By Jeff Copper, MBA, PCC, PCAC, CPCC, ACG – May 12, 2025
Emotional dysregulation was removed from the clinical conceptualization and diagnostic criteria for ADHD back in the 1970s. At the 2010 Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) conference, Dr. Russell Barkley reviewed the evidence and argued for its return. He went on to explain how the addition of emotion points to six things people can do to manage their ADHD.
ADHD impacts the ability to inhibit emotions and take steps to regulate them. There are six things people can do to manage ADHD. The first deals with medication while the next five are psychological strategies anyone can use to manage emotion:
- Select the situation by consciously selecting an environment conducive to success.
- Modify the environment to suit yourself if what you selected is not optimal.
- Deploy attention by managing or changing what you are paying attention to.
- Change thinking patterns and downgrade your emotions.by asking yourself, “How does this serve me?”
- Modify the emotion, because, once it is out there and has taken over, it can be beneficial to focus on breathing, meditation, etc., to begin to de-stress the situation.
Note: The later in the sequence you are, the harder it is to have an impact and the less successful you might be.
How do we manage an emotion? To begin, we need to understand emotions. Dr. Barkley defines an emotion as a short-term change in the body or mind that stimulates an evaluation of an event. We decide within a split second whether a situation is threatening or positive and how best to respond to it. How we respond to an emotion is what defines our behavior. Dr. Barkley identifies four stages of this emotional response:
- A situation or event occurs.
- We pay attention to it.
- We appraise it.
- We react.
While these reactions are innate in all species, humans possess the ability to:
- Inhibit the first level of emotion; that is, override the first level.
- Downregulate the emotion.
- Refocus our attention away from the triggering event.
- Organize a new emotion or experience.
Dr. Barkley sites a simple example to illustrate the two levels of emotion and their management. Imagine being in a business meeting and someone boldly declares that you are stupid. At the first level, we have a situation that you paid attention to and perceived as a threat; you might come across the table and clock the person who said it. But as humans, we typically don’t let this happen. We override the emotion, inhibit ourselves from hitting the other person, downregulating the emotion, and refocusing our attention away from the event. We organize a new emotion focused on the individual’s ignorance or minimize the influence of the derogatory comments.
Dr. Barkley argues that the inclusion of emotional dysregulation in the diagnostic criteria creates a teaching opportunity not available in previous models of ADHD. For example, an ADHD coach can help by educating individuals around the near-instantaneous stages of an emotional response. By understanding the process, a coach can teach techniques to observe emotions as they arise.
As the individual becomes better able to recognize the presence of physical symptoms (e.g., muscle tension, headache, accelerated heart rate, etc.), the perceived gap between emotion and reaction widens. The individual can then pause and make a choice about how to manage his feelings, using proven strategies that have worked in the past.
What I want to highlight as the purpose of this article is simply this. Given the evidence that suggests emotional dysregulation is very much a part of ADHD, it follows that we need to pay attention to emotion if we are going to manage ADHD effectively.