How ADHD Adults Manage Emotional Dysregulation
Episode Summary:
Having big emotions or feelings is not a failure for ADHD adults. The challenge is being able to take the step you want after the surge in emotions that is in alignment with your values.
I’ll look at different strategies you can use to help you shorten the spikes, steady your focus, and recover faster so you can do this with greater ease.
Then you will feel calmer, keep perspective in the moment, and protect your relationships.
What You’ll Learn About ADHD and Emotional Dysregulation:
- How to feel calmer, keep context in mind, and choose to respond the way you want.
- The role CBT and DBT therapy can play in teaching skills you can use to regulate your emotions.
- How to externalize cues you can use to remind you of why you want to regulate your emotions, and how to do that
- The role that mindfulness, sleep, exercise, food, and water can play in giving you a more stable baseline.
- How medication may help as one option among many to shrink reactivity.
Transcript – ADHD and Emotional Dysregulation
(00:03):
Emotions and feelings are obviously not right or wrong, but I know you want to express them in a way that aligns with your values, right? You want to be in the driver’s seat, not your emotions.
You’ve tuned into Reimagining Productivity with ADHD, a podcast for ADHD adults like you who want to learn how to adopt the best strategies, tools, and skills to be able to get your essential work done in a way that works with the way your brain is wired. I’m Marla Cummins, an ADHD and Productivity coach, and I’m glad you decided to join me today on this journey to finding your way to doing what matters most to you without trying to do it like everyone else.
Most adults with ADHD that I work with, either individually or in a group, tell me that they’re not impulsive, and it’s usually true when it comes to emotions.
(00:56):
You also may not express your feelings impulsively, at least externally, but if you experience emotional dysregulation, as many ADHD adults do, your emotions may come on impulsively, though you are able to contain them for the most part. Maybe it’s in the form of an unseen but stormy undercurrent that you can feel acutely.
Whether it’s externalized or internalized, the result is that you are distracted by the pull of the emotion and probably unable to focus and attend to what you want. Outwardly, it may look like slowly disengaging or maybe even shutting down. Whether others recognize it or not, you may eventually even leave the situation entirely.
And this comes as a result of low frustration tolerance and impatience, as well as reactivity that is just common for ADHD adults. If it feels as though your emotions are bigger and last longer than your neurotypical peers, it’s because they likely do.
(02:05): Is emotional dysregulation part of adult ADHD
One reason is that your internal systems are prone to hyperarousal because of your ADHD brain chemistry, and this can apply equally to what you may call positive or negative emotions. So when you’re happy in the moment, you may feel like you can conquer anything, and when you’re mad or sad, in some sort of distress, you may feel like the world is going to end, the sky is falling, and there’s nothing you can do about it.
Sound familiar?
I really like the Intersection Model, the late psychologist and ADHD coach Allison Kravitz used as a metaphor to describe how ADHD impacts the brain functions behind the various symptoms and difficulties we experience. And when it comes to emotional responses, Kravitz noted that the prefrontal cortex acts as an intersection through which these responses run. She noted there is no deficit in the ADHD brain, but rather, there are no traffic lights or stop signs at the intersection.
(03:11):
So the fastest car, or rather the strongest message, gets through first. That means when emotions run through the intersection, so to speak, the prefrontal cortex, they may look like sudden or quick mood changes, meaning we can become angry, sad, or excited in reaction to the initial impression of a situation.
The reason for this, she noted, was not a shift in mood, but rather the inability to incorporate all aspects of the experience in the moment. So the feeling that seems to come from nowhere is really just a quick reaction to what just happened.
That is the message that got through first. So while you may want to say and act in a certain way, without your prefrontal cortex keeping the rest of your brain under control, your thoughts and feelings are careening through your brain, and you’re focusing on the most predominant thought or feeling.
Think of it as a truck coming your way, and you’re not thinking about the pedestrian crossing the street or the bicyclist, which you can think of as sort of the weaker messages, like wanting to regulate your emotions, for example, or wanting to maintain a relationship.
(04:36): Why do my emotions with ADHD feel like too much?
You are just thinking about staying out of the way of that truck. While you may tend to hyperarousal, there are steps you can take so you are more often in the driver’s seat and not your ADHD brain. So you can also focus on the important, albeit sometimes weaker, messages in the moment, like wanting to balance perspectives, to be present, and again, to maintain relationships.
What’s the reason you want to regulate your emotions better? According to Russell Barkley, ADHD expert and author of, among other books, Taking Charge of Adult ADHD, the goal of managing your emotions is one, being able to inhibit inappropriate, however you term that, behavior related to strong negative or positive emotions.
Number two, being able to self-soothe and downregulate physiological arousal related to this. Number three then being able to refocus your attention from the emotionally provocative event.
(05:46):
And the last one, organize your emotions for coordinated action in the service of your goals and your long-term welfare. And to do this, you need strategies and skills. But before moving on to these strategies, I want to point out what you probably already know, which is that your response to situations in the moment, of course, is not only due to your ADHD.
Your responses are, of course, much more complicated than that. But today I’m going to talk about them from the lens of ADHD because, well, that’s what I do. But I would encourage you to seek out resources and supports so you can take a holistic approach to managing your emotions. Okay, on to the strategies. Some of the strategies I’ll share are ones you can learn and implement yourself, and others you’ll need, maybe more professional support.
I know you’re already curious about how medication may be able to help you, so I’ll start there. And while medication doesn’t erase your feelings, you know that it can strengthen the brain’s control system just enough so that the emotional wave ramps up slower, may feel less intense, and also may pass quicker, which then can give you the time you need to respond the way you want. Your prescriber can help you decide whether stimulants or non-stimulants may be helpful for you to manage your ADHD symptoms, including emotional reactivity.
(07:26):
The next strategy is, well, fairly simple, straightforward, but not always easy. And that one is choosing the context in which you’ll participate and those that you won’t. For example, could you decide not to go out to dinner with your colleagues or to the holiday party? Or if you’re invited to a family dinner, could you decline? Maybe, maybe not. Only you can decide that, likely based on the perceived consequences.
But if you do decide to go somewhere where you know there may be a chance you can become dysregulated, having an implementation plan in advance can help automate the pause so that you can regulate and then perhaps decide what to do next. That is, if Uncle Hirsch brings up politics, could you redirect and tell him about your adult soccer league? If Jamila corners you at the company party, could you excuse yourself and go to the bathroom? Having an implementation plan in advance can help you when you’re most distressed and least able to think clearly.
(08:40): How can I regulate with ADHD when my emotions surge?
Of course, you also know you have challenges with working memory. So, for this next strategy, that means that remembering your values and how you want to respond in the moment when you’re most distressed could be a non-starter for you. So another way to regulate your emotions in the moment is to externalize your working memory.
And one way to do this is to write down three things. Write down the goal you have for the relationship or that particular interaction. The second thing you should write down is a key fact that you know is true. And the third thing you can write down is what you want to say in the moment. Then put this where you can see it during the conversation.
By offloading it this way, you’ll be able to anchor the context so that you can make a values-aligned response. For example, for potential conflicts at home, you might put a note on the fridge or on your phone lock screen. Maybe it says, “Agree on one next step and maintain the relationship,” for the goal.
(09:53):
Then, for the fact, you can say, “When we talk about this stuff, we’re often tired,” and the line you may use is, “I just need some time to think about this.” Maybe for a work meeting, whether in person, over the phone, or via video, you can write down in a notepad or a sticky or whatever, where you can see this.
Maybe the goal is, “Leave with one next step and, again, maintain the relationships.” The fact that you may write down is, “We all want the same outcome,” and the line that you may use is, “Give me a moment to finish this point,” or perhaps, “Let me think about that and get back to you.” The idea is that you’re externalizing your working memory by writing it down someplace that you’ll have access to it in the moment.
(10:51):
The next strategy is a mindfulness practice, and while the effects are generally smaller and slower than medication, a regular mindfulness practice can perhaps strengthen your attention and inhibition, and this will give you a longer, steadier pause as your emotions will ramp up a bit slower, peak a little lower, and settle sooner because the brakes stay online.
And that pause can indirectly help you by reducing your reactivity so you can keep the context in mind and, again, choose the response you want. Maybe you start with five minutes a day, most days. Once it feels automatic, maybe you nudge it up to eight or 12. I don’t know. Current research seems to indicate that the more often you do it is the most important part, more important than the length of time.
And there are a lot of different apps you can use. I use Insight Timer, which has a huge free library, which I know can be a little overwhelming because it is for me. So what I do is I pick a few of my favorite tracks and just keep returning to those until I want to find a new one. You can try this.
(12:13): What actually helps with ADHD emotional dysregulation
How about the effects of sleep when it comes to regulating your emotions? I know you already know that when you’re sleep deprived, your fuse is, well, shorter, and you may get sad quicker, right? And this is, as you probably know, because your prefrontal cortex, which is already compromised because of your ADHD, fires less efficiently and is less able than usual to temper down your amygdala when you don’t have enough sleep.
So even though I know you already get this point, if you’re trying to regulate your emotions and you’re not getting enough sleep, consider whether there’s anything you can do to improve in this area.
(12:57):
You also know exercise is good for you. There are a few ways exercise can help ADHD adults modulate their emotions. Maybe you’ve had this experience already. There is clear evidence that aerobic exercise can help improve attention, working memory, and inhibition in the short term, which seems to be about one to three hours after exercising.
In addition, if exercise helps you sleep better, then it could indirectly help you regulate your emotions, right? Another indirect result of exercise is that it may help your stress resilience, which then might help you regulate your emotions. You’ll have to experiment and see.
Recently, I had a client share with me that going to the gym made him feel better because he mostly worked at home, and he got to see other people, and he just felt better. If I were to extrapolate from this, maybe this connection with others could also help regulate his emotions.
(14:01):
No evidence. Just a thought. How has exercise helped you? Beyond mindfulness and medication are two specific types of skill-based therapies that can provide concrete strategies to help you regulate your emotions. One is cognitive behavioral therapy. In CBT, you learn how to identify the cues that you are becoming dysregulated, which may be a feeling in your body or a thought that typically precedes your emotions.
Then you’ll also work on ways to replace that thought to use in the moment when it happens, and you rehearse the plan so that you’re able to use the strategies when you need them.
(14:47):
With dialectical behavioral therapy, or DBT, you’ll learn skills in a different way that can also lower your emotions in the moment. For example, one is distress tolerance, where you might do a minute of slow exhale breathing. Another is mindfulness, where you might pay attention to one thing, such as the first sign of an emotional surge.
Then take slow breaths and label the feeling. That is, CBT will help you notice the trigger, rethink it, and practice a plan so that you can choose your response. DBT, on the other hand, gives you the in-the-moment downshift tools to help you regulate your body in those hot moments. Skills you learn in either of these therapies can help you create, again, the pause that you need.
Last, there’s just not enough research on nutrition to suggest it as a treatment for ADHD generally, or emotional dysregulation specifically.
(15:58):
At the same time, though, you also know that mild dehydration or blood sugar swings can affect your mood, so something to watch out for. That is, are you drinking enough water, or do you have enough protein and fiber to stay steady during the day? If sugar is your thing, can you replace it with some other foods you may like?
And if caffeine is your jam, which is true for me, maybe you can just make sure you have it earlier in the day. Of course, none of this can take the place of skills or perhaps meds, if that’s the route you decide to go, but it’s just one more lever you can use.
(16:39):
What I hope you’re taking away from this episode is that you don’t need to shut down your feelings. What you do need, though, is a little room between the surge and what you do next. Medication can help create that room, and skills can also help you. That is the whole through line.
So start small. Decide which situations you’ll step into, and go in with a plan. Help yourself towards steadier control by maybe five minutes of mindfulness. Protect your sleep. Exercise. And if you need more help, reach out to a professional, maybe a therapist or coach. And if you try only one thing this week, notice what shifts for you in terms of your emotional regulation, and let that be enough for now.
And that’s it for now. And if you want to continue to learn how to work with your ADHD, sign up for my biweekly newsletter. You’ll get time-tested ADHD-friendly strategies and resources from me straight to your inbox. You’ll also receive a complimentary guide I created titled “Six Common Planning Mistakes Adults with ADHD Make (and How to Avoid Them).”
You can find the link in the podcast description, or you can go to marlacummins.com/planning to sign up and get the guide. Until next time, this has been Reimagining Productivity with ADHD and Marla Cummins, reminding you that ADHD doesn’t define you, but remember how you work with it can shape what’s possible.
ADHD and Emotional Dysregulation Resources
- Learn how to plan better with my Free Guide: 6 Common Planning Mistakes Adults with ADHD Make
- You can visit ADHD expert and psychologist Russel Barkley’s website to learn more about his work.
- Find out more about the Insight Timer Meditation App.
