How’s Your Emotional Resilience? Learning to Cope with Intense ADHD Feelings

Emotional dysregulation is a pervasive and at times paralyzing experience for many people with attention deficit hyperactivity disorder (ADHD or ADD). Despite exclusion from diagnostic criterion, experiences of emotional dysregulation – outsized anger, irritability, shifts in mood, intense feelings, sensitivity, and more – are common and frequently very troubling components of the ADHD experience.

ADHD treatment can dampen the severity of these emotional symptoms to some extent, but standard treatments for ADHD do not restore emotional balance as well as they help with inattention. Therefore, to get the most improvement it is usually necessary to also learn how to build emotional resilience. From practicing coping skills to meeting basic health needs and seeking professional interventions, adults and children with ADHD can deploy various strategies to rein in extreme emotions and achieve greater emotional stability. Here are the most common and effective strategies.

Understanding ADHD and Emotional Dysregulation

Why is emotional dysregulation so ubiquitous with ADHD? The frequent presence of ADHD’s comorbid conditions — namely anxiety, trauma, and substance abuse — is certainly one reason. But not the only reason. The connection is more fundamental to ADHD as well. Here are prevailing theories:

• Executive dysfunction: Implicated in ADHD, deficits in executive function skills like inhibition and working memory make regulating emotions all the more difficult. The same skills that help us concentrate also work to adjust emotions to the situation.
• Confused internal signals: Research shows that poor emotional coherence — or mixed physiological signals (heart rate, facial muscles, brain activity) — is a complication for many with ADHD. Emotional coherence is the melody played by an orchestra with many harmonized instruments; it sums up to become how one feels. With mixed signals, the melody becomes a cacophony and difficult to interpret — people may feel strongly but with confused emotions. For example, frustration and disappointment may feel the same, but they aren’t. Frustration is a signal to move forward with more effort or a new strategy, while disappointment is a signal to move away. Thus, responses may be mismatched to the situation.
• Hidden expectancies or biases. Emotion has conscious and automatic influences. It involves interpreting physiological signals — at first we do so automatically, then deliberately. Heart rates, for example, may jump at a sudden sound, initially afraid. But once we realize the small sound is  nothing to fear, we feel fine. But if one has a hidden bias, they may interpret ambiguous signals as a threat, or in some other way that makes it harder to map emotion to the situation.

Developing Emotional Resilience: Starting Principles

1. Monitor Overall Health for Emotional Resilience

Neglecting to eat and sleep well, coupled with a lack of exercise, will impair one’s ability to feel good and deal with life’s stressors and challenges. Adults should assess current habits and change them as needed (this also applies to drinking alcohol and smoking). Dedicating to a new schedule for a month is usually enough time to see if there’s any positive change. Some habits may help regulate emotions in the moment, but they are seldom useful in the long run.

[The ADHD-Anger Connection: New Insights into Emotional Dysregulation]

2. Ensure Social Support for Emotional Resilience

Social circles are critical to cultivating emotional resilience. For adults, this means choosing social relationships carefully, recognizing which persons provide support and encouragement, and staying away from those who don’t. Of course, healthy relationships include time apart, but in this prolonged time of isolation, it is important to find ways to stay in touch. Phone calls, social media, video chats, or even a socially distanced, in person meet-ups can help.

Social support is also crucial for children. For teens, seeing their friends is necessary and should be supported (in a safe manner). For very young children, parents are their critical source of support.

3. Manage Stress for Emotional Resilience

Children and adults with ADHD are more prone to feeling stress, even when faced with the same events as their neurotypical peers. While a strength in some situations, this sensitivity can create overwhelm and make coping more difficult.

A child’s tantrum, for example, can simply be a sign that they cannot cope with the situation. They are overwhelmed, and thus their coping skills are breaking down. One solution is to help reinforce their coping skills (like developing an alternative behavior or learning self-calming skills).

[Meltdowns Happen: 7 Healthy Ways to Respond]

It’s almost the same for many adults who lose their tempers in inappropriate circumstances – in those moments of anger and outburst, the stressors exceed available coping skills. The goal in this case is to reduce stressors and/or improve coping skills.

In both cases, it’s critical to become aware of chronic stressors and triggers, and to figure out which stressors can be eliminated, and which can be managed.

4. Address Trauma and Ongoing Adversity for Emotional Resilience

Many people with ADHD have a history of adversity or emotional trauma, sometimes directly stemming from the experience of ADHD and emotional dysregulation itself.

Traumatic history can cause the body to expect and see trauma, even when it isn’t there. The result is an overreaction to a given situation. For adults with ADHD, part of building emotional resilience is in examining personal histories for unresolved traumas, and in assessing current stressors.

The process is similar for children. Caregivers need to know if a child is dealing with an adverse situation, like bullying or feeling discouraged at school. On the other hand, many times, when parents are very stressed (by worrying over finances or other concerns), children and teens pick up on this and become dysregulated in response.

5. Develop Coping Strategies for Emotional Resilience

Emotional regulation begins with self-awareness. Coping strategies, which may take shape or be honed with the help of a professional counselor, include planning ahead for stressors and having a plan for dealing with them. Some steps include:

• Anticipatory coping. This entails building a mental framework before facing a recurring, stressful situation (like dealing with a child’s tantrums or a difficult coworker). The anticipatory coping strategy may be escaping, planning a different response, or going through with it, but practicing self-care afterward. With a plan, it is much easier to maintain emotional match to situation and reduce overwhelm.
• Self-talking appraisals. These entail mentally reframing an event so as to diffuse its intensity. Assuming that the stressor means deliberate harm (like a tailgating driver or a clumsy person bumping into someone) is the start of the problem. Rethinking the situation to assume the best or extend the benefit of the doubt eases tensions.
• Shifting attention is especially helpful for children, who may lack more advanced coping skills. Sometimes, the best way to avoid a stressor (like a web page, a television show, the news, or a specific person) is to direct attention away from it.
• Humor. Laughing about a situation (like joking about it with a friend or exaggerating its importance) sometimes helps change perspectives and attitudes around the once troubling situation.
• Rationalize. Although often referred to in a negative light, rationalizing can also be an effective way to cope – also by changing perspectives.

Using Counseling and Psychotherapy to Build Emotional Resilience

For adults and children, counseling is the most well-proven intervention for addressing the emotional dysregulation tied to ADHD, as well as anger problems and extreme irritability (compared to medication). Professional counselors help patients identify coping skills and put them into practice so they actually work. The logic of counseling, however, is slightly different for children than for adults.

Behavior Counseling for Children Building Emotional Resilience

This type of intervention teaches parents how to respond effectively when a child is experiencing emotional and behavioral difficulties. Often, a child’s angry or excessive response can cause parents to react similarly, creating a cycle of tantrums and frustrations. Parents, for example, may unwittingly reward child tantrums by giving in or otherwise teaching the child that tantrums are effective.

Behavior counseling teaches parents to reduce critical comments and increase warmth and support to change their child’s behaviors and their own. Counselors, in turn, also work directly with children to teach them alternate behaviors, help them change their own attributions and beliefs, and increase their frustration tolerance.

Psychotherapy for Adults Building Emotional Resilience

Psychotherapy can help with emotional coping, but not all therapies are the same. Cognitive behavioral therapy (CBT) is the most effective for addressing emotional dysregulation, helping to build adaptive coping strategies that can be used in everyday situations. Dialectical behavior therapy (DBT), which features a mindfulness component to help build resilience against stressors, also shows promise for emotional regulation. Though studies are scarce, mindfulness training itself also appears to have some benefit for emotional dysregulation.

Adults seeking a counselor should ask about the following:

• What model the counselor uses, and if it’s evidence-based
• The counselor’s training and experience in the preferred approach
• How the approach will be evaluated for effectiveness (i.e. how and when will we look at whether this is working?)
• Practical pieces – any “homework” assigned? At what frequency?

Emotional dysregulation is often a difficult and debilitating part of the ADHD experience. Through self-coping skills and therapy, it is possible to build emotional resilience and significantly improve quality of life.

The content for this article was derived from the ADDitude Expert Webinar “ADHD Anger, Tantrums, and Mood Shifts: Effective Treatments for Emotional Dysregulation” [Video Replay & Podcast #334] with Joel Nigg, Ph.D., which was broadcast live on November 24, 2020.

Emotional Resilience with ADHD: Next Steps

• Download: 15 Ways to Disarm (and Understand) Explosive ADHD Emotions
• Read: Why We Feel So Much — and Ways to Overcome It
• Discover: ADHD & Emotional Distress Syndrome

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