm your mind and reduce mind-wandering. Apps like Focused Space or Insight Timer can help guide you through this process.

3. Use Movement and Breaks Wisely

Women with ADHD often benefit from regular movement breaks to help reset brain activity. Physical activity can help reduce the overactivity of the DMN by releasing energy and encouraging the brain to switch into task-focused mode. For chronic pain, movement can help reduce discomfort and provide relief, but it’s important to find activities that don’t aggravate your pain.

Tip: Every 30-45 minutes, take a short break to stretch, walk, or engage in light exercise. This helps both your focus and your pain levels.

4. Mindful Pain Management

Chronic pain can trigger the DMN, making it difficult to focus on anything but the pain. Learning mindful pain management techniques can help you become aware of how pain intrudes on your thoughts, allowing you to redirect focus when needed.

Tip: Practice body scans to gently acknowledge your pain without allowing it to take over your entire awareness. Guided meditations for pain management can help reduce the emotional reactivity associated with chronic pain.

5. Use External Reminders and Tools

Since the ADHD brain has trouble managing transitions between rest and task mode, external tools can help keep you on track. Timers, apps, and visual cues can provide the structure needed to stay engaged with tasks, minimizing DMN overactivity.

Tip: Use tools like Focused Space, Freedom, Time Timer, BrainFM, or simple alarms to keep yourself accountable and redirect focus when your mind starts to wander.

Final Thoughts

The Default Mode Network plays a significant role in how women with ADHD and chronic pain experience the world.

By recognizing how the DMN contributes to distractions, mind-wandering, and heightened pain awareness, you can implement strategies that help you manage both your ADHD symptoms and chronic pain more effectively.

Through mindfulness, structured routines, and regular movement, you can reduce the DMN’s overactivity and regain control of your focus, productivity, and overall well-being.

Remember, understanding your brain is the first step toward empowering yourself to live more fully — despite the challenges of ADHD and chronic pain. You’ve got this!

— Rebecca Stein

Rebecca Stein is a focused space partner, and Licensed Psychotherapist & ADHD Coach who provides thorough diagnostic evaluations, executive function coaching, and customized individual and couples therapy. She has had the privilege of helping clients at UCLA Medicine, The Pain Psychology Center, and Edward Hallowell ADHD Center. Learn more about working with Rebecca on her partner profile.