Welcome to the Middle
We made it to the middle of the semester (at least the college semester). The syllabus-week motivation has worn off, the brand-new planner is buried somewhere at the bottom of a backpack, and somehow midterms, papers and group projects all landed in the same two weeks. For many students with ADHD, this is exactly the point where things start to slip. And then the thoughts start creeping in:
“I had a plan. What happened?”
“Why am I already this far behind?”
“Why can everyone else keep up and I can’t?”
I hear these questions every single fall and spring from the students and young women I work with. I also remember asking them myself, long before I knew I had ADHD.
What the Research Says
College is a big jump for anyone, but for students with ADHD the research is pretty clear that the jump is steeper. One of the largest studies of its kind followed over 400 college students for four years, about half of them with ADHD. The students with ADHD earned significantly lower GPAs and reported using study strategies far less often than their peers. Fewer of the unmedicated students with ADHD made it through all eight semesters (49%) compared to students without ADHD (59%) (DuPaul et al., 2021).
A 2025 systematic review looked at studies published between 2018 and 2024 and came to the same conclusion. ADHD, and inattention in particular, is linked to lower academic performance in college, with executive functioning, medication use and study strategies all playing a role (Pagespetit et al., 2025).
Here is the part I want everyone to hear, though. In the four-year study, the students who did better had something in common: fewer depressive symptoms, stronger executive functioning skills and access to academic support (DuPaul et al., 2021). Those are things we can work on. That gives me so much hope.
Why the Middle Is So Hard
The beginning of the semester has novelty on its side. New classes, new notebooks, new people. The ADHD brain loves new. By October, the novelty is gone and what is left are long-term deadlines that all need to be managed at the same time. That is where a few things start to pile up.
Procrastination. Procrastination is closely tied to ADHD symptoms in college students, and one study of 595 students found that difficulties with emotion regulation and lower self-esteem partly explain that connection (Bodalski et al., 2023). In simple terms, putting things off is often about how a task FEELS, not just how it is organized. When an assignment brings up dread, shame or overwhelm, avoiding it brings short-term relief. And then the pile grows.
Emotions. A study of more than 4,000 college students across eight universities found that students with elevated ADHD symptoms relied more on unhelpful ways of thinking through difficult emotions. They also struggled more with academic confidence, organization and managing stress and time pressure (Alacha et al., 2025). Mid-semester is basically one long stretch of stress and time pressure, so of course this is when it shows up.
Sleep. Then there is sleep, which is usually the first thing to go when the workload rises. Inattentive ADHD symptoms are uniquely linked to poorer sleep quality and more daytime dysfunction in college students (Becker et al., 2018). Another study found that daytime sleepiness predicted school performance in college students with ADHD (Langberg et al., 2014). Late nights to catch up lead to foggier days, which lead to more catching up. It becomes a cycle, and a very exhausting one.
A Note for the Girls and Women
You know I can’t write about ADHD without talking about girls and women. College women with ADHD report higher levels of inattention and more impairment than college men with ADHD, across areas like school, social life, money management and daily tasks (Fedele et al., 2012). When researchers interviewed women in university who were diagnosed with ADHD as adults, they described stigma and a long list of social, academic and emotional struggles, and they pointed to how much professionals still miss (Morley & Tyrrell, 2023).
And then there is the MASKING. So many of the young women I see look completely put together on the outside. Color-coded notes, on time to class, smiling in the group chat. Meanwhile they are staying up until 3am to finish what everyone else seemed to finish days ago. Masking takes an enormous amount of energy, and by mid-semester, that energy runs out. If this sounds familiar, please know that you are not imagining it and you are not alone.
Small, Real Changes for the Second Half
There is no quick fix here, and I will always be upfront about that. What I can offer are small, real changes that the research supports. They might feel uncomfortable at first. That is okay.
Start with the feeling, then the task. Since emotion regulation is so closely tied to procrastination, ask yourself what the assignment brings up before you try to force yourself through it. Naming the dread or the overwhelm can take some of its power away. In one study, a short cognitive behavioral program focused on procrastination significantly reduced procrastination in university students with ADHD symptoms (Oguchi et al., 2025).
Be kind to yourself on purpose. University students with ADHD traits who practiced more self-compassion had better well-being and less distress, partly through fewer struggles with emotion regulation (Farmer et al., 2023). Talking to yourself the way you would talk to a friend is a skill, and it can be practiced.
Protect your sleep, even a little. Choose one thing, like a set time to put the phone down or a consistent wake-up time, and start there.
Use your supports. Academic support services were one of the strongest predictors of success for students with ADHD (DuPaul et al., 2021). Visit the disability services office, go to office hours, or find a study partner or body doubling session so you are not doing it all alone.
Check in on your mood. Depressive symptoms predicted poorer outcomes for students with ADHD (DuPaul et al., 2021). If the heaviness is sticking around, please reach out to a therapist or your campus counseling center.
Here’s to the Second Half
If you are reading this from underneath a pile of overdue assignments, take a breath. Struggling in the middle of the semester says nothing about how capable or smart you are. It is what happens when a brain that runs on interest and urgency meets weeks of long, slow deadlines. With the right understanding and the right supports, the second half can look different.
As always, if you have any questions or thoughts, please feel free to reach out to me. And if you are a woman with ADHD looking for community, our support group is always open to new faces. We need support, and we need to support each other.
Here’s to the rest of the semester. You’ve got this.
References
Alacha, H. F., Walbridge, F. C., Harton, H. C., Vasko, J. M., Bodalski, E. A., Rother, Y., & Lefler, E. K. (2025). Cognitive emotion regulation and learning effectiveness in college students with ADHD symptoms. Anxiety, Stress, & Coping, 38(1), 73–89.
Becker, S. P., Jarrett, M. A., Luebbe, A. M., Garner, A. A., Burns, G. L., & Kofler, M. J. (2018). Sleep in a large, multi-university sample of college students: Sleep problem prevalence, sex differences, and mental health correlates. Sleep Health, 4(2), 174–181.
Bodalski, E. A., Flory, K., Canu, W. H., Willcutt, E. G., & Hartung, C. M. (2023). ADHD symptoms and procrastination in college students: The roles of emotion dysregulation and self-esteem. Journal of Psychopathology and Behavioral Assessment, 45(1), 48–57. https://doi.org/10.1007/s10862-022-09996-2
DuPaul, G. J., Gormley, M. J., Anastopoulos, A. D., Weyandt, L. L., Labban, J., Sass, A. J., Busch, C. Z., Franklin, M. K., & Postler, K. B. (2021). Academic trajectories of college students with and without ADHD: Predictors of four-year outcomes. Journal of Clinical Child & Adolescent Psychology, 50(6), 828–843.
Farmer, G. M., Ohan, J. L., Finlay-Jones, A. L., & Bayliss, D. M. (2023). Well-being and distress in university students with ADHD traits: The mediating roles of self-compassion and emotion regulation difficulties. Mindfulness, 14(2), 448–459.
Fedele, D. A., Lefler, E. K., Hartung, C. M., & Canu, W. H. (2012). Sex differences in the manifestation of ADHD in emerging adults. Journal of Attention Disorders, 16(2), 109–117. https://doi.org/10.1177/1087054710374596
Langberg, J. M., et al. (2014). The impact of daytime sleepiness on the school performance of college students with attention deficit hyperactivity disorder (ADHD): A prospective longitudinal study. Journal of Sleep Research, 23(3), 320–327.
Morley, E., & Tyrrell, A. (2023). Exploring female students’ experiences of ADHD and its impact on social, academic, and psychological functioning. Journal of Attention Disorders, 27. https://doi.org/10.1177/10870547231168432
Oguchi, M., Furukawa, E., & Kumano, H. (2025). Effects of a procrastination intervention for Japanese university students with attention-deficit/hyperactivity disorder tendencies: An interrupted time series analysis. Journal of Cognitive Psychotherapy, 39(3).
Pagespetit, È., Pagerols, M., Barrés, N., Prat, R., Martínez, L., Andreu, M., Prat, G., Casas, M., & Bosch, R. (2025). ADHD and academic performance in college students: A systematic review. Journal of Attention Disorders, 29(4), 281–297. https://doi.org/10.1177/10870547241306554
