The Second Pillar of ADHD: Emotional Hyperarousal

Do you ever feel like you – just, feel more than other people? Has anyone ever described you as…dramatic? Oversensitive? Colorful? Moody? Irritable? Expressive? Were you prone to meltdowns as a kid? Are you perhaps still a little prone to meltdowns?

One fitting description of the ADHD brain is an intersection with no stop signs (the “Intersection Model“). Thoughts and feelings are like cars barreling through streets without yielding to other cars barreling through streets. There isn’t much regulation to prevent collisions, and that giant semitruck racing to the intersection has the automatic right of way if you want to live.

We get how this might look in terms of thoughts; distractibility, blurting out things, impulsivity. But what does this look like with feelings?

The fickle feelings roller coaster of ADHD can look a lot like a mood disorder, and ADHD is often misdiagnosed as depression or bipolar – especially in women. While it is true that 80% of people with ADHD have comorbid psychiatric diagnoses, there are actually pretty significant differences between mood swings as a result of a mood disorder versus ADHD emotional hyperarousal.

Age of Onset. The ADHD brain and its quirks are present from childhood. ADHD is a disorder that arises from a deficiency in the neurotransmitter norepinephrine, which affects several areas of the brain (frontal cortex, limbic system, basal ganglia, reticular activating system – very interesting, we’ll come back to that in a later post). The root cause of our emotional dysregulation is because our “traffic light” (frontal cortex) has trouble intervening when our emotions come zooming into the scene, whereas the root cause of mood disorders involve multiple neurotransmitters, some of which are responsive to sex hormones such as estrogen or testosterone. This is why you will see ADHD emotions starting at a young age: these kids may often respond to a “small problem” with a “big problem” overreaction, they tend to have shorter fuses, or they get their feelings hurt more quickly and deeply than their peers. With mood disorders, the symptoms set in during adolescence when hormones are fluctuating. In summation: ADHD emotional hyperarousal is present from childhood. Mood disorders typically present in adolescence or young adulthood.

Longevity. Feelings of anger, anxiety, or sadness – when associated with a mood disorder such as bipolar, anxiety, or depression – come on gradually and last for at least two weeks, sometimes spanning months. These episodes can be triggered by a life event, but linger long after the event has quieted. During this time, it is very common to experience some of the same executive functioning difficulties that come with ADHD, such as distractibility, trouble motivating, poor memory, or brain fog. However, these symptoms typically correspond with mood symptoms. In addition to that, ADHD moods correspond with external stimuli, which means powerful feelings come and go with changes in the environment. This would look like flares of anger, sadness, or mania/excitement that may dissipate just as quickly as they appeared. People with ADHD, in a positive and stimulating environment, actually have very consistent internal moods. With mood disorders, internal moods may be influenced by, but don’t respond to, the environment. In summation: ADHD emotional hyperarousal comes and goes quickly in response to the environment. Mood disorder episodes come gradually and linger, regardless of environment. 

“But Abby, my ADHD kid literally flips out at nothing. Surely she also has bipolar disorder!” I get this a lot. Yes, bipolar can show up alongside ADHD, which adds an extra layer of complexity. However, ADHD is way more common than bipolar disorder in the general population (11 percent vs. 2.6 percent) and it is even more rare for bipolar to show up in kids. So this usually means that there is a trigger for the meltdown, even if we – including the kid – don’t know what it is. That trigger may be hypersensitivity to sensory stimuli. Or perhaps, that trigger is rejection sensitive dysphoria – which just so happens to be the third pillar of ADHD.

Wow, so many things bookmarked in this chapter just waiting for us to come back and explore!* For now, just rest with the knowledge that those meltdowns will pass, and remind your kids that it is okay to feel every inch of your feelings as long as you can manage your behavior. Then check out these tips for how to deal with meltdowns.

As I’m sure you can tell, the effects of ADHD are varied and complex. I could talk about emotional hyperarousal all day – because it expands our understanding of ADHD beyond just paying attention in class. Some days emotional hyperarousal feels like a curse, something that isolates us and makes us difficult to love. But I like to think of us as mantis shrimp – experiencing a wider and deeper range of color than humans can even dream.

How do you or your ADHD loved one cope with strong emotions? Have you found tips/tricks/medications that help you manage these swings?

Message me | theadhdmanual@gmail.com | Comment below ↓↓

Stay tuned for the third pillar, rejection sensitive dysphoria.

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About Abby Minor, LMFT, ADHD-CCSP

I am a marriage and family therapist based in Seattle, WA. I also have ADHD! And I love learning more about it, by myself and with my clients. Join me as I create an ADHD Owner's Manual! (she/her)