ADHD and sensory overwhelm: Itchy tags and tight clothes

Itchy tags, tight clothes, and scratchy fabrics can trigger real ADHD sensory overwhelm. Dr. Monica Johnson explains why it happens and what can help.

For many women with ADHD, some clothing isn’t just uncomfortable — it can feel unbearable. This sensory overload can make even getting dressed a challenge. On this episode, you’ll learn:

• Why sensory overwhelm is more than being “too sensitive”


• How ADHD and sensory overload intersect, especially for women

• The common clothing triggers that spark discomfort (tags, textures, tight fits, etc.)



• Practical strategies to make daily routines easier

• ADHD and emotional dysregulation

• ADHD and sensory overload

• ADHD, sensory systems, and communication

• Evaluating dopamine reward pathway in ADHD: Clinical implications

• Abnormal functional connectivity in children with attention-deficit/hyperactivity disorder

• The impact of deep pressure stimulation on anxiety

• The effects of background white noise on memory performance in inattentive school children

We love hearing from our listeners! Email us at podcasts@understood.org.

(00:00) Intro

Dr. J: You're already running late again, and it's not because you overslept or got distracted, it's because every shirt in your closet feels wrong, too itchy, too tight, too something. Maybe you've spent 20 minutes trying to find socks that don't feel like sandpaper, or you had to turn around halfway to work because your sweater felt like it was cutting into you. No, you're not being dramatic. This is the sensory side of ADHD that almost no one talks about. This is "ADHD and," where we talk about everyday life and ADHD. I'm your host, Dr. J. I'm a licensed psychologist who works with those with ADHD. Today, we're talking about ADHD and sensory challenges.

Sensory processing issues are common in ADHD, especially in women. Let's talk about what sensory processing is.

(00:58) What is sensory processing

Dr. J: Sensory processing refers to the way that our nervous system receives, organizes, and responds to information from our senses. So this includes vision, touch, taste, smell, balance, movement, and proprioception, which relates to body awareness. Fun fact, when you're taking a sobriety test and they ask you to close your eyes and touch your finger to your nose, that's an example of proprioception, which can be impaired when you're intoxicated.

In other words, sensory processing is how your brain takes in data from the environment and your body decides what's important and filters or modulates so you can respond appropriately. When sensory processing is well-regulated, you can filter out things like the itchy feeling of a clothing tag or the fact that the fluorescent lights are flickering. You can do this without really thinking about it because everything is operating smoothly between your sensory input and whatever task you're trying to focus on.

When sensory processing is dysregulated, as it often can be with ADHD, the brain's filtering and modulating system may misfire. And this can lead to a few challenges, which I'm going to review now.

(02:14) How to body responds to sensory overload

Dr. J: The first is having an overly responsive sensory system. This basically means that you're feeling flooded by sensory inputs. So bright lights can feel blinding, clothing textures can feel unbearable, and it can also be difficult to filter out background noises.

The next is an underresponsive sensory system. So basically what this means is that you're missing or not noticing sensory cues. So for example, you might not notice that your hands are freezing until they go numb. And then lastly, there's sensory seeking. This is basically where you're craving intense sensory input to stay alert. This can look like fidgeting constantly or listening to really loud music while working.

When sensory overwhelm kicks in, ADHD makes it harder to recover. Executive functions are already taxed in ADHD. So let's break down what this looks like so that we have a clear understanding of what sensory processing challenges can look like.

(03:17) What sensory processing challenges can look like

Dr. J: First, sensory input competes for limited attentional capacity. If your brain is processing every flicker of the overhead light, the hum of the AC, or the sound of that dang co-worker's pen clicking, that energy is not available for holding a task in working memory or staying on track.

Next is overstimulation triggers emotional dysregulation. Research shows that sensory overload increases emotional reactivity while reducing prefrontal cortex activity. In ADHD, this shift happens faster and takes longer to recover from.

Next is shifting between tasks gets harder. Executive functions rely on your ability to be able to switch from one mental task to another. When you're bombarded by sensory stimuli, the brain might get stuck in a stress or avoidance loop, making transitions much more difficult.

Next is that decision fatigue sets in sooner. Sensory stress eats up self-regulation bandwidth, so even small decisions like what's for dinner can feel overwhelming after a day of sensory bombardment.

Here's what sensory overwhelm can look like in a daily routine. So let's set the scene. It's morning, you put on a shirt with a scratchy tag. It's mildly irritating, but you're rushing. Your brain is already allocating processing power to ignore the itch, leaving less focus for remembering your to-do list. So because of that, you leave without your lunch.

On your commute, there's traffic noise, bright sunlight, and if you live in the city, maybe there's perfume or other irritants on the subway. Because of all of this, you arrive at work already overstimulated. Your open office is visually busy. Phones ring, people chat, and you can hear every keystroke. You keep losing your place in an email draft. You start avoiding harder tasks because they require mental energy that you no longer have.

After work, you head to the grocery store and it's packed. The music is loud, the lights are bright. So by the time you actually get home, you're so drained that you skip dinner and just decide to scroll on your phone instead. In the evening, you feel guilty for wasting time, but your brain is actually in a recovery mode from hours of unfiltered sensory processing.

Let's take a minute to talk about what happens when you repeatedly push through sensory distress without addressing it.

(07:04) Why sensory discomfort is different for women

Dr. J: First, chronic stress load increases. The body stays in low-level fight or flight, raising cortisol. Over time, it can worsen ADHD symptoms like irritability, brain fog, and poor working memory.

Next is executive function declines further. Ignoring overload leads to a pileup in your brain because it never gets to reset. So transitions feel harder and motivation tanks.

Next, your burnout risk rises. Chronic sensory overwhelm contributes to mental and physical exhaustion, sometimes mislabeled as laziness when it's actually a neurological depletion state. Next is increased emotional reactivity. Small frustrations start to trigger bigger reactions because your nervous system is already at its stress threshold. And then lastly, avoidance patterns solidify. You may start unconsciously avoiding environments, tasks, or people that overstimulate you, shrinking your world without even realizing it.

Women with ADHD are often socialized to hide discomfort, so their sensory struggles go unnoticed even by themselves. Here are a few factors that contribute. The first is gendered socialization to tolerate discomfort. From a young age, girls may be subtly trained to endure rather than report discomfort, especially if it risks being labeled as dramatic or picky. Sensory issues like hating tags, feeling overwhelmed in crowds, can be hidden or suppressed.

Number two is a misattribution to mood or anxiety disorders. Sensory overload in women, such as irritability in noisy environments or emotional shutdown after long social exposure, can be misdiagnosed as anxiety, depression, or burnout, bypassing ADHD evaluation entirely.

And number three, there's a research bias towards children, especially boys. Sensory processing research in ADHD has historically focused on pediatric samples, where boys are more likely to show externalizing behaviors that are linked to sensory overwhelm. So for example, acting out in a noisy classroom. Women's more internalized responses of shutdown or withdrawal are less studied and less disruptive to others, making them easier to overlook.

Okay, so how do we cope? Because honestly, we can't expect the world to meet all of our sensory needs. It's literally impossible, but you also don't need to suffer unnecessarily.

(08:32) Tips for managing sensory challenges

Dr. J: Number one is environmental modifications. The goal is to reduce sensory noise so your brain can reserve resources for executive functions. So here are some examples of noise control. You can use noise-canceling headphones or earplugs during work or commuting. You may also want to consider introducing white noise or ambient sounds like nature sounds. This can help make the unpredictable background noise blend in. Research shows that noise reduction can significantly improve sustained attention in ADHD.

Next, we're going to talk about lighting adjustments. One thing you may want to consider, if you have control over it, is replacing fluorescent lighting with full spectrum or warm LED bulbs to reduce flicker sensitivity. You can also use dimmable lamps for gradual light transitions.

The next thing I'll mention here is visual decluttering. So you may want to keep your main work area as visually calm as possible. So neutral colors or minimal patterns. And I've had some patients who've enjoyed storing items in opaque bins to reduce visual load and they found that to be really helpful.

Number two is sensory diets and movement breaks. This is borrowed from occupational therapy, and a sensory diet is basically a proactive schedule of sensory activities that maintain an optimal state of alertness. The first thing to mention here is deep pressure input. So things like weighted blankets, compression vests, or like really snug clothing can all have a calming effect by activating the parasympathetic nervous system pathways.

Next is vestibular stimulation. So this includes things like rocking chairs, gentle swinging, or balance exercises, which can help to reset sensory thresholds. And then lastly, proprioception input. So things like wall pushups, resistance bands, or carrying weighted bags can regulate arousal levels.

Number three is mindfulness-based sensory awareness. Mindfulness doesn't eliminate sensory triggers, but it does train the brain to notice without escalating into overwhelm. Here are a few ways to do this. First is sensory labeling. Pausing to name what you're sensing, so I hear traffic or I smell coffee, can reduce emotional reactivity by shifting processing to the prefrontal cortex.

Next is body scans. This is basically where you do a daily check-in to identify tension or overstimulation before it peaks. And then last up here is grounding techniques. So the 5, 4, 3, 2, 1 method--and this is basically where you do five things I can see, four things I can touch, etc.--can stabilize attention.

Number four is structured recovery periods. Women with ADHD often push through sensory distress until they crash. Recovery windows prevent depletion. One way to do this is through micro-breaks. So taking two to five minutes every hour to step away from stimuli. Another one is low stimulation spaces. So create a design quiet corner at home with calming textures, senses, and lighting. And then lastly here, transition rituals, listening to calm music, changing your clothes, or washing your face after work to signal to your nervous system to downshift.

Number five is psychoeducation and self-advocacy. Understanding your sensory needs and communicating them is crucial. So the first thing here is to track sensory inputs. Keep a brief journal of situations that overwhelm or under-stimulate you. Patterns help you anticipate and prepare. And then lastly here, language for self-advocacy. Practice phrases like, "I focus better with fewer background conversations. Can we move to a quieter space?" These sorts of ways that you can self-advocate are really helpful.

My bonus tip is energy mapping. So this is basically where you plan demanding tasks during low-sensory periods of the day. For example, using your early morning before your kids wake up. An example of this is I have a patient who does better with tasks like emails during quiet periods. Therefore, we planned out a work routine that capitalizes on answering emails during the low periods of the day. They now are able to respond to emails significantly quicker because of less sensory distraction. I strongly encourage you to start experimenting on what could work for you. While these strategies may not eliminate all of the sensory inputs, it can turn the volume down on them and allow you to have a more enjoyable experience from day to day.

That's it for this episode of "ADHD and." What's a sensory hack that you found works really well for you? Let me know in the comments. Thank you so much for joining me. And if you enjoyed today's session, check out our episode on ADHD and emotional dysregulation, where I explain why feelings like anger, sadness, and frustration can feel so strong for ADHD women to manage.

Be sure to check out the show notes for this episode. There you'll find resources and links to anything I mentioned in the episode. 

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

Dr. J: "ADHD and" is produced by Tara Drinks, with video by Calvin Knie. The show is edited by Alyssa Shea. 

Our theme music was written by Justin D. Wright. Andrew Rector provides production support.

Briana Berry is our production director. Neil Drumming is our editorial director.

For Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Jordan Davidson.

And I'm your host, Dr. J.