HealthyGamerGG - What Nobody Knows About ADHD and S*x

Episode Date: November 3, 2025

Dr. K explains how ADHD shapes attraction, intimacy, and desire. From hyperfocus courtship that burns hot then fades, to tactile defensiveness that changes how touch is felt, to why chores lower stress and boost arousal, this episode reframes “dead bedroom” problems through brain science. You will learn how to slow the early dopamine rush, communicate around sensory needs, and understand swings between hypersexuality and hyposexuality that often come with ADHD. Topics include: Hyperfocus courtship and why the spark drops later Slowing the pace to build lasting pillars of a relationship Tactile defensiveness and clear touch communication Chores, stress load, and the physiology of arousal Hypersexuality, hyposexuality, and emotion regulation ADHD, self-concept, and using sex to cope Practical ways to keep attention and connection during foreplay HG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3Szt HG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode is brought to you by CarMax. Want to buy a car the easy way? Start at CarMax. Want to browse with confidence? Get pre-qualified with no impact on your credit score and shop within your budget. From luxury to family rides, CarMax has options for almost every price range, including over 25,000 cars under $25,000.

Want to get started? Head to CarMax.com for details and get pre-qualified today. Want to drive? CarMax. You said you were over him, but his hoodie is stealing your rotation. It's time. Grab your phone, snap a few picks, and sell it on Deepop, listed in minutes with no selling fees. And just like that, a guy 500 miles away just paid full price for your closure. And right on cue.

Hey, still got my hoodie? Nope. But I've got tonight's dinner paid for. Start selling on Deepop where Taste recognizes taste. List now with no selling fees. Payment processing fees and boosting fees still apply. See website for details. If you're interested in applying some of the principles that we share to actually create change in your life,

check out Dr. K's Guide to Mental Health. And so we start by understanding what literally is meditation. How does experience shape us as human beings? How do we strengthen the mind itself as an organ? And so by understanding our mind, we understand a very, very simple tool, a crucial tool that we have to learn how to use if we want to build the life that we want to. So check out the link in the bio and start your journey today. Welcome to the Healthy Gamer Gigi podcast. I'm Dr. Alokinoja, but you can call me Dr. K.

I'm a psychiatrist gamer and co-founder of Healthy Gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you. So let's dive right in. All right, chat, today we're going to talk about ADHD and sex. I've been wanting to make this video for a long time. I think a lot of times when we talk about ADHD, we talk about things like productivity, we talk about academic achievement,

we talk about being able to focus and maybe do what you want to do in life. But the truth of the matter is that ADHD is a neurodevelopmental disorder. And what that means is that the brains of people with ADHD are different. And if your brain is different, the way that you engage with any activity that involves your brain is going to be different. And we don't talk enough about how ADHD specifically impacts sex. So let's get started with the first thing, which is ADHD hyperfocus courtship. So if we think about ADHD,

people tend to get into hyperfocus. They get really obsessed with things. We get a nucleus accumbens and ventral striatum that is very susceptible to dopamine. So if you're someone who's had ADHD or you've been in a relationship with someone with ADHD, what you'll notice is that falling in love feels absolutely amazing. Suddenly you're into this person. Oh my God, this person is amazing. I love spending time with them. We spend eight hours together. We spend 10 hours together. It's so awesome. The problem is that that kind of feeling is driven by this hyperfutable. dopaminergic parts of our brain. And in the same way that we get hyperfocus in a particular thing with ADHD and then

never touch it again once we lose that hyperfocus, this same thing happens in relationships. So from the receiving end, it can be amazing to be the recipient of someone with ADHD's hyperfocus. They're thinking about you all the time. They're obsessing over you, but in a good way, right? They think about what you need. They're like, oh, my God, you had such a hard day at work today. Let me cook you dinner.

they're texting you all the time. Like it feels amazing to be on the receiving end of this ADHD hyperfocus. And if you have this ADHD hyperfocus, that also feels amazing. You're like, oh, my God, this is the one. Every interaction with them releases dopamine in your brain. So it's not just that like you like them, but you're obsessed with them. Even minor things, doing things for them are dopaminergically rewarding. And it feels wonderful, right?

if you have ADHD, you know how luxurious and awesome hyperfocus feels because your mind is finally focused. Instead of being distracted by a million things, you're like into this thing. And it feels so good to be into this thing. The problem is that the ADHD induced hyperfocus, if that forms the foundation of the relationship, when the hyperfocus ends, both partners are left in a lurch. It can feel kind of like a bait and switch, where suddenly this person is like, you were texting me all the time, now you're ghosting me completely. And from the perspective of the ADHD person,

they no longer have the benefit of the extra dopamine that they get from the thrill of the chase. When I work with my patients, what this sort of feels like is I was super into them, but I don't know what happened. The spark just disappeared. So when we're talking about the spark in a relationship, that is oftentimes driven by our dopaminergic circuitry, which will gradually decline over time. The first time you play a video game, there's a burst of dopamine. But if you play that game every single day, it's not going to give you that same burst. And so what do we do about this? This is where I want you all to understand that if a particular part of your brain dictates this relationship, the reason I'm in this relationship is because one part of my brain is hyperactive. What that means is that

the moment that that part of our brain becomes deactivated, then my lust for the relationship, no pun intended, will also disappear. So this is why it's important if you have ADHD and you're dating someone to actually scale back from that hyperfocus. So, So if we sort of give into those parts, like I want to text you every day, I want to text you every day, I want to text you every day, some part of your brain is telling you to text them every day. And if you give into that, what you are doing is listening to your brain. And if you are listening to your brain, when your brain tells you not to do something,

you will listen to that too. So oddly enough, what I tell people who fall into these relationships way too quickly is to slow it down. Don't listen to it. I know it's super exciting. I know you love it a lot. I know there's the thrill of the chase. but if you want this relationship to last, you've got to slow it down.

So the way that I sort of think about it is there is a certain amount of dopaminergic thrill that you get from this relationship. Do you want to blow your load all at once, right? Do you want to spend all of your thrill right up front? And then generally speaking, what we see in healthy relationships is when we sort of conserve some of that thrill to get us through into three months, four months, five months, six months, and this is when other pillars of the relationship will start to form. Once those pillars are formed, we will hopefully end up with a setup that will lead to a healthy relationship.

The second thing that a lot of people don't understand is something called tactile defensiveness. Now, remember, ADHD is a neurodevelopmental disorder, which means that it alters the way that our brain works. And one of the key things that we're discovering more and more about is that ADHD alters our perception of physical stimuli. So it's not just sounds and sights and things like that, but the way that things feel in our mouth, so a lot of times, you know, people with ADHD will be very sensitive to particular textures and also the way that things feel in our body. So people with ADHD may be very, very sensitive to things like swings and stuff like that, like in a good way. Moving your body becomes really, really important for maintaining your focus. So if you tell

a kid with ADHD to sit still, it becomes really, really hard for them. Now, normally when we think about ADHD, we think about things like sitting still in class. But this actually enters the realm of sexual relationship as well is something called tactile defensiveness. This is where particular ways that we get touched may trigger responses that are different from neurotypical people. So for a neurotypical person, you know, the way that they will touch you, they touch you that way because when someone touches them that way, their brain interprets that touch in a pleasant way. But oftentimes what people with ADHD will experience is like a lot of touch will feel ticklish. People will feel like super super hypersensitive, especially around erogenous zones, or the touch can even be perceived

by your brain as aggressive. So instead of feeling comforted by a touch, your brain like you're kind of locks up, it's like, oh, we're being attacked. And this is because generally speaking, there's a gating problem in the brain. What that means is that the way that our brain gaits stimuli, so when I get a stimulus, my brain will sort of like lower it down a little bit or even block it, and that gating function is impaired in ADHD. What this practically looks like is a bewildering amount of like sensitivity to touch. So the moment that you understand that tactile defensiveness is an issue that even though your partner is touching you in a particular way, or if you're dating someone with ADHD, if you're touching them in a particular way and they don't respond in the right

way, be aware of this principle. What the practical way to deal with this is just to have a lot of communication, a lot of dialogue, and don't take things personally when there is a loving touch that is given that is not received in a loving way. Now, the third thing is incredibly fascinating. So if you're struggling to have sex in a relationship, if the intimacy in your relationship is gone, if there's sort of a dead bedroom syndrome, and there's ADHD at play, this is true of non-ADHD as well, the culprit could be household chores. So this is what's wild, okay? So in a survey, 56% of people said that I would feel sexier if my ADHD partner helped me out more at home. The Pew Center did a research survey on American adults that basically found that the most important thing in a relationship is faithfulness.

The second most important thing in a relationship is healthy, satisfying sexual activity. The third most important thing in a relationship is actually sharing household chores. This is more important than income, more important than looks. So all these like social media influencers out there who are telling you to be an alpha by like making more money and getting super sexy and going to the gym, that's actually not what the data shows. So I know this sounds really insane, but like I want you all to think for a second about what you see on the internet. How much of what you see on the internet is based on actual science or research? Very little. What determines whether something propagates on the internet is the emotional engagement it gets,

which if you stop and think about it for a second is the very opposite of science. Like, real science can be very exciting, but oftentimes it involves a lot of methods, a lot of data analysis, a lot of really drab and dreary stuff. Before you all take issue with me telling you to be a beta cuck and start to like help your wife out with chores, let's take a quick look at what the experience of this is like from someone. So this is from a wonderful qualitative research paper. It seems the loss of intimacy in the non-physical sense is almost universal among us. And that often leads to the physical loss of intimacy as well. It's pretty much impossible to feel close with a spouse when ADHD problems create a wall that blocks the way. For some of us, the wall is a

control battle for a clean, safe place to live. For others, it's a fight against our ADHD partner's addictions or obsessions du jour, financial jeopardy, irritability, substance use, thoughtless words or deeds, unreliability, or various other issues. It doesn't seem to make a heck a lot of difference what specific wall is there. A wall defeats intimacy every time. Now, what does this mean? Practically, what's going on is if we look at the way in which intimacy forms, in order to become aroused, we need activation of the parasympathetic nervous system. The parasympathetic nervous system is our rest and relaxation kind of system. So oftentimes when I'm working with patients who have newborns and they kind of have dead bedroom and they have young kids, not just newborns, but three-year-olds, four-year-olds, five-year-old, seven-year-olds, the rate of sexual activity declines.

Now, why is that? This is really because of the physiology of sex. So we tend to have sex when we have a lot of like relaxation. We feel pretty good. Like if you're well-rested, you're on vacation. If you're exhausted, what happens when you get into bed? You hit the bed. You don't feel like having sex.

You kind of pass out, especially if you're a woman. And this is where there are some biological difference. So if we sort of think about the cost of sex for a man, it's like three to eight minutes of pleasure, and then like tomorrow rolls around, my energy level is totally the same. But from a biological perspective, what is the cost of a sexual act for a woman? It's potentially nine months of pregnancy, a lot of energy investment, a lot of child-rearing investment. So these things are viewed somewhat differently on a biological level. You know, that doesn't mean I don't want you guys to interpret this, like, over-extrapolate this into like, women don't like having sex. That's not what it is. This is just a broad-strokes biological kind of thing. thing. What we do know for both genders is that parasympathetic activity or relaxation is the first step to arousal. Now, once we start to feel aroused, then our sympathetic nervous system kicks in. This is the part of our nervous system that increases our adrenaline, increases blood flow, leads to erections in the penis, leads to clitoral engorgement, which also happens when women are sexually aroused, which if you're wondering, like, why you can't just jump to, you know, engaging with the clitoris, with fingers,

mouth, whatever, and why women, like, may be turned off from that. It's because actually women need a certain amount of clitoral engorgement from increased blood flow that comes from the parasympathetic nervous system to prime those nerves to make it actually feel like it's pleasurable. So practically what this looks like is, you know, when I have patients who have ADHD, they're in a high stress state. You come home, there's decision in the sink, the trash is overflowing, we've got to pay these bills, we've got to pick up this thing. Your kid needs this kind of birthday gift. So there's just so much overwhelming work. And by the way, 96% of people who are in relationships with people with ADHD also feel like their partner is a burden to them in some way. And 92% of people in relationships with people with ADHD also feel like they have to compensate for the lack of organizational contributions from their partner.

So what this practically means is that if your house is a mess, if your shit isn't taken care of, you will be in a high stress state. Once you're in a high stress state, the circuitry that makes you aroused gets disabled. And this is why it's crazy, but like the most arousing thing you can do for your girlfriend or wife is actually housework. And there's a physiological chain for that. The problem is in today's world, everyone's like, oh, yeah, I ain't going to do housework. Like, I ain't going to be a beta cock. We have these very traditional gender roles. And if that's the kind of relationship you want and your partner sort of wants that.

And by the way, that relationship also works because usually in that class, traditional gender relationship, you know, the wife or the woman of the household has somewhere between 40 and 60 hours to take care of household work. They don't have a job. So hopefully that's sufficient. In today's world, when we have double income households, women will get absolutely crushed. Now, a lot of dudes out there will be like really upset by what I'm saying right now, but this is literally the science, right? This is how physiology works. This is how sexual arousal works. We have survey level data that also shows that doing household chores is one of the sexiest things that you can do. And why is that? Once the stress level goes down, we can activate the parasympathetic

nervous system. Once the parasympathetic nervous system kicks in, then we will start to feel more aroused. We'll have opportunities for connection, et cetera. The last thing that we're going to talk about is ADHD induced hypersexuality and hyposexuality. Oftentimes people with ADHD experience a certain amount of hypersexuality. This has been associated with things like inattention and impulsivity. So if you sort of think about, you know, your sexual desires, what are they? They're particular impulses. So if I'm not, you know, if I'm sort of sitting around and I'm like, let's say I'm walking down the street and I see someone walk by and I start to have like a sexual impulse. Oh my God, that person is so hot. Man, I would like to, you know, X, Y, Z. So if you sort of think about

the way that we get aroused, sometimes we get aroused through sensory stimuli and arousal. like I'm sitting here doing my work and now I'm feeling frisky, let me go ahead and approach my partner and try to engage in some sexual activity. That's basically an impulse. So a lot of the hypersexuality that we see is a function of how sensory we are, how susceptible to sensory stimuli we are, as well as how impulsive we are. The other aspect of hypersexuality that we see a lot, especially with like compulsive behavior and ADHD, is that sex can be used as a form of emotional regulation. And remember that people with ADHD, their negative emotional circuitry is more jittery. It experiences negative emotion more intensely, more quickly, and for a longer period of time. The problem with ADHD is that we oftentimes have difficulty engaging in alternate emotional regulation activities.

So if I have a neurotypical patient, I tell them if you're feeling stressed or anxious, meditate. Meditate for 20 to 30 minutes. Do this breathing exercise and then you'll feel better, right? That's what we'll sort of say. But if you're someone who's got ADHD, it can sometimes be hard to remember that you should meditate. It can be hard to even realize that you're feeling anxious. And the ability to engage in meditation, which involves sitting your ass down in a chair for 20 to 30 minutes at a time, is really hard to do. So oftentimes what I see in my patients is that they will default to regulating their emotions and managing their sex through sexual activity.

The last thing that we also know is that hypersexuality is actually very tightly correlated with, self-concept and self-esteem. The worse your self-concept is, the worse your self-esteem is, the more likely you are to engage in hypersexual behavior. If I don't feel content about myself, if I don't feel great about myself, one of the best things that I can do is engage in sexual activity because then I feel connected, then I feel good. I get this rush of vasopressin, oxytocin, I feel connected to this other human being. I feel seen. I can pleasure them in some way, which helps me feel really good. And, you know, if you sort of look at like alpha males on the internet, providing sexual pleasure with their very, very big penises is one of the best ways

that they feel better about themselves, right? I've got a big guy. I'm a sexual Messiah. That makes me a great human being. So there's a lot about self-concept and sexual activity. The last thing to keep in mind is that if you grow up with ADHD that is under-treated, which is probably the case, we see a causal risk between growing up with ADHD and being depressed. So oftentimes what I sort of think about every time I have a patient who comes into my office, if they come in and they have a diagnosis of ADHD, I assume they have a mood disorder like major depressive disorder until proven otherwise. Growing up with ADHD just means that there's a very high risk of developing depression later in life.

Now, last thing that's very bewildering for many people is that not only will they be hypersexual, they will also be hyposexual. Now, why is this? So hyposexuality and ADHD has to do with a number of different things. The first aspect is emotional regulation in the jitteriness of our amygdala. We talked already about stress. So that whole mechanism is at play. If you're someone who's got ADHD and you have an assignment coming up a week from now that's due, your mind is going to be so occupied by that, so stressed out about that, that you can't think about anything else. And the really frustrating thing is not only can you not think about anything else, you can't even do the work and be done with it. Because you have to wait until last minute panic in order to induce your motivational system to actually like write that paper or study for that exam or whatever.

Right. So there's a very high stress state that we live in that leads to hyposexuality. The other mechanism that's important for hyposexuality is that usually getting aroused involves a chain of events. Right. So I start by being relaxed. I start by sort of having my parasympathology. nervous system active. I'm not stressed out. I'm sort of somewhat rested. And then there's some amount of touching. There's some amount of like maybe I'm like touching you a little bit. Maybe you're touching me a little bit. Then maybe we're kissing a little bit. And then maybe there's some heavy petting. And then we sort of have this graduated response of like moving from A to Z. This is what we sometimes call foreplay. When I have patients with ADHD, it's crazy. Like their partners will say like, you know,

they don't understand that I'm trying to seduce them. They're so distractible. Like someone else can be like hitting on them, rubbing their shoulders, whatever, like giving them a kiss, like rubbing breasts up against their face and things like that. And the person with ADHD is like, I'm trying to figure out why Mind Sweeper doesn't have a newer version that someone has released on Steam. So there is basically a chain of attention, which you have to maintain in order to move from initial, like, sexual overtures to the completion of the sexual act. And that chain of attention can be sometimes very hard to maintain in ADHD, which, leads to a sense of hyposexuality. So in my experience as a clinician, the more that I equip my

patients with this kind of understanding, this isn't necessarily like a clinical intervention. This is just, hey, your brain is different, and that's going to impact every part of your life. Thanks for joining us today. We're here to help you understand your mind and live a better life. If you enjoy the conversation, be sure to subscribe. Until next time, take care of yourselves and each other. Ambition comes in all shapes and sizes. At first, Citizens Bank, we're fit for your ambitions, whatever shape they may take. Whether you're planning for today or tomorrow, we've got the flexibility and know-how to help you reach your goals, because we're built for what you're building. First Citizens Bank, fit for your ambition.

Learn more at firstcitizens.com slash ambition.