When we think of ADHD the first things that generally spring to mind are hyperactivity, fidgeting and/or attention difficulties.  However, one of the biggest burdens someone with ADHD must deal with is the inability to regulate their emotions.  This emotional dysregulation is extreme and largely underestimated.

Whilst children with ADHD experience the same emotions as others, they experience them more intensely.  As discussed before, (The ADHD Brain) there are very real brain differences in a child with ADHD.  These differences result in delayed development of parts of the brain, one of these being delayed emotional development.  The prevalence of emotional dysregulation among children with ADHD is thought to be about 80% in children and 70% in diagnosed adults.  These are high figures!

When I talk to parents of children with ADHD the most common issue is managing meltdowns.  We’re all at a loss.  Sometimes there appears to be no trigger.  Our children go from 0 to 100 in a matter of seconds.  The meltdown can last for what feels like an eternity, leaving us both worn out and exhausted by the end of it.  Believe me, I can handle the nonstop talking and the hyperactivity for the most part, but the meltdowns.  Wow.  That is the most challenging part of ADHD for me as a parent.

Every day problematic situations arise, it’s life.  We generally use our cognitive brain to appraise it.  The cognitive part of a child with ADHD’s brain is also slower in development.  Therefore, they may be less likely to evaluate the situation correctly.  The cognitive brain requires effort and tires quickly. Just think about a time when you’ve worked on something that has required you to really concentrate, like an essay or a large form that needed to be filled out.  Then imagine you are asked to evaluate another situation quickly.   (And that’s if the situation was holding the child’s interest in the first place and they were able to pay full attention to it).   If the cognitive brain is too tired to evaluate what has happened the speedier ‘under-developed’ emotional brain takes over.  And that is where the meltdowns come in! 

When you are tired, you generally don’t make the best decisions.  I know I don’t!  You feel irritable and can snap at the slightest thing.  I can only imagine that this is slightly like having ADHD all the time.  Without your brain functioning and evaluating situations correctly because you are tired, you don’t make the best choice.

FIGHT or FLIGHT response

Fight or Flight response is a kind of stress response.  It is the reaction both behaviorally and physiologically that your body makes in the event of a stressful situation.  When an individual senses danger or a threat, signals are sent throughout our bodies causing:

• Heart rate to increase
• Blood pressure to rise and blood vessels to constrict
• Blood is directed from extremities in the body and towards major organs
• Breathing because faster and deeper
• Air passages dilate allowing more air into the lungs
• Digestion shuts down to focus on the issue at hand
• Perspirations increases
• Adrenaline kicks in, stimulating the heart and other organs

Basically, this is the way our body prepares us for ‘flight or fight’ mode in the face of a threat.  We are either prepared to run or fight.  When this mode is triggered, we lose the ability to use our executive function as the brain goes into escape or attack mode.  Sometimes this is a real or a perceived threat.  Now imagine if your fight or flight mode happens too easily or frequently.  This is where the problems occur.  Children with ADHD are more likely to suffer from RSD (Rejection Sensitive Dysphoria).  This is intensive emotional sensitivity.  So, they are more likely to react to a threat or situation.  This in turn then causes anger and meltdowns. 

What is Emotional Dysregulation?

Emotional Dysregulation can be thought of as the inability to control one’s emotions and responses which result in disproportionate and extreme responses.  They are often inappropriate for the child’s developmental age.  This is thought to be due to the slower development of the executive functioning area of our brain.

Emotional regulation can be thought of as the unconscious, automatic or conscious, controlled response to an event.   Koole (2009), believed that most people have a primary and secondary reaction to an issue.  I think of this as going into the kitchen and discovering your child has spilt fresh (sticky) orange juice all over the floor.  Your immediate reaction inside might be anger at the sight of the mess that you’re too tired to clean it up, and don’t know where to start.  However, when you see their little face, which genuinely didn’t mean to make the mess, you rationalise it and think, ‘there’s no use crying over spilt milk or orange’…

Another example, later in life, maybe in a workplace where your boss has just told you something that you vehemently disagree with.  Using your inbuilt emotional regulation, you can are able not to immediately whack them around the head with the nearest hole punch, but contain it, calm, and give your response in a composed manner.

Signs of Emotional Dysregulation

• Having an unpredictable and explosive reaction to events due to emotional impulsivity.  This can be shown as impatience, rapidity to having an anger outburst, and low frustration tolerance.
• Difficulty in refocusing their attention away from that particular strong emotion e.g., anger, excitement, anxiety.  Hence not easily calmed, and are unable to self-soothe.
• Being so overwhelmed they are unable to moderate what they are feeling and therefore unable to give an appropriate response.
• Focussing on the negative aspect of the situation and not evaluating it in its entirety

Yup, my daughter pretty much ticks all those boxes.  For instance, trying to get her to do home-schooling.  I would try to explain something to her, obviously, it was boring as anything to do with school = boring.  She would become bored and frustrated (as would I!).  Then she would say, ‘I’m stupid, I can’t do this’ and get angry so quickly generally ripping up the sheet and lashing out at anything in the vicinity that she could break.  Oh, and her language at this point would become atrocious and then I would get angry and yes, you can see where this is going, I’m sure.  Children with ADHD are so sensitive to emotions that they will definitely pick up on their parent’s emotions too, further increasing the emotional thunder ball.

How to Help Children with ADHD with their Emotional Regulation

• Enhance their emotional intelligence.

Talk about emotions, age-appropriate.  If the child is very young, simple faces can be a great way to do this.  Get the child to point to the face they are feeling.  Let them discover that not all feelings are anger.  Increase your child’s vocabulary, frustration, sadness, jealousy, anxious.  This will help them describe how they are feeling and learn ways to deal with it.  Let them know how you are feeling.  Sometimes when I’m tired, I will pre-empt and say to my children, ‘Sorry if I’m snappy today, it’s not you, it’s me, I’m very tired and a bit ratty’.  It’s ok to have emotions!

• Validate emotion, not unwanted behaviour

Let them know you can see they are upset, angry, excited, and empathise with that part.  However, add that it is not acceptable to hit, swear, or break things.  My son smashed his tv in frustration, on the first day of isolation.  I was not happy, but he was in absolute bits.  He was angry due to the game he had played (and not won, unfairly he claimed..).  He lashed out, and his beloved tv cracked.  Mortified.  He was sobbing, saying how stupid he was, how he was such an idiot.  It actually broke my heart to see him so upset!  But I said, ‘it’s ok to feel angry at losing, but not ok to break your tv.  He is saving up for a second-hand one now.  I’ve never seen anyone so keen to unload the dishwasher.

• Medication

I know this is not for everyone, but medication has truly helped with impulsiveness in my family.  I would like to point out that my son above was not on medication at the time of the tv smashing incident!  Since he has been on medication, his school have seen a real change in his behaviour and impulsivity, which was always getting him into trouble! 

• Mindfulness

Now, I will confess I haven’t yet used this so I am writing simply what I am learning and will have to let you know if it works in another blog post.  But this is supposed to be amazing for our kids with ADHD, and having done some quick reading on it, it does sound good, but I’m not sure my children will join in.  Mindfulness literally involves paying attention to the actual moment we are in and teaches you methods of how to do this. 

The key benefits of teaching Mindfulness to all children are:

• Better focus and attention, self-control, compassion and even classroom involvement.
• Improved ability to resolve conflict and overall well-being
• Lower levels of stress, anxiety, depression, and disruptive behaviour

Doesn’t that sound good?  Watch out for the Mindfulness blog coming soon!

Meltdowns are horrible, for all concerned.  They can be triggered and escalate very quickly without apparent warning.  Being aware of how your child with ADHD’s brain works may help you pre-empt some situations.  I think talking about them when calm is a great way to expand their vocabulary and their understanding.  Keep a picture of emotions on the wall/fridge for your child.  See if they can identify each day, which one they are feeling. After all, whilst we, as parents and carers, can read and help as much as possible, our ultimate aim is to teach our children to emotionally regulate themselves. 

Please don’t feel bad that your child can’t do this themselves yet.  I know it’s hard, but it isn’t you.  It’s another part of ADHD that needs to be acknowledged.  Both you and your child are doing your best.  Keep going.