Emotions & Shame

ADHD & Emotional Distress Syndrome

A common component of ADHD, Emotional Distress Syndrome strips you of self-confidence, despite a lifetime of successes and a strong circle of support. It makes you feel flawed. Worthless. Hopeless. But it IS within your control. Here’s how.

woman overcome by stormy moods of emotional distress syndrome
woman overcome by stormy moods of emotional distress syndrome

Is Emotional Dysregulation a Symptom of ADHD?

It’s useless. All of that information about ADHD medication and diagnoses, how to get things done or finished faster, how to feel more confident about your decisions — it’s all useless until we first confront and resolve the crippling emotional stress of living with attention deficit disorder (ADHD or ADD). That emotional stress traps us inside a glass box that is sometimes easier to ignore than it is to deal with — in part because the mind’s natural instinct is to fight, run off somewhere shiny and exciting, or freeze.

When I first introduced my ADHD clients to Emotional Distress Syndrome, they got it. Hell, they were living it. They didn’t feel confident, despite their Ph.D.s, bank balances, and successful careers. Unless you’re having a breakdown or failure, it’s hard to evaluate the emotional distress in your life, the havoc it’s creating, and what will happen if it continues unchecked.

What Is Emotional Distress Syndrome?

Emotional Distress Syndrome (EDS) is the cumulative effect of the neurological processing differences and behavioral changes associated with ADHD. It’s a chronic state of stress related to the struggle to live with ADHD, a stress that breaks down emotional tolerance, stamina, and a sense of wellbeing and spiritual health. The chronic, lifelong nature of ADHD-related stress can increase to become a syndrome akin to post-traumatic stress disorder (PTSD).

As with other ADHD symptoms, there’s good news and bad news, and you have choices to make:

  • EDS won’t disappear by itself. One way or another, you’ll have to manage your emotional distress for the rest of your life.
  • If you choose not to manage it, EDS will continue to erode your sense of emotional, mental, and physical wellbeing.
  • EDS can be managed.
  • You’re not broken.
  • You can live a full, interesting, potential-reaching life.

There will always be emotional storms. Even if your meds are working well and nothing seems broken in your life, the emotional part of you needs shoring up. You need more than meds or a consistent schedule to tolerate the inevitable inconsistency. Things will get out of balance, and if you feel lousy every time they do, that’s too much vulnerability.

[Self-Test: Could You Have Emotional Hyperarousal?]

I now know that it’s possible to get past living in permanent survival mode, to use internal strength to calm myself during the storms. In other words, I know it’s possible to thrive.

Maybe, like my newer clients, you’re skeptical. You might think thriving is a matter of luck, and you don’t see yourself as lucky. You might think that, to function, you have to win the lottery. But even lottery winners can be at emotional risk because of the way they feel about themselves. How many multi-millionaires fear that the world sees them as a fraud, or that they got where they are because of an undeserved break?

That’s survival thinking. It’s not thriving. Thriving is different. It’s about the ability to know yourself, to understand how you operate, how you organize things, what you’re good at, and what you need help with. Thriving begins by getting connected to yourself. You can get used to thriving. You can have fun thriving.

Thriving isn’t a magical ability. In fact, you can learn to thrive. The work ahead is to build, and then strengthen, a solid sense of oneself. I do mean “build,” because people with ADHD come with structural problems. They may have once used their ADHD to function, to see the problem, to get the oh-crap-it’s-due-tomorrow-at-8-A.M.-and-now-it’s-11-P.M. paper written at the last minute, but they can’t seem to pull it off any more. Even when they appear confident, their inner strength has been eroded and compromised by continual emotional stress.

[How’s Your Emotional Resilience? Learn to Cope with Intense ADHD Feelings]

But it’s possible to build, or rebuild, a strong foundation, and, from there, you can reach your goals. Courage, confidence, and taking risks with ADHD depend on having a strong foundation. The two pillars that you need to achieve your dreams are self-esteem and self-identity.

How Can I Overcome Emotional Distress Syndrome?

Self-esteem is your sense of value as a person, separate from the way you’re defined by the outside world. Having self-esteem means a commitment to finding meaning in your life, to the belief that you deserve happiness and fulfillment.

There is something unconditional about self-esteem. Some people experience it as self-love, others more as acceptance of where they are and what is happening at any particular moment. Self-esteem is what makes you able to hold your own hand, to be there for yourself with moral support.

Are you your own best advocate and cheerleader? To start with, can you say “Good morning” to yourself? I started doing this 15 years ago, when I leased my first office space. I’d unlock the door, say “Good morning” to myself, aloud, and listen to the vicious answers that came from my own head: “Oh, great, James — now you sound schizophrenic. You’re finally losing it.”

The next day I’d say it again. More nasty voices. But I kept at it, and, at some point, it became a friendly, two-way conversation. “Good morning, James. How are you today?” “You know, I’m a little tired, but I love this office.” You have my permission to feel ridiculous while saying good morning to yourself.

Self-identity is your perception of your value and significance in relation to the rest of the world. It’s how you present yourself, how you measure yourself against who you ideally want to be, and how you filter out the performance reviews that stream in from the outside. A strong self-identity helps you advocate for yourself, explain yourself, redeem yourself.

We need a firm foundation if our best qualities are to take root inside of us and flourish. These qualities include:

> Courage, confidence, persistence, resilience, the ability to take a risk, finding your voice, giving voice to your ideas, repairing the world, apologizing and making amends; reaching your potential — though you may have given up thinking that was possible.

It seems that some people are born with these two pillars firmly in place, raised in safe, loving households. Others capitalized on favorable conditions — or developed the right skills — to build their own pillars and keep them in good repair.

Unfortunately, none of that is typical for people with ADHD. If you’re seen as someone who comes up with wild ideas and never follows through, or if you see yourself that way, your pillars are going to stand on a shaky foundation.

Self-Esteem and ADHD

You probably know how that feels — to root around, scrambling to make sense of your back-against-the-wall scenario, wondering where you put your courage and confidence. Sometimes you are able to assemble a stack of ideas on how to get through the next emotional storm, and sometimes you can climb up on top of the stack, high enough to get some perspective. But you’re never quite sure how you got there, and then something — seemingly from out of nowhere — comes along and knocks you off again.

If your self-esteem and self-identity are balanced on an unstable foundation, and you’re called upon to act confidently or courageously, it can throw you into a tailspin. How can you stand firmly on a pile of rubble?

You can’t. But you can dig in and start rebuilding.

[Expert Webinar: Emotional Distress Syndrome and the ADHD Brain]

Excerpted from Focused Forward: Navigating the Storms of Adult ADHD. Copyright 2016 by James Ochoa, LPC, a member of the ADDitude ADHD Medical Review Panel.