Emotions, Relationships,
& ADHD
Kate Carr-FanningVice Chairperson, HADD
Ph.D. Candidate, Psychology in Education, Trinity College Dublin
September 20111
Contents• What is Adult ADHD?
– Executive function deficits.
• Emotion & ADHD.– Neurobiological & psychological explanations.
• Relationships & ADHD.– Why relationships are difficult for pwADHD.
• Professional treatment.
• Coping strategies.– Self-awareness.– Managing stress.– Communication.
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Potential Issues
Possible Solutions
What is Adult ADHD ???
3
What is Adult ADHD ???
4
Childhood Adolescence Adulthood
INATTENTION
HYPERACTIVITY
(Mick et al., 2005)
IMPULSIVITY
• Symptoms manifest
differently across the life span.
• Changes to DSM-V
& ICD-11.
• Maturation vs. environmental demands.
What are Executive Functions ???
Brown EF
Barkley EF
•Activation•Effort•Emotions•Memory •Action
•Self –Regulation•Working Memory•Internal Monologue•Reconstruction
“... deficits in self-regulation, impairment in the ability to organize behaviour towards present & future goals & difficulty
adapting socially & behaviourally to the environment ...“ (Barkley, 1994).
“The symphony of the brain” (Brown, 2006)
Emotions & ADHD
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Emotions & ADHD• “Affective Liability”:
– Emotional volatility is not diagnostic core symptom but frequently seen (esp. in adults).
– Co-morbidity (co-occurrence of mood disorders).
• Commonly Reported Examples:– Frustration / irritability.– Sensitivity. – Impatient.– Anxiety and depression.– Motivation and perseverance.– Changeable.
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(Barkley, 2001, 2003, 2006; Lewis, 2010; Wender, 1987, 1995)
Neurobiology of Emotional Disregulation
Two Sides to the Story:
• Barkley’s (1997) response inhibition.
• Brown’s (2006) modulating emotions and managing frustration.
Brown EF Barkley EF
•Activation•Effort•Emotions•Memory •Action
•Self -Regulation•Working Memory•Internal Monologue•Reconstruction
Psychology behind Emotional Disregulation
• History of negative experiences.– Perceptual sequencing difficulties & anxiety.– Repeated failures.
• Living in a state of tension.
• Underdeveloped skills &/or coping mechanisms.
• Unrealistic self appraisal &/or goals.
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Relationships & ADHD
Relationships• Relationships are difficult for pwADHD:
– Higher divorce rate, quickly falling in and out of love / intense relationships, frequent arguments with friends and family quickly get out of hand, etc.
• Biggest problems for spouse / partner of pwADHD1. Sharing responsibilities.2. Doesn't listen & never remembers.3. Social skills.4. Getting into trouble.5. Disorganized, messy, & collecting things.
Relationships• The relationship we have with ourselves:
– Confusion and anxiety.– Self-blame and loathing.– Inadequacy.– Processing emotional information.
Professional Treatment
Professional Treatments• Psychiatric and psychological treatment for emotional
disregulation:
1. Medication.
2. Psychological therapies: – Cognitive Behavioural Therapy (anxiety).– Talk therapy &/or couples / family therapy.
3. Getting help getting your physical world in order (e.g., OT, life coach) can have a big impact on how you feel.
Practical Coping Strategies
1. Self-Awareness2. Managing
Stress3. Communication
Self-Awareness• Self-awareness is the key!!!
– Who am I, what do I want & value,?– What are my strengths & weaknesses?– How does my ADHD affect me?– How does my ADHD affect others?
Why is Self-Awareness SO Vital ???
SELF SOCIAL
RE
CO
GN
ITIO
NR
EG
UL
AT
ION
Self Awareness Social Awareness
Relationship Management
Self Management
Developing Self-Awareness• Strengths, capabilities, and talents:
– Start from a strengths based model - we often get stuck on what’s wrong with the person, & ignore what’s right with them.
– Positive aspects of ADHD.– Consider realistic applications and options.
• Acceptance: – Mindfulness vs. externalizing or blocking of emotions /
difficulties.– Don’t get stuck in the tyranny of the “should”.
• Develop and implement strategies.
• Evaluate effectiveness of strategies & adapt:– Trial and error where error is your friend.
www.authentichappiness.sas.upenn.edu/Default.aspx
Managing Stress• Finding the Balance:
– Extreme ‘all-or-nothing’ living & emotional imbalance;
• e.g., over-working, over-drinking, over-sleeping, etc.– Time management;
• Hyper-focusing on one area of life & letting all the other aspects on life.
– Holistic.
• Organization Skills:– ADHD brain is an exciting, disorganized, & unpredictable
place - so make your physical environment as predictable & calm as possible
– e.g., de-clutter your space & your life, make plans & lists, have a routine, don’t over commit yourself, etc.
Managing Stress• Counteracting Impulsivity:
– Impulsivity (immediate reaction) to emotional stimulus = problem!
– Stress is when there are too many demands placed on us relative to our actual capacities and resources.
– Since people with ADHD lack certain capacities certain parts of life are going to be much more stressful for them than for others.
– So be aware of what this means for you (know your weaknesses) and plan ahead!
Communication• Develop Understanding:
– Not always easy for someone with ADHD to communicate their thoughts and feels.
– But educating each other is so important in relationships:• If you don't know why you'll make up your own story and it
will not be pretty.
• What is “Fair”?– “You don’t care”
• Faking flaky is more trouble than it’s worth!– “You’re wrong”
• Often there is no right or wrong - it’s all about perception.
Communication• Some Helpful Communication Tips:
– Sitting on the couch whining about ‘our relationship’ might not be the most productive things - try the walk and talk approach.
– “I feel” statements.– Give lots of examples (make it real and tangible).– Active listening.
• No drifting off, interrupting, or offering solutions.– Positive communication aids - figure out structures for
remembering without nagging.– Set clear limits and expectations.
• Reasonable & realistic – don’t set up more failures.– Collaborate on finding solutions.
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