ADHD and moral injury: How it affects women at work

Witnessing a workplace event that goes against your ethics can be more than just upsetting. It can trigger a complete rethink of your job, career and even your life, especially if you have an inherent sensitivity to what is morally ‘right’ and what isn’t.

Moral injury is the psychological and emotional damage that happens when someone sees something that goes against their moral beliefs. According to a large systematic review and meta-analysis published in BMJ Open, 67% of workers across different occupations experience events that could lead to moral injury.

You might work for a non-profit that supports women to get back into work, but you find out that staff members are routinely ‘pushed out’ of the organisation after taking maternity leave. In a newsroom, you may witness reporters working hard to build their names, only for the credit for their hard work to be awarded to their male peers. You see someone in the office being laughed at for being ‘too autistic’, when your bosses preach about inclusivity.

These situations are difficult for anyone to witness. But for people with ADHD, the unfairness, dishonesty and hypocrisy can feel all-consuming, and even harder to process.

Although having a ‘strong moral compass’ isn't part of the diagnostic criteria for ADHD, many anecdotally report having a strong sensitivity to injustice, explains Kate Moryoussef, an ADHD coach, podcast host and author.

“For many women, this isn’t simply an intellectual disagreement,” she says. “Perceived injustice can create a very real emotional and physiological response. Their nervous system may react strongly when they witness bullying, exclusion, discrimination or behaviour that conflicts with their values.”

What is the link between ADHD and justice sensitivity?

We don’t know exactly why some people with ADHD report being particularly sensitive to injustice. A person’s sense of right and wrong is shaped by many factors, including their personality, experiences, upbringing and other influences. Importantly, too, having ADHD doesn’t automatically mean you have stronger morals – but rather, may experience a more intense emotional reaction to something that seems unfair or unjust.

Emotional dysregulation, a known trait of ADHD, may play a part in this. This means feelings escalate quickly, feel very intense and are hard to manage. And these ‘big feelings’ are more than a TikTok phenomenon – emotional dysregulation is thought to come from differences in the brain networks connecting emotional/reward systems (such as the amygdala and ventral striatum) with prefrontal regions responsible for inhibition, perspective-taking and emotional control. 

(Creatopy/Unsplash)

This means emotionally significant events, like rejection, unfairness or perceived injustice, feel particularly salient. At the same time, it is harder to pause, reframe the situation, shift attention away, or regulate the immediate response. 

“The challenge is that they may also find it difficult to stay silent when something feels wrong,” says Moryoussef. “Rather than overlooking unfairness to maintain workplace harmony, they often feel compelled to speak up, even when doing so may create tension or place them at personal risk.”

Repetitive thinking , hyperfocus and rumination are also common in ADHD, which can make it hard to shake off emotional ‘sticky’ thoughts. Of course, though, this doesn’t mean the event witnessed wasn’t wrong or unjust. It means that the event may leave a lasting effect on the individual and make it harder to move on.

The impact of this can be significant. When something violates your values, it can trigger intense anger, guilt, shame or disgust. You may feel disillusioned with colleagues, organisations, those in positions of authority and even your entire career. You may feel anxious and sad, which can chip away at your confidence and self-worth.

"Past experiences of being misunderstood, invalidated or treated unfairly can also shape how strongly something is experienced."

Trupti Popat, therapist

How gender expectations amplify the issue

However, explains psychotherapist and Counselling Directory member Trupti Popat, the way some women with ADHD respond to unfairness is often the result of lots of different factors interacting with each other.

“From my perspective, it's rarely just one thing,” says Popat. “There may be a greater sensitivity to unfairness, but that doesn't happen in isolation. Cognitive factors, such as ‘black-and-white’ thinking, can influence how situations are interpreted.

“Past experiences of being misunderstood, invalidated or treated unfairly can also shape how strongly something is experienced,” she adds. “Add in the hypervigilance and heightened pattern recognition, and it’s easy to see why someone may feel stuck on situations that are unfair.”

Time management, attention to detail and motivation don’t always come easily to people with ADHD, meaning they often face challenges at work. A recent survey by Focused, in partnership with the ADHD Chatter Podcast, found that 77% said that ADHD had negatively impacted their performance at work. Forty-seven percent said they had lost a job due to or partly because of ADHD and 56% said ADHD had caused them to have disciplinary issues.

Gendered expectations and workplace biases can amplify the problem for women, as the tendency to mask and internalise ADHD traits can lead to chronic exhaustion, anxiety and impostor syndrome. Against this backdrop, witnessing further unfairness or hypocrisy can feel especially difficult to process. For someone already overly familiar with being misunderstood, underestimated or treated differently, moral injury and a heightened sensitivity to injustice can add another layer of emotional strain.

Moral injury can leave someone questioning their colleagues, workplace and even their life choices. But, the same qualities that make unfairness difficult to ignore can also be strengths, like being compassionate and valuing authenticity. So rather than being deemed ‘too sensitive’ or being accused of overreacting, it’s important to recognise how women with ADHD experience work, and the world.

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