HSP or ADHD? When Taking In More Can Look Like Paying Attention Less

Could what looks like an attention problem sometimes be an information-overload problem?

Over the years, I have worked with many people who I would describe as highly sensitive. I also recognise many of these characteristics in myself.

They notice subtleties. They read a room quickly. They are deeply affected by other people's emotions and energy. Busy environments can become exhausting. Noise, light, conflict and constant stimulation can feel like too much.

And sometimes, they struggle to concentrate.

This is where an interesting question emerges.

Is this ADHD? Or could some of what we interpret as attention deficit actually be the result of heightened sensitivity and processing?

The distinction matters, because while ADHD and high sensitivity can look remarkably similar from the outside — and can absolutely coexist — research suggests they are not simply different names for the same thing.

First, what do we mean by HSP?

The term Highly Sensitive Person (HSP) was popularised through the work of psychologist Dr Elaine Aron. In research, the underlying trait is generally referred to as Sensory Processing Sensitivity (SPS).

SPS is not currently a clinical diagnosis like ADHD. It is conceptualised as a temperament or personality trait involving greater sensitivity to internal and external stimuli and deeper processing of information.

Aron's work is often summarised through the acronym DOES:

D — Depth of processing
O — Overstimulation
E — Emotional reactivity and empathy
S — Sensing the subtle

That last point is important.

A highly sensitive person isn't necessarily simply "more emotional." Their system may be noticing and processing information that someone else barely registers.

Why HSP and ADHD can look so similar

From the outside, both can present with:

sensory overwhelm, distractibility, difficulty concentrating in stimulating environments, emotional intensity, fatigue after social interaction, and difficulty filtering competing sources of information.

There is also evidence of an association between the two. Research referenced in our exploration found a significant positive relationship between self-reported ADHD traits and sensory processing sensitivity.

So this isn't necessarily an either/or conversation.

A person can have ADHD and be highly sensitive.

The more interesting question is whether similar outward behaviour can sometimes arise from different underlying processes.

Could one brain be struggling to regulate attention while another is processing too much information?

This is where the neuroscience becomes fascinating.

ADHD is a recognised neurodevelopmental disorder involving difficulties with attention regulation, inhibition and/or hyperactivity and impulsivity. Research has implicated differences across brain networks and neurotransmitter systems, particularly dopamine and norepinephrine and circuits involved in executive functioning and attention regulation.

Sensory Processing Sensitivity presents a different research picture.

In a 2014 fMRI study led by Bianca Acevedo, higher SPS scores were associated with increased activation in areas involved in awareness, sensory-information integration, empathy and action planning when participants viewed emotional images.

Regions implicated included the insula, cingulate cortex, inferior frontal gyrus, middle temporal gyrus and premotor areas.

This is particularly interesting to me.

Because perhaps what looks like:

"I can't pay attention"

can sometimes be:

"I am paying attention to too many things."

Those are very different experiences.

The empathy connection

The Acevedo research also offers an interesting perspective on empathy.

When highly sensitive participants viewed emotional images of loved ones and strangers, greater SPS was associated with activation in brain regions involved in empathy, awareness and integration of sensory and emotional information.

For someone who experiences high sensitivity, this may sound familiar.

You walk into a room and immediately notice tension.

Someone tells you they're fine, yet something in you registers otherwise.

Noise isn't simply noise. You notice multiple conversations, movement, facial expressions, the music playing in the background and how the person beside you seems to be feeling.

Eventually the nervous system says:

Enough.

And that is where my own interpretation of this research begins.

Where Science Meets Soul

This next part is not something neuroscience has established. It is my own working hypothesis, developed through my experience of myself and decades of working closely with people.

I think of some highly sensitive people as being more permeable.

Within the language of yoga and metaphysics, we might describe this through concepts such as prana, life force, the energetic field or subtle body.

My hypothesis is that some highly sensitive people are not only consciously noticing more sensory information, but experience themselves as extraordinarily receptive to the people and environments around them.

Science can currently investigate the measurable aspects of that experience — sensory processing, nervous-system responses, attention, brain activation and empathy.

Whether there is also an energetic dimension to what is being perceived is a different question.

I don't think we need to confuse the two.

For me:

Science explores the measurable.
Metaphysics explores the invisible.
Soul is the bridge between them.

Science gives us one lens through which to understand sensitivity. Ancient traditions and lived human experience may give us another.

The important thing is to be clear about which lens we are using.

The overloaded electrical system

One analogy I often use is the wiring in a house.

Imagine a house with an electrical system capable of running a certain load.

One light is on.

Then another.

Then the television.

The heater.

The washing machine.

The kettle.

The computer.

Nothing is necessarily wrong with any individual appliance. There is simply too much drawing on the system simultaneously.

Eventually the breaker trips.

For a highly sensitive nervous system, overwhelm can sometimes feel similar.

The system may be registering the conversation, the bright light, the person's facial expression, the uncomfortable clothing, the background music, internal thoughts, emotional cues and perhaps — within my own energetic interpretation — subtler information from the surrounding environment.

The question then changes from:

"Why can't you concentrate?"

to:

"How much information is your system trying to process right now?"

That is a very different way of approaching the person.

What about ADHD medication?

This is an area where considerable caution is needed.

There is research suggesting an association between sensory processing sensitivity and medication sensitivity. A 2023 brief report referenced in our discussion found moderate significant correlations between SPS and medication sensitivity across multiple samples.

That does not mean stimulant medication has an "opposite effect" in HSPs, nor does it demonstrate that people diagnosed with ADHD are actually highly sensitive rather than having ADHD.

Those claims would go beyond the evidence currently available.

It does, however, raise a worthwhile question about individual sensitivity to medication and the importance of careful clinical assessment.

Someone wondering whether they have ADHD, SPS, autism, anxiety or another condition deserves a proper assessment rather than trying to determine the answer from a checklist or social-media post.

HSP is not a substitute diagnosis for ADHD.

And ADHD medication response is not a reliable diagnostic test for distinguishing the two.

Perhaps we need a better question

Rather than asking only:

"What diagnosis explains this behaviour?"

we might also ask:

What is happening underneath the behaviour?

Is attention wandering because the brain is struggling to regulate attention?

Is concentration collapsing because the nervous system is overwhelmed by sensory input?

Is anxiety involved?

Is there trauma or chronic stress?

Is this person highly sensitive?

Are two or more of these things true simultaneously?

That distinction matters.

Because the goal isn't simply to attach the right label.

It is to understand the human being.

Sensitivity isn't necessarily the problem

Perhaps one of the most important shifts is moving away from automatically seeing sensitivity as weakness or dysfunction.

A system capable of noticing subtle changes may also bring extraordinary empathy, intuition, creativity, pattern recognition and depth.

The same sensitivity that allows someone to recognise what another person needs can become exhausting when they don't know how to regulate their exposure.

The same depth of processing that produces insight can become rumination when the nervous system is overloaded.

The same openness that creates connection can require stronger boundaries and greater recovery.

So perhaps the work isn't always about becoming less sensitive.

Perhaps it is about developing the capacity to live well with sensitivity.

Understanding the body.

Supporting the nervous system.

Learning what overstimulates us.

Creating boundaries.

Building recovery into our lives.

Understanding our mind and patterns.

And perhaps exploring the energetic and spiritual dimensions of ourselves as well, for those who resonate with that lens.

This is where my own Body • Mind • Energy • Soul framework becomes particularly relevant.

Rather than asking whether something is purely neurological, psychological, physiological or energetic, I am increasingly interested in what happens when we become curious about the whole system.

Because two people can display remarkably similar behaviour while having very different experiences underneath it.

And understanding that difference may completely change how we support them.

References

Acevedo, B. P., Aron, E., Aron, A., Sangster, M., Collins, N., & Brown, L. (2014). The highly sensitive brain: An fMRI study of sensory processing sensitivity and response to others' emotions. Brain and Behavior, 4, 580–594.

Aron, E. N., Aron, A., & Jagiellowicz, J. (2012). Sensory Processing Sensitivity: A review in the light of the evolution of biological responsivity. Personality and Social Psychology Review.

Acevedo, B., Aron, E., Pospos, S., & Jessen, D. (2018). The functional highly sensitive brain: A review of the brain circuits underlying sensory processing sensitivity and seemingly related disorders. Philosophical Transactions of the Royal Society B, 373(1744).

The relationship between sensory processing sensitivity and attention deficit hyperactivity disorder traits: A spectrum approach. ScienceDirect (2020).

The relationship between sensory processing sensitivity and medication sensitivity: Brief report. Frontiers in Psychology (2023).

ADDitude Magazine. Highly Sensitive Person: Sensory Processing Sensitivity vs. ADHD.

Roles of Dopamine and Noradrenaline in the Pathophysiology and Treatment of ADHD. Biological Psychiatry / PubMed (2011).

Sensory Health. Is It Sensory Processing Disorder or ADHD?

Note: This article explores emerging research and my own theoretical framework. HSP/Sensory Processing Sensitivity is not a clinical diagnosis, and this discussion is not intended to diagnose ADHD or recommend starting, stopping or changing medication. Questions about diagnosis or medication are best explored with an appropriately qualified health professional.