Have you been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) by a doctor? Or does someone you know have this condition? If so, you may be familiar with the symptoms of losing control over even the smallest things, getting upset easily, and having a hard time getting over a bad situation. Many people think that ADHD is just a problem with not being able to focus and stay in one place. But the truth is much more complex. Today we are talking about this emotional imbalance that is often associated with ADHD, but which no one talks about.
What is this DESR?
Doctors call this condition Deficient Emotional Self-Regulation, or DESR for short. Simply put, this means the difficulty in controlling, calming, and behaving appropriately when one feels a strong emotion (for example, anger, sadness, or anxiety).
Imagine this. You're in a queue, and someone cuts you off and moves forward. A normal person can control their anger, even if it's a little. But a person with DESR may not be able to control their anger at that moment, and may even yell or curse at that person. This means that their emotional response is much greater than the incident.
Surprisingly, the official medical diagnostic manual (DSM-5) does not list DESR as a symptom. However, experts like Russell Barkley, an expert in the field, say that it is one of the main and fundamental symptoms of ADHD.
What are the main features of DESRs?
We can identify this lack of emotional control in four main ways. When many people with ADHD see these, they think, "Oh... I have this too."
| Characteristic | Simply explained |
|---|---|
| Emotional Impulsiveness | Patience is very low. One gets angry easily over even the smallest things. This can be seen in agitation, impatience, and expressing emotions very strongly. |
| Inability to Self-Soothe | When a strong emotion, for example anger, comes up, it's hard to reduce its intensity and return to normal, which means you can't calm down. You feel trapped inside that emotion. |
| Difficulty concentrating | If someone says something hurtful, you keep thinking about it, and it becomes difficult to take your attention away from the incident and do something else. Your mind is stuck on that incident. |
| Difficulty choosing a good response | When angry, instead of yelling, they know they should talk things out and resolve the issue, but they lose control at that moment and end up yelling and making things worse. That is, they allow their emotions to dominate the moment rather than the long-term good. |
What is the connection between ADHD and emotions in the brain?
This is not just a behavioral issue. It has a clear neurological basis. There are parts of the brain that control our emotions. We call these the limbic system . The part in this is called the amygdala, which is the main center of emotions. And the part in the front of the brain that controls thinking, making decisions, and behavior is called the prefrontal cortex .
Research has found that people with ADHD have some differences in the functioning of these parts and the communication between them. The higher-level mental processes in our brains, such as planning, organization, time management, and emotion regulation, are called executive functioning . So this emotion regulation is a key executive function that is impaired by ADHD.
Why is this misunderstood?
This is the biggest problem. Because this emotional regulation problem in ADHD is not recognized as an official symptom, even doctors can sometimes mistake it for another illness.
This is especially common in women. Imagine a woman who is constantly anxious, easily sad, and angry. When she goes to a doctor, if she doesn't think about ADHD properly, there's a good chance she'll be misdiagnosed with depression or bipolar disorder . The medication she receives won't solve the real problem, which is ADHD.
As experts point out, " The emotional control problems of someone with ADHD, especially the uncontrolled release of emotions and the inability to cope with and control them when they arise, are part of ADHD itself. There is no need to look for another mental illness to find the cause. It is a weakness in executive functioning in ADHD itself."
So how do you distinguish this from other mental illnesses?
This is a bit complicated, but let's try to keep it simple. There are some key differences between ADHD and a condition like bipolar disorder. But remember, only your doctor can make the right diagnosis.
| Attribute | DESR in ADHD | Ex: Bipolar disorder |
|---|---|---|
| The reason for the change in feelings | It often occurs as a response to something happening at that moment (trigger). (e.g. someone criticizing you). | A mood change that lasts for days or weeks, often without an obvious cause. |
| The time of feelings | Short-term. It can subside within a few hours or a day after the event. | Long-term. Depressive or manic states can last for weeks. |
| Context | The intensity of the emotions, even if 'higher' compared to what was happening at the time, is related to it. | The nature of emotions can be unrelated to what is happening at that moment. |
As you can see, there is a clear difference between the two. But these symptoms can overlap. So if you or someone close to you has this problem, definitely see a psychiatrist and talk about it. It is very important to avoid self-diagnosis and seek proper medical advice.
Take-Home Message
- ADHD is not just an attention problem. Disturbance in emotional regulation (DESR) is also a major and fundamental part of it.
- If you or someone you know has symptoms of ADHD such as getting angry easily, feeling sad, and having low patience over small things, it could be DESR.
- This problem with emotion regulation can sometimes lead to misdiagnoses such as depression or bipolar disorder.
- If you have any concerns about your feelings, talk openly with your doctor about them. It is very important to get an accurate diagnosis and treatment.
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