Emotion regulation is our ability to notice, understand, and manage our emotions, something that sounds
relatively simple but can be a lot more difficult in practice. It often involves pausing to process our
feelings instead of acting out as soon as they come up, ultimately helping us to respond in ways that align with who we want to be as a person.
Those with ADHD will likely tell you that they have firsthand experience when it comes to struggling
with emotion regulation, and this is not something that is just in our heads! Research indicates that
34-70% of adults with ADHD experience significant emotional dysregulation, yet it is an aspect of
ADHD that is often left out of the discussion. Well, for the fourth session of our ADHD program, we
decided to have that conversation and learn more about the science of emotion regulation in ADHDers, as well as strategies to better regulate our nervous systems.
The Brain Science: Why Emotions Feel So Fast
As always, it is crucial to acknowledge that the difficulty in regulating emotions is not a character flaw of
ADHDers, but rather, a result of structural brain differences, neurochemical imbalances, and a unique
speed factor. So why is it that ADHDers struggle so greatly with slowing down? The easiest way to
understand the disconnect is to think of the emotional cycle as a traffic light, going from green to yellow
to red.
In neurotypicals, this traffic light functions as usual. The green light is the triggering
situation/circumstance occurring when we are in our calm, baseline state, the yellow light is the cognitive
appraisal where the pause takes place for individuals to interpret and evaluate the situation, and finally,
the red light is where the individual reacts to the situation, feeling a particular emotion or taking a certain
action. In those with ADHD, the process is the same, save for one crucial difference: the missing yellow
light! Because this thought phase is bypassed completely, those with ADHD usually end up reacting
emotionally or physically before they can stop, evaluate the situation and determine how best to
proceed.
That’s not all, though, as there is another biological component working against those with ADHD in the
form of a functional mismatch between the amygdala and the prefrontal cortex. The amygdala is the
region responsible for threat detection and emotional processing, while the prefrontal cortex is responsible for inhibiting impulses and putting feelings into context. In those with ADHD, the amygdala is not able to slow down in the way that it does for neurotypicals, leading our nervous system to interpret anything that is even slightly triggering as an active threat. This can result in a lot of dysregulation, which can look like feeling on edge, anxious, or overwhelmed when there is no logical reason to feel that way. In ADHDers, the prefrontal cortex has decreased activation and weaker structural connectivity to the amygdala. This means that the alarm received from the amygdala rings louder and longer before the prefrontal cortex can jump in to pump the brakes, making it difficult to stop an emotional/physical reaction. If we relate this back to the traffic light analogy, this means that there is another component leading those with ADHD to jump from green to red, with no yellow light to slow us down.
Rejection Sensitive Dysphoria
Another factor that can lead to poor emotion regulation is Rejection Sensitive Dysphoria (RSD), which is
described as intense emotional reactions triggered by perceived criticism or rejection, commonly seen in
those with ADHD. A typical rejection response can result from concrete social rejection, with an intensity
that is unpleasant but manageable, and feelings of lingering sadness/disappointment. It is important to
note that rationalization and logical thinking can still occur. In RSD, though, the trigger is not only actual
rejection, but any rejection or negative social cues that we perceive, even if they are not objectively true.
This can lead to an immediate and intense feeling that is often accompanied by catastrophizing. It can be
difficult to get out of these feelings due to cognitive dissonance, leading to our emotions ruling over us.
In ADHDers, this can look like rapid, intense mood shifts following social interactions, physically intense
emotional pain, avoidance or withdrawal in anticipation of rejection, and people-pleasing or
perfectionistic behaviors linked to the fear of rejection. ADHDers who experience RSD usually have
difficulty slowing down and thinking their reaction through, and will often go from 0 – 100 if they feel
that they are being rejected.
Regulation Tools
To successfully regulate our emotions, the goal is to notice and name them, accept them as valid, get
curious about the deeper reason for the emotion, and allow for the emotion to pass naturally. But what do
we do as ADHDers when we have multiple components that make it difficult for us to take a moment to
pause and think? The answer is to adapt and learn to manually create that pause for ourselves. Here are
some regulation tools that can help us more easily remind us to take a second and reflect!
- HALT: Check the biological dashboard before attempting emotion regulation, as we cannot out-think physical components that are contributing to nervous system dysregulation. – Hunger: Blood sugar drops can mimic anxiety and strip the prefrontal cortex of the energy we need to think things through rationally. – Anger: Unprocessed frustrations can add up over time and build up emotional pressure. – Loneliness: Isolation can amplify our brain’s threat detection. – Tiredness: Sleep deprivation can severely limit prefrontal cortex function. – Sensory overload: Overstimulation due to noise, light, or other physical input can lead to
feelings of overwhelm. - STOP: – Stop whatever you are doing – Take space between you and the triggering situation/person/setting; allow yourself to take a time-out. – Observe what is really going on internally and notice what emotion you’re experiencing. – Proceed mindfully by re-evaluating how you wish to act and move forward in alignment
with your values - TIPP: Temperature: Use ice water or an ice cube on your skin to trigger the mammalian dive reflex and instantly slow the heart rate. – Intense exercise: 60 seconds of a physically difficult movement like jumping jacks, sprinting, or wall pushes can burn off the immediate surge of adrenaline and cortisol. – Paced breathing: Breathe out longer than you breathe in (e.g., 4 seconds in, 6 seconds out) to force the parasympathetic nervous system to engage. – Paired muscle reaction: Tense muscle groups tightly for 5 seconds, then release, noticing the contrast; you can work your way up or down the body to bring awareness back to your physical self.
- Urge Surfing: This can be used to manage cravings or impulsive behaviors like intense emotions/reactions. It involves understanding that it is simply a neurochemical wave that will come and go on its own in due time. By riding the wave rather than fighting back against it, we
can reduce the emotional distress and time lengthening that comes with denying our natural
experiences.
Strengths and Superpowers
We’ve talked at length by now about how the ADHD brain can work against us, so let’s take the time to
remind ourselves of how these differences can also act as great strengths and be our superpowers –
- Justice Sensitivity: The same alarm system that was discussed earlier can make those with ADHD
fierce advocates for fairness and truth. If something seems unjust, we can feel strongly about it
and work with passion to repair it. - Creativity and Passion: The lack of emotional filtering means that ADHDers experience the world
in vivid, unbounded technicolor. This can fuel creativity, lead to outside-the-box thinking, and
innovative ideas. - Hyper-Empathy: Feeling deeply not only means that those with ADHD fight for what’s right, but
also that we deeply connect with others. We can put ourselves in other people’s shoes and feel
their joy and sadness with them, adding great meaning and depth to our relationships. - Resilience: Remember that because the ADHD brain can make things so difficult at times, we
have experience with persevering and working hard. We have survived a lifetime of emotional
storms and have found ways to adapt through them!