What Is Emotional Dysregulation In ADHD?

Emotional dysregulation in ADHD is a common issue that can be confusing for individuals and families. Many parents will ask themselves, “If my child’s problem is attention, then why is she getting so upset all the time and having a hard time calming down?” Even though ADHD means “difficulty paying attention”, ADHD and emotions are closely linked.

How are emotional dysregulation and ADHD linked?

The answer to this question starts with understanding ADHD on a deeper level. Although the title of the disorder highlights the attentional difficulties, ADHD is a much broader disorder that affects many aspects of a child’s ability to regulate themselves or use executive functions. As executive functioning is defined as the ability to coordinate present action toward a future goal, this includes being able to manage one’s emotions in the present so that they can continue to achieve future goals.

For children with ADHD, this is nearly impossible. They feel an emotion but are unable to stop it from taking over their mind and directing their behaviors. Other children might feel the beginning of the emotion and redirect themselves before the emotion takes over, but the child with ADHD cannot do this.

For example, if a child is walking down the hallway at school and is bumped by another child, they often will have an immediate feeling of anger at being bumped. However, they usually size up the situation quickly in their mind and will often decide that it’s better to forget about the slight and move on with their day because getting in a fight will not help them in the long run.

The child with ADHD, however, is unable to do this because they respond right away without thinking of the long term consequences of their behavior or regulating the emotion. The emotion builds inside of them, and, without being calmed, they quickly go into an acute stress response (“fight or flight”) generated by their sympathetic nervous system. At this point, their body is overwhelmed with adrenaline and will take a significant amount of time before it can return to its previous state. This is also why children with ADHD appear to be easily triggered but can take a long time to calm down.

In addition, the emotional difficulties in ADHD also affect motivation, as that is an emotion as well. When a child with ADHD feels an initial motivation to do something, they may start the task with enthusiasm. However, very soon afterwards they can also become easily distracted which causes the motivation to fizzle.

Why isn’t emotional dysregulation considered a core symptom of ADHD?

Although many children with ADHD display difficulty regulating their emotions, there is no provision for this aspect of the disorder in the current medical criteria. As noted by Dr. Russell Barkley, this was not always the case, as many of the early descriptions of ADHD included emotional impulsiveness as part of the core symptoms. This changed with the publication of the original DSM in 1952 and the various revisions, most recently the DSM-5 in 2013.

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