ADHD & Emotional Regulation

Welcome to another insightful episode of "Thriving with ADHD," presented by Animo Sano Psychiatry. In today's discussion, we dive deep into the complex relationship between ADHD and emotional regulation with our special guest, Stephanie Solomon, a highly experienced physician assistant at Animo Sano Psychiatry. Stephanie offers her clinical expertise to help us explore why adults with ADHD often struggle with managing their emotions and what can be done to improve emotional well-being.

Stephanie explains that emotional dysregulation is not officially included in the diagnostic criteria for ADHD, yet it is increasingly recognized as a core symptom. We learn how ADHD affects brain systems involved in emotional control, leading to challenges such as impulsive behavior, heightened emotional sensitivity, and difficulty in maintaining relationships and productivity.

In this episode, Stephanie highlights common signs of emotional dysregulation and offers a variety of strategies and therapies to improve emotional control, including mindfulness, cognitive behavioral therapy, diet, and exercise. She also emphasizes the importance of support from family, educators, and peers in managing emotions and fostering a supportive environment.

Stephanie and our host, Nada Pupovac, conclude the episode by underscoring the significance of emotional acceptance and support, reminding listeners that emotions are a natural part of human existence. Join us in learning how to embrace and manage emotions more effectively to thrive with ADHD.

Tune in to discover practical tips and supportive strategies that can help individuals with ADHD enhance their emotional regulation skills and overall quality of life. 

Don't miss this valuable conversation!

Thank you for listening to Thriving with ADHD. This show is produced by Animo Sano Psychiatry. For more information about our clinic, please visit animosanopsychiatry.com.

Animo Sano Psychiatry has introduced new services for enhancement of our patients' mental health - ASP Concierge and Health & Wellness Program. Please visit our website to learn more.

Animo Sano Psychiatry is constantly looking for the talent in behavioral health. If you are a psychiatrist, nurse practitioner, physician assistant, or mental health therapist, we'd love to hear from you. Visit our Careers pages to learn more about the available positions. https://animosanopsychiatry.com/careers/

Transcript

   📍     Welcome to Thriving With adhd, a podcast we'll share every day practical tips to thrive in life as an adult with adhd.  This podcast is brought to you by Animo Sano Psychiatry, a behavioral health practice with a specialist ADHD clinic based in North Carolina. And this is your host Nada Pupovac.

Welcome to Thriving with ADHD, dear ADHD community. We are back with a new fantastic and very important episode with Animo Sano's physician assistant, Stephanie Solomon. Stephanie and I are going to talk about ADHD and emotional well being. regulation. As always, before we jump into conversation, let's learn a bit more about Stephanie.

Stephanie brings a unique combination of education and clinical experience , to her role as a physician assistant. She is involved in all aspects of patient care, including taking detailed histories and physical exams, developing and implementing treatment plans, and prescribing medications, Stephanie's commitment to providing comprehensive and compassionate care is evident in everything that she does. Stephanie, welcome back to Thriving with ADHD.  Today, it's a very important topic, I think, very crucial for the ADHD community, and that's emotional regulation and ADHD. So, I'm happy to have you back, and I'm sure you will be a perfect person to talk to. to talk about this topic with us.  Yeah, I'm happy to be here.

Thank you. Yeah. Yeah.  I'm delighted to have you back. So can you explain the connection between ADHD and emotional regulation and why people with ADHD often struggle with managing their emotions? Sure. Um, so emotional dysregulation  Is basically an inability to modulate one's emotional experience and expression, which can result in excessive emotional response or lead to extreme or overblown reactions that don't really fit this situation. 

So, although it's not formally. a part of the diagnostic criteria for ADHD. It's increasingly seen as a core ADHD symptom that is clinically associated with greater functional impairment and comorbidities.  Emotional dysregulation amongst children diagnosed with ADHD is estimated to be about between 24 to 50 percent in adults diagnosed with ADHD.

The prevalence of emotional dysregulation is estimated to be around 70%. People with ADHD often experience emotional dysregulation due to how ADHD affects brain systems involved in emotional control and regulation. So the part of your brain that plays a significant role in processing emotions Particularly those related to fear, threat and stress is called your amygdala and tends to be your amygdala tends to be more reactive and ADHD leading to stronger and often disproportionate emotional responses to situations that might not be as intense for others. 

And then there's also the prefrontal cortex, which is the part of your brain that is responsible for regulating the amygdala's responses and helping to calm emotions and impulses.  So, in a typical brain, um, the prefrontal cortex helps regulate the amygdala's emotional responses by providing thoughtful reason input.

Before acting on emotions in ADHD, the prefrontal cortex is often under active or less effective at controlling the image of the amygdala. Um, it tends to have reduced activity and weaker connectivity. So  once emotions are triggered, they can become more overwhelming, leading to impulsive reactions and difficulty calming down.

Um, it can be difficult to respond to your feelings in a way that helps. You achieve your goals. Um, additionally, untreated symptoms can significantly impact emotional regulation, making it harder for individuals to manage their emotions. Effectively related impulsivity, for example, makes it harder to pause and think before responding to emotional triggers.

People may. have difficulties with organization, procrastination, and completing tasks  with ADHD. So that can lead to chronic stress. And this stress lowers tolerance for emotional triggers and increases irritability.  That sounds like a vicious circle. And it sounds like people with ADHD have it from coming, coming from all sides.

So, um, yeah, hopefully we will talk about some solutions and, uh, things that can help, but let's talk a bit more about some common signs of emotional dysregulation  in people with ADHD.  Sure. So many people with ADHD have heightened emotional sensitivity. making them more reactive to emotional stimuli.

And so this can result in overreacting to criticism or stress or feeling easily frustrated or overwhelmed. Um, they may have emotional impulsivity, so they may react impulsively to stress, frustration or other emotional triggers. without the typical delay that allows others to manage their emotional responses.

They may feel emotions so intensely that result in impulsive behaviors they regret later, like yelling, storming off, or making rash decisions. They may have difficulty managing anger, so Quick, impulsive outbursts of anger, even in response to minor triggers can occur for someone with impulsive  anger can arise because their brain isn't as adept at holding back immediate emotional reactions and this can cause intense, intense reactions to small frustrations or perceived slights that others might be able to ignore or manage more calmly. 

People with ADHD also tend to react quickly to emotional stimuli, often without pausing to think through their response and to reflect on the best way to handle a situation, such as using calming techniques or problem solving strategies before reacting emotionally. Um, they may have rapid. Shifts in their mood, so people with ADHD might experience, um,  going from calm to furious in seconds, or they may experience highs and lows more frequently and intensely and don't have much control over the transitions between them.

They may have delayed emotional recovery, which is. Essentially, difficulty returning to a baseline state after an emotional response. So after experiencing frustration or excitement, it can take longer for someone with a calm down or reset. Um, they may stay upset, frustrated or agitated. longer than someone without ADHD. 

Um, they may have low frustration tolerance. So people with ADHD often have a low tolerance for situations, um, that, you know, where they feel triggered and frustrated, um, situations that require patience, persistence, or delayed gratification, and this can trigger anger. So, for example, waiting in line, or, Dealing with unexpected changes or trying to complete a difficult task may provoke strong feelings of anger or irritability.

Um, so just overall, like I mentioned, feeling completely overwhelmed by their emotions. So people with ADHD frequently experience emotion so deeply that they become overwhelmed or flooded. Things may feel very all or nothing or like 0 to 100. So it's often hard to see past the emotion and get perspective.

Like, is this thing really as bad as I feel like it is? What is a more rational response to the situation? So it's hard for  them often to kind of ask themselves those questions so that they can react, um,  in a different way.  Okay. And I think everything you've said leads us to the next question.  So how all of these overwhelming emotions impact daily lives of people?

People living with ADHD, meaning relationships, work, and overall well being.  Yeah, so because of these challenges, individuals with ADHD may resort to poor or effective coping strategies, such as avoidance. So, they may ignore or avoid stressful situations instead of addressing them directly. Um, they may result  Or resort to aggression, so lashing out in anger, frustration, due to an ability to control emotional impulses,  procrastination.

So, delayed tasks or responsibilities that trigger emotional discomfort  may cause someone to procrastinate. But this only adds to stress later on.  They may. Overused distractions, so activities like video games, Internet browsing or eating to escape from emotional discomfort can occur  and they may shut down and withdraw from social situations or become emotionally numb to avoid dealing with, um, with intense feelings.

So, as far as relationships.  People with emotional dysregulation may have trouble maintaining friendships and romantic relationships due to impulsivity and difficulty managing emotions. Um, minor pet peeves can lead to explosive reactions that can make your friends and loved ones feel like they have to walk on eggshells around you.

Um, emotion, emotional difficulties can directly affect social interactions with others as people with ADHD may struggle to convey their feelings effectively. You may end up ruminating on issues, um, or an on an issue versus trying to find a healthy solution. Um, and then as far as in the workplace, they may have difficulty maintaining employment due to their impulsivity, difficulty, managing stress and anxiety.

Conflicts with colleagues and difficulty with time management and productivity so workplace stressors, like deadlines can trigger anxious feelings and make it more difficult to meet demands. If you're the hypersensitive or temperamental coworker, it can make your work life stressful and harm your ability to advance in your career  can also affect, um.

Academic settings, so emotional dysregulation can make concentrating learning and being productive harder due to intense stress. So students with emotional dysregulation  may have difficulty in academic settings due to high demands for productivity  students often also struggle with managing the stress and pressure of testing and exams. 

And then it can also affect other areas of your life, like self esteem can cause, you know, a lot of low self esteem parenting stress. So people who are parents who have ADHD might be more stressed or have more stress  just parenting in general because of the emotional dysregulation.  It can  also result in things like impulse buying and therefore maybe poor credit.

Um, research also shows that people with. Trouble regulating emotions are more likely to participate in risky behaviors, such as substance abuse and dangerous driving. So this can result in more like road rage and crash risks,  um, and then also self harm. So, emotional dysregulation can, you know,  tends to result more in self harm than maybe those who don't have. 

Those, um, issues regulating their emotions.  Okay. So Stephanie, um,  you told us a lot of maybe hard truths to swallow. So I would like now to  change the tide a bit and talk about solutions and strategies. So what strategies, what therapies have proven to be effective in helping individuals with ADHD to improve?

Emotional dysregulation and generally to gain , emotional regulation skills.  Sure. So, well, first off you want to name your emotions. So taking a break to acknowledge the feeling can be a first step towards regaining control. Research has shown that naming your emotions, also known as effective labeling, can reduce the intensity of negative emotions and possibly increase the intensity of positive ones.

So recognizing one's emotions is a crucial first step in effective emotional regulation. When emotions are left unrecognized,  They can build up leading to emotional escalation, a situation where small irritations turn into overwhelming feelings. Um, when individuals are aware of their emotional state, they can make deliberate choices about how to respond rather than reacting impulsively.

So emotional recognition involves identifying and labeling the emotions you're feeling, which increases self awareness when you can name the emotion. So for example, I feel frustrated or I feel anxious. It helps you understand what's happening internally. And this clarity allows you to acknowledge the emotion before it escalates and spirals out of control and better understand why you're feeling that way and what triggered it. 

Um, it then allows you to separate your emotional response from the situation itself,  which gives you more control. It also allows you to use appropriate coping mechanisms, like deep breathing, reframing thoughts, or taking time to cool off, which prevents negative emotions from intensifying, and over time, regularly recognizing and addressing emotions.

Help this helps build emotional resilience. There's also mindfulness. So mindfulness practices, such as meditation and deep breathing exercises can help increase awareness of one's emotions and tap into your  ability to self calm. Many studies have found that these practices facilitate clinically significant improvements and stress, anxiety and overall well, being  cognitive.

Behavioral therapy can be helpful in learning how to cope with and regulate emotions by identifying and changing negative thought patterns and can also help individuals with ADHD to recognize and label emotions accurately.  It also helps to challenge emotions, which are not  context appropriate and to cope with intense negative emotional reactions. 

Um, diet and exercise can be helpful. Um, so exercise, you know, some studies have suggested that physical exercise has a positive impact on emotion regulation ability, especially aerobic exercise intervention, um, has a more significant effect.  Regular physical activity can improve mood and reduce feelings of anxiety and depression by.

Increasing neurotransmitters, lowering cortisol levels, and releasing endorphins, which create feelings of calmness and help reduce anxiety. As far as diet, protein rich foods and complex carbs like whole grains, fruits, and veggies can promote neurotransmitter production and deficiency in micronutrients like magnesium, zinc, iron, and B vitamins.

can lead to worse ADHD symptoms and emotional dysregulation. Things like artificial colors and preservatives have been shown to trigger hyperactivity and emotional instability in some children with ADHD.  Processed foods often  contain high amounts of sugar and unhealthy fats, which can negatively affect mood and energy, contributing to mood swings and irritability. 

There also appears to be some benefit from omega 3 fatty acid supplementation in ADHD. So given that low levels of omega 3 fatty acids are associated with, um, anomalies during emotional processing in ADHD, emotional dysregulation in ADHD may benefit from supplementation of that. Okay.  Um, there's also  the factor of sleep.

So, sleep plays a crucial role in regulating emotions.  Individuals with ADHD are more likely to have sleep problems.  Ensuring adequate sleep can help improve your emotional regulation. Good sleep helps by decreasing the intensity of emotional responses to stress or frustration, making it easier to stay calm under pressure.

Um, and improving the ability to pause and reflect before reacting emotionally. It also can help reduce impulsivity in emotional situations. Um, so I mentioned people with ADHD often struggle with sleep issues such as insomnia, restless sleep, or difficulty waking up, which can worsen all, can worsen emotional dysregulation.

And then, um, practicing self care, so engaging in activities that promote physical, emotional, and mental well being such as yoga. Um, or getting a massage can help reduce stress and improve emotional regulation.  There's also  go ahead.  One more thing I was going to mention, um, using visualization and imagery.

So these mental strategies involve creating vivid mental images or scenarios that can help reduce stress, manage intense emotions and foster calmness and control. So by mentally transporting oneself to a peaceful place or scenario, the brain shifts focus away from the emotional trigger and reduces physiological arousal.

So visualizing a peaceful scene, like a beach or a mountain, can help you to relax and calm your emotions when feeling overwhelmed, and they can engage all the senses to make the scene as vivid as possible. So, for example, hearing the ocean or feeling the breeze.  Excellent. I think you gave us loads of  options and suggestions how emotional dysregulation could be improved.

And, I suppose not one  solution will, , work for all people, but, uh, I think the beauty of what you said is that there are so many ideas and options and people maybe can try with one. Maybe meditation is not for everyone. Maybe some people do better with exercise. So I would say I encourage people to try some of these and see if it works for them.

If not, try something else. But again, you provide loads of  possibilities and ideas how emotional dysregulation could be improved. So thank you for that. That's, that's excellent.  And, uh, of course, we don't live in isolation and we live in the communities in families. We interact with our peers, educators, colleagues.

So how it is that  people that, live , , around individuals with ADHD, uh, can help and support management of their emotions and, uh,  and also can they play a role in the therapeutic process as well?  Yeah, definitely. So, um, family members can help by encouraging their loved one to share their feelings.

Active listening without judgment creates a safe space for expression. So using reflective listening, for example, it sounds like you're feeling frustrated because,  um, can help the person to, you know,  kind of acknowledge their emotions and work together to do that. Um, setting clear expectations and boundaries can help.

So clearly defining family rules and routines can reduce anxiety and emotional outbursts. Celebrate each other's strengths. Focus on their accomplishments,  um, and strengths rather than dwelling on challenges. Positive reinforcement builds self esteem. Educators can help. By creating a supportive classroom environment, so establishing predictable routines and providing visual schedules,  use common corners where students can take breaks when feeling overwhelmed. 

They might  provide emotional cues  using visual or verbal cues to help the student recognize and name their motions. So they may say things like, it looks like you're upset. Would you like a moment to breathe? Um, they can also teach social and emotional skills.  They can incorporate social emotional learning into the curriculum, focusing on empathy, emotional identification, and self regulation. 

They may be patient and flexible, allowing for accommodations like extended deadlines or reduced workloads during emotional difficulties.  Um, and avoid punitive responses to emotional outbursts. So instead, they can discuss their behavior calmly after the moment has passed  as far as peers, peers can help  each other by promoting inclusion.

By encouraging group activities that highlight the strengths of individuals with ADHD, fostering a sense of belonging, um, teach peers, you know, we should teach peers to recognize that ADHD related behaviors are not intentional and to approach them with empathy, rather than judgment,  invite others to join in activities that are calming and enjoyable, such as art or nature walks, which may help regulate emotions. 

And they can stand up for others. So if other people are misunderstanding or mistreating someone, peers can advocate by explaining ADHD's challenges and asking for kindness. So by creating a supportive environment and offering practical tools, family members, educators, and peers can help individuals with ADHD better navigate their emotions and develop long lasting self regulation skills. 

I love this. I love this kindness over judgment and support.  Hopefully we all can do our bit to help.  And, , create society that's, , less judgmental and doesn't stigmatize, uh, individuals with ADHD. So, I, I really love this. Let's wrap up and, uh, if there is one thing from everything you talked about in this episode that you would like our listeners to remember, what that would be? 

Just know that emotional regulation is something  that's common with individuals with ADHD. So if you're someone that struggles with that, you're not alone.  Just surround yourself with people who will be supportive of your challenges. Emotions are a normal part of being human and are a natural reaction to situations we experience.

So it's okay to express our emotions in a healthy  um, such as through talking about them or writing them down. No one can completely eliminate difficult emotions, whether or not they have ADHD, and it's okay to feel them.  Excellent. Thank you so much, Stephanie. You gave us loads of ideas. You explained beautifully the connection between emotional regulation and ADHD.

And  I hope that we all learned from everything you said here. So it was really beautiful. Thank you so much. Thank you. Thanks a lot. Hope to see you next time. Sounds good. Bye. Bye.



  📍 Thank you for listening to Thriving with adhd. This show is produced by Animo Sano Psychiatry. Please follow, rate or share our podcast on Spotify, Apple Podcast, or any other streaming app of your choice. Music is by Daddy's Music music from Pixabay. For more information about Animo Sano Psychiatry, please visit animosanopsychiatry.com