Emotional regulation in ADHD - a step-by-step guide from overwhelm to ease

Updated: Jun 4

With ADHD, we often experience "big feelings" or emotional turmoil. We find it difficult to regulate our emotions. From current world events to a minor argument in the family: we're easily overwhelmed by our emotions.


Unfortunately, many people with ADHD have developed unhealthy habits for coping with demanding or overwhelming emotions.


In this post, I'll try to offer you a step-by-step guide with proven tips on how to deal with complex emotions without driving yourself "crazy" or suppressing your emotions.


A downloadable checklist will help you practice emotional regulation. Because even with ADHD, we're not powerless over our emotions. With practice, we too can experience less overwhelm and more ease.

Emotional regulation in ADHD - how to manage complex emotions

A word of caution: if you've suffered a severe loss or trauma, are affected by depression or other mental illness, or if things are "just too much" for you at the moment, then the tips here won't be enough and may even hurt you, for example, if they make you feel worse because you can't implement them. Please get the support you need.


If you're unsure if these tips are right for you, be sure to discuss them with your healthcare professional first before trying any of them.


Now let's dive into the world of feelings, followed by tips for a less stressful way of dealing with them.


What did your childhood teach you about emotions?


Can you remember what you learned about the "right" way to deal with feelings when you were a child? At home, at school, in sports, in your free time?


Did you have emotional outbursts like many people with ADHD? Were you punished or shamed for them and had to suppress them, or do you still lash out just the way you did as a child? Or did someone support you in learning to express your feelings in a measured way?


Were there certain feelings that were "allowed" and certain ones that were "forbidden"? For example, was the teacher the only one allowed to get angry, or only the boys, who in turn were not allowed to cry? Did you learn to suppress your emotions and not show them?


How were emotions talked about at home? Were there nuanced words for feelings like distressed, upset, nostalgic, melancholy, disappointed, dissatisfied, or did one simply feel good or bad?


Often our childhood did not provide us with the best possible tools for dealing with our emotions. Fortunately, there's a lot that can be relearned. But first, let's take a look at the habits we've developed in adulthood.


What habits have you developed for dealing with emotions as an adult? What about your emotional regulation skills?


In adults with ADHD, there are often two ways of dealing with feelings: emotional outbursts and emotional suppression - often combined in one person, depending on the feeling (anger, for example, is fully expressed, fear is completely suppressed).


The feelings that are "allowed" are often let out without restraint, so that even pets run for cover. In this case, objects may be destroyed or the person themselves or others may be harmed.


In addition to the more highly sensitive people with ADHD, there are also those who have difficulty perceiving, classifying, and processing feelings. Such people can also have massive freak-outs because when a difficult feeling finally makes it into their consciousness, they are often completely flooded by it.


"Illicit" or unwanted feelings are often suppressed by people with ADHD. For example, we learned in childhood that we're only accepted and acceptable if we keep certain or all feelings bottled up.


In addition, a disturbing number of sensitive adults with ADHD find their intense feelings almost unbearable and have learned various avoidance tactics in order not to have to feel. Popular tactics include drinking alcohol (excessively), binge eating, gaming, consuming various internet content (you can guess which ones, for example), or even using work as an escape.


In the long run, this doesn't work and in exceptional situations - like the present one for many of us - we're completely at a loss.


Are you able to stop for a moment and listen to your body even though you have ADHD?


The first step is to regularly take a short break to actively notice your emotions or how your body is feeling at the moment.


Even if you're one of those who can't perceive their feelings well, the emotions still show up in your body in their own way, e.g. through tension, a feeling of pressure, restlessness, etc. The ability to sense what signals your body is sending is called "interoception". Whether this is more difficult for people with ADHD is still unclear, there are still too few studies.


And no, you don't turn into a hypochondriac by listening to your body, that's complete nonsense. On the contrary, good awareness of how your body is feeling at the moment has been scientifically proven to help regulate emotions.


A regular pause, a check-in with ourselves, allows us to (re)gain access to ourselves, which is often missing or lost in everyday life.


Can you match up a feeling with your bodily sensations? Naming emotions tames them


Now that you're aware of the signals your body is sending you, can you describe them? And can you match them up with a feeling? There's research that shows that giving feelings a name can already lead to more ease. Building a wider vocabulary of feelings may therefore be worthwhile. I'll talk about this in more detail in a later post.


I know it's difficult to put this into practice, if only because we tend to forget again that we wanted to pause for a moment. But with practice, it gets easier, even for us. I sometimes draw a pause button on the back of my hand to remind myself to check in with my body.


If you feel strong resistance to trying this or are convinced you won't be able to do it (without trying it out): maybe you are simply afraid of what you might discover when you get closer to your body sensations and therefore your feelings? Is the "I definitely won't be able to implement this" perhaps just a convenient excuse? Many people with ADHD are very courageous. This courage might be helpful here as well.


If you're more prone to intense emotional outbursts, you'll find additional help in this post on dealing with meltdowns in ADHD, because in that case, it can indeed be really difficult to pause. But again: practice makes perfect. For real.


The ADHD superpowers curiosity and interest in new things help us cope


If we're willing to find a new way of dealing with our feelings, we've got an ace up our sleeve: our ADHD brain is fundamentally curious and finds new things exciting.


When we've got access to this superpower, it can help us stay in the moment and notice what's happening inside us or to us right in the moment.


Be curious about your body sensations, feelings, thoughts, and what else is there, here, in the present, around you, such as sounds, smells, what you see, etc.


Curiosity enables us to say "hmmmm, interesting..." - a skill taught to deal with addictions and fears (see J. Brewer's book). I mentioned this in the post about rumination, and it's just as relevant here.


Feelings want to be felt


Feelings start with bodily sensations - if we're inattentive, we often don't notice them building up and can become flooded and overwhelmed seemingly out of the blue. So, if you can: pause and pay curious attention to your bodily sensations.


Depending on what we learned about emotions in our childhood and experienced over the course of our lives, our brain interprets the bodily sensations in a certain way (our brains are meaning-making machines) and poof, there's an emotion.


Depending on how empty our "batteries" are (lack of sleep - you may want to look at this post about ADHD and sleep problems - hunger, thirst, pain, etc.), this can act as an amplifier of the emotion, sometimes massively so.


As a first step, the emotion simply wants to be perceived as a signal. There is (or was, if we're inattentive) something that our body and brain thought was important enough to expend energy on to get our attention.


If we've got a good perception of our bodily cues and good emotion regulation, we notice the signal early, do a quick check-in the here and now: does this make sense right now, or is this a reaction to something from the past, or a misinterpretation from my brain and then either act or let the feeling pass again.


A concrete example from my life:

  • I notice

  • that my heart is racing (body sensation)

  • although I'm calmly sitting on the train (context)

  • it feels bracing and hyper-alert (naming the feeling)

  • as if danger were near (interpretation of my brain)

  • I look around and listen carefully (check in the here and now)

  • notice a man speaking on the phone two compartments behind me

  • with what to me sounds like a very irritated tone, using subtly threatening words and

  • sounding similar to a choleric former boss

  • I realize that this is what my system has reacted to

  • and that there is no danger for me at the moment

  • I briefly shiver and then move around a bit

  • and my heart rate goes down again

Another example - same beginning, different outcome:

  • I notice

  • that my heart is racing (body sensation)

  • although I'm calmly sitting on the train (context)

  • it feels bracing and hyper-alert (naming the feeling)

  • as if danger were near (interpretation of my brain)

  • I look around and listen carefully (check in the here and now)

  • and notice that a man has entered the empty train car (except for us) and has sat down one compartment away from me, but is looking in my direction

  • he's staring at me and trying to make eye contact

  • I realize that my system has reacted to this and that the feeling is now increasing

  • although I can't rationally say that there is any danger for me at the moment

  • I pack up my things as if I had to get off the train and at the next stop

  • and change the train car to one with more people and sit down near a group of older ladies

  • slowly my heart rate goes down again (because I interpreted this as an actual possible danger, it takes longer for my pulse to drop again)

Did I overreact here? No idea. The important thing to me is that I listened and my pulse was able to drop again.


Now, of course, I could go on and on about this and doubt myself, which would leave me ruminating, which is a painful waste of energy (see this post on how to break out of rumination).


Emotions just want to be allowed to come and go


If we succeed in perceiving our emotions as they come up, we also realize how short-lived they can be. We can allow them and let them pass. By this, I don't mean suppressing them, but rather, as described above, feeling them and noticing when they go away on their own.


If they're strong feelings or emotions that we don't like or that are painful for us, they may come up again and again, which means that we go through the cycle several times. This isn't pleasant, but it's still less painful than getting stuck in the rumination trap.


By sensing into our bodies, we also notice how many different or even seemingly "incompatible" feelings can show up almost at the same time.


"Yes, and..." lets us feel the wonderful as well as the painful


The fact that we can feel completely different emotions at the same time can be confusing. But it's a true resilience factor - it helps us get through difficult times.


"Yes, and..." is often used in various contexts - from improvisational theater to coaching.


When we can say "yes" to our feelings of grief, anger, despair, helplessness, allow them to come and go.


AND say "yes" to the enchantment of beautiful views, the first signs of spring, the giggle of the baby, the wag of my neighbors' dog (this dog isn't wagging its tail, the whole dog's wagging), to gratitude, to the joy of a moment of connection, to the pride of having achieved a goal - in spite of everything - and also let these feelings come and go.


If we can consciously allow all this up and down and up and down of life, it can release an enormous amount of power. Because our bodies react anyway, whether we perceive it or not. Even the most sophisticated avoidance tactics are of no use against our neurobiology.


I'm not claiming that any of this is easy. Nor that I always manage, far from it. But practice really helps. And every little bit adds up. Accept that, with ADHD, we're simply not consistent and just keep going. It does get easier.


I've created a checklist to help you practice.

You can get it here as a free download:

Checklist ADHD Emotional Regulation


Taking constructive action helps against helplessness


When we feel powerless or helpless in a situation, be it world events, at work, or in the family, this can be almost unbearable for many people with ADHD.


To counteract this feeling, what helps most is to take helpful action. Do something constructive. Think about it: what can I do that is helpful, no matter how small a step it is? Take it. And if it is too big, think about a smaller one and take that one.


If we all just do our best with what we can today, it adds up. And makes a positive difference. Despite everything.


"If I knew the world would end tomorrow, I would still plant a little apple tree today." - Attributed to Martin Luther, first documented in writing in 1944


An important caveat: get professional help sooner rather than later


There's no prize at the end of life for the person who's endured the most.


If you're not doing well, get professional help sooner rather than later. And ask your healthcare professional if the tips in this post are suitable for you before you try them.


It's a strength to recognize when we're in over our heads, not a weakness. This post describes how shame can keep us from getting the help we need with ADHD.


If you're not in crisis, but simply having trouble managing your emotions, as most of us with ADHD do, or simply want to learn a more energy-efficient way of dealing with your emotions, ADHD coaching can go a long way. This is where I can help.


Please take good care of yourself!


Download the Checklist ADHD Emotional Regulation for free.

 

References:


Brené Brown, Atlas of the Heart Mapping Meaningful Connection and the Language of Human Experience, 2021 (Website Brené Brown)


Judson Brewer, Unwinding Anxiety: Train Your Brain to Heal Your Mind, 2021 (Website Judson Brewer)


Lisa Feldman Barrett, How Emotions are Made: The Secret Life of the Brain, 2017 (Website Lisa Feldman Barrett)


Annie Murphy Paul, The Extended Mind The Power of Thinking Outside the Brain, 2021 (Website Annie Murphy Paul)


Viktor Frankl, Man's Search for Meaning, 1946, (Wikipedia page for the book)


Emotion dysregulation in attention deficit hyperactivity disorder. Shaw P, Stringaris A, Nigg J, Leibenluft E. Am J Psychiatry. 2014 doi: 10.1176/appi.ajp.2013.13070966 Link to publication about emotional dysregulation in ADHD


The role of stress coping strategies for life impairments in ADHD. Barra S, Grub A, Roesler M, Retz-Junginger P, Philipp F, Retz W. J Neural Transm (Vienna). 2021 doi: 10.1007/s00702-021-02311-5 Link to publication about unhealthy coping strategies when facing stress with ADHD


The Relationship Between Alexithymia and Impulsiveness in Adult Attention Deficit and Hyperactivity Disorder. Kiraz S, Sertçelik S, Erdoğan Taycan S. Turk Psikiyatri Derg. 2021 Link to publication showing that low emotional perception is also common in ADHD and seems to occur with impulsivity and anxiety


A Systematic Review of Associations Between Interoception, Vagal Tone, and Emotional Regulation: Potential Applications for Mental Health, Wellbeing, Psychological Flexibility, and Chronic Conditions. Pinna T, Edwards D J. Front Psychol. 2020 doi: 10.3389/fpsyg.2020.01792 Link to publication showing how interoception and effective emotional regulation appear to be connected


The link between interoception and ADHD is not yet clear; these two small studies reached different conclusions:


Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD). Kutscheidt K, Dresler T, Hudak J, Barth B, Blume F, Ethofer T, Fallgatter AJ, Ehlis AC. Atten Defic Hyperact Disord. 2019 doi: 10.1007/s12402-019-00299-3 Link to publication showing relevant reduction of interoception in adults with ADHD compared to healthy controls and the co-occurrence with problems in behavioral regulation


Interoceptive awareness in attention deficit hyperactivity disorder. Wiersema JR, Godefroid E. PLoS One. 2018 doi: 10.1371/journal.pone.0205221 Link to publication showing similar interoception for ADHD adults


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