That friend who can't stop interrupting you? It might not be their fault

While wealthy celebrities like Paris Hilton may refer to ADHD (attention-deficit/hyperactivity disorder) as a "superpower," many find the condition to be more debilitating than empowering. Indeed, ADHD can make it seem as if you are not in control of your own mind. As someone with ADHD, I frequently feel as if my brain is a television set where a stranger is holding the remote; even if I want to stay on one channel, I have to struggle with a force that may change the programming against my will. This is immensely frustrating when a person is trying to collect their thoughts — and even more so when the ADHDer's brain, connecting to their mouth without any filter, causes them to rudely interrupt other people with no ill intent.

Take Iris Gray, a 54-year-old editor for Victoria, British Columbia who was diagnosed with ADHD one year ago. A couple months ago, when she went to a preliminary greeting for a new social group that she was thinking of joining, she casually offered her own opinions and casual comments.

"I tried to wait my turn, but as I often do, I failed and ended up interrupting people a few times," Gray recalled over Facebook. "The person next to me turned to me and said, 'Maybe you could try being quiet for a little while.' I felt so ashamed that I said nothing for the rest of the meeting. I left as soon as it was over and refused the offer of a ride home from one of the other attendees. I haven't gone back to any meetings since then."

Gray isn't alone. Stories abound of people who struggle with interrupting; many of them are documented in numerous online forums for those with ADHD.

"One of the things I sometimes feel ashamed about in having ADHD is my impulsive behavior of cutting people off when they are talking or busy doing something," explained an anonymous contributor to the website The Mini ADHD Coach. "I want their full attention on me when I try to say something out of my head. Before having my ADHD diagnosis, I tend to suffer a lot from this ADHD trait, and I didn't understand how my brain works."

An ADHD mother recalled to ADDitude Magazine a situation where she interrupted a fellow parent, writing that the impulse to speak "came on so suddenly, and so strongly, that the need to tell you superseded all social convention. I'm not ignoring you. I'm not obsessively self-centered. My conversational skills just misfire – sometimes badly."

Stanford University psychology professor Dr. Joshua William Buckholtz told Salon that, as far as he knows, there is a dearth of neuroscientific work on people who seem to be chronic interrupters. Yet Buckholtz said scientists can deduce what type of "impaired" cognitive processes could result in that behavior.

"Action cancellation — the ability to stop the execution of a prepared motor response — would seem relevant," Buckholtz wrote to Salon. "There is a wealth of literature describing brain circuitry responsible for action cancellation and its impairment in disorders such as ADHD."

Buckholtz also observed that because human-to-human conversations involve constant use of nonverbal cues such as "facial affect, body posture, prosody of speech," anyone with a condition that limits their ability to pick up on those cues will be prone to interrupting.

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Of course, not everyone who is prone to interrupting might have ADHD or a comparable condition. (Some people are just self-centered.) Terry Matlen, LMSW, ACSW — a nationally recognized expert on ADHD in women — pointed out that there are other conditions which cause interrupting. Matlen listed autism spectrum disorder (ASD) and mood disorders that lead to impulsivity (such as bipolar disorder) as conditions that, along with ADHD, might lead one to uncontrollably interrupt others.

In other words, the tendency towards uncontrollably interrupting may occur with anyone who has "cognitive impairments who have difficulty reading social cues and knowing when to talk and when to listen."

"They may interrupt for fear of forgetting what they want to say," Matlen continued. "Or they cannot stay connected via audio communication."

Matlen added that the trait can also be seen "in certain personality disorders such as borderline personality disorder." 

Dr. Stephanie Sarkis, a clinical specialist in child and adolescent counseling, wrote to Salon that uncontrollable interruption can also be a symptom of an anxiety disorder or a traumatic brain injury.

"Neurological reasons can differ based on the medical condition," Sarkis wrote to Salon. "Executive functions of the brain, in the frontal lobe, regulate behavior. It helps us inhibit (not do) behaviors. If there is impairment in the frontal lobe, it can lead to a lack of inhibition (known as disinhibition)."

Buckholtz added that there is another group that might uncontrollably interrupt: people with tic conditions like Tourettes syndrome, who may engage in involuntary movements and vocalizations that can be perceived by others as "intrusive conversational interrupting." While Tourettes syndrome may seem like a more clear-cut case of someone being unable to control themselves when compared to other conditions, Buckholtz also noted that an important framework for understanding why there are so many conditions that lead to chronic interrupting — ADHD, bipolar disorder, borderline personality disorder, anxiety conditions, traumatic brain injury, autism spectrum disorders, Tourettes syndrome — is that neurologists and psychologists define "uncontrollable" differently than the general public.

"The subjective experience of someone who exhibits the kind of behavior you describe is that it is 'uncontrollable,'" Buckholtz noted. "I think it's important to distinguish that subjective experience from what non lay-persons (specifically, scientists, philosophers, and legal scholars) mean when they talk about a behavior being uncontrollable."

For example, people with bipolar illnesses may display "conversational intrusiveness," because when they enter a manic state they will "speak very rapidly and with an urgency that makes it difficult for others to get a word in," a symptom known as "pressed speech."

Buckholtz observed that individuals with schizophrenia and those who abuse psychostimulants like cocaine and amphetamine will likewise exhibit uncontrollable "pressed speech." When in this state, such individuals will tend to interrupt others more frequently. This symptom ("pressed speech") can also be present in individuals with schizophrenia, and in people who abuse psychostimulants (e.g. cocaine, amphetamine). Yet when people are engaging in "pressed speech," it is not because they choose to show disrespect to others. The neurological mechanisms that they need to effectively communicate are, quite simply, impaired.

So is there any way to help chronic interrupters, if you are not one yourself?

"It can often be helpful to start talking about your own personal challenges and asking that person to help you with improving yourself," Sarkis suggested. "This could open up a gentle discussion about how the other person's interrupting can be frustrating, or worse. Or you may simply ask if that person is aware of their interrupting and that it is creating tension (or fill in the blank) between you two. Ask them: how can we work on this together so that we can improve our relationship?"