Emotional Regulation, Executive Function and ADHD #72
Do your feelings go from 0-100 in no time flat?
I can not explain what ADHD is without discussing Executive Function, because executive functioning is the CEO of our brain. Our Emotional Regulation discussion includes sensory overload, fear, fight or flight, frustration, children pushing our buttons, anger, embarrassment, period cycles, hormones, Premenstrual Dysphoric Disorder, Bipolar, and Rejection Sensitivity Dysphoria. Holy Moly, Batman! Let's learn about our ADHD brains.
Mentions:
Episode 37 on Letting Go of Thoughts
Dr. Sandra Kooij’s Women, ADHD, and Hormones webinar with ADHD Europe
Dr. David Goodman’s article on Emotional Regulation
What happens when brains feel fear?
What is Emotional Lability?
Defining Sensory Processing Disorders
Free resource from Patricia: Managing ADHD Beyond Medicine
The Disorganized Mom’s Guide to a Peaceful Morning: Patricia’s free how-to video series to bring calm to your mornings in 5 steps
Patricia Sung 00:00
Do you lash out like a wounded beast more often than you'd like? Are you an expert and fiercely bottling in your feelings so that no one can tell the difference between your insides being totally fine and volcano eruption status? Do your feelings go from zero to 100 in a blink of an eye, and then back again, just a short time later. These are all part of your executive function, specifically emotional regulation. I left all of the regulation parts of executive function to the end of the series because they are disease get ready to learn about your brain. Welcome to motherhood in ADHD, I'm your friend Patricia. My mission is to be a lighthouse for mothers with ADHD helping you find your path to success by learning to appreciate your ADHD as an asset I'm seeking to change the paradigm that ADHD means your life is doomed to be a hot mess. So I'm sharing strategies and encouraging you in your pursuit of happiness to love who you are every day of your ADHD
Patricia Sung 01:18
Hey there successful mama, it's your friend Patricia Sung. Have you ever asked yourself what's wrong with me? Why can't I get my act together? Why am I constantly stressed? Why does it always feel like something's going wrong? We are at the tail end of our executive function series. And executive function is the CEO of your brain. It runs everything. And I really can't explain ADHD. If I don't mention executive functioning. If you're not familiar with it, you can go back and listen to the first episode of the series which is number 53. For an overview, and as we wrap up, we're talking about all the types of regulation.
Patricia Sung 01:50
Well, this week is emotional regulation. emotional regulation includes temper control problems, affective lability, and emotional over reactivity. No, I was like, well, let's lability so I had to look it up. emotional lability is a sign or symptom typified by exaggerated changes in mood or effect in quick succession. Sometimes the emotions expressed outwardly are very different from how the person feels on the inside these strong emotions can be disproportionate response to something that happened, but other times there might be no trigger at all. The person experiencing emotional lability usually feels like they do not have control over their emotions.
Patricia Sung 02:27
For example, someone might cry uncontrollably in response to any strong emotion even if they don't feel sad or unhappy. It can also be an associated feature of ADHD. Children who display a high degree of emotional ability generally have a low frustration tolerance and frequent crying spells or tantrums. During preschool adhd with emotional lability is associated with increased impairment and may be a sign of internalizing problems or multiple comorbid disorders, y'all can I just tell you that on my kindergarten report card, it said Trisha cries a lot red flag, y'all now they thought that I was a crier, because I was not emotionally mature enough to be in kindergarten, I'm actually quite young for the grade level that I was in. But I was smart. So they didn't want to hold me back. Well, don't you know, when you have ADHD, you tend to be behind when you talk about like a maturity level. So not only was I significantly younger than everyone in the grade, I also was less mature emotionally speaking, then even kids my own age who are in the grade below III now want to go back a little bit earlier in that definition, where it says sometimes the emotions expressed outwardly are very different from how the person feels on the inside.
Patricia Sung 03:35
Sometimes when I'm feeling a really strong emotional response. And it's probably around bedtime, that's usually when it gets the worst, when my meds are starting to wear off. And the way that I react to the situation. It's almost like an out of body experience. Like I can see myself being really upset about the situation like my three year old, taking 400 years to brush his teeth. When, if this was happening at 9am, I would just be like, yep, ps3, and coax him along with what we need to get done. But when my emotions are dysregulated, towards the end of the day, I'm getting so frustrated that he's not doing what I want him to do. And I can see almost like stepping back and watching this crazy level of frustration over something that wouldn't necessarily bother me and another time in the day, and I love the example where it says someone might cry uncontrollably, even if they're not sad, like for me, like when I get nervous, I laugh uncontrollably. So if something terrible is happening, I'm probably laughing and it's really awkward. It's always at a very bad time. But to sum it up, we get angry easier, we get frustrated easier, our emotions ramp up quickly, and our outward response doesn't necessarily match the inside feelings or the level of the problem.
Patricia Sung 04:47
Now as a side note, emotions are not included in the current DSM, which is the list of diagnostic criteria that doctors use to diagnose ADHD. Why? Because you can't measure emotion. There's no like, oh, that person's had a level three emotion. But if they would have hit a level five, that would have been ADHD, well, no, you can't just stick a number on something, my level five is going to be different than your level five and is different to the next person's level five, and also who's to say what a level five is. This is why a clinical interview is so important in the diagnosis process to go through the history and see these emotional patterns because you can't measure emotions. In an article by David W. Goodman and he says emotional dysregulation can be defined by excessive expression and experience of emotions with rapid and poorly controlled shift and emotions and abnormal allocation of attention to emotional stimuli. Is this a dysfunction with the accelerator in parentheses, the rapidity of emotional intensity, or the lack of breaks, which in parentheses is leading to impulsive expression feels like it's one of those like chicken in the egg things. science hasn't figured out what's causing it, but we're clearly having a problem.
Patricia Sung 05:58
When I looked at Dr. Brown's two themes, he discusses a low tolerance for frustration and a chronic difficulty in regulating subjective emotional experience and expression. Now, keep in mind, all these resources that I am citing, they are going to be on my website, so you can go look them up and read these articles and do some investigating yourself at patriciasung.com/podcast. If it's too much for you, you don't need to go read those. But if you're somebody who loves to dig into the nitty gritty, I want you to have those resources. Because I work really hard to find quality science specific information for you that it's not just random jibber jabber on the internet. I mean, I could just random jibber jabber for myself if I wanted. I want you to have good information so that you're learning quality, quality science about your brain.
Patricia Sung 06:44
Now, separately, I was reading this article in the Smithsonian Magazine, which talks about fear. And it says fear reaction starts in the brain and spreads through the body to make adjustments for the best defense or flight reaction. The fear response starts in the region of the brain called the amygdala. Sound familiar? It goes on to say this almond shaped set of nuclei in the temporal lobe of the brain is dedicated to detecting the emotional salience of stimuli how much something stands out to us. For example, the amygdala activates whenever we see a human face with an emotion. This reaction is more pronounced with anger and fear.
Patricia Sung 07:22
A threat stimulus such as the sight of a predator triggers a fear response in the amygdala, which activates areas involved in preparation for motor functions involved in fight or flight. It also triggers release of stress hormones in the sympathetic nervous system. Now, isn't it interesting that fear starts in the amygdala, which is one of the areas of the brain that is affected by ADHD, we spend a lot of time in that fight or flight response because our body has all this extra stimuli. And we're constantly processing extra information and like ready to go, which I think back in the day when we were not farmers, but hunter gatherers was probably a really great skill, but not so helpful when you're in a test job. Even though there isn't a ton of knowledge or research in terms of scientific studies, which require a significant amount of protocols to be considered official scientific research.
Patricia Sung 08:20
We those with ADHD can clearly tell you that emotional dysregulation is a big problem. How do we see this show up in our lives as an adult with ADHD, often that low level irritation should equal a low level frustration. But for us, it doesn't. We hit that medium and high frustration level. At small things, we can hit a high frustration level it just about any irritation, there's an overwhelming intensity of feelings, we lose sight of the other priorities like the other people's feelings around us or the consequences of our actions.
Patricia Sung 08:55
Dr. Brown calls it a computer virus that takes up all of our mental capacity that we can't think about anything else except that particular stimuli. And I think part of it sidenote, just my opinion, is that because we're processing so much information all the time, everything's kind of this like overload of information with the constant barrage of incoming messages, that our body has trouble filtering out what's really a problem and what's not. And that's where the messages get mixed up. Because our brain is just so busy processing way more messages than it needs to that there's constantly going to be a flare up of like, Oh, what about that? That's great. What about that? Oh, and so our brain never has a chance to calm down and say, Hey, we don't have to worry about that. It's not a problem. We can filter that out before we get upset. So just kind of my like side processing of, you know, patterns I've seen in what I've been researching.
Patricia Sung 09:49
Okay, back on topic. The other ways that we can see this show up as an adult, our feelings go from zero to 10 right away, and then back again, we have a lot of anger. So, road rage or yelling at our kids being super frustrated when they're probably is a quote unquote simple solution. Many of us have rejection sensitivity, dysphoria or RSD, which means we overanalyze how other people feel and disproportionately feel like we caused it or we did something wrong. And then we send ourselves into this, like anxious spiral, analyzing what happened, or what was said, we hit that sensory overload quite often, all the noises, the textures, the light, we may not necessarily have a sensory processing disorder that's different, but definitely sensory overload. And just as a side note, in case you're not familiar with sensory processing disorders, that's referring to the way your nervous system receives messages from the senses, and then turns them into a response.
Patricia Sung 10:49
So if you have a sensory processing disorder, the information goes into your brain, but it doesn't get organized into the appropriate response. So if you have SPD, you don't have any issue, detecting the information, it gets mixed up in your brain, and then your response doesn't match. So but keep in mind that this is also one of ADHD comorbid friends, and it is common for people with ADHD to have both ADHD and a sensory processing disorder. So even though the signals might not get mixed up in our head, there might just be too many signals that would be sensory overload. So eye contact can feel overwhelming, we can feel hyper empathetic to someone telling us a story of what happened, we feel the emotions like the person who was there, it could be books or movies. Over the years, I've had to filter out a lot of things that are good for me to do. Like I used to love horror movies. But now I realized that they're just not good for my system, the level of stress that I feel in that movie. And the nightmares I'm going to have later it's not worth the entertainment factor at the time, I've had to let those go, which is sad. I really did like horror movies. But I realized that they're just not that good for me.
Patricia Sung 12:02
Another part of this is that we often don't experience joy to the same level as neurotypical people. We downplay our achievements. And we don't feel the same satisfaction after we achieve a goal. So we work really hard to get something we achieve. And it's like, Oh, yep, well did that. What's next, because where we get that dopamine hit is in the process of chasing the goal. And getting there actually getting the goal doesn't really give us much of a dopamine release.
Patricia Sung 12:33
Another area where emotional dysregulation really shows up is in women and their cycle. I can remember a time early in our marriage where I had to send my husband calendar invites that said, don't mess with Patricia, about three or four days before my period started. Because my husband would pick out a fight more than it needed to be, you know, we were newlyweds and everything felt like it should be a battle. We've learned a lot since then. We've been married for 10 years, but that way he knew like, if you have a big problem, this is not the time to bring this up a few days before my parent, you need to hold on to that too later, or you talk about it beforehand. But don't bring it up. In the danger week, you're just gonna get a very illogical Patricia, who yells a lot of angry things and is not based in anything real or logic. I do a lot of general blaming statements like you always do this, and you never do this. And that's not true. He didn't always do that, or never do this or whatever, like, but emotionally dysregulated Patricia was not logical in I mean anything but especially in fights.
Patricia Sung 13:37
Now, I watched a really great webinar last night about hormones and women with ADHD by Dr. Sandra Kui, and I'm going to link that in the show notes. I mentioned it last week. But there is a definitive correlation between women's cycles and the hormone levels and ADHD. I won't get all into what I talked about last week, because then, you know, that's going to be another long episode. But we do need to be aware of that as our hormones change. Estrogen is tied to our dopamine. And as our estrogen is lowering right before our cycles, and during our cycle, our ADHD symptoms are going to appear more of a nuisance, just a bigger problem overall.
Patricia Sung 14:16
One thing that I really hadn't heard much about at all is premenstrual dysphoric disorder, which a lot of ADHD women deal with in Dr. Kouichi. Presentation she said three to 8% of women have PMDD. And it is almost 10 fold that in women with ADHD that's a huge part of our population. This is where women who read before their cycles, their mood swings are out of control, their rage, crying, extremely sensitive to rejections, interpreting things the wrong way, snapping, yelling, anxious, really low motivation, wanting to control everything because it's so much easier. How to control their time pulling what they can feeling lethargic or fighting with people all the time. It's like PMS on steroids. But what a lot of women don't want to share, because it's scary is that a lot of these women also have suicidal thoughts, and safety concerns. In this time, my heart breaks for how many of you are struggling with this and are too afraid to say something because it makes you sound like an awful mother, I so want to encourage you in this moment to say that you are a wonderful mother. And this is something that is not in your control. This is not you, this is not who you are, this is not your value. I want you to hear that loud and clear. And I want you to know that you are beautiful and loved, even when your emotions are out of control. That there is help out there that you're not the only one who deals with this. And you can have a plan to mitigate this. Because if you know it's coming, you can make a plan. I love Dr. Kui saying of when you're aware, you can prepare an awesome lady named emerald shared her PMDD plan with me so that I could share it with you all. And she runs through the warning signs, which are the ones I just read to you. Those are her words, she talks about her internal coping of what she can do to deal when she's feeling overwhelmed with all of this.
Patricia Sung 16:24
So like taking a break, laying down and snuggling with a stuffed animal or a pet praying just cried out exercise, take a shower journal pain, what is it that's going to bring you in are calm in that time, then she's got distractions she could do to, you know, get her mind off of it of running errands or phoning a friend asking her family for a hug. She also included who she can contact when she's struggling. So family and friends that she can reach out to and you know, make a phone call and say, Hey, I'm having a bad day. Can you support me right now she has written down her professional contacts, so her doctors or therapists support group leaders that she can talk to, and then how she can reduce safety concerns. So sharp objects need to be out of reach any medicines, give them to someone else don't drive in your car. And then she has written down the time period before her period where she knows these things start appearing in making a note of okay, I need to be watching my, you know, tracker on my phone of when it's coming. And then using medicine to lessen symptoms, and what can she do to naturally boost her energy and mood, because she has a plan. And she's written it out like on her calendar she has written like, these are the danger days of things are gonna go awry. And here's where my cycle starts. Because she has a plan in place, how much more likely is it that she is going to be successful in mitigating the struggles during this time, we're not going to make them disappear. But when you know it's coming, you can figure out what works for you and have that plan ready so that when you start to struggle, you're not in panic mode it's in.
Patricia Sung 18:05
Okay, let me get out my plan and see which of these ideas Sounds good right now, because I gotta pick one. So this emotional dysregulation is so common for us women, and other people are going to interpret this in some rough ways of us being angry or sad or crazy or weird or too sensitive or too picky. All of the negative reputations that women have, like they're all in here on this one. And it is crazy, the number of women who are diagnosed with things like bipolar or depression and anxiety before the ADHD is recognized, they may have those things as well. But a lot of times that bipolar is coming out because of that shift in the hormones and around your cycle, not because you actually have bipolar disorder. So be aware that that's a very common misconception is they're looking for like okay, what's making this person fly all over the place in terms of their emotions, that's a much easier obvious diagnosis than the ADHD which is definitely not studied as much as a lot of other mental health issues.
Patricia Sung 19:06
So let's turn this around to a positive note. We are kind and helpful and empathetic humans we feel for other people and we understand people well and when we're truly connected in we can make such a great difference in the world around us in helping others this is a gift that we have and that we can use to make the world a better place not just on a grand scale but with the people in our lives the people that we love the people that are close to us in reaching out and being willing to say hey, I struggled to I'm here for you. That is a gift that we have that we can use for so much good.
Patricia Sung 19:47
Hey there, Mama is your morning defined by chaos or by calm? Are you hunting down lost shoes and keys and permission slips all before the sun has even come up? Are you Are you flying out the door running to the car arms full of stuff that never made it into your bag? Are you still wearing pajamas at lunchtime more days than not? No matter what stage you are in your motherhood, whether it's frenzied exiting with older kids or flopping around the house with littles, I have to ask, does your morning look like what you want it to look like? I know that you want your morning to be more together, you want less nagging, less yelling, you want less frumpy, lumpy and productiveness. You want to feel confident and how you start your day. And do you want your children to have that competence to so I am so excited. I'm finally finished writing the disorganized moms guide to a peaceful morning. It's here. I put this together just for you. It's down and dirty basics to get you on your way to a better morning and fast. It's five quick videos straight to the point of cutting chaos. Each video is delivered to your inbox with one action step because I want this to be doable. today. I'll be right there with you to remind you to do your baby step in case you forget and get off track. And it's totally free because I want you to take the next step in the right direction. Now I want you in the motherhood and ADHD Facebook group, you can share what's working for you and ask questions of the other mamas to brainstorm ideas if you get stuck. So hit pause right now and sign up for the video series. The disorganized moms guide to a peaceful morning. It's on my website Patricia sung.com. Forward slash peaceful hyphen morning and a link arms with like minded mamas I am so excited to see how your mornings move to a happier mama and a happier family.
Patricia Sung 21:48
So what is my connection with emotional dysregulation? Well, I told you quite a bit already. But since really overload is definitely a struggle for me, especially with my kids, the noise level, when you have small kids is just overwhelming, especially when they were younger, it's a little bit better now. But when they were younger, this being touched all the time. I'm like, please, nobody else touched me, please just leave me alone, it's too much. This can take a big toll on our relationships, when other people can feel like they are the cause of our discomfort. Whether or not we mean it that way or not, they can definitely take a toll on others when they feel like they're the cause of our struggle. We don't have to say it out loud, people can feel that I feel awful when I get abruptly angry with my kids over something that's you know, seems little, and it just kind of comes out of nowhere. And I have learned to take time for myself when I need that extra space to let the sensory overload come down. And I'm okay telling my kids I need a second I'm I'm very frustrated. And I am not frustrated with you. But I need some space for a couple of minutes and get them situated safely for a few minutes. So I can take a couple minutes and take some space for myself. And as a mom, obviously we're dealing with our own kids, and an escalated adult cannot de escalate an escalated child.
Patricia Sung 23:12
So when your kids are struggling, which let's be honest, it's way more likely that our kids have ADHD if we do when we're trying to help them. And then we're getting upset too. How can an upset person make someone else calm? It just doesn't happen. So we have quite the task on our hands to feel to rein in our emotions so that we can help rein in theirs. Now whether or not you take medicine is your choice. But that is something that I've seen a huge difference above all the other things and I mean, it's great to be productive, what have you. But to me, the most important difference in my life is that emotional regulation that I get when I'm taking medicine, it is so much better when I'm on medicine, especially that like witching hour before bedtime, where life is rough. When I'm on the wrong medicine, that time is worse when I'm not on medicine. That time is worse when I'm on the right medicine that really helps that bedtime hour go far more smoothly, because I'm more in control and can take a step back and look at things objectively and be like, okay, he's just being a toddler. I'm not going to take it personally. And I can pause and take that breath before I react. But if you are not on medicine, Fear not. I do have a whole list of resources on my website. And one of them is a non medicine idea list of what you can do to treat your ADHD if you're not wanting to focus on medicine, because medicine is just one item in our toolkit. It's not the end all be all. It's not a magic fairy wand. So whether you're taking medicine or not, you should be implementing all of these other skills, strategies, etc, into your life that you can because every time you implement something that's better for you, you're doing better in the long run. So you can go to the website and grab that download patriciasung.com/resources. They're all there.
Patricia Sung 25:02
So what are my hacks for this? Well, as I've said, in every one of these executive functioning episodes is awareness. Just knowing where you struggle, where this is repetitively hard for you, you will grow in awareness of it, and you can make a plan for those times that are hard, we also have to take care of ourselves to lower our load. If we keep overloading frequently, then we're going to be triggered more frequently. So we have to know how we can lower our frustration meter. In order to keep it down. You have to know your triggers, and then create your plan for when you feel overloaded. When you feel overwhelmed when things are feeling out of control, what are you going to do that list that I gave you from Emerald is a great starting place of where you can start to brainstorm what would make sense for you.
Patricia Sung 25:49
I love CBT, which is cognitive behavioral therapy, I have made huge strides in my anger process, like slowing that down and understanding what to do when I feel angry, but also being able to voice my opinion earlier, so that I don't get as angry because I'm frustrated later. So like, it's the combination of like, I'm getting angry, how do I slow that down, but also doing things differently at the beginning, so they don't get as angry. Another part that's really helpful is just treating your ADHD as a whole, when you have it more under control, it allows you to work on the other parts of the problem, especially emotional dysregulation. It's hard to monitor your emotions, if you're too tired, or too sleepy, or overloaded, or all the other things that go on, if you're not treating the other issues that you have, if you're not treating your depression, if you're not treating your anxiety, you're not treating your OCD, you're not treating your learning disabilities, all of those things are adding fuel to the fire. So the more that you can work on the different pieces, the more overall it gets better. So it's again, like it's frustrating. It's like the chicken or the egg. It's like, well, if you know, I wasn't so frustrated, I couldn't make this better. But if I made this better, I wouldn't be so frustrated, I get it. But know that every little bit that you're making progress on is making the end result better. So don't discount the work that you're doing. It is making a difference.
Patricia Sung 27:17
Another habit that I've gotten into is accurately labeling my feelings like getting to the root of something, sometimes we've we're not even quite sure why we're mad or mad. So we can dig down to what the actual problem is and get to the root. That's how we're going to solve the problem. Solving the symptoms isn't going to solve the actual problem. We're just being dating. So when you're really frustrated with your kids data, like why am I frustrated? They're not listening to me. Why are they not listening to me? They're too tired. Okay, well, what can I do about that? Like, do I need to start bedtime earlier? Can I like prep some stuff earlier in the day, so that bedtime goes faster? Like there's things you can do to lessen the problems when you have a plan to work ahead. But getting to that root of I'm so angry. Why? Because I'm frustrated. Why? Because I'm feeling disrespected by my kids.
Patricia Sung 28:05
Okay, well, now here we need to work on the respect issue, not the anger issue. I mean, we do need to work on the anger issue. Let me not mince words here. But if we deal with the respect issue, that's going to create less frustration and less anger down the road. So just keep asking yourself like, Well, why do I feel that way? Well, why do I feel that way and get down to that root issue. And as ADHD women, there's a pretty good chance that we have spent a really long time ignoring and doubting our own feelings. Because we've been told our whole lives we're too much too emotional, too sensitive. And we have to unlearn that doubt that we have in ourselves, of truly listening to what we feel, knowing that our feelings are valid and true. And trusting that what we feel inside is right, especially if you've had trauma as a child, you learn to doubt your feelings and you were trained to ignore them and that you are wrong, that you don't feel that way. That person harmed you in so many ways. And I am so sorry. And I wish I could give you the biggest hug ever. But we have to unlearn that we have to unlearn all of that awfulness that's been there in the past that taught us that we don't know what we feel, and that we are incorrect. So that is going to take time, and probably professional help to get through that. And you deserve that. And you are valuable, and you are worth the time, energy and effort that goes into therapy in order to know who you truly are and trust your feelings and do what's best for you.
Patricia Sung 29:39
So sweet mama, we have one more regulation to cover which is self regulation. And then we'll be finished with our executive function series, which I'm kind of sad. This has been, I would say half fun and half hard, but I've loved learning about the nuances that are in our brains because knowledge is power. And the more that we know about who we are and how our brain works, that allows us to focus on our strengths and use them for our good and a bumper pad the weaknesses that we have. And when we understand who we are, we can feel confident in running our lives with purpose. We're not trying to change who we are. We're trying to find ways to make life fit us, not the other way around. So you have an amazing week and I will talk to you next week for our last installment of executive functioning. Thank you for listening to motherhood and ADHD. For more resources, head over to our website. www.motherhoodinadhd.com