Question: Hello Dr. Barkley, thank you so much for doing this 
  
  Why is it that many people with adhd feel like they don't fit in with their peers, or just society as a whole? 
  
  Also, are comorbidities more of a nature or nurture type issue? For example, would a kid with adhd already have anxiety or ocd along with it, or would the anxiety develop over time because of the adhd?
Answer: I think the answer to this is above - ADHD is really SRDD (EFDD).  Social interactions, reciprocity, cooperation, and even intimacy all require appropriate degrees of self-regulation from an individual.  When such self-regulation is jeopardized by the disorder, it greatly impacts social acceptance and functioning because it raises problems with making and keeping promises, reciprocating with others (sharing), joining into cooperative team or group activities to accomplish some common goal, repaying favors, managing debts, accomplishing daily social responsibilities -- all are at risk from the disorder.  Others can detect these differences in adults with ADHD within minutes of getting to know them.  Of all the EF difficulties, it is the impulsive emotional and poor self regulation of emotion that is so harmful to social relationships.  Others can tolerate one's distractibility, activity, fizzy personality so to speak, but not someone's quickness to be impatient, frustrated, hostile, angry or even reactively verbally and physically aggressive.  That can easily lead to social rejection, being fired from your job,  road rage and related citations and license suspensions, intimate partner distress and even violence, etc. So it is the dysregulated emotion more than other symptoms that takes its toll on social relations when ADHD is unmanaged.
content: Q: Hello Dr. Barkley, thank you so much for doing this 
  
  Why is it that many people with adhd feel like they don't fit in with their peers, or just society as a whole? 
  
  Also, are comorbidities more of a nature or nurture type issue? For example, would a kid with adhd already have anxiety or ocd along with it, or would the anxiety develop over time because of the adhd?
   Ans: I think the answer to this is above - ADHD is really SRDD (EFDD).  Social interactions, reciprocity, cooperation, and even intimacy all require appropriate degrees of self-regulation from an individual.  When such self-regulation is jeopardized by the disorder, it greatly impacts social acceptance and functioning because it raises problems with making and keeping promises, reciprocating with others (sharing), joining into cooperative team or group activities to accomplish some common goal, repaying favors, managing debts, accomplishing daily social responsibilities -- all are at risk from the disorder.  Others can detect these differences in adults with ADHD within minutes of getting to know them.  Of all the EF difficulties, it is the impulsive emotional and poor self regulation of emotion that is so harmful to social relationships.  Others can tolerate one's distractibility, activity, fizzy personality so to speak, but not someone's quickness to be impatient, frustrated, hostile, angry or even reactively verbally and physically aggressive.  That can easily lead to social rejection, being fired from your job,  road rage and related citations and license suspensions, intimate partner distress and even violence, etc. So it is the dysregulated emotion more than other symptoms that takes its toll on social relations when ADHD is unmanaged.