Why We Feel So Intensely: Understanding ADHD Emotions
Anger, outbursts, anxiety, irritability, impatience: more than most people, ADHDers can be driven by emotions.
by Thomas E. Brown, Ph.D., author of Smart but Stuck: Emotions in Teens and Adults with ADHD
Few doctors factor in emotional challenges when making an ADHD diagnosis. In fact, current diagnostic criteria for ADHD include no mention of “problems with emotions.” Yet recent research reveals that those with ADHD have significantly more difficulty with low frustration tolerance, impatience, hot temper, and excitability than a control group.
Processing Emotion: A Brain Thing
Challenges with emotions start in the brain itself. Sometimes the working memory impairments of ADHD allow a momentary emotion to become too strong, flooding the brain with one intense emotion. At other times, the person with ADHD seems insensitive or unaware of the emotions of others. Brain connectivity networks carrying information related to emotion seem to be somewhat more limited in individuals with ADHD.
When an adolescent with ADHD becomes enraged when a parent refuses him use of the car, for example, his extreme response may be due to “flooding” – a momentary emotion that can gobble up all of the space in an ADHDer’s head just like a computer virus can gobble up all of the space on a hard drive. This focus on one emotion crowds out other important information that might help him modulate his anger and regulate his behavior.
Extreme Sensitivity to Disapproval
ADHDers often become quickly immersed in one salient emotion and have problems shifting their focus to other aspects of a situation. Hearing a slight uncertainty in a coworker’s reaction to a suggestion may lead to interpreting this as criticism and an outburst of inappropriate self-defense without having listened carefully to the coworker’s response.
Significant social anxiety is a chronic difficulty experienced by more than one third of teens and adults with ADHD. They live almost constantly with exaggerated fears of being seen by others as incompetent, unappealing, or uncool.
Giving In to Avoidance and Denial
Some people with ADHD don’t suffer from a lack of awareness of important emotions but from an inability to tolerate those emotions enough to deal effectively with them. They become caught up in behavior patterns to avoid painful emotions that seem too overwhelming – looming deadlines or meeting an unfamiliar group of people.
Carried Away with Emotion
For many ADHDers, the brain’s gating mechanism for regulating emotion does not distinguish between dangerous threats and more minor problems. These individuals are often thrown into panic mode by thoughts or perceptions that do not warrant such a reaction. As a result, the ADHD brain can’t deal more rationally and realistically with events that are stressful.
Sadness and Low Self-Esteem
People with untreated ADHD can suffer from dysthymia – a mild but long-term form of depression or sadness. It is often brought on by living with the frustrations, failures, negative feedback, and stresses of life due to untreated or inadequately treated ADHD. People who are dysthymic suffer almost every day from low energy and self-esteem.
Emotions and Getting Started
Emotions motivate action – action to engage or action to avoid. Many people with untreated ADHD can readily mobilize interest only for activities offering very immediate gratification. They tend to have severe difficulty in activating and sustaining effort for tasks that offer rewards over the longer term.
Emotions and Getting Started 2
Brain imaging studies demonstrate that chemicals that activate reward-recognizing circuits in the brain tend to bind on significantly fewer receptor sites in people with ADHD than do those in a comparison group. People with ADHD are less able to anticipate pleasure or register satisfaction with tasks for which the payoff is delayed.
Emotions and Working Memory
Working memory brings into play, consciously and/or unconsciously, the emotional energy needed to help us organize, sustain focus, monitor and self-regulate. Many ADHDers, though, have inadequate working memory, which may explain why they are often disorganized, lose their temper, or procrastinate.
Emotions and Working Memory 2
Sometimes the working memory impairments of ADHD allow a momentary emotion to become too strong. At other times, working memory impairments leave the person with insufficient sensitivity to the importance of a particular emotion because he or she hasn’t kept other relevant information in mind.
Treating Emotional Challenges
Treating the emotional challenges of ADHD requires a multimodal approach: It starts with a careful and accurate evaluation for ADHD, one that explains ADHD and its effect on emotions. ADHD medication may improve the emotional networks in the brain. Talk therapy can help a person manage fear or low self-esteem. Coaching may help a person overcome problems with getting boring tasks completed.
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