ADHD and Emotional Regulation

ADHD is not just a disorder of paying attention and impulse control but also managing and coping with emotions. We call this emotional regulation. If you suffer from this as a woman, your family and work-life suffer. You may have crying spells or bouts of anger where you yell at your children, friends, coworkers, or spouse. You may be easily hurt, angered, or sad and have dramatic mood swings. 

Do you become anxious or depressed suddenly and feel like you cannot regulate it? It may be that until this moment, you did not know that ADHD and emotional regulation could be the culprit. Many women with ADHD feel like they are alone in these symptoms, but you aren't; it's prevalent!

During my 26 years as a therapist, I would rarely consider ADHD the cause if I saw these symptoms.

I wasn't given appropriate training in understanding the relationship between ADHD and emotional regulation. It wasn't until recently that I understood this relationship. It makes sense because the same circuits involved in regulating our thinking and behaviors are also involved in our emotions.

Paul Windsor of the Utah group discovered that emotionality is a hallmark of ADHD. Russel Barkley, probably the most renowned expert in ADHD, believes it should be part of the core criteria.

Russell Barkley refers to emotional regulation issues as emotional impulsivity or emotional impulsiveness. These issues are estimated in the ADHD population to impact about 45- 55 percent of ADHD adults.

Emotional regulation impacts marriages. Relationships are complicated and challenging. Communication, difficulties, intense bouts of depression and frequent arguments are standard when you have ADHD. Often, this is a result of emotional dysregulation.

Emotional Regulation issues or Dysregulation (ED), as it's often referred to can contribute to traffic accidents and road rage and even substance abuse! One-third of adults in treatment programs for substance abuse have ADHD.

At work, emotional regulation issues cause trouble with coworkers, and unmanageable feelings, and behavior such as crying spells. Contributing to low self-esteem, many ADHer's are already grappling with.

Emotional regulation can also cause women with ADHD to have issues with parenting. They may feel overwhelmed and have periodic breakdowns where they yell and lose their temper. This behavior is damaging to their relationships with their children and their spouses. Later they may feel guilty and awful.

If you are a woman with ADHD, emotional regulation issues can cause you to feel inadequate across so many domains of your life!

How ADHD and Emotional Regulation is it treated?

The great news about emotional regulation and ADHD in women is that medication alleviates it. Dopamine deficiency is responsible for the emotional regulation issues that people with ADHD suffer. Medication helps the underpowered circuits function better! There is a significant improvement in women when they take stimulants. There is also some evidence that atomoxetine is helpful, and Guanfacine extended-release has been shown to help with temper irritability and reactivity.

Other Treatments?

There is evidence for Cognitive Behavioral Therapy, and for children, the incredible years is effective in decreasing frustration.

Mindfulness-based interventions and Acceptance and Commitment Therapy, as well as Self-compassion work, would also be great fits

Why do women with ADHD have emotional regulation difficulties?

People with ADHD seem to have difficulties regulating their emotions because of two reasons. The ADHD brain might have problems generating too much emotion. Problems with generating too much emotion are called bottom-up processing. You might experience this as a flood of intense and overwhelming feeling—excessive anger, sadness, or alarm that feels unmanageable and can come out of nowhere. You also may have trouble regulating the emotions already there. We call this top-down processing. Some women with ADHD and emotional regulation issues struggle with issues of bottom-up and top-down processing. Their feelings are too intense, AND they have trouble regulating their emotions regardless of the intensity. That's like a double whammy.

What else makes it more likely you will have emotional regulation issues if you have ADHD? Research is also showing that two other factors influence whether you will have personal regulation issues. Your childhood temperament and whether you have reward deficiency syndrome.

  1. Childhood temperament. If you have a sunny disposition, you are less likely to struggle with emotional regulation issues. Those who are prone to more negative temperament seem to be more likely to develop emotional dysregulation.
  2. Reward Deficiency Syndrome. Reward deficiency is essentially when nothing you seek satisfies you. If you find something that helps you, your suffering is intense if it's taken away or can't have it. ADHD people can struggle with this due to their dopamine levels. People with reward deficiency syndrome are also more prone to overeating and addiction and are at risk for aggression.


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Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.