ADHD Symptom Spotlight: Delay Aversion

Waiting is the worst. Whether it’s sitting in a doctor’s waiting room, standing in line at the store, or even slogging through monotonous but necessary tasks like household chores or an uninteresting work assignment, it can make you feel bored, frustrated, and restless. This kind of enforced delay pops up in so many areas of daily life and, for people with ADHD, an intense delay aversion can make those situations feel unbearable.

What Is Delay Aversion?

Delay aversion refers to the unusually high sensitivity to a delay before an expected reinforcement, whether positive or negative. It has been a recognized factor in ADHD since the 1980s, but early research defined it mostly as a consequence of impulsivity or a tendency to prefer instant gratification. In other words, delay aversion is best understood as an intense need to escape the boredom or frustration of waiting as quickly as possible.

In fact, research involving fMRI data has found that the imposition of a delay activates the fight or flight response in people with ADHD. Specifically, the amygdala, the region of the brain that detects and responds to threats or danger, is hypersensitive to cues of delay in ADHD but not in neurotypical brains. Moreover, the possibility of avoiding that delay is a stronger motivator for people with ADHD than those without.

When I choose to stand over the sink eating cold leftover spaghetti right out of the Tupperware, it’s not because I prefer cold spaghetti to hot spaghetti with freshly-grated parmesan gently melting on top. It’s because I prefer cold spaghetti to waiting for my food to reheat, plating it, and then grating parmesan over it.

Delay Aversion Impacts Most Areas of Daily Life

Delay is built into most rewards, especially the bigger ones. The payoff of a home-cooked meal requires 30 minutes or more of repetitive work and waiting. Even just having a job involves weeks of working before the paycheck you’re working for arrives. Buying a house or going on vacation requires months or years of saving money and, by extension, resisting all those impulse purchases that pop up along the way.

When your amygdala is literally reacting to that delay like it’s a life-threatening danger, enduring it can feel impossible. You’ll do anything to escape that delay, like ordering takeout or opting for foods that require little to no cooking. You might rush through boring tasks, if you do them at all, making lots of mistakes along the way just because you feel this intense need to get it over with as quickly as possible. You might blow your savings in a shopping spree if you manage to save any money at all, because it feels like it would take forever to actually save up enough for a down payment on a house anyway.

Why Does ADHD Come With Such Intense Delay Aversion?

Why people with ADHD are more delay averse is not fully understood yet, but three possible explanations include:

1. Lack of stimulation during the delay. The delay-associated task is too slow, boring, or generally not intrinsically rewarding enough to sustain interest. Examples include mundane chores, homework for subjects you’re not interested in, and the often repetitive or boring practice required to learn a new skill, like the basic chord exercises you have to learn before you can play a song on the guitar.
2. Negative emotional associations with delay. If you struggled to master delay-associated tasks when you were a child and were often reprimanded or criticized as a result, you may have developed a negative association with them. Now, the delay-associated task itself feels like a negative consequence to be avoided at all costs.
3. Impatience regarding the expected reward. When the anticipated outcome is something you want badly enough, you might become too impatient to focus on the intermediate steps you have to take to get there. This is especially likely in situations where the delay-associated task is too indirectly related to the driving force behind your motivation. One example would be wanting to become a doctor so much that you struggle to sit through the basic biology prerequisite courses you need to take to get into medical school.

How to Manage Delay Aversion

The motivation to escape delay can be so strong that it overpowers any other motivation you have. Fortunately, there are some ways to either leverage that motivation or circumvent it. It just takes a little creativity.

Identify the Source of the Aversion

The first and most important step is to figure out what specifically you’re trying to escape. Then, figure out ways to address that underlying issue so that the delay doesn’t feel so unbearable.

• Are you feeling under-stimulated? Then, find ways to incorporate more stimulation. Read the text out loud instead of just in your head. Take notes instead of just passively reading or listening. Go for a walk while you talk on the phone.
• Does the delay feel like punishment or otherwise put you in a bad mood? Then, find ways to make it more pleasurable. Put on music. Switch to a more pleasant work environment if possible, like studying for an exam while taking a bubble bath or working at your favorite cafe. You can also use a continuous reward system. Instead of delaying the reward until the end, allow yourself to enjoy it for the duration of the delay. For example, get a pint of ice cream that you’re allowed to keep eating only so long as you stay on task. When you get distracted, you have to stop eating.
• Are you feeling too anxious or excited about the anticipated outcome to focus on the process? Set up some intermediate milestone goals you can focus on achieving along the way, like a series of increasingly more challenging songs you want to learn on guitar. Alternatively, try to find purpose or a way to be interested in the process. When I have to write an article about a topic I’m not especially interested in, for example, my go-to approach is to imagine that one day, I’ll find myself in a debate with someone on the subject. So I’m storing this information in preparation for winning that future debate. I may not be motivated by the topic itself, but I do love winning an argument, no matter what it’s about.

Always Be Prepared for Unexpected Delays

Unexpected delays, like long lines at the grocery store, can make you anxious and short-tempered. So always have something with you that’s enjoyable and purposeful to pass the time, like:

• A book
• A handheld video game device
• A game on your phone
• Headphones to listen to music or podcasts
• A portable charger in case your phone is the “time passing mechanism” so that you never risk running out of battery

Take Breaks as Needed

Even if you manage to make yourself start the delay-associated task, delay aversion can still cause you to disengage when the lack of stimulation or negative emotional response becomes too overwhelming to ignore.

If you have to read a research paper for class, but find yourself spacing out or getting distracted after a paragraph, get up and take a five-minute break. Come back and read as much as you can before your brain disengages again. Then, take another break.

I like this approach more than a regimented schedule like the Pomodoro technique because it follows the natural rhythm of focus and disengagement.

However, if you’re struggling to engage at all, you may need to establish a very easy minimum target you have to accomplish before the next break. For example, when reading that paper, your minimum might be to read at least one paragraph. This will require a small exertion of willpower, but the frequent breaks can help counterbalance that.