Crash Course: Understanding ADHD & Big Emotions

Highlights:

• ADHD is more than problems focusing, sitting still, or acting impulsively

• Difficulties managing emotions is a common symptom of ADHD, but not everyone experiences these issues

• Emotional dysregulation is often not viewed as a symptom of ADHD; instead, they are attributed to other emotional or behavioral issues, and may increase the likelihood of additional and inaccurate diagnoses

• Treating emotional dysregulation in individuals involves behavioral therapy, not simply medication

Scenario: Your child is diagnosed with ADHD. They struggle to focus, stay organized, remember things, and do their work. Maybe they’re hyperactive, impulsive, or careless.

Chances are they also have big emotions that they struggle to manage – easily frustrated, problems rebounding from setbacks or failures, irritable, sensitive to negative feedback or rejection – and act impulsively when these big emotions overwhelm them. And the flip side: emotional dysregulation impacts their positive emotions, too, and may result in your child becoming overexcited, overstimulated, and ‘out of control.’

The past 15 to 20 years of clinical science tells us that ADHD, once understood as a problem confined to paying attention and/or regulating behavior, also has an impact on how we experience and manage emotions [1]. Specifically, individuals with ADHD may experience emotions (1) quicker than others, (2) more intensely, and/or (3) take longer than others to rebound and return to their ‘emotional baseline’ [2].

While ADHD is associated with various other challenges in childhood – anxiety, depression, oppositional behavior, problems getting along with peers – emotional dysregulation does not mean your child is inherently anxious, depressed, or defiant. Rather, the emotional dysregulation issues associated with ADHD may be ‘driving the bus’ that otherwise looks like behavioral issues, nervousness or worry, and low mood.

It's easy to envision how children with big emotions and problems managing them may also experience issues making, keeping, and playing well with friends. When we don’t intervene and help children better understand and cope with these emotions, they may evolve into increasingly severe and sustained issues, problematic behaviors, and even more negative social feedback from peers. In general, the negative feedback loop beginning with problems managing emotions, acting impulsively, peer rejection, and resultant issues with self-esteem is real.

How do we help?

First, it’s important to work with a psychiatrist or prescriber with a strong knowledge of how to treat the other core features of ADHD – inattention and/or hyperactivity/impulsivity – while also accounting for your child’s emotional dysregulation issues. This is because certain common medications for ADHD have been found to worsen emotional issues in children.

Second and equally important, work with a trained mental health provider who can help both you, the parent, and your child develop and practice self-regulatory strategies to manage their intense emotions. This may include:

• Helping children identify and name their emotions rather than simply experience and act on them; this also includes recognizing milder emotions during times of less stress

• Avoiding unhelpful thought patterns – black and white thinking, not taking responsibility for their actions or placing blame on others, or jumping to the worst possible scenario

• Developing simple coping skills that allow them to problem solve and consider possible outcomes of their behavior prior to acting

• Enhancing joyful experiences and reinforcing your child’s positive behavior, including when they use their coping skills and manage their emotions independently

 Please contact Alex if you have concerns that your child may suffer from ADHD. Or, if your child is already diagnosed with ADHD and are seeking help to differentiate emotional dysregulation from other possible challenges (i.e., anxiety, defiance) that warrant separate treatment.

Wish to schedule an appointment? Call us at (863) 274-3768 or independently schedule a free consultation call with Alex here.  

References
[1] Soler-Gutiérrez, A. M., et al. (2023). Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLOS ONE, 18(1), e0280131.

[2] Bunford, N., et al. (2015). ADHD and emotion dysregulation among children and adolescents. Clinical Child and Family Psychology Review, 18, 185-217.