Emotional Regulation and Diagnostic Failures
Emotional regulation issues, including Rejection Sensitive Dysphoria (RSD), are not officially recognized in the DSM as part of ADHD. However, clinical experiences and research consistently show their significance. This omission has major implications:
🟢 Misdiagnosis: Women are often misdiagnosed with borderline personality disorder, bipolar disorder, or anxiety and are improperly medicated.
🟢 Inadequate Treatment: Even when diagnosed with ADHD, emotional regulation challenges are poorly researched, leaving gaps in treatment strategies.
We need more targeted research and strategies to address emotional regulation and RSD in ADHD women. Without this, emotional dysregulation remains an under-recognized and under-treated aspect of ADHD.
The Goal of Emotional Regulation
The main goal of this group is to help you increase your self-confidence and self-trust.
- By learning to decode and master your feelings, you can trust your ability to understand and care for yourself.
- Emotional regulation becomes challenging when emotions overwhelm you, activating stress responses like fight, flight, freeze, or fawn.
For ADHD women, these stress responses often lead to coping behaviors such as perfectionism, pleasing others, or shutting down, which compromise executive functioning.
Why Emotional Regulation Is Hard for ADHD Brains
- Postponing Daunting Tasks: Procrastination and time blindness can amplify stress, making emotional regulation harder.
- Alexithymia and Interoceptive Awareness:
- Many ADHD women struggle to identify emotions or bodily signals like hunger, thirst, or stress.
- Impaired interoception can trigger automatic responses like freezing, fleeing, or fighting, complicating communication and basic self-care.
If these challenges resonate with you, our exercises will help you build awareness and strengthen your ability to interpret emotional and physical signals.
Emotional Regulation Challenges
Focus on the Negative
- ADHD brains often notice negative aspects of situations before positive ones, amplifying emotional distress.
- In our session on "Taking in the Good," we will explore practices like awe, gratitude, and savoring to shift focus toward positivity.
Filtering and Ruminating
- Neurotypical brains filter negative experiences like a bouncer at a club, while ADHD brains are like outdoor parties where everything gets in.
- ADHD women often get stuck ruminating, unable to let go of difficult emotions or thoughts.
Struggles with Cognitive Control
- ADHD women may struggle to "right-size" their emotions once they start.
- It's helpful to address emotions proactively rather than waiting for them to escalate, as they can be hard to manage once triggered.
Default Mode Network (DMN)
- The DMN, a brain network active during rest or wandering thoughts, often remains "on" in ADHD brains.
- This can lead to rumination, worry, and obsessive thinking, particularly about perceived mistakes or anxieties.
Emotional Sensitivity in ADHD Women
Women with ADHD face unique emotional regulation challenges, including:
🔵 Intense Emotional Responses: Strong emotions influenced by past experiences, cultural teachings, or beliefs about oneself.
🟢 Difficulty Regulating Emotions: Once triggered, emotions can feel overwhelming and hard to calm.
🔴 Threat Differentiation: ADHD women may struggle to distinguish between major and minor threats, leading to strong reactions.
🟠 Impulse to Act on Emotions: Emotional impulsivity can lead to regret.
🟣 Preoccupation with Emotions: Intense emotions can make it hard to focus, causing further distress.
🔵 Trauma and Triggers: Past trauma can intensify emotional responses and make regulation even harder.
Stress as Danger
ADHD women often experience ordinary stressors—such as criticism, sensory overload, or unmanageable routines—as threats to survival.
- When stress activates the sympathetic nervous system, the brain shifts into survival mode, making logical thinking difficult.
- Coping mechanisms like hiding, silencing, or perfectionism may take over without conscious awareness.
Developing Emotional Regulation Skills
Our group will focus on regular practices to enhance emotional regulation:
- Self-compassion
- Self-care
- Self-awareness
- Self-accommodation
- Self-advocacy
By incorporating these skills, you'll strengthen your ability to navigate emotional challenges.
Unlearning False Beliefs About Emotions
Emotional regulation starts with challenging harmful beliefs about emotions, such as:
✔️ Emotions are irrational or untrustworthy.
✔️ Strong emotions mean you're out of control.
✔️ Positive emotions are always good; negative emotions should be avoided.
✔️ Feeling emotions means something is wrong with you.
Replace these with new beliefs:
☑️ Emotions aren't good or bad—they're information.
☑️ Emotions are temporary and don't define your worth.
☑️ Befriending your emotions can help them pass more quickly.
☑️ Understanding emotions helps guide decisions and build self-trust.
Self-Care and Emotional Regulation
Self-care involves intentional actions to care for your physical, emotional, mental, and spiritual well-being. For ADHD women, self-care is essential to:
- Prevent burnout.
- Navigate a neurotypical world more effectively.
- Support emotional regulation by addressing basic needs like rest, nourishment, and hydration.
Self-Compassion
Self-compassion means treating yourself with kindness and understanding during emotional difficulties.
- Instead of reacting with criticism, respond with support.
- This reduces emotional dysregulation and builds resilience.
Self-Advocacy
Self-advocacy involves recognizing and asserting your needs, boundaries, and rights. It helps prevent emotional overload by:
- Asking for what you need.
- Setting boundaries to protect your energy.
- Communicating effectively with others.
Self-Accommodation
Self-accommodation means adjusting your environment or expectations to meet your needs.
- ADHD women are often taught to endure stress to please others.
- Self-accommodation involves breaking this pattern by creating conditions that support your well-being.
Examples of Self-Accommodation:
🔵 Avoiding stressful situations or relationships.
🟢 Creating safe sensory environments.
🔴 Setting boundaries.
🟠 Adjusting personal expectations.
Reflection and Group Exercises
Reflection Questions:
- What false beliefs about emotions were taught to you?
- How have these beliefs impacted your emotional regulation?
Group Activity: Assertiveness
Review the Assertive Bill of Rights, which highlights your right to:
- Express feelings and opinions.
- Say "no" without guilt.
- Set priorities and make mistakes.
Reflection:
- How do these rights resonate with you?
- If you were deprived of these rights, how has it affected your emotional regulation?