Emotional dysregulation is common among young people with ADHD. They may experience intense emotional reactions that are difficult to soothe, contributing to challenges in everyday life, such as interpersonal difficulties or problems in school.
Emotional dysregulation can, however, be addressed through mental health treatment. By developing different kinds of emotional regulation skills, children and adolescents can learn how to manage emotional responses, calm down more easily and cope with situations in ways that are helpful and in line with their values and goals.
This blog explores emotional dysregulation among young people with ADHD and outlines some of the interventions that can help.
Understanding ADHD and Neurodiversity
Attention-deficit hyperactivity disorder is a neurodevelopmental disorder that shapes the way a young person experiences the world. It’s a type of neurodiversity, a different way of interacting with the world that brings both strengths and challenges.
While some traits of ADHD may make everyday life difficult for young people, other traits give young people skills and superpowers, such as hyperfocus or creativity. In a world often structured to meet the needs of neurotypical people, inclusivity is about creating environments where neurodiverse young people can thrive.
What Is Emotional Dysregulation in ADHD?
Young people with ADHD often experience challenges in managing both positive and negative emotions. Emotion regulation in ADHD may manifest as intense angry outbursts in friendships or with teachers at school. Or it may cause outbursts of excitement and enthusiasm that might be considered childish or inappropriate by others.
Emotional dysregulation is expressed through strong emotional reactions, difficulties in self-soothing or calming down and a lack of consideration for the long-term consequences of an emotional response. It can also involve challenges in identifying and understanding emotions.
Emotional dysregulation in ADHD is often misdiagnosed as or mistaken for oppositional behaviours and oppositional defiance disorder. But the angry outbursts associated with emotional dysregulation are often not oppositional or aggressive: instead, they are intense and uncontrolled reactions to a genuine perception of unfairness or mistreatment.
Understanding Emotional Regulation and Dysregulation
Emotional dysregulation happens when someone has difficulty using the different processes involved in emotional regulation. Emotional regulation, in turn, is a two-step process involving various mechanisms that affect our emotional responses.
- The first step involves managing the initial emotional response by slowing the speed at which an emotion escalates and the intensity at which it’s expressed
- The second step involves de-escalating an emotion by self-soothing, focusing on other things and changing behaviours to manage a situation in a helpful way
Young people with emotional dysregulation may struggle at both stages of this process. This means that their emotions may escalate more quickly and intensely than other people’s, and they may take longer to calm down afterwards.
How Does Emotional Dysregulation Develop?
Children start learning to regulate their emotions almost as soon as they are born. Infants learn by observing their caregivers and begin to understand the difference between various emotions, such as sadness, happiness or fear. They also learn that emotions can have different intensities and durations.
As they grow older, children learn to regulate their emotions through secure and trusting connections with parents, caregivers and other figures. By observing, internalising, replicating and interacting, children can develop different ways to manage their feelings, including help-seeking, avoidance, distraction, and problem-solving. This learning process relies on positive role modelling and behaviours by caregivers, family members and friends, as well as certain cognitive skills.
For some young people, this developmental process is disrupted. This can happen when a child grows up in an unstable environment without secure attachment figures or when personality traits prevent effective learning. Personal experiences, such as experiences of trauma and other mental health disorders, can also impact the way these skills develop. This can lead to emotional dysregulation.
Some experts think that emotional dysregulation happens when a young person experiences intense emotions in a setting where they’re unable to learn how to cope with them. This might be because of their home environment, relationships with caregivers or relationships with peers. Emotional dysregulation may also develop when a young person’s emotions are repeatedly ignored, minimised or de-validated.
How Common Is Emotional Dysregulation Among Young People with ADHD?
Research shows that more young people with ADHD are emotionally reactive and have dramatic and rapid shifts in emotions than children and adolescents without ADHD.
One study found that 46.92% of children with ADHD displayed high levels of emotional lability (rapid, exaggerated shifts in mood) compared to those without ADHD (15.38 %). Other research shows that children with ADHD are significantly more emotionally reactive than others.
Emotional dysregulation also tends to appear much earlier in childhood among young people with ADHD than those without.
How Does Emotional Dysregulation Affect Young People with ADHD?
Among children with ADHD, emotional dysregulation is linked to challenges in various aspects of cognitive, emotional and social domains, including:
- Emotional recognition
- Working memory
- Interpersonal relationships
ADHD, Emotional Dysregulation and Interpersonal Relationships
Some young people with ADHD find it hard to form and maintain friendships with peers and may experience interpersonal difficulties. Research suggests that children and adolescents with ADHD and emotional dysregulation are more likely to have difficulties in friendships than those with only ADHD. It’s also found that the link between ADHD and a lack of social skills is mediated by aspects of emotional dysregulation.
Emotional Dysregulation, ADHD and Family Conflict
ADHD and emotional dysregulation are both linked to increased conflict in the family. Without support, some parents may find managing and responding to certain traits of ADHD difficult, especially when they may be unsure of what ADHD is or how it affects a young person. This can cause additional stress in a family environment, which may lead to conflict.
Emotional dysregulation, on the other hand, may be both a cause and consequence of family conflict. While intense and enduring emotions may make parenting more difficult, the instability that results from conflicts at home can also disrupt the development of emotional regulation skills. It’s possible that the increased family conflict that may result from ADHD can contribute to the development of emotional regulation.
Why Do Young People with ADHD Often Have Emotional Dysregulation?
Research suggests that the co-morbidity of ADHD and emotional dysregulation may be explained by both genetic and environmental factors. However, the evidence we have is still limited and in some cases inconclusive. More scientific studies are needed to gain a clear and reliable picture of what causes emotional dysregulation in young people with ADHD.
Some possible explanations include:
- Certain genetic vulnerabilities may make the development of both ADHD and emotional dysregulation more likely
- ADHD may lead to more conflict and stress at home, which can increase the risk of emotional dysregulation
- ADHD-related behavioural difficulties that are hard to manage may make parents more likely to invalidate or punish a child’s emotions
What Interventions Can Support Young People with ADHD and Emotional Dysregulation?
There are different kinds of interventions that can support young people with ADHD and emotional dysregulation. Some types of therapy work directly with young people to improve emotional regulation skills, such as self-soothing or mindfulness. Other interventions support parents or other family members to respond to young people’s behaviours in a way that validates their emotions and encourages the development of emotional regulation skills.
Parenting Skills Coaching
Parenting skills coaching can help parents develop effective parenting skills in the context of more disruptive behaviours. This might involve setting clear and consistent boundaries, avoiding punishments and using de-escalation techniques. It may also involve role-modelling positive behaviours and listening to and validating a young person’s emotions.
Skills training sessions may also focus more broadly on building secure attachment relationships that provide the basis for a young person’s emotional and social learning.
Dialectical Behavioural Therapy
Dialectical behavioural therapy is a type of talking therapy designed for people who experience very intense emotions. In DBT sessions, young people learn a variety of different skills, including mindfulness, distress tolerance, emotional regulation and interpersonal skills.
Mindfulness Meditation
Mindfulness meditation involves shifting your attention to your thoughts, feelings and bodily states, observing them without judgement. It can help people develop ownership over their emotions and soften emotional reactivity.
The Wave: Transformative Mental Health Support for Young People and Families
The Wave offers specialist mental health support for young people and families. We prioritise inclusivity and fairness, celebrating neurodiversity and adapting environments and approaches to meet each young person’s needs.
Our programs are trauma-focused and family-centred, emphasising the role that past experiences and interpersonal relationships play in shaping how young people think, feel and act today.
If you’re interested in finding out more about our programs, contact us here. We’re here to make a difference.
