I was 16 years old when I received a diagnosis of ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). As with most investigations into persistent fatigue, a plethora of tests had taken place in an attempt to rule out other causes, yet the results consistently came back “normal”. As my mother was also living with ME/CFS (and research suggested possible hereditary/genetic links) the doctor’s conclusion was understandable.
Even then, I wasn’t sure what to believe. My mother’s experience of the condition had been much worse, leaving her unable to work – whereas I was still somewhat functioning. Fatigue wasn’t my only symptom. Concentration had become increasingly difficult, and I found myself forgetting things more often – words, belongings, appointments, homework. At times I could see how those things ticked the right boxes. Other times, I questioned whether it might be something else.
All I knew was I was tired.
All. The. Time.
Every day I would sleep on the bus to and from school, head banging limply against the window. I couldn’t bear the boredom of staying at home – my mind was too busy for that – so I dragged myself out the door, moving through each day’s activities like I was wading through treacle. Even the simplest of tasks that I saw my peers engaging in with ease felt like a tremendous effort for me – leading to many spontaneous naps under tables in empty classrooms.
For much of my teens and early 20s, I lived my life like a zombie. I tried to lean into it, even make it something quirky about myself. I embraced the image of the dopey girl with the soft, slow voice, always half-asleep and drifting off to dreamland.
It never occurred to me, or anyone around me, that I might be neurodivergent.
My ADHD diagnosis
Many years later, when I received a diagnosis of ADHD, a common sceptical response from casual acquaintances was “But you seem so calm”. Of course, that made sense from the outside. My fatigue reduced a lot of outward expressions of hyperactivity. I rarely had the energy to interrupt, or to get up and move around restlessly. I wasn’t, as so many ADHDers are described, “full of beans”.
What they couldn’t see was the never-ending activity going on inside my mind, draining my cognitive energy. The constant demand for stimulation that my exhausted body could not meet. The daily experiences of lost items, forgotten appointments, half-finished (or never started) tasks etc., that would inevitably stack up and drive me into overwhelm. There was a tug of war going on inside me at all times, but the outward presentation didn’t match some people’s ideas of what ADHD looked like.
So, out of a desire to explain this seemingly paradoxical experience, I began to examine how my ADHD and ME/CFS interact. I became curious about whether others struggled with this comorbidity and wondered how the presence of something like ME/CFS, or any other chronic condition, might muddy the waters of presenting neurodivergent traits. I even wondered if ME/CFS was the correct diagnosis, or if my ADHD brain might be the source of my fatigue itself. I dove into research mode, reading anything I could find on the subject. I joined online communities to hear others’ experiences.
One thing became clear quickly: I was not alone.
The facts and figures
As it turns out, fatigue is a much more common experience within the ADHD community than one might think. Research suggests adults with ADHD are “significantly more fatigued” with “62% meeting criteria for fatigue caseness” (Rogers et al., 2017). On the flip side, those with chronic pain/fatigue were found to be “13 times more likely to meet criteria for ADHD” (Quadt et al., 2026).
Beyond the surface, it’s easy to see why certain aspects of ADHD might impact energy by themselves – cognitive overload, sleep disruption, differences in brain chemistry, sensory overload, emotional labour. There is a great deal of overlap in symptoms of ADHD and ME/CFS, particularly inattentive type, but ADHD is rarely part of the “ruling out” phase of testing for those presenting with fatigue. For many women, the existing gender bias in research and screening tools means clinicians frequently attribute these overlapping symptoms to CFS before considering ADHD (Abe, 2026).
Some studies suggest higher inflammation plays a role in fatigue for some neurodivergent adults (Quadt et al., 2024), while others have found links to “central fatigue” – fatigue relating to the nervous system (Yamamoto, 2025) – even going as far as suggesting this may be the cause of inattentive ADHD (Yamashita and Yamamoto, 2021). The more I read, the more I could see that my experiences of fatigue weren’t something that made me an unusual case. In fact, fatigue and ADHD/CFS seemed to be inextricably linked for a lot of people.
To my surprise, there had even been attempts to treat ME/CFS with ADHD medications. In one study, about one-third of ME/CFS participants using methylphenidate showed significant improvement (Blockmans and Persoons, 2016). This has led to suggestions that “ADHD and chronic fatigue syndrome share a common underlying mechanism” (Young, 2013). Just taking a quick look at the experiences shared in the Reddit group called ADHDplusME/CFS, you will find anecdotes from individuals on both sides – some who say medication helped their fatigue, while others found it worsened it (Reddit, n.d.).
The experiences of those suffering with ME/CFS are so broad, with such a vast spectrum of severity, that it is difficult to pin down a one-size-fits-all for what will be helpful. Either way, these studies have added to a growing awareness that the old stereotypes of ADHDers are counter to many individuals’ experiences. And more importantly, that misinformation has prevented some from benefiting from the right support.
What can I do about it?
It has taken me many years of personal development – through both therapy and accessing self-help literature – to develop my own strategies for meeting my conflicting needs. It is hard to give my body the rest it needs and give my ADHD brain the stimulation it wants. I often feel like I am fighting a battle on both ends. I don’t believe there is a generic set of instructions for what will be helpful from one ADHDer to another; that is always for you to uncover.
Managing these co-morbidities side by side might mean paying mindful attention to things like pacing. It might mean working with concepts like Spoon Theory (Miserandino, 2003) to try to make realistic choices about what you can achieve. It might mean negotiating with those opposing parts, making compromises that address needs on both ends.
And it also might mean compassionately giving space to the grief, frustration and stress of living with those ever-changing, unpredictable factors that lead to a life set on hard mode.
If you think you are struggling with the intersection of ADHD and any form of fatigue, talking to a therapist who is informed about both sides of that street can be incredibly helpful – to develop personal strategies of your own, and also to be heard and understood deeply by someone who will never tip their head and say “but you seem so calm”.
References
Abe, Y. (2026). “Why many women with ADHD are misdiagnosed with CFS: The science.” Ubie Doctor's Note, 13 May. Available at: https://ubiehealth.com/doctors-note/adhd-fatigue-cfs-women-misdiagnosed-science-risk-752q4 (accessed 26 May 2026).
Blockmans, D. and Persoons, P. (2016). “Long-term methylphenidate intake in chronic fatigue syndrome.” Acta Clinica Belgica, 71(6): 407–414.
Miserandino, C. (2003). “The Spoon Theory.” Available at: https://web.archive.org/web/20191117210039/https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/ (accessed 1 June 2026).
Rogers, D. C., Dittner, A. J., Rimes, K. A., Chalder, T. (2017). “Fatigue in an adult attention deficit hyperactivity disorder population: A trans-diagnostic approach.” British Journal of Clinical Psychology, 56(1):33–52.
Quadt, L., Csecs, J., Bond, R., Harrison, N. A., Critchley, H. D., Davies, K. A., Eccles, J. (2024). “Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: A longitudinal case-control study.” BMJ Open: 14(7):e084203. doi: 10.1136/bmjopen-2024-084203.
Quadt, L., Savage, G., Bond, R., Davies, K. A., Critchley, H. D., Eccles, J. A. (2026). “Likely neurodivergence and variant connective tissue in patients with chronic pain/chronic fatigue: a case-control study.” Journal of Psychiatric Research, 197: 125–132.
Reddit (n.d.) r/CFSplusADHD. Available at: www.reddit.com/r/CFSplusADHD/ (accessed 26 May 2026).
Yamamoto, T. (2022). “The relationship between central fatigue and Attention Deficit/Hyperactivity Disorder of the inattentive type.” Neurochemical Research, 47(9):2890–2898.
Yamashita, M. and Yamamoto, T. (2021). “Core studies on central fatigue and neurotransmitter dynamics in ADHD with inattention as the main symptom.” The 85th Annual Convention of the Japanese Psychological Association, PD-097, 1–8 September.
Young, J. L. (2013). “Chronic fatigue syndrome: 3 cases and a discussion of the natural history of attention-deficit/hyperactivity disorder.” Postgraduate Medicine, 125(1):162–168.
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Published 10 June 2026
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