Emotional Dysregulation & ADHD

In this video, I further unpack the concept of emotional self-regulation and the problems those with ADHD have in regulating emotions. This is an extension of my earlier videos on this channel on this topic. People with ADHD are more prone to expressing their emotional reactions to provocative events and to have stronger such expressions (what I call emotional incontinence) that they then find difficult to regain control over through self-regulation. By viewing emotion through the framework of Gross and others as a five step process, one can see that there are 5 vectors or means by which one could intervene to help treat emotional dysregulation. The earlier in this sequence you intervene, the more likely it is to succeed at managing emotion. I hope you find this video to be informative.
You can find more information on this topic in my books, Taking Charge of ADHD: The Complete Authoritative Guide for Parents, and Taking Charge of Adult ADHD.

[@deechonada]

I can't ignore how i feel, and ironically I'm on this video as an attempt to calm myself. I am highly irritated right now at my work place and i cant explain exactly why, but i just cant be in that room right now. I appreciate this video essay. I find the only thing that quells my bouts of high emotion is learning about why i have them I think as a black man, I've had my own experiences of making myself more docile in environments anyway, so i find myself able to outwardly manage my frustration (or at least i think so), but it doesn't mean I'm not mad. If im irritated, i simply cannot be where the thing irritated me until i calm down

[@EdwardThomasLee]

One of the main issues with my emotional dysregulation. You can't tell what is real or not. What is the right decision/action and what is just impulse. Then you don't want to do anything because you can't tell what is right.

[@awonugatemilorun]

Apt! There have been moments when i ask myself... or am i just crazy? This is too much, is it even normal? 😔

[@charliegreyfriars3691]

You've had, and continue to have, such a positive effect on my life. Diagnosed with combined ADHD in my 50s, and your books and videos have really helped me understand myself. My emotions and behaviour are much more manageable with Elvanse. You're a lifesaver in the truest sense. Thank you. ✌️

[@russellbarkleyphd2023]

Thank you!

[@alanberkeley7282]

@@russellbarkleyphd2023 ADHD is no gift and it is irresponsible of people to say it is. Would you agree?

[@Christina_Yeo]

Very helpful for someone like me, struggling with emotion control. I appreciate your videos. Many thanks from South Korea

[@PeterPepper93]

Diagnosed a year ago, 35 years old. A lot of the things that i go through emotionally were a lot easier to handle once i understood that my adhd brain was highjacking the control room. I started doing exercise 6 days a week, one full your of sweat and suffering like you said, being tired is a great way to stop pating attention to what is not essential. Blessings

[@Chizuru94]

4:10 - It is? I was rarely or ever able to do that. It's so crazy to me how people can have such control of their emotions or them not going haywire or linger for hours and not go away or them being able to say Stop and take a step back or think before they speak or evaluate if it's rational what they feel and why :( All these and functional executive functions seem like utter superpowers to me.

[@rdklkje13]

.b = very effective way to regulate even strong emotional responses. “Stop. Breathe.” It takes practice, i.e. will only work when needed if you’ve made it a habit beforehand. E.g. every time you stop to cross a road, add “.b”. Every time you walk into your kitchen, open your fridge, drink any liquid, whatever. You can link “.b” to any frequent action in order to give you enough pracice and make it a habit, although it’s easier to remember if that action already involves a Stop (like crossing a road). After a while of this kind of practice it becomes a habit, which you can then transfer to emotional responses. It’s best to start with milder ones just to experiment and eventually you’ll find yourself able to apply .b also to regulate stronger emotional responses. And it’s important to breathe properly, as oxygen to the amygdala makes a physiological difference that matters. I know this sounds like an awfully not-now trajectory, but if you just focus on remembering to Stop and Breathe every time you take the action you’ve linked this to for habit forming, you’ll get there. No need to always think about the long term purpose for this to work. You can even gamify the habit forming practice if necessary.

[@Kayteeoxox]

This sounds a lot like a mindfulness practice I’ve learned which is responsive breathing space as a way to help gain better control over the emotions we are feeling and our reactivity to them. It really makes sense to use this in line with ADHD and something I will try to help my daughter learn!

[@rdklkje13]

@@Kayteeoxox It is actually a UK Mindfulness in Schools Project! If you google “.b mindfulness website” you’ll find more information about their programmes for different age groups. The .breathe curriculum is for kids aged 9-14. But the basic technique as described above in its simplest form can work also for people, kids as well as adults, who haven’t done the full programme. Which is helpful since this programme and others like it aren’t available to most people. For adults interested in a full 8-week MBSR course who cannot access an in-person course for whichever reason, I really recommend Palouse Mindfulness. They offer the complete course for absolute free online - no ads or collection of personal data, it’s simply a public service offering (available in five different languages at this point). But it’s obviously much more difficult for people with ADHD to stick with a whole long course like this. Hence my initial recommendation of just one basic technique that can make a difference even if you do nothing else 🙃

[@soyvoz_]

didn't know how much I needed to find this channel. Thank you very much Doctor!

[@Andrei_K1G1K]

Physical activity. Leaving my feelings out on the mountain is the ONLY thing that has ever helped me to contain my emotions. If I'm tired, I can't be bothered to have opinions about whatever is going on. It's a crutch, I know, but it really does help.

[@TheHjalmur]

Crutches aren't a bad thing. Like eyeglasses, they help people do what they couldn't do without them. But when your crutch consists of understanding something about yourself, that's pretty damn good!

[@ShutchyerLips]

I honestly wish either these videos were longer or were broken up into multiple long form videos. Each step through the "Managing Emotional Behavior" PowerPoint could be its own segment. It's very easy to see how going into depth on each topic would easily be at least 10 minutes. The short form just doesn't provide quite enough information and seems more like an intro.

[@russellbarkleyphd2023]

Interesting idea. Thanks for the suggestion. Let me think it through some more as to content of each step for a video. Be well

[@S3L3N3BEAR]

Thank you for this. I struggle so much with emotional dysregulation.

[@fizbanpernegelf5363]

Same! Though under the right medication it is so much better. Thanks to Ritalin a couple of days ago I was even able to communicate my own borders clearly, calmly and politely without getting emotional or loud or sth like that. This is the reason I also take Ritaline on weekends or on vacation.

[@publius9350]

I know the emotional dysregulation encompasses the issues of "rejection sensitivity" and "justice sensitivity" but for those interested in the emotional component, these two common descriptors very much help understand our emotional sensitivity, and thus address it.

[@bexsolo369]

I've never heard of justice sensitivity.... is that why I can't let it go if something is unfair??? Whether it actually affects me or not, i get physically angry, shaking angry, if someone is taken advantage of. I've actually spoken up in a work meeting with my highest bosses and called them out for not doing the right thing. Luckily, i didn't get fired, but I very well could have

[@publius9350]

@@bexsolo369 - yep. Some European studies call it "justice sensitivity.". It's not a diagnostic category or anything, but a useful description of the emotional elements (which also aren't considered part of diagnosis in the DSM).

[@kristianramserran]

I've been coming back frequently to your channel as a means to cope. Everyday is a challenge. Thank you for your videos.

[@mazedmarky]

I totally understand, do you need further help?`I have been following for a hot minute and just answer me if you need any Peace

[@kristianramserran]

@@mazedmarky ty you're an angel. Honestly there are some good days and bad.. it's just exhausting staying afloat.

[@mazedmarky]

if ou are okay w it may you could give us an idea of what is going on? what is challenging you?

[@kristianramserran]

@@mazedmarky anxiety and guilt, ptsd, dysthymia

[@mazedmarky]

heyy, happy new year! glad to hear from youuuu I have the Ideas - and I call them ideas for a reason: - did you check thyroid (probably) - do you have any fked up methylation Genes? -> Look into that AFTER point 1 - methylene blue if you think all off the above will not bring you further (start with B1, B12 and methylated Folate first) Have a great new year and remember, this is very important but it should nothing but help you to enjoy Life ;) @@kristianramserran

[@narutofox2100]

thank you this video has opened by eyes, I haven't looked at my adhd in this way thanks doc

[@Spamhard]

For me it's almost impossible to get out of the spiral once I'm in. I learned early on to internalise it, but it still rages within. I've learned to remove myself from the problems, but they still just cycle in my brain even when I'm away from the situation. I've learned to pick up on when I can't regulate, and the logical part of me even points out "hey this is just poor emotional regulation happening right now", and yet I STILL can't bring myself down. It seems only time is the real healer, but that can mean HOURS of real shitty emotions, which then starts bringing in the s* ideation thoughts. It sucks, because it only takes one small comment to send me down that spiral and ruin my entire day, which then makes work places really difficult for me, so keeping jobs is super hard. I was diagnosed late in life and currently on a wait list for medication. I desperately hope medication will help just a little with it all, because I'm not quite sure what else will.

[@SN-xq8uv]

Thank you so much for your education about ADHD and emotions! I was diagnosed at 46 years and until it was suggested to me I would never have made the connection to ADHD. I was diagnosed with cPTBS first and had therapy which helped greatly - but certain things persisted no matter what and how hard I tried. ADHD medication and a lot of new strategies helped but I am still feeling like an imposter sometimes and have a question regarding regulation of emotions and impulsivity: I (female) was raised in an unsafe family with a highly impulsive, unpredictable, emotional abusing father and a codependent, unavailable, unprotecting mother. I did always have those overwhelming, sometimes unbearable emotions but I seldom expressed them. I would describe it more like I was imploding instead of impulsively lashing out. I developed an eating disorder and some other bad coping strategies to help me regulate myself. My feelings tell me (and my therapist agrees but she is no ADHD expert) that as a child I instinctively knew that it would be dangerous to act on those impulses I had and turned them towards myself instead. In fact especially my anger is stuffed so far down inside myself, that even with therapy I still find it very difficult to let it out. It's associated with danger, fear of hurting others and I feel like I don't want to go there because I am worried it will completely overwhelm me if I do. But so often I hear that if I really do have ADHD I could not stop my impulses no matter what. So my question is: is there evidence how experiencing trauma growing up might affect behaviour or regulation of ADHD emotional dysregulation and impulsivity? And is there a difference in how girls/women might react as opposed to boys/men?

[@gaelenhixson5152]

I'm overjoyed at the fact that they have included the emotional side of this in their medical books. I would love to hear more about how I can manage emotional incontenience.

[@RoSa-kr8hy]

Are emotions felt more strongly or deeply by people with ADHD or is it just a matter of disinhibition in expression and/or difficulty in moving on once a feeling is felt? My kids with ADHD seem to be extremely sensitive and to have very “big” feelings, even when they aren’t being hugely expressive about them (sometimes literally hiding themselves in order to hide feelings like embarrassment or disappointment). Or noticing things other people might skim over, like being moved very deeply by sad stories or witnessed injustices, etc.

[@publius9350]

It is definitely not just disinhibition in expression. My emotions can feel like they sweep me away. There is some difficulty in moving on. For myself personally, I find that guanfacine, an alpha agonist very much helps in this as a complimentary medicine for my stimulant.

[@Chizuru94]

I think it's just like you said. I for my part am not sure if I feel stuff more strongly, but when I get "RSD" symptoms, it def. feels like someone is gutting me and it's an intense emotional pain that sometimes makes me wish I didn't exist (to feel it). It can be THAT bad for some of us. I'm usually also not able to self-soothe, have to distract myself for hours or it doesn't go away until next day after I slept. I definitely have massive issues with moving on from feelings and regulating them and not feeling them so strongly is what I can say. Emotional dysregulation issues is what got me diagnosed early as a kid (with 12). I'm also usually unable to hold in tears or to not cry. While it seems automatic or manually possible for people to hold back tears, for me it seems to be the opposite. My default is crying or catching myself in miliseconds of time and not ending up crying (or missing it and crying regardless) or fighting a thousand tsunamis I don't stand a chance against at all :') It's really tough and sucks a ton. And yup, the latter is also true, at least for me. Even bad or tragic news, like people dying on TV due to tragedies like atm can bring me to tears (but not all the time ). I also feel deeply for the people who died there and if smth happened in general. This also expands to animals. Flies and mosquitos are the only things I "kill" and I even got over some of my arachnophobia to help spiders get outside (with a glass still, but yeah). Big feelings and feeling deeply is def. a massive thing for us and not being able to let feelings go (at least until we're massively distracted for a long while and forget about it and even then it can linger for hours still, sometimes). It's so insanely crazy to me how people without ADHD don't deal with all of this or not to this extreme extent. I'm envious of people without the disorder daily. It's so crazy to me. Like those other people are gods or smth *sigh* 😢

[@rdklkje13]

Seems so. I’ve only ever watched one movie that made every single person in the cinema cry, whereas any slightly sad story/book/movie/news item etc used to make me cry quite easily.

[@tarav7854]

I believe it’s likely a combination a multiple factors.

[@russellbarkleyphd2023]

It’s both. Because of the poor inhibition emotions that are shown are less moderated and so stronger than in others, I believe.

[@bilemcin]

This makes so much sense, I've done therapy for most of my life and definitely have a good grip in how to understand my emotions and where they come from, but that doesn't mean i can manage them very well in my day to day life. Just now, open KZbin to distract myself cus i got overwhelmed by traffic and unfinished work that is taking me more effort than usual. I rationality know those things are a thing of the moment, thats not how i feel it. Medication definitely helps, but I'll take note of the strategies you list here. Thank you very much Doctor Barkley, you channel is a source of conform and help, as well as information

[@KairosDBT]

Thank you, Dr. Russell. Your work has become invaluable and informative in the treatment of my ADHD and in my work as a therapist helping other adults with ADHD.

[@amandafox815]

Thank you so very much for all of your work with ADHD. I just found your channel and am excited to learn more from you. 4 years ago I found some of your work and presentations at conferences that really helped me understand and seek help for my son who was struggling so incredibly much at the time. I sought out help and medication combos you suggested. He is doing well now, there are still things we are working on so I am excited to follow your videos and implement even more ideas. Thank you, your work saved my son.

[@russellbarkleyphd2023]

Thank you, Amanda. I wish you all success with your son and family.

[@Tuggie2]

Thank you doctor for continuing to help those of us diagnosed. As someone who was diagnosed in the mid 2000s I was never properly explained what my diagnosis entailed. They just told me I had it and shoved a bottle of pills and told im better now. So thank you for helping us all understand what we are going through.

[@russellbarkleyphd2023]

Thanks!

[@herchenm]

thank you so much for making all of this available for everyone to see and learn.

[@Chizuru94]

EDIT: I should maybe also say that CBT never helped, made me feel worse, incapable, lazy, dumb and gaslit, so there's that :') And I know what to do, know all the CBT stuff, but can't use or apply it. 11:35 - Can't escape my family that is also (although not as much as me) affected by this stuff nor was I able to back then in school or even at working places. Unmedicated, though, should I say. Not able to get meds easily here in Germany since all kinds of professionals are full. Even emergency appointment numbers don't help. Sucks to have a diagnosis, but no means to get meds. 12:06 - I'm way too deep in my emotions to stop myself. I'm like a train or car going full speed then, sadly and even when my rational mind is still somehow there sometimes, Ican just "watch myself do and say all that horrible stuff and have a severe anger attack". I know what I could and should and can do in these cases, but I'm unable to use any of that knowledge or act on it, sadly. I wish I could. I genuinely wish I was able to. Emotional Dysregulation is the bane of my existence next to severe executive dysfunction x-x

[@missannaventure]

I’m in Germany and found a psychiatrist after 2 years of searching. It was pure coincidence that he‘s very interested and educated on adult ADHD (i suspect because he has adhd, too). So, i understand your frustration about not being able to find a doctor to prescribe meds. I tell you to keep going! I’m rooting for you ❤

[@jazzyj7834]

I just found a doctor myself after nearly 2 years of searching as well. Meds have helped tremendously. Keep looking, it's a tough path, but they're out there.

[@gabrielladeass]

Thank you Dr. Barkley for the insight. That helps me!

[@andreasmuller5223]

Thank you for sharing your work.

[@Michael_Beazley]

The list to manage the emotions is the actual reasons ADHD exist, it’s what ADHD people do to mitigate their emotions which lead to the “focus” “inattentive” “distraction” etc.. Avoid the Situation or Alter It Interrupt or Preclude Attention Cognitive ReAppraisal Suppress or Down-Regulate Responses Alter Consequences for emoting ^Describes ADHD. These are instictual / intuitive coping mechanisms.. the very cause of ADHD

[@rodrigofoggiato]

Thank you so very much for this content, truly appreciate. 👏

[@fizbanpernegelf5363]

I see that the wrong diagnosis more than 15 years ago was no surprise as I was suffering from the emotional disregulation as most prominent symptom of my ADHD. That makes it a little easier to accept. Luckily Ritalin helps that so much now... even though my current psychiatrist seemed surprised as I mentioned that observation. Thanks for the video it is an important one in my opinion.

[@kljsth6669]

I've recently developed an interest in the The Dynamic-Maturational Model of Attachment and Adaptation (DMM). Unlike previous models of attachment theory, the DMM has a much deeper focus on information processing, making the DMM relevant to topics that haven't previously been associated with attachment including adhd. I'm not sure how to integrate my existing views of adhd with views the DMM offers on adhd. It would be super interesting to hear your thoughts on the intersection of these two topics. "By not attending and instead flitting from one thing to another, he could escape both knowing consciously about frightening events and also the discomfort of the discrepancy between what he saw and what he was told. [...] Given a child’s inability to protect himself - or his parents - early developing attentional difficulties might have functioned self-protectively in Jean-Paul ‘s unclear, inescapable, and unsafe context." -from a pdf "IASA's 3rd Biennial Conference a Success!"

[@rickinwast]

Adult male age 73 severe ADD all categories. Having this emotional dysregulation and reading about it here, makes me sad! It occurs in a blink of an eye. It is like blacking out and a different me emerges. Medication? No impact with each known stimulant and non-stimulant :-( Thanks for your tutorials!

[@jenA9026]

Emotional incontinence 😂 love it. It feels like that.

[@richardfox9919]

Dr. Barkely, do you see potential later in time to include emotional dysregulation as an official part of diagnosis? With all the talk about RSD, it makes me wonder if eventually emotional dysregulation will become official and rule out RSD

[@Andrei_K1G1K]

I am VERY patient until I'm not. It's like I have no middle ground. With years I have learned to be "kind-er" when my emotions overflow, but it's still a very surprising thing for people I am with. It's a cross I bear and I know I do that. Difficult with relationships.

[@leonaedwards7104]

Other helpful things are watching what we eat. What helped me is avoiding processed foods, sugar and keeping my carbohydrates low.

[@montycora]

Yep, I am always doing keto... it helps immensely.

[@jennyportelli]

I'm interested in your advice as to how to deal with family members who also have ADHD, RSD and regularly "lose" it. They are not really aware or interested in getting a diagnosis or treatment. I find these meltdowns profoundly upsetting due to my own adhd and RSD but It is much harder to avoid family members than friends. I am having trauma therapy to help with this lifelong problem.

[@Ellipsis115]

15:20 Onwards - add to like 5 charts for life this is probably the most important one.

[@cillinodonnell8729]

What role does the emotional state of family members have during development on emotional regulation and ADHD symptoms in children?

[@vendrameister]

It‘s interesting what you say, because i‘ve been trying to suppress emotionality in order to level my emotional state ever since - it seemed I felt more, laughed more, cried more, was more angry than people around me. Now I find myself hardly capable to express and even feel emotions. I didn’t get an adhd diagnosis yet but everything points to it. Do you think suppression is a coping mechanic which might be overly applied (creating problems of emotional management of the opposite type); and do you think that behavior and the surrounding do have a causal effect on the adhd type - people would call me inattentive ;) Thanks for your work and bless

[@djallalnamri1]

incontinence or inability to contain (anger, panic, anxiety, etc., etc.)? These emotions are raw and at work well before our acquisition of language, the rules of life in society, meanings, etc., etc., etc. in short, well before the start of our apprenticeship. Are these emotions the only obstacle to learning or is there something else like culture, representations, the meaning commonly accepted by this or that group, ideologies?

[@aidan34i56]

Hi Dr. Barkley. I'm 22 male, I'm currently receiving medication and have commenced treatment for my ADHD. I understand based on your website that you have retired from the field of clinical psychology and by law are not licensed to provide any personal advice. However, I am looking to inquire if you have any general therapeutic resources (such as playlists to watch) that I can utilize to see what necessary steps I can take to get over my tumultuous past throughout my formative years during elementary school, middle school, and high school. Best regards, Aidan

[@christinekinn6178]

I have an issue with my emotional wires being crossed. When i experience gratitude or joy, I'm overwhelmed with grief. I assume its the result of some type of trauma or a preverbal learned response but various techniques have provided very little or no relief.

[@bessiepadua]

This is happening to my grandson very strong emotion to the point he hurt me and even his playmate when his upset😢

[@Chizuru94]

Could also be related to Autism, btw (and be a meltdown, where they can control their emotions even less than someone with ADHD can) :( So hope that is also checked. But yeah, it's pretty tough. I luckily don't hurt others, but my words and screaming and anger attacks can be pretty hurtful still. 29 and still dealing with this issue 😢I can just say most, if not all of us, don't mean it and we can rarely control it or stop us. At least I can rarely ever do that D:

[@bessiepadua]

@@Chizuru94 same with my grandson he only 9 year's old but the way he answered it may hurt my feeling's but alway's tried to understand him because i already know he has adhd sometimes i feel emotionally drained because everyday he has an outburst truly living with an adhd is full of struggle😌

[@jamiejohnson5748]

I'm not sure I struggle with this... I don't know. Maybe with irritability and arousal 😅I do find that most of my interactions with people require lots of patience, I guess I am highly irritable, but I have that patience to get through those interactions. I don't have emotional outbursts. I'm more likely to withdraw from a confrontation vs escalate it. I think I seem normal to most people on this emotional front. Maybe not internally, but it's hard to compare my internal thoughts and feelings to that of others since I can't know how people feel.

[@ok_roman]

6:30 is that movie "Sideways" ?

[@philippa5101]

I have basically lost all my friends. It’s all been associated with being unable to control my emotions. Im 39. I’m just too much work for people. I am having so much trouble fixing this even though I know I need to. I’m a solo parent and it’s even harder. I worry I’m not modelling self regulation to my son. I work in high pressure environment too. I am on Dex but I’m not sure that it’s helping with this. It does help me focus. Does Vyvanse assist with this symptom better?

[@piotr780]

is there video about ADHD and oppositional disorder ?

[@carisbennell5685]

I’ve never slept since I was a baby and so hyperactive and impulsive I wake at 2am unable to regulate my emotions Since being on my meds I’m sleeping till 6 am I feel so bad as if I’ve not achieved anything Why do I sleep better when having a stimulant during day ? It’s so nice to not feel every emotion and cry then be hyper I don’t need to save everyone anymore because I used to feel everything And I’m not working out for 3 hours a day trying to regulate

[@lizbeth.gonzalez]

I’ve had 6 jobs in 2 years… man I’m tired of not being able to stick it out anywhere

[@eojj-bk3di]

What is the best medication to support emotional regulation? I’ve been seeing support that alpha antagonists medicines are the best Any insight appreciated

[@russellbarkleyphd2023]

All three types of medication work but to varying degrees and via difference routes in the brain so it’s quite individualistic at the moment. I don’t know of any head to head comparisons of drugs for their effects on emotional control. Be well.

[@montycora]

Ritalin has done wonders for me on that regard. it keeps me very calm, collected and regulated.

[@StellaLeeThreads]

Those that experience challenges with emotional self-regulation can feel ashamed of occurences where they fail to regulate successfully, likewise those with incontenince. Attaching one term to the other doubles down on that shame which is unhelpful in many ways. I could go on to discuss how these are simply academic terms that should not be construed as shameful or I could delve into how shame impacts self-image, anxiety, depression and so forth, however I'm sure that is all self evident and I shall leave it at that.

[@christinekinn6178]

What about emotions that are related to being ghosted or realizing that you don't fit in?

[@montycora]

That you have to learn to deal, there is no way of regulating. We don't fit in, people think we are weird and tend to ignore us then. I am fully convinced I am invisible, because people just seem to see right through me... I am 43 now and I have already accepted this... There is nothing we can do, just understand that we are different and people have a hard time dealing with that...

[@erikasinternetgerat8019]

whatever stronger emotion i experience now, a tiny part of myself always sits next to myself, very calm, and saying "it is totally fine to have this emotion while it lasts, it will not last forever", so i can unnecessarily stress about something unimportant and feel totally calm and ok with myself at the same time. due to long covid i had an extremely dysregulated system, would have several crying fits per day and a minor thing would ring all alarm bells. boy was i glad to have this skill of relying on 5% calm regardless of the 95% overwhelm.

[@melindagardner1280]

Thank you so much, Dr Barkley. You help me so much. I have such a crush on you!!!

[@carebear6790]

Do you think there is something to the idea that these strong emotions are harder to quell or switch out of because they ultimately provide the brain with the neurotransmitters it lacks and therefor it’s almost like a “high” that the brain doesn’t want to easily let go of? Being flooded with these neurotransmitters I mean.

[@russellbarkleyphd2023]

I could understand such a process in bipolar disorder where manic e Isolde’s certainly create euphoria but in ADHDmi think it is the problem with poor inhibition that creates these faster and stronger emotional expressions. I don’t see a craving here as much as a lack or loss of control. Be well

[@carebear6790]

I see. That makes a lot of sense. Thank you for your response.

[@Chizuru94]

Tyvm for the video

[@sandrapawula4109]

I appreciate your explanation. At the same time, I find the term "emotional incontinence" insulting and dehumanizing.

[@montycora]

Why? I am not insulted. It perfectly describes what happens to me...

[@PeterPepper93]

No, it's just what it is and you being triggered by it reflects more your incapacity to accept it rather than the insulting potential of that label. Peace

[@TheLivingVision11]

How can I help my child with this when the provocative event can be as simple as my asking him to make his bed, or to have a piece of fruit for snack?

[@tomatoeggs48]

I don’t know if I missed something but it sounds like the problem that makes people with ADHD unable to emotionally regulate is impulsivity. So, the solution is to try to take a step back and try not to be impulsive? 😅 How can people with ADHD access this place of mindful response? Avoiding the problematic situation altogether makes sense and is an accessible strategy, even for us, but how about the other strategies?

[@montycora]

Ritalin has helped me GREATLY in regulating my emotions. I am in college and as I can't afford paying rent and college, I was forced to move back in with my mother, who is a narcissist and loves to treat me like shit ALL THE TIME. I had to stop taking my meds for a week and... OMG... It was horrible. A lot more fights and I was unable to bounce back from her tortures. Now I am back on my meds and this episode made me see how much Ritalin helps me regulate my emotions. It is so much easier dealing with her BS when I am medicated. I am able to control the pain she causes me with her comments and focus on graduating.

[@sonyaparkin7841]

💚

[@jonr6680]

Going to emphasize 4:44 that the strong feeling and over-reaction are two utterly separate things... I was brought up to be introverted and so unresponsive. So don't suffer the 'incontinence' unless severely provoked. But a lifetime of resentment and passive-aggressive rollercoaster. Plus the toxic burden in the unexpressed and so repressed desires. But it seems obvious that genpop culture is generally extrovert, with structural rewards especially for male dominance instilled in kids... I.e. macho, misogynistic and bullying aka combative. Basically a perpetual cock fight. Dating, work, business, sports: Everything is competition!! So from my perspective EVERYONE is verbally incontinent!! Their opinions wants and needs vomited out constantly... (Noting Dr B and his ilk are typically extremely well balanced with both rational vocalisations at work and at home, intelligent and one assumes emotionally sanguine for the most part.) Imagine for folks with a problem in this area, the even greater lack of control requires a strong compensatory protocol like anger management to understand how the interaction could be de-escalated. Mostly by CBT to learn how the other people are affected (empathy, kindness, love) and assign greater weight to the consequences (e.g. getting punched in the face)... Beyond that, probably clinical towards psychopathy??

[@publius9350]

Would you be interested in doing a video on correlating disorders? Both things like depression and anxiety, but lesser known issues like premature ejaculation, the high rates of ADHD with primarily innatenntive traits amongst type 1 diabetics, and the numerous other issues? I feel like some of these should automatically result in an ADHD screening, particularly if the disorders compound each other, such as ADHD causing difficulties in medication compliance. I'm finding out about new correlations every week or so, such as caesarian birth and premature birth having a correlation. Secondly, it seems logical that ADHD would often lead to accidents that result in TBI that subsequently exacerbates ADHD. There is simply too much belief in the world that lack of treatment is without risk, while treatment has risks, when the balance seems weighed in the opposite direction. I also support people being able to make their own decisions on healthcare pursuits, but the system seems to be that if you don't immediately seek treatment, you shall be punished by finding that treatment later inaccessible when it is vitally needed. It would of course also be good to know to what degree we know or don't know about causality and the direction as well!

[@ALADDIN22091978]

It is a central issue. The psychiatrist does not mention emotional dysregulation in the diagnosis of ADHD, medication does not treat emotional dysregulation in my opinion. Treatment should be exercise, medication, breathwork/meditation/ mindfulness.

[@StephanieDefinitely]

I disagree with the commenters who find the word “incontinence” infantilizing - I find it to be an extremely apt way to describe the involuntary nature of my emotional dysregulation and how these responses come in these waves that hold me completely hostage (unless I have been medicated, etc). I think when dealing with non-ADHD people, it is hard to explain the real severity of these issues because “dysregulation” sounds so sterile and scientific! It suffers from being somewhat jargon-y and abstract (hell, it’s not even in the iPhone dictionary for autocorrect), but “emotional incontinence” is a very evocative, relatable term and may encourage people to think about how that might FEEL to us. If it doesn’t make sense to you and your ADHD brain, that’s fine, but it makes ALL the sense to mine. (Not to mention, I don’t think we consider it a slur or infantilizing to tell an older adult, for example, that they have *urinary* incontinence…? Yeah, they may not enjoy the experience, but the term itself is +neutral+ and doesn’t really have any malice in it that I can tell.)

[@soyvoz_]

great comment!!

[@DanS8204]

Dr. Barkley, perhaps a term more sensitive and less pejorative than “emotional incontinence” might be used for the kinds of emotional dysregulation you describe as being related to AD/HD. Among other things, if only for the purpose of disambiguation, the term is much more commonly associated with, and is also known as, pseudobulbar affect (PBA), a type of neurological disorder characterized by uncontrollable episodes of crying and laughing.

[@tiranul86]

I don't like the term "emotional incontinence" it makes me feel even more ashamed of my outbursts

[@RoSa-kr8hy]

I agree. I think there are also people with ADHD who bottle up or repress their strong emotions to a negative extent because they are criticized for being too emotional and too sensitive. They aren’t incontinent, but they are still experiencing extreme emotions.

[@treaclecustard]

The shame I feel for all those times I couldn't run away and hide my ott reactions haunt me ALL the time. The intensity of how I can feel/ the countless negative experiences attached to the times that joe public witnessed my over reactions has made me withdraw from o much of life - avoidance tactics. I hate that I can't ever feel confident in my own skin - I dread making a fool of myself. It''s a double whammy of intense humiliation/shame/agony that people are likely embarrassed/shocked/disappointed in me... or laughing at me. It causes great anxiety, I hide so much and pretend so much until I can escape. The times I didn't manage that pop into my head on a daily basis and I have to live that pain like it was yesterday (even if it was 4 decades ago). If I'd not received so many daily criticisms (from my v earliest memories) maybe I wouldn't be crucified by receiving (or just perceiving) negative feedback ...? maybe I would... 🤷‍♂️...or maybe everyone would have witnessed the real me, with regular anger or tears - more in line with many of my male relatives. It's ruining so much of my life and emotional 'incontinence' is not making it feel any better! ( I want people to be more aware of this side of adhd, but I just can't share anything that might just get laughed at or belittled). Disregulation works just as well, no? To me it feels like just about everything involved in adhd is disregulated.

[@PeterPepper93]

Changing the term doesn't change the fact. The point here is to be self aware to have it in check, if you don't like the term that's great, maybe it will help not doing emocional outburst

[@j.s.c.4355]

“Emotional incontinence” is really offensive. My emotions are not shit.

[@montycora]

Mine are... I think this term is quite on point. Me without Ritalin is a real emotional incontinence.

[@dumbgames4933]

This clearly isn't your intent, but Incontinence seems like a deeply infantilizing term, which seems particularly counterproductive given existing prejudices. Someone using it to describe us in-person might be provided an immediate demonstration, I suppose. It seems likely to guide folks away from serious aspects like rumination as well - I don't believe anyone would benefit from adding the obvious corollary. Is the framing of "utter lack of control" accurate in a meaningful % of adults? Of the many ADHDers I know, it wouldn't describe a single person, or myself even at a young age. That seems like an uncharacteristic mis-framing of the science.

[@IamXodus]

I never like it when others speak in a matter of fact way about adhd. I don't care about your degree. I've been living with adhd for almost 50 years and it is physically painful at this point.

[@PeterPepper93]

Whats your problem man ? We all have Adhd, doesn't allow you to be a Dick about it

[@Deviliza]

Right.. next time my boss wants to talk to me, I'm just going to either avoid it or look away and cover my ears. 🤔 🤷 And no, I'm not loving the "incontinence" sry. Find another word 🙂

[@mymodularjourney]

Although the term emotional incontinence could be fitting to the way emotions come out uncontrolled, I’m not sure it will contribute to a wider awareness and acceptance. Emotional dysregulation is sufficiently descriptive of the condition without linking it to a term associated to another very inconvenient and embarrassing condition.

[@russellbarkleyphd2023]

Yes, in hindsight it might not have been the best choice of phrasing but a writer or speaker searches for expressions that can convey information in catchy or striking ways to make a point. I thought the term from a recent movie cut right to the heart of the issue but for some the imagery was likely too crass. Thanks!

[@MichaelWVagg]

Please don't call it emotional incontinence. It's embarrassing and shameful enough.

[@mindfulmoneymojolifestyle]

It also (the word "incontinence") implies spewing shit. Pretty low blow man. Way to trigger RSD and shame. It's already rough when you're self-aware. 😮😢😂 Is there a different word? May as well say we have emotional IBS - SMH 😵‍💫😭💔 you're breaking my heart Russell. It's repulsive the word incontinence. 😶‍🌫️🧠 #Medicated #Outburst #Tantrum #Brutal

[@mindfulmoneymojolifestyle]

Dysregulation is a sufficient word. #ItsNotAJoke Would you have said that Roosevelt had muscular leg dragging rather than polio? Super barf on your language.

[@montycora]

Well, usually incontinence happens more with urine that shit. When I hear the word incontinence, I immediately think of urine, not shit. Having said that, I think the word is spot on. it sums up the way I feel greatly when not on medication...