Mental Load in ADHD: Everything You Keep in Your Head

One day evening came, I looked at the list and three items were crossed out. I was worn out. That exhaustion could not be explained by those three items.

Then I understood: the source of my tiredness had not been the three crossed-out items. It was carrying in my head, all day, the twenty items that were not crossed out.

In the glossary this is called mental load, and I think it is the least discussed and most expensive side of ADHD. Because it cannot be shown to anyone, it cannot be measured, and it has no defense against the sentence "but you didn't do anything."

Where the load builds up

Mental load is invisible because it has no output. Nobody reports "today I remembered the bill for eight hours." But it consumes energy, and the energy it consumes is subtracted from the energy that would go to the work itself.

There is a concrete reason why this load is heavier in ADHD. Working memory, that is, the capacity to hold information in mind for a short time and operate on it, is consistently measured as lower in ADHD (Kofler et al., 2010). I described the mechanism in detail in the article on working memory and forgetfulness.

The everyday result is this: the number of things you can hold in mind is small, while the number of things you need to hold is the same as everyone else's. The gap is closed with constant effort, and that effort has no name.

On top of it comes the fear of forgetting. Someone who has forgotten something many times checks again and again what they do remember. Every check is a new load, and if I tried to count how many times a day I check the same thing, I would forget that number too.

The book on adult ADHD by Barkley and colleagues (2008) shows that the picture is not limited to attention but affects a wide area of everyday functioning. Mental load stands exactly in this area: it is not on the symptom list, but it is everywhere in life.

Making the list does not tire you. Carrying the list in your head does.

How it shows

• Sentences like "don't forget this tomorrow" coming one after another as you fall asleep.
• Remembering the same thing five times a day and not doing it all five times.
• The chain suddenly snapping while answering a simple question.
• The feeling of having forgotten something; lasting all day without knowing what.
• Even a day on which nothing is done being tiring.

The most familiar one in me is the fourth. A feeling all day as if someone is following behind me. What I finally remember is usually something very small and is never in proportion to the weight I carried all day.

Moving the load outside

The logic here is this: instead of forcing the mind to work better, transferring what the mind carries to somewhere else. In the glossary it appears as externalizing memory.

The one-place rule. Everything goes to the same place. A notebook, a phone app, a piece of paper; which one does not matter, how many of them there are does. A person who keeps two lists trusts neither, merges the two in their head and increases the load. I described the details in the article on the single list rule.

The capture habit. Write it down the moment it comes to mind. Saying "I'll write it later" means having to remember it until then. Writing takes five seconds, remembering takes the whole day.

Brain dump. Once a week, sit down and pour out everything that is on your mind in its raw form. Without looking for order, importance or logic. This is the thing that gives me the fastest relief and it usually takes fifteen minutes. I described how it is done in the article on the brain dump.

Write the decision too. "I won't do this" is also a decision, and when it is not written it comes back. Deleting an item leads to the same door as doing it: it leaves your head. I no longer delete the jobs I have given up on; I cross them out. The crossed-out version stops me from having to make that decision again.

Automate. An automatic payment instruction for bills, a calendar reminder for recurring jobs. A system set up once is incomparably cheaper than a job remembered again every month.

Write the waiting jobs too. Jobs that are not with you, that you are waiting for from someone else, produce load too: an email awaiting a reply, a document that should arrive. Keeping a separate line for them took the question "I wonder if they forgot" out of my head.

Trusting the system is also something you learn. In the first weeks you will keep holding things in your head even though you have written them, because you do not yet trust the system. This is normal and temporary. After the system has saved you a few times you begin to let go. In me this trust took about two months.

A common mistake: multiplying the load with a system

I fell into this trap, which is why I am writing it. The system I built to reduce mental load became a load itself after a while.

Labels, categories, priority levels, recurring tasks. Each was reasonable on its own. Together they produced a screen that was tiring to look at, and because I did not look, I was still carrying the load in my head.

The criterion should be this: when you open the system, do you feel relief, or do you want to close it? The second answer says the system has grown too big. Simplifying is a job needed more often than adding.

The invisible household load

Part of this load is not distributed equally at home. The person who keeps track of who will go to the doctor and when, which ingredient has run out, whose birthday is approaching, usually does it alone, and nobody sees that labor. In the glossary it appears as invisible work.

Combined with ADHD it creates a double injustice: you both carry the load and are criticized for struggling to carry it. Moreover this distribution is even more disproportionate, especially in women; I covered that side in the article on women with ADHD and the household load.

There is a part of this that is solved by building a system, but not all of it. The rest is solved by sharing, and sharing too has to begin by talking.

How you know the load is shrinking

For me the criterion was not the length of the list. Because as the list grew longer the load decreased, and as it got shorter the load increased; because a short list meant the rest was in my head.

Three criteria that worked were these:

• Am I forming the sentence "don't forget this tomorrow" as I fall asleep?
• How many times a day do I check the same thing?
• Does a day on which I do nothing pass restfully?

The third is the best indicator. An empty day being tiring does not mean you did nothing that day. It means you carried things all day.

I described the same logic applied to objects in the article on the visible place system: there too the missing inner structure is built from outside. The World Federation consensus statement (Faraone et al., 2021) points to the same place: the effect of ADHD spreads over a far wider area than the symptom list and shows in every corner of daily functioning. Mental load is the quietest but most continuous item in that area.