ADHD Emotional Dysregulation: Neuroscience & 9 Coping Skills

[00:00:00]Hi, I'm Emma. I'm a therapist. I also meet the  criteria for ADHD. And I've had to manually learn to regulate my emotions for the last  35 years because it feels like the dial on my emotions is turned way, way up. And it turns  out that up to 70% of people with ADHD struggle with emotional dysregulation. So today, we're  going to dive into the brain science behind why ADHD and emotional dysregulation are so closely  linked. I'm going to break it down into three main chunks and I have some practical strategies  for you to manage those emotions. Now guys, this is Therapy in a Nutshell, but I have been  working on this video for like 8 months, and it's been hard for me to boil all this information  down into a short video. So today's video is going to be the biggest nutshell in the world,  which happens to look like a butt. And that has nothing to do with ADHD and emotional regulation,  but maybe everything to do with it. So, let's go.

[00:01:10]Okay. So, what actually happens in the brain  that makes emotions feel so hard with ADHD?

[00:01:18]On average, kids with ADHD have a 2- to three-year  delay in brain maturation. MRI scans of hundreds of kids found that cortical thickness typically  peaks for a normal kid around the age of 10 and a half. But for kids with ADHD, it's closer to 13.  And this delay was most pronounced in the areas responsible for executive function, attention,  and working memory. So, this means that kids with ADHD often catch up neurologically in the mid to  late 20s, but the timing lag can cause significant struggles with emotional and behavioral regulation  during childhood. So, by that point, you've already gotten in trouble a bunch of times. Maybe  you've already labeled yourself as the bad kid, the dumb kid, the sensitive kid, the reject,  or maybe you've built up a bunch of maladaptive coping strategies. So this prefrontal cortex  is the part of your brain, right behind your forehead. It's your braking system. It helps  you pause and think and choose your response.

[00:02:27]And in ADHD, that part of the brain tends to be a  little underactive, especially during stressful or emotional systems. Whereas the alarm system in the  brain, the amygdala, is overactive. It tends to go off more easily and stay on longer, especially  when something feels unfair or frustrating or rejecting. So instead of calmly deciding what to  do, the emotional part of the brain gets there first. It's like the feelings hit the gas pedal  before the brakes even know there's a problem.

[00:02:57]And that leads to what researchers call short  emotional latency. You feel something and react very fast, often before you even had time to  think about it. Because of this, the brain is less likely to be aware of its overreactions or  thinking errors, and it's a lot harder to calm down after an emotional event. So, when you've  had an emotional reaction, it can really quickly spiral. Another interesting thing about the  ADHD brain is low dopamine can make it hard to be patient. And the norepinephrine tends to swing  between too much and too little, which contributes to that feeling of tired and wired that emotional  volatility that comes with ADHD. So in a nutshell, with ADHD, the manager brain develops much more  slowly and connects much less efficiently to the feeling brain. And that's why emotions can flood  the system so quickly. And here's a side note.

[00:03:52]Whatever you do find interesting or stimulating,  whether that's jumping your bike or art or music, or for me it was actually school, like yay female  ADHD, that area that you're interested in is going to seem disproportionately advanced. You might  seem really skilled at basketball or piano, but emotionally underdeveloped in other  areas. So, people might think, "Oh, she's so smart or gifted. Why isn't she trying?  She has so much potential." And then all of this can fuel that cycle of shame or withdrawal.  But the good news is with the right support, with therapy and skills and medication and  lifestyle tools, these connections can strengthen and emotional regulation can absolutely improve.  Okay. So I mentioned the prefrontal cortex. This is where executive function happens. It's the  brain's ability to manage thoughts, emotions, and actions to reach a goal. It includes skills  like impulse control, prioritization, planning, shifting attention, holding ideas in your mind,  and time management. Long story short, it is really important. And so, let's just take a look  at five areas where this poor executive function shows up. ADHDers have lower impulse control. They  may react to emotions quickly and intensely before they have time to process them. Let me tell you  about Alex. Alex is a 22-year-old college student who's working on a group project. Yay. A teammate  Sam, suggests a different approach than the one that Alex was thinking about. Without thinking,  Alex immediately snaps. That's a terrible idea. We don't have time to start over. Sam looks offended.  The rest of the group goes quiet. And then later, Alex feels really guilty for overreacting.  But he consistently struggles to control these emotional outbursts in the moment. So poor  impulse control can look like outbursts of anger or tears or raised voices or storming off. But it  can also show up as being like overly exuberant, overly happy, laughing really hard and being  unable to kind of stop and slow yourself down.

[00:05:58]These executive function deficits can also show  up as difficulty shifting emotional states. So once an emotion takes hold, whether that's  anger or sadness or excitement, people with ADHD often struggle to shift states. They might  experience what's called emotional stickiness, where these emotions linger longer than they  do for neurotypical individuals. So Jordan's a 35-year-old with ADHD and depression. She made a  small mistake in a work email. Her boss pointed it out casually, but now Jordan feels embarrassed and  ashamed. And instead of moving on, she ruminates on the mistake for hours and hours, replaying it  in her mind and just feeling like a failure. Even after work, she struggles to shake that feeling.  She ends up canceling dinner plans because she feels too down. So this emotional stickiness as  part of ADHD, there's two processes that can fuel this. The first one is hyperfocus. This is an ADHD  superpower, where when something is intense or stimulating or interesting, you can get completely  absorbed. And this can happen with a new crush or with the worry about what you said in that email.  Hyperfocus can make it difficult to step back, shift attention, or gain perspective. Positive or  negative emotions can be really stimulating. So, it's almost like a fidget toy to just dwell on  them. The second difference is the default mode network. So, this is basically what's going on in  your head when you have nothing to think about.

[00:07:29]People with ADHD are more likely to have their  brain wander and it might constantly wander into worries or ruminations and this can fuel  negative moods like anxiety or depression. Okay, the next one is low frustration tolerance. So due  to dopamine differences, ADHD brains crave instant rewards and stimulation. This makes waiting or  dealing with setbacks or handling boredom really difficult. Small inconveniences can feel really  overwhelming and that can lead to irritability or outbursts. Okay, next one's time blindness.  ADHD brains struggle with tracking time. So, when something feels bad, it feels like it has  always felt bad and it will always feel bad.

[00:08:12]Dr. Ned Hallowell said that for people with ADHD,  there are only two times, now and not now. And you couple that with a low frustration tolerance  and it's a pretty potent way for any emotion to feel like it's going to last forever and then  you start to spiral. Number five is poor working memory. Working through emotions is a multi-step  process. It requires you to hold multiple pieces of information while moving through the steps. But  people with ADHD often have poor working memory.

[00:08:42]That means they have a hard time holding multiple  ideas at the same time or like remembering that it's all going to be okay. So, let's take a look  at Fred. Fred says, "I hate my job. My boss is a complete jerk. When I requested to take a day  off so I could attend a wedding, he denied the request." His impulse is to quit right now. And  before you know it, Sam is still mad at his boss, but now he's panicking because he doesn't  have a job and he's super mad at himself.

[00:09:08]And if you really look at it, he also had a hard  time remembering to tell his boss he wanted the time off and the wedding's tomorrow. It's easy  to see how poor working memory and poor executive function start to pile up. These deficits make it  really hard to process emotions and carefully plan how to act. And I don't want to spend too much  time on this, but speaking of emotion processing, emotion processing is how you work through  and resolve emotions. I've done a bunch of videos on this and a whole course on emotion  processing. So, for this video, I'm just going to briefly walk through what I would tell Fred  to do when his impulse is to quit that job. So, he needs to name his emotions, which requires him  to like, use the thinking part of his brain. So, he would need to name his emotions, pause, notice  his thoughts. He needs to explore and clarify, like question your thoughts. Huh? Maybe the reason  my boss isn't giving me time off is because I gave him no warning. And then to choose, you know,  like what do I really want to do? Do I really want to quit my job? And to think through this and  then eventually to take action that lines up with your values, you know, like, oh, I need to keep  my job. Next time I need to do this differently, right? And just notice how each of these steps in  emotion processing requires you to hold multiple ideas in your head while trying to remember what  to do next while you're feeling intensely angry.

[00:10:35]Right? So, not only is it hard to work through  those feelings, but poor executive function makes it harder to solve the actual problem that  the emotion is about. The actual problem is you need to plan ahead better to request time off.  Long story short, every single step of emotion processing requires executive function and that  requires multiple steps. And as Kjrstin Walters, my favorite ADHD expert, says, "For people with  ADHD, two steps is one step too many." Okay, so it's easy to see why people with ADHD struggle  with emotion regulation. But these are skills that can be learned and supported. And I pretty  much had to learn how to do this manually.

[00:11:13]But with time, I did learn how to work through my  feelings in a healthy way. Okay, so those are five ways that executive dysfunction really impairs  regulation and ADHD. Okay, now we're going to talk about RSD and biological triggers and then  we'll talk about some helpful strategies. Okay, many people with ADHD have rejection sensitive  dysphoria. This is intense emotional pain in response to perceived criticism or failure or  rejection. When you get criticized or rejected, it can feel like you're being stabbed. And I  can remember when I had a friend breakup and it destroyed me for like years. I felt like there  was something wrong with me. I was so hurt and confused that I literally withdrew from having any  friends for like 2 years now. I know this doesn't make sense, and that's what dysphoria means. It's  a much bigger than expected emotional response and it can happen even when it's just a small piece of  feedback or a tiny mistake. Now, because rejection feels so painful, it often leads to defensiveness,  social anxiety, social withdrawal, or people pleasing. The fear of saying the wrong thing  or making someone mad can be paralyzing. Now, I'm going to make a whole video on this. So, if  you'd like to see that, you can subscribe or click the bell. All right, there's my annoying call to  action. But I am making a bunch of videos on this, so stay tuned. Okay, the last main category of  how ADHD is linked to emotional dysregulation is biological triggers. Up to 70% of ADHDers  have a natural delay in their internal clock.

[00:13:02]This means that their brains don't start releasing  melatonin until much later at night. This is like 2 hours later. So even if they go to bed early,  they just lie there awake. Then you add in the racing background noise of the brain, that loud  default mode network, and difficulty calming down.

[00:13:23]And what you end up with is a lot of ADHDers end  up chronically sleep-deprived and that makes it much harder to regulate emotions. Now again, this  topic deserves a whole video, so stay tuned. But let's talk about hanger. People with ADHD often  struggle to eat on a regular schedule because the same brain networks that manage attention and time  awareness and self-regulation, those same networks also control hunger cues and routines. So, when  you're hyperfocused, you might not notice that you're hungry until you're shaky and irritable. Or  when you're distracted or overwhelmed, preparing food can feel like an impossible task. So this  irregular eating pattern causes these blood sugar spikes and crashes, which intensifies emotional  dysregulation and that can lead to irritability, anxiety and impulsivity. Okay, last is sensory  overload. People with ADHD have brains that are extra sensitive to incoming information,  sounds, lights, textures, and movement.

[00:14:23]They all compete for attention at once. And  when too much sensory input hits the system, the brain's filtering mechanism gets overwhelmed  and that overload can quickly trigger the nervous system's fight or flight response. So to manage  your sensory load, it might be really important to decrease multitasking and to change your  environment to be more ADHD friendly. Okay, before you get all down in the dumps about all the  ways that ADHD makes it hard to regulate emotions, I have to tell you about some ADHD superpowers.  And I'm just going to list a few. Strong emotional intuition. This is one of my gifts that helps me  be a good therapist. Quick emotional recovery from setbacks. Some emotions are intense but fleeting.  Now, this can feel really confusing because some emotions are intense and stick around for a long  time, but sometimes you just bounce back. High emotional resilience in stressful situations.  There's some fascinating studies showing that many people with ADHD perform really well under  pressure and they regulate emotions much better in fast-paced, high-intensity situations. So, you  might make a great first responder. Passion-driven emotional regulation. When we care about a  goal, we can channel frustration into action.

[00:15:41]And creativity. People with ADHD often find unique  and adaptive ways to regulate emotions. We might use humor, storytelling, music, art, or movement  to shift our emotional state. You aren't broken.

[00:15:53]You aren't bad. Your brain is just different  from typical brains. You might just thrive in a different environment. Okay. So, finally, we're  at the part of this video where we are going to talk about the practical strategies that help  ADHDers regulate their emotions. Okay, so first let's talk about biological triggers. Again, with  ADHD and these changes, it almost never works to just try harder. That's like telling someone who  needs glasses that they just need to try harder to see. That just won't get them very far. They need  glasses. And if you've got ADHD, you need systems that change the environment around you to work for  you. So, make it easier to get sleep and hydrated by keeping granola bars and water bottles nearby.  I don't have time to address like all of these topics. So, we are going to touch on them briefly  and you and your brilliant ADHD brain can watch the videos and do the research. When you choose  one of these areas to work on, watch the videos, do the research, and figure out how to implement  one of these changes into your life. Okay, second one is sleep. Get better sleep. This is  easier said than done, but do your best. Again, video incoming. Exercise and nature time have both  been shown to improve mood and focus. Manage your environment to deal with sensory overload. Now,  again, guys, I know I'm just listing these ideas, but out of everything I say in this segment,  choose one. Go do your ADHD fueled research on the topic. Pick one action item. There's  plenty of good videos on how to do this with ADHD. And then of course, medication. ADHD meds  can help strengthen the brain's ability to pause before reacting. And stimulants can often reduce  emotional impulsivity and mood swings by enhancing the thinking part of your brain. Non-stimulants  can also help level out your emotional reactivity.

[00:17:43]And of course, talk with your doctor.  Okay, so minimizing biological triggers and using medication will help prevent some of the  overwhelming levels of emotion, but stuff is still going to come up. So, let's talk about nine skills  you can do to help regulate your emotions even when ADHD is doing its thing. Learn to pause when  you feel a strong emotion. The number one most important skill is to buy your brain some time  for your executive function to turn on. You've got to train yourself to pause before reacting. So,  let's go back to Alex. He was the college student who made it awkward during the group project.  What I would say is Alex could use a script, a neutral phrase to buy himself some time. It  might be something like, "Hm, let me think about that." Or you just repeat back to them what they  said. Something like, "Oh, you're saying we should take a different approach." Or take a break when  you're feeling overwhelmed and go for a walk or go to the bathroom. Okay. Now, here's the thing with  ADHD, right? When you're trying to make changes, when you have ADHD, you have probably tried over  and over and struggle to be consistent to actually maintain those changes. So, you might feel like  giving up or like, "Oh, yeah. I've tried that, but it just hasn't worked." I would just say, "Don't  give up. Don't just try harder. Try differently."

[00:18:59]With ADHD, you've got to outsource your  executive function and treat each attempt as a tiny experiment. And you're probably not going to  succeed the first time you try to learn to pause.

[00:19:10]So you've got to build better systems. So let me  give you an example. When it comes to outsourcing that executive function, let's say like your  impulse is that you spend money impulsively. You can't just try harder to not spend money. You've  got to build in things that are going to slow you down. So some examples of this are like taping  a reminder on your credit card that you have to call your partner before spending over $100  and you have to sleep on it before spending over $500. You gotta outsource your executive function  so you don't have to remember to slow down. It's like printed right there. You could delete the  autopay options, like saved credit cards on online shopping and that forces you to stand up and  get your credit card and manually add it to the purchase. Or you can add an app to your phone that  forces you to wait before making online purchases.

[00:19:59]Long story short, these are all examples of how to  build an environment that supports your executive function to help you be less impulsive. Now again,  this topic deserves a whole video. I'm actually writing it right now. It'll be out in a couple  months. As we talk about the next couple of ideas, pick just one area to work on. Watch three to  four videos on that specific area. And then you could work with an executive function coach  or a therapist to come up with some creative strategies of how to implement that change in an  ADHD friendly way. And I would just say don't try to change everything at once. Just pick one area  at a time to work on for a month until you find a routine that works for you and becomes a new  habit. So, going back to this learning to pause thing, I know we're spending a lot of time on  this one, but I'm trying to teach you the system for creating change instead of just like trying  to white-knuckle these changes. So, if you're trying to train yourself to pause before speaking  impulsively, you might decide that you're going to use a script. And your script is, "Hmm, let  me think about that." And you are going to need to practice that at home like 20 times before you  start to remember to use it at work. Maybe you're going to make yourself a bracelet that says, "Hmm,  let me think about that." And you're going to add a reminder to your phone that says, "Hmm, let me  think about that." And then you make a physical calendar where you do a tally mark for each day  where you use that skill at least once. You have to make this physical, tangible, not too big.  The last thing to remember is this is all a huge experiment and you're probably going to find a lot  of things that don't work for you, but keep trying and just keep experimenting with new things until  you do find something that works for you. Okay, so that's the process, right? Like we have all  these psychological strategies. Just pick one.

[00:21:32]Experiment with a system that's going to help you  support your working memory and executive function so you can make the changes you want to make.  Okay, now we're going to move through these other ones a little bit more quickly. The second one is  labeling or naming the emotion. Alex could think, I feel frustrated because my idea wasn't accepted.  It's important to say this out loud and be sure to use an emotion word. And what this is doing is it  helps sync the amydala and the prefrontal cortex.

[00:22:00]It helps your brain slow down. The third one is  calm your body. Learn some skills to ground your nervous system when you're feeling overwhelmed.  You can learn a bunch in my free course, Grounding Skills for Stress, Anxiety, and PTSD.  The easiest one though, is to take a slow exhale.

[00:22:22]Okay. Number four, support your working memory.  Make it concrete. Because your working memory can't hold so many ideas at once, you've got  to find a system to process your feelings in an external way. This can include writing, whether in  a journal or even just talking into a voice note on your phone or talking it out with a friend  or a therapist or diagramming it. When you want to actually make a change, when you've chosen  one thing you want to change and you've built a new routine, you're going to make copies of this.  You're going to write this down and put copies of it all over your house so that you can remember  it. And what we're doing is we're taking all these ideas out of your head with the gazillion  flighty thoughts that you have and we're making it concrete. Now you can look at it and you can  see the various parts. Number five is learn to shift focus. Remember Jordan, who messed up the  email at work? ADHD brains often have a hard time thinking their way out of hyperfocus. You can't  think your way out of hyperfocus. We often need a physical or body sensory activity to help shift  emotions. And one of my followers told me that his mantra is move a muscle, move a thought. Now, in  the past, you may have tried to do this in harmful ways like eating something, breaking things,  or dangerous stimulating activities. Instead, let's explore some like healthy ways to do this.  This might be a quick walk, even just walking around the room or doing some jumping jacks or  stretching. Movement helps the various parts of the brain connect and talk to each other better.  So you could talk through emotions while folding laundry or you could process anger or sadness  while exercising. Long story short is if you have ADHD, move a muscle, move a thought. It's much  harder to just sit there and think your way out of a problem. On to number six. You've got to prepare  ahead of time to counteract negative thoughts because you're going to have a hard time slowing  yourself down. Now, this is probably best done by working with a therapist, but you can practice  on your own as well. So, let's use the example of Maya. She's a teenager with ADHD, and she has  a tendency toward rejection sensitivity. Now, her friends aren't texting her back. Are they  mad at her? Are they doing something fun without her? Do they hate her? My therapist taught her to  write down the negative thought, like, "They don't like me." And then list at least two to three  alternative explanations. So you remind yourself, "Oh, this feeling is intense, but it will pass."  Or, "My brain is jumping to conclusions because of ADHD, not because it's true." Now, if you  have ADHD and you also frequently go down the rabbit hole of catastrophizing, you'll probably  need a visual reminder to not believe everything you think, that you are safe and you are loved and  everything is figureoutable. Okay. Number seven, break down big tasks or problems. So instead  of being paralyzed by big problems, one of the essential skills with ADHD is to break down tasks  into actionable chunks. There's like two ways you could do this. You could write it out on paper.  And again, this is supporting a working memory by writing it down. Write out a now versus later  list to separate what's urgent from what can wait.

[00:25:30]Or find one to two tiny goals per day. So for  example, find one document instead of getting all the paperwork done. And again, with all of  these ideas, there's like 20 plus ways to do this, and a great therapist or executive function  coach can help you come up with some good ways to implement these strategies. You don't have  to do this on your own. Okay, we are almost done. Number eight, schedule emotional check-ins.  Because emotions can feel really overwhelming, it's easy to want to avoid them. And plus,  when there's no crisis, it's boring. It's not urgent. So, schedule a regular time to check  in with your feelings instead of ignoring them.

[00:26:07]until there's a crisis. And this could look like a  weekly therapy session or a set time to talk with a friend or a 5-minute check-in every evening and  just ask yourself like, "How did I feel today?"

[00:26:19]This can help you manage your emotions before  they become overwhelming. Okay. Number nine, reflect. You don't have to be perfect. It's okay.  Learning to regulate emotions is a process. It's not a destination. One of the best things you can  do is a careful reflection after a big emotion.

[00:26:36]like you could write about what happened, what  triggered my reaction, how could I have responded differently, and write out exactly what you would  say or do next time. This lays neural pathways to act differently in the future. And I would say  just get good at apologizing. This is a skill that can be learned, so work on that. Okay, was  that all super overwhelming? Just as a reminder, just pick one area to work on. Write it down.  Add a daily reminder to your phone, outsource the executive function, and work on it for a few  weeks. While regulating emotions is harder for many people with ADHD, I know that you can learn  the skills to get better and better at feeling.

[00:27:18]For me, big emotions used to feel like the end  of the world. Like literally the end of the world. Everything is awful and it will never get  better. Now, I only feel like that sometimes. Just kidding. Um, big emotions do take over sometimes.  But what's different now is that I feel super confident that I can figure them out, that they  won't last forever, and that I have the supports in place to work through them. So, what this means  is they don't usually stick around nearly as long, and overall, I handle situations a lot better.  So, by practicing these strategies, you can learn to interrupt impulsive emotional reactions and  build better emotional regulation over time. Okay, I hope this was helpful. I've mentioned several  resources in this video, including videos I'm working on about ADHD, and I'll put those links in  the description. So, if you'd like to learn more, you can check those out. Thank you again  for being here, and please take care.