Emotional Dysregulation in ADHD

Emotional dysregulation can lead to outbursts, uncontrollably intense feelings, and an inability to jump back into the swing of things. It’s a common symptom of attention-deficit hyperactive disorder (ADHD), which can cause individuals to struggle to manage and control their emotions. While it can be frustrating, it isn’t unmanageable.

Understanding ADHD emotional dysregulation and finding helpful ways to manage it can help you regain control of your emotions. Here’s what you need to know.

Emotional Dysregulation in ADHD

Emotional dysregulation is a common ADHD symptom that decreases a person’s ability to manage and regulate emotions [*]. Individuals with emotional dysregulation might encounter internal or external triggers leading to disproportionate and overwhelming emotional responses.

This emotional dysregulation can make it difficult for individuals with ADHD to focus on something else or see the situation for what it is.

What Does Emotional Dysregulation in ADHD Look Like?

People with ADHD experience emotional dysregulation more significantly than most because they may struggle to know how to react to their feelings. If you have ADHD, emotional dysregulation can feel like “all or nothing” or “going from 0 to 100.” It may also look like:

• Intense emotional responses to major and minor triggers, such as anger outbursts or high anxiety
• Experiencing feelings that are blown out of proportion
• Crying in response to negative or positive experiences
• Having mood swings over unpredictable emotions
• Being unaware of their own or other people’s feelings
• Focusing on the negative aspects of an experience
• Becoming overly excited or stimulated
• Difficulty calming down after feeling upset
• Acting impulsively without considering the consequences of specific actions
• Difficulty succeeding in academic and work settings

Children with ADHD are more likely to have immediate, situational triggers, such as not getting a toy they want, whereas teenagers with ADHD have triggers related to social rejection, academic stress, and family problems.

In boys with ADHD, emotional dysregulation might manifest through explosive outbursts, expressed emotions through physical actions, and even aggression. Girls with ADHD might experience emotional dysregulation on an inward level—they might feel shut down, have mood swings, or become sensitive to rejection [*].

Why Does ADHD Cause Emotional Dysregulation?

ADHD can make it more likely for someone to be emotionally dysregulated because of differences in brain structure, neurotransmitter function, and executive functioning deficits.

In the ADHD brain, the amygdala, which regulates fear, anxiety, aggression, and anger, functions differently [*]. The amygdala may vary in size and activation, causing people to experience more intense emotions than usual [*]. When the amygdala becomes overstimulated, it can impair a person’s rational thinking and cause emotional outbursts. Variations in amygdala activity can also cause difficulties managing anger, rapid mood fluctuations, and poor emotional recognition.

The frontal cortex of the ADHD brain may also function differently. This region interprets, expresses, and regulates emotions. In people with ADHD, it is less activated and less likely to inhibit intense emotional reactions [*]. This can make deciding what they should and shouldn’t do or say challenging.

How Does Emotional Dysregulation Impact Life?

Emotional dysregulation can significantly impact a person’s life, especially without support. School-aged children and teenagers may struggle to succeed academically because they have difficulty concentrating and learning. Being overly emotional can also make it challenging for them to develop long-term social relationships.

Emotional dysregulation in adults can cause workplace challenges. Minor issues can result in overwhelming reactions, and individuals may struggle to develop healthy working relationships with colleagues.

People with ADHD also tend to ruminate over the problem versus proactively finding solutions, which can turn minor disagreements into full-blown arguments. Over time, it can become more challenging to manage sadness, anger, and other emotions, which can result in mental health struggles.

How to Manage ADHD Emotional Dysregulation

While you can’t change how your brain functions, there are ways to manage emotional dysregulation and improve executive functioning. Here’s what you can try.

Use a journal

Occasionally, it can feel like no one understands you. So, you’ll have to find a way to see your emotions through to the end without letting them hurt you. One way to do so is through journaling.

When you write down what happened and how it made you feel, you can reflect on your emotional responses and determine what changes you need to make.

Practice self-regulation

For people with ADHD to overcome emotional dysregulation, they must learn to self-regulate. Self-regulation can include progressive muscle relaxation, which involves repeatedly tensing and relaxing the muscles to reduce stress and calm down.

Another option is to use grounding techniques, such as the 5-4-3-2-1 method, which asks individuals to name things they see, hear, feel, smell, and taste to bring focus back into the present moment.

Create structure in your environment

Predictability can benefit people with ADHD because they are less likely to respond negatively to unexpected events. While predicting everything that may happen is impossible, developing structure in one's home or work environment can help.

Establishing routines involves following a regular wake-up time and daily schedule. If you’re helping a child, you can create visual schedules to set easy reminders.

Get exercise

Physical activity and regular exercise do wonders to reduce stress and can help clear your headspace when you feel emotionally dysregulated. When you feel overwhelmed, exercising can give you an outlet for physical urges.

Any movement helps—if you’re working with children, choose age-appropriate activities they’ll enjoy like going for a run in the park. Work with your current activity level. If you’re capable of high-intensity exercises, try kickboxing. If you prefer something more laid back, try yoga.

When to Seek Professional Help

Emotional dysregulation can be manageable, but seeking professional help may also become necessary. Situations that may prompt intervention include:

• Frequent and intense emotional outbursts that regularly disrupt work, school, and personal lives
• Inability to recover from severe emotional episodes and slipping into deep depression
• Persistent anxiety, depression, and mood swings
• Co-occurrence with other mental health problems
• Impulsivity and risky behavior like reckless spending, self-destructive behaviors, and substance use
• Constant problems in interpersonal relationships that lead to isolation or rejection
• Avoidance of certain situations due to emotional reactions
• Emotions becoming unbearable and leading to thoughts of self-harm

Emotional Dysregulation Treatment Options

You can manage emotional dysregulation through a combination of treatment options. Below are a few treatment considerations:

• Medication: If your emotional dysregulation is causing anxiety or depression, a psychiatrist might recommend certain medications. For instance, stimulants like Adderall or Ritalin can improve impulse control, while selective serotonin reuptake inhibitors (SSRIs) can regulate mood and reduce reactivity [*].
• Executive function coaching: Executive function coaching can help people improve cognitive skills typically impaired by ADHD. Coaches help clients manage daily tasks and achieve goals by enhancing their time management, focus, planning, and organization. The coach can help identify specific areas of difficulty, such as workload management, interpersonal relationships, or daily productivity, and provide the appropriate tools and techniques.
• Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) is among the most effective treatments for emotional dysregulation [*]. It helps people identify their emotions before they spiral out of control. CBT teaches individuals to identify and challenge negative thoughts that might trigger overwhelming emotions.
• Cognitive restructuring: Part of CBT is cognitive restructuring, which replaces negative thoughts with more positive and productive interpretations. With practice, it can help individuals modify their responses to specific situations. Another aspect of CBT for emotional dysregulation is mindfulness. Through mindfulness, individuals can become more aware of their responses and feelings and enter the present moment.

The Bottom Line

Dealing with unpredictable emotions when you have ADHD can be challenging, but there are strategies you can practice when your emotions get the best of you. With the right support, healthy coping mechanisms, and professional help, you can regain control of your emotions.

Explore our ADHD worksheets and Anger Management worksheets for resources on helping kids and teens better manage emotional dysregulation and ADHD-related struggles.

Sources:

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