ADHD and Emotional Dysregulation: Support for Navigating Life’s Challenges

Flying off the handle. Flipping your lid. Melting down. Any way you say it, when emotions get out of control, it’s hard for everyone involved - especially when ADHD is part of the picture.

Everyone knows about the attention and focus challenges inherent in Attention Deficit Hyperactivity Disorder (ADHD) - but one symptom that is often overlooked or forgotten is emotional dysregulation. In this article, we’ll uncover the connections between ADHD and emotional dysregulation to shed light on impacts, causes, and ultimately, what can be done to achieve a more well-regulated emotional life with ADHD.

Table of Contents

What is emotional dysregulation?

How can emotional dysregulation impact your life?

What causes emotional dysregulation in people with ADHD?

What are some approaches to improving emotional dysregulation?

Signs and symptoms of emotional dysregulation

What are some strategies to improve emotional regulation?

The takeaway

What is emotional dysregulation?

Emotional dysregulation is the decreased ability to effectively manage and regulate emotions and behavioral responses.  This causes unexpected and seemingly disproportionate emotional reactions in individuals. You might observe emotional dysregulation in various forms, such as intense mood swings, low frustration tolerance, impatience, angry outbursts, crying, anxiety, and depression. 

Emotional dysregulation is a common symptom of ADHD and occurs due to differences in the nervous system and brain that also influence deficits in executive functions like working memory, organization, focus, task initiation, and time management. It’s not just those “negative” emotions that are impacted by dysregulation - you can also observe heightened excitability, energy, and humor from those with ADHD. However, intense emotions, whether positive or negative, can directly affect all aspects of a person's life: school, work, social and family relationships can suffer if your ability to maintain an even keel is reduced.

How can emotional dysregulation impact your life?

Emotional dysregulation can have a significant impact on a person's life in a variety of ways. Here are a few examples:

1. Difficulty in relationships

   • Individuals with emotional dysregulation may have trouble maintaining friendships and romantic relationships due to impulsivity and difficulty managing emotions. They may also struggle with trusting others and have difficulty expressing emotions appropriately. Misunderstandings and arguments can wear away at the bonds of friendship, which can lead to social isolation.

2. Difficulty in the workplace

   • Individuals with emotional dysregulation may have difficulty maintaining employment due to impulsivity, difficulty managing stress and anxiety, conflicts with colleagues, and difficulty with time management and productivity. Workplace stressors like deadlines can trigger anxious feelings and make it more difficult to meet demands.

3. Difficulty in academic settings

   • Similar to the workplace issues described above, students with emotional dysregulation may have difficulty in academic settings due to high demands for productivity. Students also often struggle with managing the stress and pressure of testing and exams.

4. Difficulty in daily activities

   • Individuals with emotional dysregulation may have difficulty completing daily tasks if they get sidetracked by emotional responses to those demands. They may also struggle with self-care and maintaining a healthy lifestyle.

5. Difficulty in self-esteem

   • Individuals with emotional dysregulation may have low self-esteem and a negative self-image due to their difficulty managing emotions. They may also struggle with feelings of guilt, shame, and self-blame from past failures.

6. Difficulty in physical and mental health

   • Emotional dysregulation can lead to physical and mental health issues such as depression, anxiety, and sleep disorders, leading to a vicious cycle of negative emotions, physical symptoms, and more emotional difficulties.

It is important to note that emotional dysregulation can also lead to self-destructive behaviors such as substance abuse, self-harm, and suicidal thoughts. It is crucial to seek professional help if these symptoms appear. A therapist or mental health professional can help individuals with emotional dysregulation develop coping strategies and improve their emotional regulation.

What causes emotional dysregulation in people with ADHD?

Recent brain imaging studies shed some light on the causes of emotional dysregulation in people with ADHD. The ADHD brain oftentimes has an overactive amygdala and an underactive prefrontal cortex. The amygdala is a small almond-shaped structure located in the temporal lobe of the brain. It plays a crucial role in the processing of emotions and emotional memories. 

When the amygdala is overactive, it can trigger strong emotions, such as fear or anxiety, in response to situations that may not warrant such a reaction. For example, if an individual with an overactive amygdala encounters a neutral or even positive situation, they might experience strong feelings of fear or anxiety. This overactivity can lead to emotional dysregulation.

On the other hand, the prefrontal cortex is responsible for filtering and moderating emotions. It works in conjunction with the amygdala to process and respond to emotional stimuli. The prefrontal cortex plays a key role in regulating emotions, making decisions, and controlling impulses. (The prefrontal cortex is responsible, in large part, for our higher-order cognitive skills, including executive functioning.)

In ADHD individuals, research suggests that the prefrontal cortex might be under-active, which can lead to difficulties in regulating emotions. This underactivity might be caused by a lack of dopamine, a neurotransmitter associated with attention and motivation, in the prefrontal cortex. When dopamine is low in the prefrontal cortex, it may not be able to effectively modulate the emotional response of the amygdala, which can lead to emotional dysregulation.

It is worth noting that emotional dysregulation is a complex issue, and the cause of emotional dysregulation in ADHD individuals can be multifactorial. Therefore, it is essential to consult with a mental health professional to understand the root cause and develop an appropriate treatment plan.

What are some approaches to improving emotional dysregulation?

One effective treatment for emotional dysregulation is therapy, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), which can be helpful in learning how to cope with and regulate emotions. Additionally, medication, such as antidepressants, can be prescribed to help manage dysregulation. Finally, you can gain emotional regulation tools and strategies from working with an Executive Function coach.

Signs and symptoms of emotional dysregulation

There are several signs and symptoms that may indicate that someone is experiencing emotional dysregulation. These include:

1. Difficulty managing anger

   • Individuals with emotional dysregulation may have trouble controlling their anger and may become easily frustrated.

2. Rapid mood swings

   • Individuals with emotional dysregulation may experience sudden and intense changes in mood, often with no apparent trigger.

3. Overreaction to minor events

   • Individuals with emotional dysregulation may have an excessive emotional response to small or insignificant events.

4. Difficulty calming down after becoming upset

   • Individuals with emotional dysregulation may have trouble calming down once they have become upset, and their emotions may continue to escalate.

5. Impulsive behavior

   • Individuals with emotional dysregulation may act impulsively without considering the consequences of their actions.

6. Self-harm or suicidal thoughts

   • Individuals with emotional dysregulation may engage in self-harm or have suicidal thoughts as a means of coping with overwhelming emotions.

7. Difficulty in maintaining relationships

   • Individuals with emotional dysregulation may have trouble maintaining relationships due to their impulsivity, difficulty managing emotions, and trust issues.

8. Difficulty in academic and work settings

   • Individuals with emotional dysregulation may have difficulty in academic and work settings due to their impulsivity, difficulty managing stress and anxiety, and difficulty with time management.

What are some strategies to improve emotional regulation?

Despite the neurological differences in the ADHD brain, it is possible to improve emotional regulation through a variety of interventions, including: 

• Mindfulness practices, such as meditation and deep breathing exercises, can help increase awareness of one's emotions and tap into their capacity to self-calm. Many studies have found that these practices facilitate clinically significant improvements in stress, anxiety, and overall well-being.

• Cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), can be helpful in learning how to cope with and regulate emotions. to identify and change negative thought patterns

• Executive Function coaching can be beneficial to improve challenges with emotional regulation as this type of support involves an ongoing, collaborative approach to help strengthen global self-management skills that are often at the root of challenges with self-regulation.

• Social skills training can help improve communication and conflict resolution which are often central to untreated emotional dysregulation.

• Medications, such as antidepressants, can be an essential component of the treatment for emotional dysregulation as this challenge can often stem from neurological factors and conditions that impact one’s ability to regulate mood and emotions. (Note: it’s essential to explore medication as an intervention only under the supervision of a licensed prescriber.)

In addition to these approaches, individuals with ADHD and emotional dysregulation can try the following strategies to help improve their emotional regulation:

1. Develop a daily routine

   • Having a consistent daily routine can provide structure and predictability, which can help individuals with ADHD feel more in control of their emotions - and their lives.

2. Exercise

   • Regular physical activity can improve overall mood and reduce feelings of anxiety and depression. It need not be marathon running or weight lifting - simply walking daily or gentle bike rides can be incredibly effective in helping you manage intense emotions.

3. Get enough sleep

   • Sleep plays a crucial role in regulating emotions, and individuals with ADHD are more likely to have sleep problems. Ensuring adequate sleep can help improve your emotional regulation and your overall executive functioning.

4. Practice self-care

   • Engaging in activities that promote physical, emotional, and mental well-being, such as yoga, can help reduce stress and improve emotional regulation.

5. Use visualization and imagery

   • Visualizing a peaceful scene can help you to relax and calm your emotions when feeling overwhelmed. Imagine you are walking in the woods, watching gentle ocean waves, or seeing a flower-strewn meadow. Listening to sounds such as rain falling or birds singing can also help modulate intense emotions.

6. Hit the “pause” button

   • When feeling frustrated or angry, allow yourself some space and time to regain your composure. It’s better to say “I need a few minutes before I answer that” than to lash out at a colleague or loved one.

7. Label your feelings

   • Take a moment to identify exactly what you’re experiencing. Is it frustration? Fatigue? Disappointment? Building self-awareness of the nuances of your emotions can help you begin to effectively address your triggers.

8. Use diaphragmatic breathing

   • Taking slow, deep breaths can help to activate your natural relaxation response and calm your body and mind.

9. Use positive self-talk

   • Talking to yourself in a positive and supportive way can help change negative thought patterns and improve emotional regulation. Notice how you feel when you say to yourself, “I can handle this small problem and it won’t ruin my day,” versus “This situation is a disaster!” 

10. Use a fidget toy

    • Fidgeting can help to release pent-up energy and reduce stress and anxiety. There are many kinds available now that can be quite unobtrusive, such as specially designed jewelry that has moving parts you can manipulate.

It is important to remember that emotional regulation is a complex process and that different strategies may work better for different individuals. With the right tools and support, people living with ADHD can learn to effectively manage their emotions and improve their relationships with others.

The takeaway

There is a direct relationship between ADHD and emotional dysregulation, rooted in brain differences in two key areas responsible for triggering and processing emotions: the amygdala and the prefrontal cortex. While the effects of poor emotional regulation can be profound, shaming someone for their challenges is neither a compassionate nor effective way to address these difficulties. Rather, we should seek to understand the root causes of the issue and work toward equipping people with ADHD and emotional dysregulation with tools that help them gain stability and confidence in themselves.

If you or somebody you know has been diagnosed with ADHD and you’ve noticed issues surrounding emotional behavior, consider implementing some of the strategies we revealed in this article. If you find you need additional support, contact a certified mental health professional or learn about how executive function coaching can help improve emotional regulation in people with ADHD.

Photo by Andre Hunter on Unsplash

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