ADHD and emotional regulation: navigating mood swings and impulsivity

ADHD, meaning attention-deficit and hyperactivity disorder, is a neurodivergent condition with many characteristics that can prevent a person from engaging appropriately with tasks and other people. In the same way that ADHD makes it difficult to stay focused on one task and energy levels, the emotions may be similarly turbulent and hard to keep in check. This is known as emotional dysregulation. In this article, renowned consultant psychiatrist Dr Mostafa Shalaby shares his tips for navigating mood swings and impulsive emotions.

What is emotional regulation and dysregulation?

Emotional regulation is the capability to manage emotional responses to situations and stimuli. This means that ADHD people with emotional dysregulation can be prone to overreact disproportionally, feeling emotions intensely and suddenly, which are then expressed externally. It functions similarly to a lack of impulse control, another characteristic which is typical of ADHD, where people with ADHD may act or say things without adequately thinking through the action. Emotional dysregulation isn’t officially considered a component of ADHD in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but it is well-documented in children and adults with ADHD. Not everyone with ADHD will struggle with emotional dysregulation, but it is not unusual for those who do to also have depression or anxiety.

Emotional dysregulation can manifest as bouts of anger, overexcitability, or perhaps being easily moved to tears – essentially, it is an impulsive hypersensitivity. Emotions can become mixed up, and difficult to differentiate due to their intensity. People with ADHD can be swept up in the moment due to the immediacy of their feelings, acting out and veering from one emotion to another rapidly. Other people can react negatively to this unstable emotional state, and people with ADHD may face stigma or ostracization from their peers, which can further disrupt their emotions (this is also known as rejection sensitivity) in a toxic cycle.  

What causes ADHD and emotional dysregulation?

There is no definite cause of ADHD. There are theories that it is genetic, and that children will inherit from their parents directly. Other theories say ADHD is linked to an imbalance of the neurotransmitters in the brain, namely a lack of serotonin which is responsible for mood, appetite, libido, and sleep.

Much like the cause of ADHD is not certain, the cause of emotional dysregulation is also unknown, though it is likely associated with the differences in brain structure and how the brain processes information, as compared to people who don’t have ADHD – especially in the prefrontal cortex, which is where emotions are managed and regulated.

Emotional regulation is an important skill to acquire because it can help you make decisions, stay calm in stressful situations, better identify your emotions, and connect with others more easily. In order to manage impulsive emotions, there are some skills that people with ADHD should practice.

Learn your emotions

Improving emotional regulation means understanding the emotions and what triggers them. Be aware when presented with situations, environments, and information by purposefully taking a moment to process your feelings and overcome impulsive reactions. When the body feels a certain way, notice where in the body and how it is felt so that the emotion can be accurately identified.

Learn your mind

Once emotions are known, the response can be measured by creating distance from them.

Learning mindfulness techniques can help you regain agency in your expression and foster awareness of the circumstances. These coping skills may need to be learned from counselling or psychotherapy, such as cognitive behavioural therapy.

With mindfulness, there is a recognition of consequences and the space to reframe and analyse situations effectively, helping you avoid cognitive pitfalls that often accompany strong emotions, such as defensiveness, exaggeration, or assigning blame.

Take the time

Taking an active step back from the heat of the moment to calm down, sit with your feelings and process how you truly feel about something, so that you can reengage when you are ready, with a clear head and with intentionality. Emotional dysregulation can often be a personal roadblock in relationships, work, and self-development, so actively taking a moment to consider can help prevent actions or words that don’t accurately represent your stance or beliefs. This can be hugely beneficial for maintaining healthy connections with friends, family, colleagues, and partners.

However, managing emotional dysregulation may not be possible without a diagnosis of ADHD. When diagnosed, there is clarity about the way the brain works and how it is unlike others, which means when confronted with strong emotions – or even with other symptoms like fidgetiness or distraction – you are equipped with the vocabulary and the coping behaviours to control your impulses and improve social skills.

If you are struggling with ADHD, you can consult with Dr Shalaby today via his Top Doctors profile.