One of the greatest struggles of ADHD is emotional regulation. Now, a study examining the brains of children with ADHD has found a physical correlation.
While children (and adults) with ADHD can learn methods to help regulate their emotions, this new information emphasizes how much different the process is compared to the experience of those with neurotypical brains.
Many of the symptoms that make ADHD so frustrating can be linked back to emotional dysregulation, including stress, impulsivity, and even executive functioning struggles.
A Study Of 1,000+ Pre-Teen Brains
Looking at multiple data sets, researchers examined MRI data totalling over 1,000 brains from preteens diagnosed with ADHD, as well as a few hundred more without.
They compared the brain scans to other participant data, including behavior, motivation, and emotional dysregulation information. They found strong correlations between emotional regulation symptoms and a specific physical representation in the brain. According to PsyPost:
“Analysis of neuroimaging data revealed that emotion dysregulation has a distinct neural correlate. Children with more severe emotion dysregulation tended to have a smaller surface area (but not cortical thickness) in the right orbital part of the inferior frontal gyrus.”
This suggests that emotional dysregulation is its own symptom, rather than a result of other symptoms of ADHD.
Emotional Dysregulation As A Secondary Effect
ADHD, like other neurodivergent brain types, is still far from fully understood.
The emotional dysregulation symptoms are commonly theorized to be a secondary effect from the other symptoms. For example, if one struggles with impulsivity, that could result in consequences that could leave a person stressed and dysregulated, or delays in executive function could cause a person to be routinely frustrated and make emotional regulation more difficult. The ADHD Centre even draws these connections, suggesting, for instance, that hyperactivity is a cause of emotional dysregulation:
“Emotional dysregulation is common in people with ADHD due to the symptoms that ADHD can present, but it is not in itself considered one of the major markers of ADHD in the same way that hyperactivity, inattention and impulsivity are…When people are constantly moving and on the go, they are less likely to take the time to process their emotions, leading to impulsive reactions and responses.”
Why Does It Matter Whether Emotional Dysregulation Is A Distinct Symptom?
How we look at the symptoms of ADHD (or any disorder, really) can change how we handle treatment.
In ADHD, if the emotional dysregulation is a result of other symptoms, like impulsivity and hyperactivity, then medications or treatments that reduce or control hyperactivity and impulsivity should result in less emotional dysregulation.
However, the alternate theory is that emotional dysregulation is a separate symptom. In that case, we can expect that it could continue even if other symptoms are controlled or reduced and recognize that a child is still struggling with this symptom even if he’s sitting quite still and apparently concentrating on his work.
How Emotional Regulation Is Distinct From Other Symptoms
In fact, researchers found that there was not a strong correlation between emotional dysregulation and cognitive performance from the previous year. Nor was there a link between difficulty with motivation and emotional dysregulation.
One link that did surface was between strong inattentiveness and higher emotional dysregulation. The researchers consider the possibility that emotional dysregulation leads to inattentiveness “plausible,” but still see some other possibilities, noting that there is also a direct correlation between greater inattentiveness and a smaller surface area in the relevant part of the brain.
While this all calls for further research, the conclusion most relevant for the average child and parent is that this all means the current treatments for ADHD may not help at all with emotional regulation.
How To Help Kids With Emotional Regulation
For adults, some medications (Ritalin and Concerta) may help manage emotional regulation in adults, according to the American Psychological Association.
However, they acknowledge that this isn’t a complete answer. They suggest programs falling under the umbrellas of Cognitive Behavior Therapy, social skills training, and parent training to help kids manage emotions.
Some specific skills to practice (or, as a parent, help your kids practice), according to VeryWell, include stepping back and naming the emotion; taking a break from the situation; writing the feelings out; using exercise or music to manage the emotions; and making a list of the coping mechanisms that work for that individual.
