Aphantasia & ADHD: Understanding the Connection

What Is Aphantasia?

Aphantasia, or “image-free thinking”, is when an individual has difficulty conjuring visual imagery from their memory. This could look like having difficulty remembering what a specific familiar place looks like, or having difficulty conjuring an image of a sunset. Currently, there is no official diagnosis for aphantasia, and it is more of an umbrella term to describe a type of experience. As our ideas of mental health are constantly evolving, it is possible that aphantasia could be more formally recognized and diagnosed in the future.

While people with aphantasia may struggle to think about things in a visual sense, it does not mean they have no imagination. A recent study found that in a sample of 500 graduate students, 4% appeared to have aphantasia.¹ This study failed to find any gender bias associated with this condition. While research investigating the cause appears to be lacking, it seems that aphantasia may be caused by brain damage or by another psychological trigger, such as trauma, wherein a lack of visual imagery may be developed as a coping mechanism.²

Common signs of aphantasia include:

• Difficulty recognizing people (not to be confused with prosopagnosia, a formally diagnosable condition wherein an individual cannot recognize faces)
• Less ability to imagine the future
• Lack of vivid memories
• Difficulty imagining a hypothetical scenario
• Infrequent dreaming or lack of vivid dreaming
• Inability to access other sensory memories (smell, taste, or touch)

What Is ADHD?

Attention deficit hyperactivity disorder, or ADHD, is a mental health condition wherein an individual struggles with inattention, hyperactivity, or a combination of both. Some risk factors for ADHD include a genetic predisposition and biological differences in brain chemistry. Historically, males were more likely to be diagnosed with ADHD, however, this trend is shifting to become less gender biased. Some symptoms of ADHD include disorganization, difficulty sitting still, lack of ability to pay attention to details, and distractibility.

Common symptoms of inattentive ADHD include:

• Easily distracted
• Poor short-term memory
• Difficulty organizing tasks and activities
• Difficulty paying attention to details
• Often forgetting or misplacing important items
• Difficulty sustaining attention

Common symptoms of hyperactive-impulsive ADHD include:

• Increased impulsivity
• Difficulty sitting still
• Difficulty waiting your turn
• Often blurting out answers
• Talking excessively
• Difficulty working or playing quietly

How Are Aphantasia & ADHD Connected?

It is important to emphasize that no comprehensive research has been done which formally links ADHD to aphantasia. Some reasons why people may make this connection could be because people with ADHD struggle with focus and memory. More specifically, ADHD has been linked to impaired attention and working memory.³

Similarities Between Aphantasia & ADHD

There is some overlap between symptoms of ADHD and aphantasia, including difficulties with memory and focus. One difficulty in diagnosing mental health disorders is that symptoms do often overlap between conditions, and it can be easy for people searching for information on the internet to confuse symptoms of one diagnosis for symptoms of another.

Overlapping symptoms of ADHD and aphantasia include:

• Difficulty with memorization: People with ADHD often struggle with utilizing working memory. This can look like having difficulty solving problems in their mind or repeating a story that has just been told to them.
• Poor reading comprehension: Difficulties with working memory can manifest as poor reading comprehension if a person living with ADHD is having difficulty remembering words and attending to what has just been read to them.
• Struggle to focus: People living with ADHD often have difficulty focusing, which can make it difficult to be present in the moment and observe surroundings or remember facts of a certain event.
• Difficulty paying attention to details: People with ADHD often struggle to pay attention, resulting in difficulty remembering a specific event. This is not to be confused with brain damage or trauma that causes actual inability to conjure a specific image.

Differences Between Aphantasia & ADHD

Aphantasia should not be confused with ADHD. While people with ADHD may struggle with forgetfulness and focus, what has been found in research surrounding aphantasia is that it is more likely to be linked to trauma or brain damage. This means that the causes of these two conditions are different, though it is possible that a person can have both ADHD and aphantasia, just as a person with ADHD could have any mental health disorder, such as depression or anxiety. It is also important to recognize that aphantasia is not a formally recognized psychological diagnosis.

Treatment for Aphantasia & ADHD

If you are experiencing distress associated with symptoms of ADHD or symptoms of aphantasia that are causing significant struggles at work, in relationships, or in other areas of life, it is important to seek treatment.

Management Options for Aphantasia

There is no established treatment protocol for aphantasia, but there are treatments that can be beneficial.² It is possible that future research could find treatments that target this condition more specifically if it becomes formally recognized and diagnosable.

Management options for aphantasia could include:

• Mnemonic devices: These are designed to improve working memory, such as helping a person come up with acronyms or rhymes to remember certain information they are worried about forgetting.
• Guided imagery exercises: Working with someone who has difficulty visualizing or developing the skill of imagining through guided imagery could be helpful if they are ready for that kind of intervention.
• General mindfulness practices: Mindfulness is an effective method for calming the nervous system and clearing the mind. If aphantasia is a symptom linked to trauma, working on regulating the nervous system could help reduce overall symptom severity.
• Exposure to imagery: It could be helpful for someone with aphantasia to look at familiar images of things they have difficulty remembering to increase the likelihood of eventually being able to produce that image in their mind.

Treatment Options for ADHD

Treatment for ADHD often includes both behavioral interventions as well as medication when indicated.⁴ Behavioral treatments often involve an individualized treatment with interventions to target symptoms an individual is experiencing. Consultation with a professional about medications for ADHD and what might be appropriate based on individual needs is also often recommended. Treatment for children with ADHD can look different than treatment for adults with ADHD, so it is important to find age-specific interventions that are developmentally appropriate.

Treatment options for ADHD include:

• Medication for ADHD: Often, medication for ADHD may look like stimulant or non-stimulant medications or a combination of multiple medications. Consulting with a professional prescribing provider to find the kind of medication that would be best is important as this varies widely from individual to individual.
• Cognitive behavioral therapy (CBT): CBT for ADHD can be helpful in that it helps individuals with ADHD target specific thoughts and behaviors that might be intensifying symptoms.
• Dialectical behavioral therapy (DBT): DBT can be helpful for ADHD in that it can help individuals develop specific coping mechanisms for emotional distress surrounding their symptoms as well as improve distress tolerance.
• Natural remedies: It is possible that natural remedies for ADHD can be helpful. This includes supplements, regular exercise, and good sleep hygiene.
• Environmental changes: People living with ADHD need to have an environment that supports and affirms them. This may look like having relationships with people who don’t shame them because of their symptoms or finding a job where they can succeed and not feel like a failure.
• Symptoms-focused treatment plans: If someone is diagnosed with ADHD and already has a good relationship with their therapist, they might consider adding some symptom-specific interventions into their already existing treatment plan.

When to Seek Professional Support

If symptoms of ADHD or aphantasia are causing significant problems or distress at work, in relationships, or other important areas of life, it is important to seek professional help. You can find a neurodiverse-affirming therapist or someone specializing in treating ADHD through an online therapist directory or online therapy platform. If you are considering seeing a psychiatrist or prescribing provider to consult about medication for ADHD symptoms, an online psychiatrist option is a good choice for finding ADHD medication management.