Understanding the Connection Between Emotion Regulation and ADHD

By Dr. Mary Rooney, Ph.D.

ADHD is defined by problems with attention, impulsivity, and hyperactivity, but for many children and teens with ADHD, difficulty regulating and appropriately expressing intense emotions are equally important and challenging problems. Parents and teachers of children with ADHD know that it doesn’t take much to trigger big emotional reactions and have seen firsthand the ways that these reactions can cause problems with their child’s friendships, strain family relationships, and interfere with their child’s ability to focus on schoolwork or homework. However, because difficulties with emotion regulation are rarely talked about as a symptom of ADHD, it can be hard for parents and teachers to know whether these difficulties are related to their child’s ADHD or caused by something else.   

Where Does Emotion Regulation Fit Within the Context of ADHD? 

Why do difficulties with emotions show up alongside problems with attention, hyperactivity, and impulsivity? Dr. Russel Barkley, an internationally recognized ADHD expert, describes two categories of emotion regulation challenges associated with ADHD: problems with emotional impulsiveness and problems with emotion self-regulation.  

  • Emotional impulsiveness refers to low frustration tolerance, being easily excitable or emotionally aroused, and a quickness to anger.  
  • Deficient emotion self-regulation refers to difficulty keeping strong emotions contained so they’re not expressed at inappropriate times and difficulty using self-calming activities.  

The emphasis on emotional impulsivity and poor emotional self-regulation in Dr. Barkley’s model parallels the impulsivity and self-regulation difficulties with we see in children with ADHD in areas related to regulating attention, impulsive behavior, and hyperactivity. In fact, it’s been suggested that ADHD may be a disorder that is best characterized by difficulties with self-regulation. Brain imaging studies support this and have confirmed that the brain structures and networks associated with “classic” ADHD symptoms are also associated with the expression and regulation of emotions. So, it’s not surprising that difficulties with emotion regulation would be an added challenge for children with ADHD. 

How Does Poor Emotion Regulation Impact Academic Performance? 

Problems with attention and impulsivity interfere with a child’s ability to complete their homework and schoolwork successfully, and poor emotion regulation adds another layer of difficulty. Children with ADHD who struggle with emotion regulation become frustrated more quickly when working on assignments that they perceive as being too difficult or too boring. They are easily distracted by their emotions and have a harder time keeping their minds focused on the tasks at hand. This is especially true when they are feeling down or irritable or are preoccupied by thoughts related to an emotionally charged situation that occurred earlier in the day. In addition, their ability to use self-calming strategies effectively in these situations is also compromised, making it harder for them to “reset” their emotions and redirect their attention to their schoolwork or homework. 

How Can Parents and Teachers Help? 

 
When it comes to helping a child with ADHD improve their emotion regulation, particularly when they are completing assignments at school or at home, it’s best to start with a single calming/cool-down strategy. You can prompt the child to use this before they start their work and when they begin showing signs of frustration or emotion dysregulation while they’re working. Any strategy that is brief and simple (i.e., it doesn’t require special equipment and can be done anywhere) and is one the child is open to using can be effective. Practice the technique with the child at a time when they are calm and let them know that you’ll be helping them use this cool-down strategy when they are having a hard time staying calm.  

At first, children with ADHD will need quite a bit of coaching from a parent or teacher to use the strategy, but over time, they can start using it on their own. Pairing the coaching with praise for using the cool-down strategy will help motivate children with ADHD to use these strategies and will make it more likely that they’ll start using them independently—even when a parent or teacher isn’t there to coach them.  

For children with ADHD who have more significant problems with emotion regulation and have multiple outbursts or meltdowns each week, additional interventions may be needed. Evidence-based treatments for ADHD—like behavioral parent training for children and cognitive behavioral therapy for adolescents—can also improve emotion regulation when this is a clearly identified goal in therapy.   

Mindfulness interventions can also be helpful when they are used consistently over an extended period. In addition, ADHD medication can be very helpful in reducing the more impulsive aspects of emotion dysregulation and can reduce emotional outburst in children with ADHD. So, if you are the parent of a child with ADHD who struggles with emotion regulation, talk to your child’s providers about these challenges and treatment options.


 

ABOUT DR. MARY ROONEY

Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.

ABOUT HUNTINGTON

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