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ADHD Emotions: How They Affect Your Life and Happiness

The emotion commotion of ADHD can hurt self-esteem, relationships, and just about everything else in life. Here’s what you should know to control it.

by William Dodson, M.D.

Emotion Commotion

You can’t manage the impairments of ADHD until you understand how you process emotion. Researchers have ignored the emotional component of ADHD because it can’t be measured.  
Yet emotional disruptions are the most impairing aspects of ADHD at any age. Find out how your emotions affect your life and happiness and how you may be able to manage them.

Sensitive to Criticism

Nearly everyone with ADHD answers an emphatic yes to the question: “Have you always been more sensitive than others to rejection, teasing, criticism, or your own perception that you have failed or fallen short?” This is the definition of a condition called rejection-sensitive dysphoria (RSD), which many ADDers experience.

Depression and RSD

For many years RSD has been the hallmark of what is called atypical depression. The reason that it was not called “typical” depression is that it is not depression at all, but the ADHD nervous system’s instantaneous response to the trigger of rejection.

Disapproval from Others

The emotional response to failure is catastrophic for those with the condition. Perceived criticism and withdrawal of love and respect is just as devastating as the real thing. The term “dysphoria” means “difficult to bear,” and most people with ADHD report that they “can hardly stand it.”  ADHDers are not wimps; disapproval hurts them much more than it hurts neurotypical people.

Always Tense and on Edge

Many ADHDers say the same thing when you ask them about their emotional life: “I am always tense, I can never relax. I can’t just sit there and watch a TV program with the rest of the family. Because I’m sensitive to other people disapproving of me, I am fearful in personal interactions.” Most kids after age 14, don’t show much overt hyperactivity, but it’s still present internally.

How the Pain Expresses Itself

If emotional pain is internalized, an ADHDer may experience depression and loss of self-esteem in the short term. If emotions are externalized, pain can be expressed as rage at the person or situation that wounded them. Luckily, the rage is expressed verbally instead of physically, and it passes relatively quickly.

ADHD Emotion: How It Affects Personality

Because of the ADHDer’s sensitivity to emotional pain, the person might become a people pleaser, always making sure that friends, acquaintances, and family approve of them: “Tell me what you want, and I’ll do my best to become it. Just don’t get mad at me.” After years of constant vigilance, the ADHD person becomes a chameleon who loses track of what she wants for her own life.

ADHD Emotion: How It Affects Behavior

Some ADHDers find that the pain of failure is so bad that they refuse to try anything unless they are assured of a quick, easy, and complete success. Taking a chance is too big an emotional risk. Their lives remain stunted and limited.

ADHD Emotion: How it Affects Relationships

RSD can wreak havoc on relationships. Since the wounds of RSD are almost unbearable, the only way to deal with the situation is to deny that the person—teacher, relative, coworker, or spouse—who is rejecting, critical, or teasing has any importance to the ADHD person. Rather than suffer more wounds at the hands of an authority figure, he devalues the importance of the other person. The ADDers has to find occasions several times a day to remind the other person how worthless, stupid, and even harmful they and their opinions are.

Treating RSD: Counseling

Clinicians and therapists need to be especially vigilant for signs of RSD because most ADHDers have learned to hide that aspect of their lives. It is vital to proper diagnosis and successful therapy that both therapist an patient are aware of the emotional intensity that is so much a part of the patient’s life. It is equally important to recognize when a patient is attempting to hide this component of their emotional lives out of fear that being wounded further if the truth were known.

Treating RSD: Medication

Until recently all that a person can do was to wait for his dysphoria to dissipate over time. Clinical experience has found that up to half of people with RSD can get some relief from the alpha agonists, either clonidine (Kapvay) or gaunfacine (Intuniv). Talk with your doctor about these medications.     

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