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ADHD Emotional Dysregulation

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects millions of people globally. While it is commonly associated with symptoms such as hyperactivity, impulsiveness and inattention, many people with adult ADHD also struggle with emotional dysregulation. This means that they have difficulty managing their emotions and responding appropriately in different situations.
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ADHD Emotional Dysregulation

20/02/2023
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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects millions of people globally. While it is commonly associated with symptoms such as hyperactivity, impulsiveness and inattention, many people with adult ADHD also struggle with emotional dysregulation. This means that they have difficulty managing their emotions and responding appropriately in different situations.

In this article, we’re going to look in more detail at what ADHD emotional dysregulation is, its causes, and ways to manage and cope with it.

What Is Emotional Dysregulation?

Emotional dysregulation is a decreased ability to control emotional responses. This can result in emotional reactions that are disproportionate to the situation. People who have problems with emotional regulation may be seen to overreact in certain scenarios; some are quick to anger, whilst others may be quick to cry.

Generally speaking, people who struggle to regulate their emotions experience more intense feelings on a more regular basis, leading to emotional episodes that can resemble tantrums.

That being said, emotional dysregulation can present itself in many ways and isn’t just limited to emotional outbursts. Other markers of emotional dysregulation include:

  • Struggling to identify and understand what you’re feeling, e.g., feeling happy and frustrated at the same time
  • Having trouble understanding what other people might be feeling, e.g., not realising someone is upset, or being unempathetic in a situation
  • Feeling lots of emotions at once and shutting down due to being overwhelmed

Emotional Dysregulation and ADHD

Emotional dysregulation is common in people with ADHD due to the symptoms that ADHD can present, but it is not in itself considered one of the major markers of ADHD in the same way that hyperactivity, inattention and impulsivity are. However, research has shown that ADHD and emotional dysregulation are connected, and that emotional dysregulation can be viewed as a core trait of ADHD.

How Does Emotional Dysregulation Impact a Person’s Life?

Emotional dysregulation can have a significant impact on a person’s life. People with emotional dysregulation often experience intense emotional reactions, mood swings, and impulsive outbursts that can negatively affect their professional career and interpersonal relationships, as well as their mental and physical wellbeing.

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Professional Career

People with emotional dysregulation may struggle in the workplace due to difficulties managing their emotions effectively. For example, they may struggle with anger management, leading to conflicts with coworkers and resulting in strained work relationships or a negative working environment.

Additionally, impulsive behaviours and mood swings can negatively impact job performance and limit opportunities for career advancement, meaning a person with ADHD may be overlooked for a promotion. This can lead to stagnant job progression, which in itself can cause frustration.

Interpersonal Relationships

People with emotional dysregulation may have difficulty maintaining healthy relationships with friends, family members and romantic partners. Intense emotional reactions, mood swings, and impulsive behaviours can strain relationships and cause conflict.

Another aspect of ADHD emotion dysregulation is not always being able to identify how other people might feel, or be sensitive to their emotions. If a loved one is unhappy, a person with ADHD might not always recognise it and therefore may not offer an appropriate emotional response or the support that is needed, leading to relationships feeling one-sided. Over time, a seeming lack of emotional awareness can lead to the breakdown of relationships.

Additionally, emotional dysregulation can cause issues with trust and intimacy, leading to difficulties in forming and maintaining relationships, particularly romantic ones.

Mental Health

People with ADHD are at an increased risk of developing mental health conditions, such as anxiety and depression, as well as conduct disorder and sleep issues. All of these conditions can lead to impaired emotional control.

Over time, emotional dysregulation can lead to feelings of hopelessness, low self-esteem and self-doubt, which can exacerbate mental health symptoms for conditions such as depression. To help cope with such feelings, people with ADHD may turn to substance abuse. It’s thought that approximately 30% of adults with ADHD have abused drugs at some stage. Substance abuse can exacerbate emotional regulation issues and cause strained personal and professional relationships.

Physical Health

People with emotional dysregulation are at an increased risk of physical health problems such as headaches, muscle tension and heart disease. Frequent intense emotions and stress can also have a physical impact, such as increased cortisol levels and a suppressed immune system.

Quality of Life

Those with emotional dysregulation problems often experience a lower quality of life compared to those who are able to manage their emotions effectively. Emotional dysregulation can lead to difficulties in maintaining stable relationships, a successful career, and good mental health, which can all contribute to a lower overall quality of life.

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Why Is Emotional Dysregulation So Common in ADHD?

Emotional dysregulation is common in people with ADHD due to a combination of factors, including executive function deficits, impulsiveness, hyperactivity, stress, comorbid disorders, and medication side effects.

Executive function deficits: ADHD is characterised by impairments in executive functioning, which is a group of mental processes responsible for regulating behaviour, attention and emotions. People with ADHD often have difficulty controlling their impulses and regulating their emotions due to issues with their executive functioning skills and the frustrations that can arise from it, and this can lead to emotional outbursts and poorly regulated emotional responses.

Impulsiveness: Impulsiveness is a common symptom of ADHD and can be linked to emotional dysregulation. People with ADHD often act without thinking about the consequences, leading to impulsive behaviours that can escalate emotions and create emotional flares.

Hyperactivity: People with hyperactive or combined ADHD typically have an increased chance of emotional dysregulation. When people are constantly moving and on the go, they are less likely to take the time to process their emotions, leading to impulsive reactions and responses.

Stress: Individuals with ADHD – especially inattentive or combined ADHD – often experience high levels of stress (typically as a direct result of symptoms), which can contribute to emotional dysregulation. Stress as an isolated condition affects the prefrontal cortex area of the brain, and this is the same area that is affected by ADHD. It can heighten ADHD symptoms and cause chemical changes in the brain. When people are stressed, they are more likely to experience intense emotional reactions which can make it difficult to regulate how they feel or to stay calm in certain situations. Stress, combined with ADHD, can lead to problems with emotional regulation.

Comorbid disorders: Many people with ADHD have comorbid disorders, such as anxiety or depression, which can also contribute to emotional dysregulation. In fact, it’s estimated that around 30% of children and 13% of adults with ADHD have comorbid depression, and around 25% of adults with ADHD have comorbid anxiety. When people have multiple conditions and diagnoses, it can be more challenging to regulate emotions and manage mood swings, especially if the comorbid condition is a mood disorder that causes heightened emotions independently, such as anxiety or depression.

Medication side effects: Some medications used to treat ADHD can have side effects that contribute to emotional dysregulation. For example, stimulant medications can cause irritability and mood swings, making it more challenging for people with ADHD to manage emotions.

By understanding these underlying causes, individuals with ADHD can work with healthcare providers to develop robust coping strategies for managing their emotions and reducing emotional dysregulation.

How to Improve Your Emotional Regulation Skills

Although emotional dysregulation can be frustrating, there are some techniques that may help. One technique might be useful, or a combination of multiple techniques could be the most practical approach. Some of the ways that emotional regulation skills can be improved include:

Step Back and Name Your Emotions

It’s easy for people with ADHD and emotional dysregulation to feel overwhelmed by lots of different emotions at once, and it can sometimes be difficult to pinpoint exactly what is being felt; however, if you feel that you’re getting to a point where you’ve overwhelmed and likely to have an emotional outburst as a result, take a moment to step back and see if you can identify your feelings. For example, you could take a moment to realise that you feel frustrated about one thing and nervous about another, and this combination is what is making you feel overcome with emotion.

Once you know more about the individual feelings you’re feeling, it’s easier to come up with a plan to tackle them.

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Write It Out

Some people find it more useful to write about their feelings as opposed to speaking about them. If you’re the type of person who is more articulate in written form than verbally, then this could be a good approach for you to take. Try and explain what you’re feeling and why you might be feeling it, as well as any possible solutions.

Exercise Instead of React

Oftentimes, people who struggle to regulate their emotions react quickly and rashly, typically in the heat of the moment. It can sometimes be hard not to, especially if you’re feeling angry or upset, but reacting when emotions are running high can lead to poor outcomes.

Before you react to something, try to clear your head first. A good way to do this is to exercise. Not only does exercising help your overall mental health (this is a good technique if you have comorbid conditions like depression or anxiety), but it can give you time to calm down, evaluate the situation, and think about your next steps.

Listen to Music (Or Play an Instrument)

Music has been found to lower levels of anxiety, making it a good way to step back and recharge if you’re feeling nervous or overly anxious about something. Anxiety can lead to abrupt decisions and social isolation, so it’s important to take measures to try and limit its impact on your life and your relationships. Classical music is a good option as it has a calming effect, but playing an instrument can be cathartic, too.

Make a List of Your Coping Mechanisms

Everyone has different ways of coping with their emotions. If you know what helps you, such as going on a walk, having a cup of tea, reading a book, making voice notes about how you feel, or even going for a nap, write them down and reference them when you feel emotional. This way, you can see what works best for you in each situation.

Understanding Emotional Dysregulation

Emotional dysregulation can have a significant impact on a person’s life and is often heightened by specific ADHD symptoms, making ADHD management and treatment all the more important.

At The ADHD Centre, we offer comprehensive treatment to children and adults, with our team of specialists working alongside patients to create a multifaceted treatment plan that effectively manages ADHD and its symptoms, including emotional dysregulation. To find out more about our services, please call us on 0800 061 4276 or email us at enquiries@adhdcentre.co.uk.

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