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What is…. Emotional Dysregulation?

I wrote this for my ADHD group, but figured I could start sharing them on here too.

What is …..? Wednesday

Ok, so the plan is that I will write about something ADHD related once a week. I’ll give you the science bit, and then do a more “this is how it actually affects you” explain it like I’m five type bit. (Me not rambling starts at the capitalised bit)

Obviously, as you will all appreciate, ADHD and “Imma do this regularly” don’t always go hand in hand, so we may have “What is...? Whursday” etc. Or miss a week. Whatever. You get the gist. Information will be out there. One day. But I’m still calling it “What is...? Wednesday” because I like alliteration. Oooh, maybe I could go with “What is...? Whenever” if it goes really wrong. Nothing like a bit of negativity to start a new thing.
Anyway.

EMOTIONAL DYSREGULATION

The s̶c̶i̶e̶n̶c̶e̶ History Bit
You see, I had intended to put a bit from the DSM, or maybe the NHS website about ADHD and emotional dysregulation, but you know what? It’s not there. It used to be, a few DSM iterations ago. It was part of the diagnostic criteria for ADHD. But you cannot measure emotions within a lab. You can’t put a number on it. It can’t be objectified. Therefore, it got quietly removed. This means that doctors don’t address it. How many of you who have been diagnosed have had emotional dysregulation covered in your appointments? I suspect very few hands went up then.
So, what is Emotional Dysregulation? Put simply, it is an inability to regulate emotions. Reacting to things in a balanced way.
Fear not though, I DO have a science bit, thanks to the amazing Dr. Russell Barkley (seriously, if you don’t know him, he is THE ADHD dude, and he rocks). Dr Barkley pushed to have “deficient emotional self-regulation” recognised as a core component of ADHD in the DSM-V. It didn’t happen, but a recent study backs up his argument. Two dudes (I use dude for any gender btw) called Graziano and Garcia combined 77 studies on emotional dysregulation, covering 32044 participants, to study the data from it. The looked at three versions of emotional dysregulation:
ERU: The ability to perceive, process and infer one’s own emotions and the emotions of others
ERNL: The intensity and valence of the emotional response. Reactivity refers to the rapidity of the emotional response (like being quick tempered vs thinking things through)
ECUT: The empathy/callous side of things. The extremely empathetic person at one end who identifies and feels everyone’s emotions, and the psychopath who shows no emotions.
It was found that those with ADHD had impairments in all three categories, with a slightly higher amount in ERNL. This emotional dysregulation increases with age, and could be more important in diagnosing Adult ADHD than the current criteria of behavioural hyperactivity which decreases with age.

MMHMMM... YOUWHATNOW?


So, pretty much ADHD means that your emotions are a great big ball of joy to experience. Or not.

Think of emotions as having a number system. 0 is your basic level with not a lot going on. 5 is OMG level (be it happy, sad, rage, rejection – yes, ye olde RSD comes into this too). NT people (neurologically typical) tend to go up the emotions in increments of 1. They fall over the shoe left in the middle of the lounge, and feel mildly pissed off. That’s a level 1 reaction, and what is considered “normal”. Falling over the shoe, hurling it across the room, whilst feeling genuine rage and hatred for whoever left it there. That’s a 5. That’s us.

It’s not all bad though. We do it with joy too. Take bubbles. NT people (adults mainly) see bubbles, and think “Ohh bubbles” and then go on with their day. A standard level 1 joy. I see bubbles and think “I fucking LOVE bubbles” and wander around with a smile on my face for the next ten minutes. Level 5 bubble reaction ftw.
Think back to being a child. Did you cry easily even though it was something that you were told wasn’t worth crying over? Were you a child who “threw tantrums” more than most? Yup, emotions bouncing to a 5.
It’s hard. It is exhausting. It is like having emotions on a bungee. As fast as you go out, you come back to 0 just as quickly, which can be confusing to ourselves, but also the people around us.

I’ve found it best to explain emotional dysregulation to people using the number example. If your loved ones know that you don’t go up in 1s, and that you really ARE feeling this thing this strongly, it is far easier for them to understand you and help you.

For myself, realising it has helped me try to control it better. I still go from 0 to 5 in the blink of an eye, but if I can ask myself “is this actually a 5?” I can control myself more easily.

In terms of ADHD children – again, explain the numbers, you can show them with teddies on stairs maybe. Once they understand the concept, you can then talk to them about their emotions more easily. If they come out of school crying because Sammy hates them, you can ask what happened (they wouldn’t let me borrow their ruler), and then you can ask if they REALLY hate them, or have they taken it as a 5? Crying over losing a pencil – is this a 1 or a 5, bearing in mind we have other pencils? Just that gentle reminder to take a step back can do so much good.

If your partner has PMT, do NOT “helpfully” ask if this is a 1 or a 5. It is a 10. A genuine 10. They WILL kill you.

Embrace the positive emotions, they make up for the negative.

A previous post on Emotional Dysregulation can be found here!

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