Many people with ADHD can relate to the experience of growing up being told they are “too emotional.”

As a kid, I cried easily during emotional situations and experiences. I remember reading Where the Red Fern Grows in class when I was 12, trying to hide the tears streaming down my face and thinking “How is no one else crying!?” I also got into a lot of fights on the playground around that age, and had plenty of minor discipline issues. A few years later in high school, there may have been an incident where I told a teacher to “Go f__ yourself” in front of a large group of people. Oops. I never considered myself an angry person, but my emotions were extreme, and at times it was nearly impossible for me to control them. It wasn’t just negative emotions either. I was also quick to excitement, would become fascinated and obsessed with new hobbies and interests, and felt extreme emotions as they related to my friendships, crushes, and other confusing childhood emotions. I was dealing with Emotional Dysregulation, a symptom of ADHD,  I just didn’t know it.

ADHD: A Failure-to-Regulate Mood Disorder

Emotional dysregulation, an inability to regulate emotions properly, is a trait that’s often found in people with ADHD, and it presents unique challenges for them. While it’s not only found in those with ADHD, emotional dysregulation is one common sign and challenge that people with ADHD deal with. Strangely, while it’s widely accepted as having a connection, the DSM definition of ADHD doesn’t even mention the word emotions.

Basically, those with ADHD experience normal emotions, but the way they feel and react to them is much more intense than the average person, and they have less control over the duration and intensity of these emotions. This means that feelings such as frustration, impatience, anger, and even positive emotions like excitement or romantic interest are all amplified. As a result, we can dwell on emotional things that have already happened instead of moving on, and a small setback can easily turn into days of lost productivity and frustration. Similarly, we can struggle to regulate the positive emotions, and can feel elated over something good that happened for days on end. While this doesn’t necessarily seem like a bad thing, it’s the pendulum of emotional dysregulation swinging the other way. It can result in clouded thoughts, make you fixate on one thing, and sometimes ignore real problems in your life.

“ADHD is not a mood disorder. It’s a failure-to-regulate mood disorder”
-Doctor Russell Barkley

For these reasons, emotional situations such as romantic relationships, or arguments, are dangerous ground for ADHD people. The beginning and end of any relationship is emotional, now imagine that magnified 10 fold.

[Link: Adult ADHD and Relationships]

Is Emotional Dysregulation a Core Symptom of ADHD?

Philip Asherson, Ph.D., who wrote the 2015 report Emotional Instability a Core Feature of ADHD believes that emotional dysregulation should be considered one of the core components of ADHD, and research he conducted on prisoners seems to back this up. He goes on to explain that it used to be considered a core symptom up until the 1970’s, when the DSM attempted to understand and define ADHD. They focused on the impulsivity, hyperactivity, and inattention aspects of ADHD, as they were easier to measure and understand.

But experts are starting to focus once again on the emotional aspects of ADHD, and it’s now widely regarded as a major component or commonly associated with having ADHD

What Does Emotional Dysregulation Look Like?

• Minor frustrations feel like major threats. We’re easily put in panic mode, and can become stressed over small things.
• We lose site of the big picture, and forget what we should be focused on. Instead we react impulsively, which often causes reactions that we regret later.
• It’s nearly impossible to calm down. A minor emotional event can stay with us for hours or days. And that overthinking and fixation impairs our ability to get back on track and do what we should.
• We are ultra-sensitive to rejection and criticism. People with ADHD often struggle with something called Rejection Sensitivity Dysphoria. Basically, we easily interpret something said or done to us as disapproval or an insult, even when none was meant. This can lead to feelings of rejection over basically nothing.
• We get excited easily. This isn’t always bad, but it’s still a dysregulation of emotions. Just as we can overreact to a minor problem, we can also get ahead of ourselves with something positive or exciting.

Why Do Those with ADHD Struggle?

Emotional self-regulation, or the ability to respond appropriately to an emotional experience, is a more complicated process than you might think. Many of aspects it requires are the exact things that people with ADHD tend to struggle with:

• Inhibition – Not reacting impulsively on an emotion – This isn’t easy for people who are naturally impulsive.
• Self-soothing – People with ADHD tend to be very hard on themselves and not so great at calming themselves down after something stressful.
• Refocusing our attention – Difficulty focusing is the exact problem many people with ADHD struggle with the most.
• Responding in a way that makes sense for our goals – I might not even REMEMBER my goals after an emotional experience.

Quick Science Lesson – Emotions and the ADHD Brain

Emotions are regulated in the limbic system, which includes the amygdala, hippocampus, and nucleus accumbens. When an emotion is generated, the limbic system connects to the prefrontal cortex, which manages that emotion. The cortex asseses the importance of the situation, and suppresses actions that aren’t in our best interest.

But in an ADHD brain, the neurochemical connection between the limbic system and the prefrontal cortex is weak, and emotions often “get through security” with ease. This can result in outbursts, frustration, and not thinking before you act. 

In a 2017 ADHD study from the Netherlands, studying size differences in different regions of the brain, researchers found that overall brain volume and 5 specific brain regions were smaller in people with ADHD – the caudate nucleus, putamen, nucleus accumbens, amygdala and hippocampus.  The differences were very small, but they were statistically significant because of the size of the study. Researchers noted that “similar differences in brain volume are also seen in other psychiatric disorders, especially major depressive disorder.” The differences were most prominent in children with ADHD, and less obvious in adults. Whether or not the patient had taken or was currently taking medications for their ADHD didn’t seem to make a difference.

Previous studies had already shown links between the caudate nucleus and putamen with ADHD, and researchers in this study were able to conclusively link the amygdala, nucleus accumbens and hippocampus to ADHD.

The hypothesis is that the amygdala is connected to ADHD through its role in regulating emotion, and the nucleus accumbens is associated with the motivation and emotional problems through its role in reward processing. The hippocampus’ role in ADHD seems to be through its involvement in motivation and emotion.

“The results from our study confirm that people with ADHD have differences in their brain structure and therefore suggest that ADHD is a disorder of the brain. We hope that this will help to reduce stigma that ADHD is ‘just a label’ for difficult children or caused by poor parenting. This is definitely not the case, and we hope that this work will contribute to a better understanding of the disorder.”

-Dr Martine Hoogman, Lead Author of study

Can I Change My Emotional Dysregulation?

Like many aspects of ADHD, you might not be able to “fix” the problem, but you can manage your symptoms to the point where it’s not really a problem anymore. Awareness of the issue is key, so that you can start to understand what causes Emotional Dysregulation in you and how to manage it when it does pop up. What are your emotional triggers? Can you remove some of that from your life? What are some ways that you can successfully calm down after an emotional experience?

I wrote this article while I was experiencing Emotional Dysregulation. Feelings of anger and resentment over something that happened were starting to take hold of me, and I recognized it and decided that writing about the topic was the best way for me to manage those emotions. I still feel the emotions, but I’m much clearer-headed about it and I was able to successfully move on and do something productive.

Many experts have started to advocate mindfulness and meditation as a tool for managing emotional dysregulation in ADHD. This makes sense, because mindfulness emphasizes learning to focus on the present moment, and having an attitude of openness and acceptance. Both of those are difficult for someone with ADHD, so practicing them can be very beneficial.

The Bottom Line

• ADHD is a real, measurable difference in brain structure
• Emotions are magnified for those with ADHD, and it’s not something that can just be controlled 
• Many experts think that Emotional Dysregulation should be part of the definition of ADHD
• The stigma associated with ADHD people being lazy, overly emotional, and needing to “just try harder” is ridiculous and counterproductive
• Learn your emotional triggers, and remove as many of them from your life as you can
• Tools like mindfulness can help you refocus your thoughts on the present moment