Published on ADDitudeMag.com
Why We Feel So Intensely: Understanding ADHD Emotions
Anger, outbursts, anxiety, irritability, impatience: more than most people, ADHDers can be driven by emotions.
by Thomas E. Brown, Ph.D., author of Smart but Stuck: Emotions in Teens and Adults with ADHD
Few doctors factor in
emotional challenges when making an ADHD diagnosis. In fact, current diagnostic
criteria for ADHD include no mention of “problems with emotions.” Yet recent research reveals that those with ADHD have significantly more difficulty with low frustration tolerance, impatience, hot temper, and excitability than a control group.
Processing Emotion: A Brain Thing
Challenges with emotions
start in the brain itself. Sometimes the working memory impairments of ADHD allow a momentary emotion to become too strong, flooding the brain with one intense emotion. At other times, the person with ADHD seems insensitive or unaware of the emotions of others. Brain connectivity networks carrying information related to
emotion seem to be somewhat more limited in individuals with ADHD.
Fastening on a Feeling
When an adolescent with ADHD becomes enraged when a parent refuses him use of the car, for example, his extreme response may be due to "flooding" -- a momentary
emotion that can gobble up all of the space in an ADHDer’s head just
like a computer virus can gobble up all of the space on a hard drive. This focus on one emotion crowds out other
important information that might help him modulate his anger and regulate his behavior.
Extreme Sensitivity to Disapproval
ADHDers often become quickly
immersed in one salient emotion and have problems shifting their focus to other
aspects of a situation. Hearing a slight uncertainty in a coworker’s
reaction to a suggestion may lead to interpreting this as criticism and an outburst of inappropriate self-defense without having listened carefully to the coworker’s response.
Bottled Up by Fear
Significant social anxiety is
a chronic difficulty experienced by more than one third of teens and adults
with ADHD. They live almost constantly with exaggerated fears of being seen by
others as incompetent, unappealing, or uncool.
Giving In to Avoidance and Denial
Some people with ADHD don’t
suffer from a lack of awareness of important emotions but from an inability to
tolerate those emotions enough to deal effectively with them. They become
caught up in behavior patterns to avoid painful emotions that seem too overwhelming -- looming
deadlines or meeting an unfamiliar group of people.
Carried Away with Emotion
For many ADHDers, the brain’s
gating mechanism for regulating emotion does not distinguish between dangerous
threats and more minor problems. These individuals are often thrown into panic mode by thoughts or
perceptions that do not warrant such a reaction. As a result, the ADHD brain can’t
deal more rationally and realistically with events that are stressful.
Sadness and Low Self-Esteem
People with untreated ADHD
can suffer from dysthymia -- a mild but long-term form of depression or sadness. It
is often brought on by living with the frustrations, failures, negative
feedback, and stresses of life due to untreated or inadequately treated ADHD. People
who are dysthymic suffer almost every day from low energy and self-esteem.
Emotions and Getting Started
Emotions motivate action -- action
to engage or action to avoid. Many people with untreated ADHD can readily
mobilize interest only for activities offering very immediate gratification.
They tend to have severe difficulty in activating and sustaining effort for
tasks that offer rewards over the longer term.
Emotions and Getting Started 2
Brain imaging studies
demonstrate that chemicals that activate reward-recognizing circuits in the
brain tend to bind on significantly fewer receptor sites in people with ADHD
than do those in a comparison group. People with ADHD are less able to
anticipate pleasure or register satisfaction with tasks for which the payoff is
Emotions and Working Memory
memory brings into play, consciously and/or unconsciously, the emotional energy
needed to help us organize, sustain focus, monitor and self-regulate. Many
ADHDers, though, have inadequate working memory, which may explain why they are
often disorganized, lose their temper, or procrastinate.
Emotions and Working Memory 2
Sometimes the working memory
impairments of ADHD allow a momentary emotion to become too strong. At other
times, working memory impairments leave the person with insufficient
sensitivity to the importance of a particular emotion because he or she hasn't
kept other relevant information in mind.
Treating Emotional Challenges
Treating the emotional
challenges of ADHD requires a multimodal approach: It starts with a careful
and accurate evaluation for ADHD, one that explains ADHD and its effect on
emotions. ADHD medication may improve the emotional networks in the brain. Talk
therapy can help a person manage fear or low self-esteem. Coaching may help a person overcome problems with getting boring tasks completed.
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