Published on ADDitudeMag.com
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.
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
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
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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