EP 165: When Love and Rage Share the Same Roof : ADHD and Emotional Dysregulation

Following her recent Daily Mail feature, Dr Olivia Kessel opens up about one of the most misunderstood and most common aspects of ADHD: emotional dysregulation and flash anger.

In this honest and practical episode, Olivia explores why emotional dysregulation isn't in the ADHD diagnostic criteria and why that matters. She unpacks the neuroscience behind flash anger and why reasoning in the moment makes things worse. She also goes into the hidden triggers behind explosions at home, including sleep deprivation, masking at school, hormonal cycles, hunger, transitions, and the "school angel, home devil" pattern so many parents recognise. And she shares the practical tools that transformed daily life in their household.

Plus, messages from the community, including parents who felt, for the first time, that their experience was finally being reflected back to them.

If you have ever felt trapped, ashamed, or utterly alone in what is happening behind your closed front door, this episode is for you.

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Transcript

A Community Invite For Mums

Sharing A Story In The Press

The Science Behind Dysregulation

Dopamine, Puberty And The Amygdala

Common Triggers That Light The Fuse

School Masking And After School Fallout

Hunger, Transitions And Sensory Overload

Messages From Parents And Naming It

Dr Olivia 0:09

Welcome to the Send Parenting Podcast. I'm your neurodiverse host, Dr. Olivia Kessel, and more importantly, I'm mother to my wonderfully neurodivergent daughter, Alexandra, who really inspired this podcast. As a veteran in navigating the world of neurodiversity in a UK education system, I've uncovered a wealth of misinformation, alongside many answers and solutions that were never taught to me in medical school or in any of the parenting handbooks. Each week on this podcast, I will be bringing the experts to your ears to empower you on your parenting crusade. Can I be honest with you for a moment? At our last group coaching call, one of the moms said something that stopped me in my tracks. She said, I feel like nobody gets it. My friends try to understand, but they don't. And some days parenting feels completely relentless. The entire group went silent because every single one of us have felt exactly the same way. If you're raising a child with ADHD, you know that feeling. You give everything you have every single day, and then you give more. You smile through the schoolgate chaos, hold it together through the meltdowns, and lie awake at night wondering what you did wrong. You love your child fiercely, but you are exhausted and you feel like you're doing this all alone. I'm Dr. Olivia Kessel and I'm a doctor. I host this podcast, and I'm also a warrior mom myself. I created the ADHD Warrior Mom community because I needed a place like this and it didn't exist. A place where you're heard and not judged, where other moms actually get it because they're living it too. In the membership, you get weekly group coaching calls with me, expert masterclasses, a growing resource library, and most importantly, a community of warrior moms who understand your world completely. There are still a few founding member spaces left at just 29 pounds a month. Cancel any time. If you think about it, it's less than a coffee a day. Go to the link in the show notes and join us because you deserve a place to recharge. You deserve moms who get it, and your child deserves a version of you who is supported. Hello and welcome back to the Send Parenting Podcast. I'm Dr. Olivia Kessel, and I'm so glad you're here today, because this episode is one that I've been thinking about recording for a long time. And honestly, I wasn't sure I was ready, but I am now, and I think if you're listening, you might need to hear it too. Last Friday, a story about me and my daughter appeared in the Daily Mail. Yes, the Daily Mail. And yes, the headline was exactly what you'd expect from the Daily Mail, sensational and bold. I'll read it to you now. Living with my violent daughter was like being in an abusive relationship. And then the subtitle says, It was only after years of being screamed at and scratched and bitten that I found out what was to blame. Now, that kind of title makes you wince a little, even as you're approving it. But here's the thing Alexandra, my daughter, and I talked about it. We sat down together and we made the decision together to put our story out there, because keeping it secret hadn't done either of us any favors. The shame of silence is heavier than the discomfort of being seen. The article was about emotional dysregulation in ADHD, specifically about the flash anger that can come with it, which can present as verbal and physical abuse. And I don't want to spend this episode going much deeper because the Daily Mail article was about what happened in ADHD. What it didn't have space to cover was really why this happens, what triggers it, and crucially what you can do about it. So that's what we're gonna do today. We are gonna talk about the science, the triggers, the practical tools that changed my daughter and my daily life, and some of the extraordinary messages that came in after the article was published, because your responses reminded me exactly why I started this podcast in the first place. So let's start with the science. Because understanding the why is, I think, the single most important thing, both for your child and for you. So, what really is emotional dysregulation? It's one of those clinical phrases that sounds dry and technical until you've lived it. And then it sounds just about exactly right because it captures something that's not a choice. It's not defiance, it's not bad parenting, it's a neurological reality. Here's what the research tells us. Emotional dysregulation affects somewhere between 25 to 45% of children with ADHD. Some longitudinal studies actually put it closer to 75%. And yet, and this is the part that still makes me angry as a clinician, it does not appear in the formal diagnostic criteria for ADHD. It was actually removed from those criteria back in 1968 and reclassified as an associated feature. That single decision has left generations of families suffering in silence. Convinced they are failing, convinced the problem is them, I know it's something that I thought. The reason that emotional dysregulation happens comes down to executive functioning. In children with ADHD, the brain's control center, the prefrontal cortex, which is right behind our forehead, governs our impulse regulation, our emotional processing, and the ability to shift flexibly between tasks and states is developing up to 30% slower than in their neurotypical peers. So, what does that really mean? So if you have a 10-year-old with ADHD, they might have the emotional regulation of a seven-year-old. And a 12-year-old might be functioning around an eight or nine-year-old. So our expectations and what their neurological emotional regulation center says are out of sync. I want you to sit with that for just a moment. Because when I finally understood it, truly understood it, not just intellectually, but in my bones, it really changed everything. I'd been holding Alexandra to a standard her brain was not yet equipped to meet. Every request, every repeated instructions or multiple instructions, every why can't you just, I was widening the gap between what I expected of her and what she was neurologically capable of. And that gap was where our conflict lived. There's also the role of dopamine. ADHD is fundamentally a condition of dopamine dysregulation, the brain chemical responsible for motivation, focus, and emotional response. And here's something especially relevant for girls. Estrogen plays a significant role in how dopamine is regulated, which is why so many girls with ADHD seem relatively manageable in childhood, and then when puberty hits, and everything changes. Hormonal fluctuations interfere with dopamine in ways that make emotional regulation even harder. The child you thought you knew transforms almost overnight into someone who seems to be at war with the world and most often at war with you. This is not a coincidence. It's neurobiology and endocrinology. And then there's what happens in the brain during a meltdown itself. When Alexandra reaches a certain level of overwhelm, she's no longer in her rational reasoning brain. She's in her amygdala, the primitive fight or flight center. The thinking brain is essentially offline. She describes it as seeing red. She says she doesn't even remember what happened afterwards. And that's neurologically accurate. The language processing, reasoning, impulse-controlling parts of the brain are offline. So what was I doing in this moment? Well, I was talking to her, I was reasoning with her. I was demanding explanations as to why she couldn't. I was asking her to justify what she was doing. And I was getting angry. So I was basically pouring fuel on the fire. She used to say, stop talking. She'd scream it at me. She wasn't being rude. She was telling me the neuroscientific truth. She couldn't process what I was saying. So what were some of the triggers? What's really lighting that fuse? Now, one of the things I really want to talk about today, because I don't think it gets nearly enough airtime, is the trigger triggers. So emotional dysregulation in ADHD really comes from nowhere, even when it looks like it does. There's always something underneath. And understanding your child's triggers is not making excuses for their behavior. It's about understanding the full picture. So you can intervene earlier, respond more effectively, and stop being blindsided. Let me take you through the ones I've most consistently seen, both in my household and in the community. So sleep. This is number one. I cannot overstate it. Sleep deprivation and ADHD have a deeply entangled relationship. Children with ADHD frequently have difficulty falling asleep, the brain simply will not power down, and they often wake up repeatedly through the night. A rested brain has a certain amount of capacity for emotional regulation. A sleep-deprived brain has almost none. So if your child has a broken night and you are starting the day with a regulation tank that is already close to empty, the smallest thing will tip it over. And combined with that is your lack of sleep. So you don't have the regulation that's needed in those moments either. So it's a double whammy. For us, it was a major piece of the puzzle before Alexandra's diagnosis. The bedtime battles, her constantly waking up in the night. It consumed hours of our evening and into our night. And it it left us both completely depleted before the day had even begun. I speak about this in other podcasts, but melatonin, prescribed by her clinician, once she was diagnosed, was honestly, I can't even begin to say it's life-changing. Within days, she was falling asleep in 10 minutes and she stayed asleep and she still stays asleep and she wakes up rested. I wake up rested. And that starts us with a less full tank. And the morning dysregulation reduced dramatically almost immediately. So if sleep is still a battleground in your house, please do speak to your GP or your specialist because it's one of the most impactful places to start. Another trigger can be caused by masking at school and what happens when they get home. And this is one that confuses and kind of wounds parents more than almost anything else, because the teachers or the Senko will say, Oh, your child is wonderful at school. You know, they're always very obliging, they're kind and creative and engaged, and you're kind of smiling and nodding. And then you drive home, they get in the car, and by the time you've pulled into the driveway, it's already started. Some people call this the school angel home devil pattern, and it's incredibly common in ADHD. What's happening is your child has spent six or seven hours at school performing, masking, suppressing their impulses, managing their anxiety, holding themselves together through sheer effort of will. It's exhausting in a way that's almost impossible for neurotypical people to imagine. And when they walk through your front door into the one place they feel safe, they can drop that mask. All the emotions they've compressed throughout the day has to go somewhere. And you're the person they trust enough to fall apart in front of. I know that's cold comfort when you're on the receiving end of it, it was for me, but understanding it as a sign of safety that she's releasing with me because she feels secure with me, even when it didn't feel like safety, it changed how I responded because I realized she wasn't doing this to me. This was her releasing a gasket that had been pressurized during the entire day. So it also could be that something's going on at school that they haven't told you about. This is related, but it's different. And I want to give it its own space because I think it's underrecognized. Children with ADHD often struggle to process and communicate difficult social experiences in real time. Their working memory is often impaired, and their ability to sequence events, identify feelings, and then articulate them, all of that is compromised. So when something difficult happens at school, a friendship falling apart, a humiliation in class, a teacher speaking to them sharply, a misunderstanding on the playground, they may not be able to tell you about it. Not because they're hiding it deliberately, but because they generally haven't processed it yet themselves. What you see instead is an explosion at home, something apparently unrelated. You might have asked them to come for dinner and the world ends. But dinner isn't the problem. Dinner is just the thing that broke the damn. I learned to ask differently when my daughter got home from school. Not how was school, because the answer to that's always fine. But later when she's calm, was there anything today that felt hard? How would she rate it on a scale of one to ten? And we do stuff like go for a walk together and just maybe let her talk about the day and help her to process it. Or if it's raining, as happens often in England, have cafe kessle where we sit with a hot chocolate and let her decompress. And when it did, everything else made much more sense. Another thing that could really trigger flash anger is hunger and blood sugar, particularly relevant for kids that are on stimulant medication, whose appetite is often suppressed during the day. So by mid-afternoon, when the medication is wearing off and they haven't eaten properly since breakfast, you have a child who's emotionally raw, physically depleted, and pharmacologically coming down at the same time. And that's a very volatile combination. So afternoon snacks, protein-based, not sugar, become a non-negotiable in our house. Not a reward, a necessity. And you know, I kind of combine the protein sometimes in the sugar. So a peanut butter and sugar cookie that I've baked, they're super easy to make, just peanut butter, egg, and a little bit of sugar, and voila, you have a protein snack that's delicious if they don't have a nut allergy. Another big one of flash anger, and this is, you know, I'm sure every parent listening will agree here, is when there's a transition or an ending of a high dopamine activity. So, in other words, to end something that's enjoyable, such as screen time, if they're having a play date, a game, this is a known cause of a trigger. The brain is in a dopamine-rich state, and having that ripped away suddenly feels neurologically, absolutely catastrophic. It's not drama, it's withdrawal. So I'll talk more about how we handle this in the solutions section, but the key principle is the more abrupt the transition, the bigger the reaction can be. Build in warnings, build in bridges. I always have to give my daughter a time between when it's time to go and when she actually has to stop. I have to connect with her and build in those bridges before we transition, and it makes a huge difference. Another trigger is what time of life they're in. So hormones. For teenage girls in particular, but also boys, this adds an enormous complexity. The week before period, estrogen and progesterone drop, and with them, dopamine regulation takes a hit. Emotional dysregulation that is manageable at other times of the month can become almost unmanageable in the premenstrual phase. Tracking this gently together, if she's old enough, can help you both anticipate and plan rather than being ambushed. It doesn't remove the difficulty, but it removes some of the mystery and it names it. And that makes it easier. Another trigger can be sensory overload that's been building throughout the day. Many children with ADHD have sensory sensitivities to noise, to light, to texture, to crowds, to the constant low-level demands of a busy school environment. By the time they come home, they may be at the capacity simply for from their sensory load. The house that feels calm to you may still feel overwhelming to them, especially if you're making demands. I know I'm guilty of this. Take your shoes off, pick up your bag, clean up your lunchbox. I'm adding to that. So transitioning from home where you let them decompress before you put demands on them is really key. And understanding your child's, we've talked about a lot of triggers here, but understanding what triggers them, it's not about building a perfect map that's going to prevent all explosions. It's about shifting from reactive to proactive, from being bewildered about it to being informed. And that shift really matters enormously for you and for them. So I wanted to share with you some of the messages that came in after the Daily Mail article because I have also been stopped and said, oh, you know, that was a bit sensational. How can you talk about with that with your daughter? But luckily, I've also had a lot of good feedback, which has really empowered me to think that I have done the right decision. One mom wrote, Your article explains so much about my daughter as a child and a teenager. And to say that she was difficult to live with is an understatement. Now at 17, she has a diagnosis, the support of an amazing school, and the intelligence to learn more about her ADHD. For those with younger daughters, things do get better and easier. Her daughter was diagnosed at 16, she's now thriving. I needed to share that. Another message: I've read every book and article I can get my hands on, covering all facets of neurodiversity. And yet the violence I've lived with for many years with my autistic ADHD son isn't reflected back to me. It's been the loneliest time. And that phrase, the loneliest time, I felt it in my heart because I've lived it. The isolation of knowing something is terribly wrong and having nowhere to put it, no one to tell, because who would understand? One mom in our community mentioned child-to-parent abuse, a term I want to name because naming it is part of surviving it. And she shared a resource called PEGS, Parenting of Emotionally Generated Stress. It's a free support service for parents and professionals, and you can self-refer. I'll put the details in the show notes. I've spoken to lots of mothers who've had to call social services for help or who've threatened their children with social services, which has impacted kind of that connection with their child because they just don't know what to do. It literally is a mother's darkest moments. And when you wonder whether you can be a parent to your child, it's scary. And you know, I was one of those mothers before we got the diagnosis, and I'm not ashamed to say it. Another key solution is when their emotions are at a level 10, the conversation has got to wait. Being quiet, being silent, even holding your hand over your mouth is so important. You cannot reason with the brain in crisis. Asking why did you do that in the middle of a meltdown is like asking someone drowning to explain the physics of water. What your child needs in that moment is not an explanation. It's safety and space and the knowledge that you're still there. First safety, then space. Then only when the storm has passed, connection. And only after that, if appropriate, the conversation and potential consequences. And I know that's difficult. Um, we always, I think, as moms, want to solve things, rationalize, and it's just more important to be quiet. And I even, I just leave the room. I leave her to have that space to calm down. Another huge thing, and this is really challenging, is regulating yourself first. And this was one of the hardest things I had to accept. The problem was not Alexandra. I had to look honestly at my own nervous system, my own triggers, and my own regulation. I suspect I have ADHD too and emotional regulation. Has never been my strongest suit. I now exercise daily. I protect my sleep fiercely. I barely drink and never drink to excess. Because if any of those things slip, my ability to parent the way Alexandra needs slips with them. It is that direct. And when she might lash out physically, holding in my mind that it's not being done to me. She is struggling. That thought has been one thing that has most consistently stopped my own fight or flight response from firing back. And that has really been key is to see her in distress, not her causing me distress. Now I mentioned earlier in the podcast that transitions can be tricky. So how do we manage transitions? And this has often been one of our single biggest battlegrounds, I have to say. I've learned to step into her world before pulling her out of it. So a moment acknowledged in her Minecraft game before I call her for dinner, rather than a shout from the kitchen. I always give her a five-minute warning, a verbal warning, putting the Alexa on so that she knows she needs that warning. And then again. So the goal is to allow her to come from her dopamine high gradually instead of having it ripped away. And then the other important thing is knowledge is power, and naming it and having a plan for it that we have created together has been life-changing. So Alexandra has a swing in her bedroom, she has a trampoline in the garden, and we have a clear understanding that when she when that flash anger hits, space first. So I remove myself, she has space to calm down. Then when that's happened, we connect again, and then consequences later. And the consequences we've decided on together. So no devices until the next day. And she knows it. She she helped to decide that as what the consequence is. And that really m matters, I think, a lot because she's got control of it. She kind of helped to implement that. Um and it gives her back some of her autonomy. So it's also not unknown. It's not said in anger. We know it's going to happen, and you've got to follow through of it. And it's not always easy to follow through of it, but you've got to follow through of it. And it actually is a huge motivator to stop her wanting to do that because she doesn't want to lose her devices. We've also built a shared language around internal states. And I've had some podcasts on the zones of regulation, but we talk about the red zones. We talk about scaling it on a one to 10. So Alexandra can name what's happening, not when she's in it, but maybe just before. You know, I'm going to go, I'm, I'm going into the, I'm going, I'm in the yellow zone, I'm going into the red zone. So she has a window there to make a different choice. And, you know, her medication has made that window bigger as well so that she can stop and kind of see what's happening and take that step to go calm herself, have that space, and then we don't erupt into that volcanic explosion. So, you know, I know medication is something that parents worry about. Um, and I know I speak quite openly about how life-changing it's been from us. Um, interestingly, when she started her ADHD medication, her emotional dysregulation was worse for the first 10 days. And I was like, oh my God, can this actually be happening? And I wish the clinical psychiatrist had told us that that's actually quite common. He did afterwards. But once we had gotten through that period, she really, you know, calmed down a lot. And a lot of the triggers also are gone. She's able to do her homework, she's able to do different things that she found really challenging. So that also decreases the frustration that she was experiencing in life. So it's not a fix-all for everything. It doesn't touch on everything, but it has really helped. Um, and it's created a foundation for us where things can happen. And even in school as well, where she wouldn't, you know, she'd have outbursts of tears, and those have lessened a lot too, because she's able to look and see things and and process things better. So something to really think about. So I want to come back to something I said at the start of this podcast. Alexandra and I made this decision together to share our story, to shine a light on what has been in the dark. Life really is genuinely different now. There are still hard days, okay? Emotional dysregulation doesn't disappear. It's woven into who Alexandra is and it's woven into who I am. And in fact, my dad, who probably has AD undiagnosed ADHD as well, he has flash anger as well. And now I can understand and recognize it. And I just give him space now. I don't try and argue it with him. I give him that space, you know? So we now know who we are and we know how to navigate it and advocate for it. We have a shared language and we have tools that really work. And the shame is gone. And that might must be the biggest change of all. And I think that's what's been life-changing for me and Alexandria is, you know, naming it, not having shame from it, and moving forward. You know, it's gonna happen and we know how to deal with it. So our hope, both of ours, is that by telling our story, other mothers and their children who are going through this feel less alone, will feel less broken, and will understand what is happening in their home has a name, an explanation, and a way through. Everything I've talked about today and much more is in my book, which is excitingly being released next Thursday, May 7th. It's called Beyond the Label: Empowering Parents of ADHD Girls. Now, I do focus on girls, but it also applies to boys. There's lots of boys that present atypically and can present like girls do as well. Um, I am so excited that I have decided to host a book launch in Hon-Tames. And I'd love to invite you. The invite is in the show notes. It's Thursday, May 7th, the date of the publication release. It's gonna be at 6:30 p.m. at the beautiful Phyllis Court here in Henley on Thames. Now I know that's not easy for anyone and everyone to get to, but if you do live locally, it's gonna be a wonderful evening. Dr. Marianne from How Not to Screw Up Your Kids podcast, who's a clinical psychiatrist, is gonna be there and interviewing me. It's a chance to celebrate something I never thought I would be able to do, which is write a book. It's a chance to meet each other in person, and it's a lovely way to continue having the conversations that we've been having for years. All the details on how to RSVP are in the show notes, so please take a look and come along if you can. I would genuinely love to see you there. So thank you, Send Parenting Tribe, as always for listening. If this episode resonated, please share it. Send it to another parent who you think needs to hear it, post it in a group because the more we talk about this, the fewer parents have to sit alone inside it. You're not failing, you're not alone, and neither is your child. Until next time, take good care of yourself.