Typical ADHD Behaviors

Why ADD Makes You Feel. So. Much.

The volatile (and sometimes destructive) emotions associated with ADHD can manifest as frustration, sensitivity, or tendency to feeling sad. Here’s what you need to know about rejection sensitive dysphoria, and how to control it.

ADHD bipolar woman holds a sign with smiley faces
ADHD bipolar woman holds a sign with smiley faces
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Emotion Commotion

You can’t manage the impairments of attention deficit disorder (ADHD or ADD) 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.

A man tries to tune out his ADHD emotions by plugging his ears.
A man tries to tune out his ADHD emotions by plugging his ears.
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Sensitive to Criticism

Nearly everyone with attention deficit disorder 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 individuals with ADHD / ADD experience.

A woman feels depressed, a common ADHD emotion.
A woman feels depressed, a common ADHD emotion.
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Feeling Blue with RSD

For many years RSD has been the hallmark symptom of an atypical mood disorder — this is the ADHD nervous system’s instantaneous response to the trigger of rejection.

[Self Test: Is It a Mood Disorder?]

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 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 […]
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Disapproval from Others

The emotional response to failure is catastrophic for those with the condition. Perceived criticism and withdrawal of love and respect are 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.” People with ADHD are not wimps; disapproval hurts them much more than it hurts neurotypical people.

A person with ADHD does math homework.
A person with ADHD does math homework.
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Always Tense and on Edge

Many individuals with ADHD 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 people with ADHD don’t show much overt hyperactivity after age 14, but it’s still present internally.

A woman with ADHD loses control of her ADHD emotions.
A woman with ADHD loses control of her ADHD emotions.
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How the Pain Expresses Itself

If emotional pain is internalized, a person with ADHD may experience periods of sadness 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.

A woman with ADHD holds a gift.
A woman with ADHD holds a gift.
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ADHD Emotion: How It Affects Personality

Because of their innate sensitivity to emotional pain, people with ADHD might become people pleasers, 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 person with ADHD becomes a chameleon who loses track of what she wants for her own life.

[Free Download: How to Rein in Intense ADHD Emotions]

A woman with ADHD puts her head in her hands, frustrated by overwhelming ADHD emotions.
A woman with ADHD puts her head in her hands, frustrated by overwhelming ADHD emotions.
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ADHD Emotion: How It Affects Behavior

Some individuals with ADHD 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.

A couple with ADHD fights while two children look upset.
A couple with ADHD fights while two children look upset.
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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 person with ADHD. Rather than suffer more wounds at the hands of an authority figure, he devalues the importance of the other person. The person with ADHD has to find occasions several times a day to remind the other person how worthless, stupid, and even harmful they and their opinions are.

A woman sees a doctor to help get her ADHD emotions under control.
A woman sees a doctor to help get her ADHD emotions under control.
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Treating RSD: Counseling

Clinicians and therapists need to be especially vigilant for signs of RSD because most people with ADHD have learned to hide that aspect of their lives. It is vital to proper diagnosis and successful therapy that both therapist and 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 his or her emotional life out of fear of being wounded further if the truth were known.

A pharmacist fills a prescription to help manage ADHD emotions.
A pharmacist fills a prescription to help manage ADHD emotions.
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Treating RSD: Medication

Until recently, all that a person could 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 guanfacine (Intuniv). Talk with your doctor about these medications.

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

William Dodson, M.D., is a member of ADDitude's ADHD Specialist Panel.