Why Emotional Dysregulation Can Happen With ADHD

Do you ever wonder if your feelings are too big for their own good? Whether it’s irritability over a late package or frustration due to an argument with your partner, it can feel like your emotions sweep you up like a current. And, if you live with attention-deficit/hyperactive disorder (ADHD), this could be a sign of emotional dysregulation.

“Emotional dysregulation is no longer part of the definition of ADHD, but many people with ADHD still have difficulty managing their feelings,” says pediatric behavioral health specialist Michael Manos, PhD.

And while not everyone with ADHD will have emotional dysregulation, that doesn’t mean that this symptom should be overlooked.

Dr. Manos explains how emotional dysregulation can be tied to ADHD, what signs to look for and how to better manage your emotions.

Emotional dysregulation in ADHD 

Think of emotional dysregulation as a magnified emotional response. It’s not the emotions that are the problem, but your ability (or inability) to manage them.

Imagine someone cuts you off while driving. It’s normal to feel frustrated or angry by this. The appropriate response is to acknowledge your emotions and keep driving. But if you’re someone who experiences emotional dysregulation, you may start yelling at the person, honking the horn or feeling overcome with rage.

So, why does this happen? As Dr. Manos points out, it has to do with how ADHD affects your attention for things you want to be doing (automatic attention) and things you don’t want to be doing (directed attention).

“We manage emotions using directed attention,” he explains. “Emotions are brought out by automatic attention, but most people can manage their feelings effectively using directed attention.”

As ADHD affects the part of your brain that controls emotional processes (the amygdala), your ability to switch attention from feeling upset in the moment to managing emotions calmly can be challenging. Instead, your brain goes full speed ahead and turns your feelings up to 100.

Signs of emotional dysregulation with ADHD

In people with ADHD, emotional dysregulation can show up in a range of symptoms that may vary in intensity and frequency.

Here are some common signs:

• Emotional outbursts. Intense emotions can sometimes lead to visible, physical expressions like crying, yelling or even storming off. These outbursts may happen suddenly and can feel out of your control.
• Mood swings. Maybe you’ll feel happy and optimistic one minute and sad, frustrated or angry the next. These changes can happen abruptly and seem unrelated to actual events or circumstances.
• Low frustration tolerance. Frustration can build quickly, and if you have ADHD, you may feel overwhelmed or defeated by challenges that seem minor to others. This can lead to giving up on tasks easily or feeling irritated.
• Impulsivity. You may blurt out hurtful comments, overreact or show anger quickly before you can process your feelings.
• Difficulty “letting go.” You may have trouble calming down or moving on after a stressful event.
• Sensitivity to criticism. You may also experience something called “rejection-sensitive dysphoria,” a condition linked to ADHD. Even small comments can feel deeply personal to you, leading to feelings of shame, sadness or anger.
• Frequently feeling overwhelmed. Emotional dysregulation can make it hard to manage daily stress and lead to overwhelm or anxiety. You may experience emotional exhaustion or burnout, even when a seemingly manageable problem arises. This is especially related to task incompletion and breaking agreements — that is, not doing something you said you would do. Procrastination is typically accompanied by the feeling of being overwhelmed and self-criticism at not doing what you said you would do.

How to cope

You may feel like your emotions are out of your control. But it’s possible to manage them through healthy coping mechanisms. Think of emotional regulation as a skill to improve. And the best way to get it down is by practicing. Here are some ways to do it.

Put your feelings into words

For starters, this can be as simple as naming the feeling you’re having specifically. Is it frustration? Anger? Jealousy? Annoyance? This way, you’re acknowledging the feeling without letting it take you over.

“I have found that what has been most effective for people managing their feelings is using language,” shares Dr. Manos. 

After that, you can take the steps to ask questions about what makes these emotions hit you so hard: 

• What was I doing right before I reacted this way?
• What triggered my reaction?
• Are there other feelings underneath this reaction that I’m ignoring?
• What physical sensations am I feeling?

Another way to manage your emotions with language is by keeping a daily record of your triggers. This will ultimately help identify patterns and help manage your reactions in the future. It can be as simple as a running list or a mood journal that tracks your emotions throughout the day.

You can do this in the moment of a conflict when you need to cool down or use it later in the day as a reflection. And you can actually extend the time between feeling the emotion and expressing a behavioral reaction (like yelling or crying) to that emotion.

Practice mindfulness and meditation

Mindfulness and meditation can improve awareness of your emotional triggers and help manage impulsive responses. Both practices can help you be in the present moment and help you take a step back from your emotions.

If you think starting a meditation habit sounds overwhelming, that’s OK. There are places you can start that require no more than five to 10 minutes.

You can try techniques like:

• 4-7-8 breathing
• EFT tapping 
• Box breathing
• Body scan meditation

These methods can help anchor you in the present moment and prevent your emotions from spiraling. Keep them in your toolkit for the next time you need them or work them into your daily routine.

Keep a consistent routine

Many of life’s stressors come from unpredictability. If you live with ADHD, you may feel derailed or triggered by sudden changes, no matter how big or small.

Having a consistent routine can help you take on any unforeseen changes. It gives you a baseline of what you can control: your bedtime, your evening workout, your morning coffee run and so on.

If you have ADHD, you know that keeping a routine can be easier said than done. Try to do things like:

• Create visual reminders, like sticky notes or to-do lists.
• Set timers, alarms or calendars to keep you on track.
• Associate healthy habits and parts of your routine with something you enjoy. For example, you could watch an episode of a TV show during your morning workout.

Make time for rest

If you have trouble regulating emotions, burnout can feel more like a crash out. That’s why it’s essential to build short, regular breaks throughout the day to prevent being overwhelmed. These breaks act as “reset points” that help prevent your emotions from accumulating unchecked. This also means getting enough sleep so you’re better equipped for whatever the day throws at you.

See a therapist

In some cases, through treatments like acceptance commitment therapy (ACT) and cognitive behavioral therapy (CBT), you can learn to recognize and reframe negative thought patterns. This can make it easier to respond thoughtfully rather than react impulsively.

In addition, dialectical behavior therapy (DBT) provides skills for regulating emotions, tolerating distress and improving relationships.

Therapy also creates a safe space to explore your unique emotional triggers and find the right coping mechanism for them.

When to seek other treatment

It can be hard to know when your emotional reactions are a larger cause for concern. You may be wondering: Are my reactions normal? Is this something I can handle on my own?

It may be a good idea to seek treatment if:

• Your emotions are consistently intense, difficult to manage or take a long time to subside
• Your emotional reactions are causing repeated conflicts with friends, family or coworkers
• You can’t focus on tasks to the point where they impact your work, school or daily responsibilities
• You engage in impulsive actions more frequently, like outbursts, reckless spending or other risk-taking behaviors
• You’re experiencing constant feelings of shame, frustration or low self-esteem
• You’re not noticing enough relief or improvement from self-help strategies like mindfulness, breathing exercises or journaling

The bottom line

Emotional dysregulation can go hand in hand with many other symptoms of ADHD and it’s normal to feel overwhelmed by it. In many cases, you can manage this through relaxation techniques, meditative practices and learning your triggers.

If you notice your emotional reactions are causing constant stress, conflict in your relationships or leading to other health concerns, you should speak with a healthcare provider. Together, you can find ways to help you feel better.