In my experience as a therapist, it seems most people are still unaware of the link between ADHD and emotions. And even the people who are aware of ADHD’s impact on our emotional wellbeing, usually only those of us living with, have large gaps in their knowledge of the topic. Those gaps make it harder for us to move in a helpful and healthy emotional direction. Meanwhile, researchers have been recently emphasizing the idea that emotion regulation problems may be the core symptoms of ADHD.
It’s obviously important that we understand the link between ADHD and Emotion, but it isn’t being talked about nearly enough. Today I’m giving a broad overview of the impact ADHD has on our emotions, why it happens and what causes it.
Does ADHD affect your emotions?
People ask this question a lot, and the short answer is 1000% YES. If you’ve already noticed that ADHD seems to come with big feelings, you’re certainly right. That’s because the underlying struggle with ADHD is regulation. Whether we’re talking about regulating attention, energy, hyperactivity, impulses, or emotions–the same part of the brain is responsible for each. So, for the same reason your ADHD makes it hard to regulate your attention, it makes it hard to regulate your emotion, as well.
I had a psychiatrist tell me once that the first ‘D’ in ADHD should have been ‘Dysregulation’ and I’ve learned over the years that he was spot on. Whether too much or too little, we’re always struggling to regulate our inner world. Unfortunately, it isn’t just dysregulation that gets us. Working memory and time blindness also complicate ADHD and emotions. They make it easy for a single emotion to sweep in and carry us away, making it feel like we’ve always have, and always will, feel this way. As such, those of us with ADHD experience emotions on a different, more magnified scale.
On top of that, our dysregulated mental processing also frequently leads us to overstimulation, which brings on a whole other plethora of emotion pulling at our regulation energy. Whereas the neurotypical brain can filter out irrelevant stimuli in their environment, the ADHD brain cannot. Part of our brain is constantly trying to process every little thing that’s happening around us. That drains emotional energy fast and drives us toward irritability, anxiety, and overwhelm.
Even our predisposition toward black and white, all or nothing thinking magnifies what we feel. So, yes. For many reasons, these and more, ADHD has a big impact on emotions.
Does ADHD make you emotionally sensitive?
That’s also a resounding yes. If ADHD magnifies our other emotions, it’s inevitable that it also makes us more emotionally sensitive, unfortunately. Between the struggle to regulate these emotions and the struggle to regulate our thoughts, which like to go on unending chains that lead to overthinking, it should come as no surprise that ADHD nearly always comes with Rejection Sensitivity. By nearly always, I mean there’s a 99% correlation according to research. Which is annoying considering emotional struggles aren’t mentioned at all in the DSM 5 criteria for ADHD, much less RSD. But that’s a rant for another post.
If you haven’t heard of Rejection Sensitive Dysphoria, it is the intense and overwhelming emotional response that comes from real or perceived rejection. While pretty much everyone is sensitive to rejection, RSD is–surprise, surprise–a magnified version of it. It sweeps in, overloads our whole system, and often results in a meltdown of epic proportions.
We’re more sensitive to criticism, and unfortunately, we also receive more criticism than your average person. Which only makes the sensitivity worse. This emotional flooding may also be part of the reason people with ADHD are more likely to have other mental health conditions like anxiety, depression, eating disorders, etc… and it’s the culprit for our struggle with low frustration tolerance.
You may or may not have at least encountered these basics of ADHD and emotions, depending on your particular struggles and how much you’ve hyper-fixated on learning the ins and outs of life with ADHD. But a lot of people don’t know that ADHD also affects emotions on the opposite end of the spectrum. Not only does it magnify our emotions, it can also make us oblivious to them.
Alexithymia and ADHD
You’ve heard of time blindness? Well, Alexithymia is emotional blindness. Alexithymia isn’t a disorder; you won’t find it in the DSM, but that shouldn’t minimize the impact it has on those who struggle with it. Instead, it’s considered a personality trait in which a person struggles to identify, experience, and express their emotions. Studies show that up to 40% of people with ADHD also have Alexithymia.
Research indicates there are many reasons emotional blindness may be more common in people with ADHD (and autism as well), but the symptoms of ADHD themselves invite a struggle with alexithymia. We’re generally less aware of our bodies and bodily cues than others. Our lack of awareness, coupled with other executive function issues like forgetfulness and distractibility, makes it harder for us to pay attention to our emotions (and other needs, too), much less regulate them.
Alexithymia is associated with experiential avoidance, demand avoidance, procrastination, impulse control issues, repression, denial, social struggles, and more. Alexithymia touches on so many of our ADHD symptoms. If you struggle with this kind of emotional blindness, it likely has a much greater negative effect on your ADHD.
The Spectrum of Alexithymia
Like most things, Alexithymia exists on a spectrum. On the farthest end, a person may be so unaware of their emotions (all of their emotions) that they only recognize the associated physical sensations. In my years of clinical practice, I’ve rarely worked with anyone who had Alexithymia that extreme. Instead, most have more of a ‘spotty’ awareness of their emotions.
I struggle with Alexithymia. For a long time, I could only recognize contentment, and anxiety. Anger on the rare occasion I couldn’t stuff it and, occasionally, sadness. But I had no framework for more complicated emotions and usually tried to ignore them. If more than one emotion hit me at once, it was too confusing to process so I primarily felt them as anxiety. Meanwhile, I couldn’t figure out why I felt so anxious all the time. Avoiding your emotions often converts them into other forms–anxiety, anger, and depression being the most common.
For most people, Alexithymia looks less like an ‘all or nothing’ awareness of emotion and more like this– ‘somewhere in between.’ You may think being cut off from emotion doesn’t sound like a bad thing. But without awareness of your emotions, you cannot connect deeply with yourself or others. That leads to loneliness, emptiness, inability to feel love or to understand the yourself or the people around you. It’s associated with higher psychological distress and suicidality. Being cut off from emotion doesn’t prevent you from experiencing distress. Instead, it prevents you from understanding it, identifying the cause, or doing anything to emotionally support yourself.
ADHD and Emotions: Flooding vs. Alexithymia
If you are seeing yourself in both pictures above–someone who experiences magnified, overwhelming emotion AND the struggle to recognize, identify, or feel them, you’re in good company. There is a link between these two extremes that is rarely talked about and more likely to show up in those of us with ADHD. Why? That pesky little regulation problem we have. We tend toward ‘all or nothing’ extremes–something has all of my attention or it has none of it. I’m either obsessed or uninterested; it’s either happening right now or it doesn’t exist. I’m either flooded or I’m emotionally blind.
But it isn’t just regulation difficulties that lead to these emotional swings. Alexithymia and emotional flooding are a vicious cycle in themselves. Having big emotional floods often leads us to avoid our emotions as much as possible. But avoiding our emotions causes them to build like a dam. At some point, that dam will reach max capacity. Then it breaks and all the intense emotions we’ve been running from sweep in at the same time and overload us. That overwhelm reinforces our fear of emotion, and causes us to avoid again.
This link can make us feel crazy–like we live on a strange rollercoaster right out of the bowels of hell. It can destabilize our functioning and ramp up our other ADHD symptoms.
Co-Morbid Conditions ADHD and Emotions Can Cause
Because of these challenges we face with regulation, ADHD makes us more likely to develop other mental health conditions related to emotion. You may be aware that ADHD is very commonly linked to anxiety disorders–that is, in large part, because the ADHD brain struggles to regulate anxiety. Likewise, we are more likely to struggle with depressive disorders for the same reason. If you are part of the 40% of ADHDers who have alexithymia, that increases the likelihood of both anxiety and mood disorders as well as conditions associated with poor impulse control. Things like Binge Eating Disorder, Intermittent Explosive Disorder, Addiction, Oppositional Defiant Disorder, and others.
Outside of diagnosable conditions like this, ADHD also makes us more likely to struggle with certain symptoms that may not be diagnosable but present major difficulties regardless. Things like demand avoidance, low frustration tolerance, overwhelm and overstimulation, rejection sensitive dysphoria, flooding, hypersensitive reactions, irritability, etc…
Common conditions associated with the link between ADHD and emotion:
- Anxiety disorders such as GAD, Social phobia, and others
- Mood disorders such as MDD, Bipolar Disorder, Persistent Depressive Disorder, etc..
- Borderline Personality Disorder
- Addictions
- Demand avoidance/Pathological demand avoidance
- Rejection Sensitive Dysphoria
- Eating disorders such as Binge Eating Disorder, Bulimia, ARFID, etc…
- Impulse control disorders such as Intermittent Explosive Disorder, Oppositional Defiant Disorder, etc…
- Impulse control symptoms regardless of diagnosis–excessive spending, road rage, etc..
- Skin picking (Excoriation Disorder) and Hair pulling (Trichotillomania)
- Alexithymia
- Emotional flooding, dysregulation, and destabilizing mood swings
- Social struggles, isolation, and loneliness
- Poor self esteem and self image
- Maladaptive coping behaviors such as self harm, suicidal ideation and gestures, risky driving, risky sexual behaviors, etc…
- Chronic procrastination
This is not a comprehensive list. If you look hard enough, you will find more overlaps between ADHD and other mental health disorders linked to emotions.
Related: When You Think It’s Anxiety, But It’s Really ADHD
ADHD and Emotions: Regulation Tips to help
There are treatments and coping skills that can help us create a healthier relationship with our emotions, despite the ADHD floods and famines. When I first started this process, I struggled to find words for complex emotions. ‘It feels kinda like anger, but not exactly. Or maybe it’s guilt? But that doesn’t make sense…’ Literal words that came out of my mouth because it hadn’t occurred to me yet that I might have more than one emotion going on. There can’t be one ‘right’ word if there are two feelings swirling around inside.
Now, I can catch myself in the moment of overthinking and shift gears to get out of it. Now I recognize when I’m getting emotionally triggered by something from the past while it’s happening, name it and explore it with curiosity. I’ve come a long way from where I started. And that’s how I know–while it takes a lot of time and practice, you don’t have to be yanked around by that rollercoaster forever. There are skills, tools, and therapies that help. In another article, I will go in depth on how to regulate ADHD emotions; For now, here’s an overview of the tools I found most effective for me.
ADHD and Emotions: Skills and Tools you can do on your own
If you struggle with alexithymia, one important starting place is to expand your emotional vocabulary. If you don’t have names for what you’re feeling, it will prevent you from effectively regulating it. If you don’t struggle with alexithymia, but flooding is your Mount Everest, identifying the emotion is still an important place to start. You may or may not need the extra tools for identifying the emotion, but don’t skip this step. Naming it isn’t a fix, but it is an important part of regulation.
Emotion Wheels
I started with emotion wheels for myself, and that’s usually where I start with clients, too. There are many different versions so find one you like. If you come across an emotion you aren’t sure of, it might sound silly, but I googled how other people experience that emotion to see if I could relate. This practice helps you learn to identify the emotions you’re experiencing and being able to put the correct name to a feeling often provides a small measure of relief in itself. When we don’t know the details of what we’re experiencing, the feeling takes on a ‘monster in the dark’ quality. That quality intensifies the feelings.
Body Scans
If you struggle to identify a feeling with emotion wheels, start with a body scan. Pay attention to the physical sensations you’re experiencing and name them. As you observe your body in this way, it can help you understand the emotions behind the sensations.
If you have identified the name of the emotion you’re feeling, use a body scan to learn more about how you experience it. Over time, you’ll begin to recognize your emotions much faster if you take the time to connect the emotion word with how it feels to experience it on the inside. Don’t try to ‘control’ the emotion, instead let yourself breathe into and through it.
Practice Acceptance and Allowance
If you’re flooded with emotion, ‘allowing it’ can feel like a terrible idea. I promise I get that. But resistance intensifies emotion in the same way that adding resistance to strength training intensifies muscle strain. While that can help your workout, it harms your ability to regulate emotion.
Allowing your emotion without letting it consume you requires you to become an observer of your emotion. It requires you to stay in your body and not get caught up in the story your mind is telling you about your experience. Pay attention to the separation between you–your core being– and the emotions you are feeling. I like to imagine my emotional flood like it’s water moving through me rather than water that’s drowning me. That imagery is something I often hang onto when a flood starts, imagining myself like an anchor weathering the storm.
For emotional acceptance, Tara Brach has some helpful mindfulness videos and exercises on Youtube. I’m a big fan of Acceptance and Commitment therapy. The skills it teaches on accepting emotion and learning to surf the urges they bring is very helpful. Including the urge to avoid, resist, and deny. This is 8 minute video is one of my favorites.
Practice Thought Diffusion
Thought diffusion is another cool skill brought to you by ACT. Thought diffusion is really helpful when emotions are overwhelming or flooding you. It teaches you to cultivate a healthy degree of mental separation from your core self and your emotions. Not in a way that leads to avoidance, but in a way that leads to better tolerance of the emotional experience. In super basic terms, ACT teaches you to shift your thoughts and language. Instead of “I am devastated [overwhelmed, heartbroken, whatever emotion you’re feeling]”, say “I am noticing that I am feeling [xyz]”.
It may sound like a silly shift, but it makes a bigger difference in practice than you might expect. It’s a mental reminder that distances us from the flood. It reminds us we are more than the experience we are having. When big emotions flood, we tend to blend with them. Logically we might know the emotion we’re feeling isn’t who we are, but in the moment, it feels that way. It’s as if we are shameful instead of feeling shame. “I’m noticing” helps us shift from emotional mind into something curious, observant and more helpful–from mired to meta, I guess.
Practice Sitting with Your Emotions
Sitting with emotion means allowing it to be, observing the way it feels in your body, without letting yourself to get caught up in the story your mind creates about why your feelings are there. Even if the story your brain tells you is 100% factually true, over-focusing on it will only fan the flames higher.
If you are flooding, bring your attention back to what you are feeling in your body. Breathe in and through the feeling. Notice the sensations in your body. When your mind wanders (because it will, probably often), notice it and pull your attention back to your body. Overtime you will get better at letting your emotion be. If you struggle with alexithymia, beware of intellectualizing your emotions. Avoidance is sneaky, and this is one particularly sly way alexithymia will crop up on you. Instead of letting yourself feel the feelings, your mind will start trying to analyze them. Notice it and bring yourself back to the experience in your body.
You don’t have to just sit with these emotions forever, but the more you let yourself stay in your body and out of your mind, the more helpful it is in cultivating a better relationship with your emotions and in taming their intensity.
Creative Coping
If you struggle too much with simply sitting with your emotion, add a creative element. I write poetry when I’m flooded. And typically I make it rhyme because it offers additional boundaries for the emotion. This kind of structured writing allows you to fully feel your feelings without letting them consume you. It allows you to introduce analytical thinking without avoiding your emotions. That acts like a safe container for it.
There are other ways you can do this if writing isn’t your thing. You can draw or paint your emotions. You can create music that embodies the feeling, make a dance or create a collage of it. My husband uses Minecraft to create a world that represents how he’s feeling. It could be anything. Whatever inspires you, tweak it to fit.
The Finch App
I’m a huge fan of Finch for like a hundred thousand reasons. The emotional check ins, the easy laid back goal setting, and the reflections are all incredibly helpful for ADHD and emotions, too. If you struggle with Alexithymia, the ‘name your emotion’ reflection is super helpful. If you struggle with flooding, there are a plethora of coping skills to choose from. All guided and all things you might learn in therapy. Having all of that in one adorable place that rewards you for taking care of yourself and your finch has been very helpful to me and everyone I’ve introduced to it.
There’s a free and paid version. Unlike most apps these days, the free version is awesome. The paid version is reasonably priced, but if you can’t afford it, they offer the chance to be sponsored by a guardian every month. It’s a great, free resource to help you identify and sit with emotions.
Therapies I recommend for ADHD and Emotions
There are several modalities than can help emotion regulation. These are at the top of my personal recommendation list.
Acceptance and Commitment Therapy
We’ve already talked a little about Acceptance and Commitment Therapy, but it’s definitely one I recommend. If you like mindfulness based approaches to change, this one is a little more robust than some of the others. It can help you tame the big emotions, and it can help you create an inner environment that is willing to approach emotion if you are more on the alexithymic side. Thought diffusion has been an ACT technique that I regularly use and find incredibly helpful.
Dialectical Behavior therapy and RO-DBT
Dialectical Behavior Therapy is another great one for the big emotions. It’s also a mindfulness based therapy but it also has a super practical skill based element that is tangible enough to be helpful for neurodivergent brains. It was originally created for Borderline Personality Disorder, which means it works for big emotions and anyone who struggles with them regardless of the diagnosis. If you struggle with Alexithymia, an alternative form of this therapy is Radically Open DBT (RO-DBT), which was created for those who struggle with over-control. Alexithymia is a form of emotional over-control. RO-DBT is a great resource to help you cultivate more openness toward your feelings.
Internal Family Systems
Internal Family Systems is the therapy I recommend most for anyone struggling with Alexithymia. IFS has helped me become much more aware of my emotions and how they feel. It taught me to sit with them in a way that keeps you from being consumed, and to explore my emotions, reactions, and responses with curiosity instead of judgement or defensiveness. It’s taken me years, but IFS is the reason I can recognize my emotions and tolerate them without drowning in them or avoiding them. It’s gentle, imaginative, and very helpful even for really big, really overwhelming emotions.
That’s a wrap
This is a broad overview of ADHD and Emotions, with a few ideas for regulation. I’ll be doing a deep dive into how to regulate big emotions, the connection with Alexithymia and more coming soon. But for now, I’ll leave you with this:
While we often fear our emotion, worrying if we let ourselves go there it will never release us, that isn’t the case. A healthy relationship with emotions allows them to act like waves. They may grow. They may feel big and overwhelming. They might even knock the breath right out of your chest. But every wave breaks, and so does every emotion. Whether you’re emotionally avoidant/ resistant, or struggling through a flood, remember that it’s just a wave. And it will break. That’s been a helpful reminder to me and I hope it’s a helpful one for you as well.
Leave a Reply