Does ADHD mean you can’t make decisions?
My clients often say, “I know my options, but I don’t know how to decide!”
Unfortunately, I can't tell you which choice to make.
But I can teach you a concept that will make decision-making easier and faster.
Why do we struggle to make decisions with ADHD?
One of the markers of ADHD is impulsivity [1]. So you might think we’d be confident decision-makers! However, we can struggle with self-criticism and perfectionism, both of which can make decisions harder [2,3, 4].
In addition, struggles with working memory mean that even if we've reached a decision we’re happy with, we may lose details that lead to doubt later [5].
So, how do we support ADHD decision-making?
Over the years, I've developed and tested a decision-making process designed specifically for ADHD brains.
I can’t go into everything in this article, but I wanted to share the underlying concepts below.
ADHD and the margin of error
All decisions have a margin of error.
Understanding this can be helpful when we struggle to decide which job to get or where to shop for dinner.
The margin of error is the formal statistical name for the concept of how precise and within which range the actual value of an estimate lies [6].
Now, I’m not a statistician; chances are, neither are you. So, I’m not going to go into depth about what makes an acceptable margin of error or researchers' arguments regarding its proper use (I found a surprising number of disagreements for something taught in schools) [7,8].
Instead, I want to draw your attention to the fact that even in the most complex and vital research, we understand there can be errors.
For example, research into medical treatment often has a 99% confidence interval with a 1% significance level. This means it still acknowledges there is a chance the treatment is ineffective.
In social science research, that significance level can get as high as 10%!
So, what does this mean for your decision-making?
Before you make a decision, I want you to stop and consider its significance level. How important is it that this decision you're making has little error?
Maybe it doesn’t matter much, so you have a 50% significance level. Essentially 50/50. Or maybe this is the most crucial decision you’ve ever made, with a 1% significance level.
To help you decide, here are some typical significance levels I've seen from clients over the years:
What to have for dinner - 50% significance level.
What to bring on a trip - 20% significance level
Which apartment to rent - 10% significance level
Which job to choose - 5% significance level.
As you can see, many decisions have a lot of room for error.
Now I understand the margin of error. What should I do with it?
A margin of error is important because it helps you decide how long to spend on a decision. There’s no hard and fast rule, but generally, you should only spend a few minutes on a decision with a 50% significance level.
After all, if you get the wrong thing for dinner, it might just be a happy accident!
In contrast, you might devote a whole year to a decision with a 5% significance level and little room for error.
So, how important the decision is to you will dictate how much time you spend on it. But remember, we can’t avoid all errors! We can only minimize them.
As you go through this week, I want you to consider the margin of error in your decisions.
Hopefully, this principle gives you some insight into how to support confident decision-making with ADHD.
Wishing you focused and balanced days,
Skye
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington: American Psychiatric Association, 2013.
Mäntylä, T., Still, J., Gullberg, S., & Del Missier, F. (2012). Decision making in adults with ADHD. Journal of attention disorders, 16(2), 164-173.
Mowinckel, A. M., Pedersen, M. L., Eilertsen, E., & Biele, G. (2015). A meta-analysis of decision-making and attention in adults with ADHD. Journal of attention disorders, 19(5), 355-367.
Beaton, D. M., Sirois, F., & Milne, E. (2020). Self-compassion and Perceived Criticism in Adults with Attention Deficit Hyperactivity Disorder (ADHD). Mindfulness, 11. https://doi.org/10.1007/s12671-020-01464-w
R. Alderson, L. Kasper, K. Hudec, and C. Patros, ‘Attention-Deficit/Hyperactivity Disorder (ADHD) and Working Memory in Adults: A Meta-Analytic Review’, Neuropsychology, vol. 27, pp. 287–302, May 2013, doi: 10.1037/a0032371.
Thompson, P. W., & Liu, Y. (2005). Understandings of margin of error. In Proceedings of the Twenty-seventh Annual Meeting of the International Group for the Psychology of Mathematics Education, Roanoke, VA. Vicksburg, VA: Virginia Tech.
Kosar, T., Bohra, S., & Mernik, M. (2018). A systematic mapping study driven by the margin of error. Journal of Systems and Software, 144, 439-449.
Thornton, R. J., & Thornton, J. A. (2004). Erring on the Margin of Error. Southern Economic Journal, 71(1), 130-135.