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Independent Medical Evaluations
Psychiatric and Psychological Evaluations
ADHD and Intense Emotion
By Jacklyn Chandler PhD
As a mother of a child with severe Attention-deficit/hyperactivity disorder (ADHD), I have experienced the trials and heartaches of the consequences of how ADHD affects behavior including the ability to complete tasks, attend to necessary homework and chores, holding a job, self-regulate and have appropriate emotional responses. I have learned through experience and found through research, that dealing with individuals who suffer from ADHD is not the same as dealing with a non-ADHD person. First, ADHD is a common diagnosis especially among children. However, ADHD is also experienced by adults. Second, if not understood by caregivers or family members, it can affect ones learning ability and destroy relationships, both in childhood and adulthood.
According to the DSM-V, diagnostic criteria for disorders, ADHD has three different diagnoses; ADHD, predominantly hyperactive/impulsive presentation; predominantly inattentive presentation and combined presentation. (1) Often you will see clinicians or teachers use the term ADD, which is only a shortcut indicating the inattentive presentation only. The DMS-V lists those symptoms we are most familiar with such as, hyperactivity, impulsiveness, distractibility, difficulty focusing, inattention and poor concentration. However, what the DSM-V does not elaborate on, is a child’s actual chronological age and their level of emotional development and intense emotions. Individuals with ADHD develop an average of 30% behind their actual age in the frontal lobe, which means that a child age 13 with ADHD has the emotional development of a child who is age 8.67 years. (2) This is an important distinction because as we know a 13-year-old is treated differently than a child who is 8 ½ years due to their level of maturity. This not only affects their social standing, but also their learning ability and emotional maturity. Intense emptions and the result of not recognizing this symptom as part of ADHD can lead a clinician to misdiagnose ADHD as another disorder such as dysregulation disorder, impulse disorder, bipolar disorder or intermittent explosive disorder. This is not to say that there cannot be comorbid disorders along with ADHD because often depression and or anxiety are experienced in individuals with ADHD. (1)
I want to focus on the symptom of intense emotions since it is the hallmark of ADHD and it seems this symptom has the most adverse effect on those with ADHD. ADHD is detected in the frontal lobe of the brain where the brain connectivity responsible for emotions are congested and constricted therefore, affecting such behaviors as planning, organization, flexibility, time management, procrastination, self-control, perseverance, forgetfulness, initiating tasks and self-regulation; the ADHD brain is over reactive and motivated by instant self-gratification and the ADHD brain lacks adequate dopamine. (3 & 4) Because of the nature of ADHD, children especially are thought of as being disobedient, defiant and rude and often punished for their behavior. Studies have revealed a majority of children with ADHD are defiant, non-compliant with what is expected of them and have problems with authority figures. The truth is that children with ADHD can be quickly overwhelmed with emotion in reaction to someone else’s exaggerated response; they are difficult to rationalize with and they have difficulty distinguishing between what is a dangerous threat and what is perceived to be a minor problem. Social anxiety is often a chronic difficulty and both anxiety and persistent depression results from frustration, low self-esteem; feeling as if they are failures; feeling they can’t do anything right or they are always in trouble receiving negative feedback. Those with ADHD also may lie to keep from getting scolded and have frequent meltdowns due to poor frustration tolerance. The amazing thing is that these individuals are able to focus on a task they enjoy, but their ADHD makes them lose track of time due to disorganization. If a task is too difficult or there is lack of interest, that same disorganized mind gets frustrated and without the ability to self-regulate, if pushed to proceed with that difficult task, the child is likely to have a tantrum. The fact is that these children’s and adult’s brains are wired differently than brains absent of this disorder and therefore an accurate diagnosis is necessary in order to obtain the best treatment possible and to educated parents and teachers giving them tools to teach and encourage these individuals who experience from symptoms of ADHD.
DIABLO ASSESSMENTS INC - INTERNAL MEDICINE NEUROLOGICAL ORTHOPEDIC PSYCHIATRIC PSYCHOLOGICAL / NEUROPSYCHOLOGY TESTING RICHMOND SAN JOSE SACRAMENTO FREMONT ANTIOCH CA
As a mother of a child with severe Attention-deficit/hyperactivity disorder (ADHD), I have experienced the trials and heartaches of the consequences of how ADHD affects behavior including the ability to complete tasks, attend to necessary homework and chores, holding a job, self-regulate and have appropriate emotional responses. I have learned through experience and found through research, that dealing with individuals who suffer from ADHD is not the same as dealing with a non-ADHD person. First, ADHD is a common diagnosis especially among children. However, ADHD is also experienced by adults. Second, if not understood by caregivers or family members, it can affect ones learning ability and destroy relationships, both in childhood and adulthood.
According to the DSM-V, diagnostic criteria for disorders, ADHD has three different diagnoses; ADHD, predominantly hyperactive/impulsive presentation; predominantly inattentive presentation and combined presentation. (1) Often you will see clinicians or teachers use the term ADD, which is only a shortcut indicating the inattentive presentation only. The DMS-V lists those symptoms we are most familiar with such as, hyperactivity, impulsiveness, distractibility, difficulty focusing, inattention and poor concentration. However, what the DSM-V does not elaborate on, is a child’s actual chronological age and their level of emotional development and intense emotions. Individuals with ADHD develop an average of 30% behind their actual age in the frontal lobe, which means that a child age 13 with ADHD has the emotional development of a child who is age 8.67 years. (2) This is an important distinction because as we know a 13-year-old is treated differently than a child who is 8 ½ years due to their level of maturity. This not only affects their social standing, but also their learning ability and emotional maturity. Intense emptions and the result of not recognizing this symptom as part of ADHD can lead a clinician to misdiagnose ADHD as another disorder such as dysregulation disorder, impulse disorder, bipolar disorder or intermittent explosive disorder. This is not to say that there cannot be comorbid disorders along with ADHD because often depression and or anxiety are experienced in individuals with ADHD. (1)
I want to focus on the symptom of intense emotions since it is the hallmark of ADHD and it seems this symptom has the most adverse effect on those with ADHD. ADHD is detected in the frontal lobe of the brain where the brain connectivity responsible for emotions are congested and constricted therefore, affecting such behaviors as planning, organization, flexibility, time management, procrastination, self-control, perseverance, forgetfulness, initiating tasks and self-regulation; the ADHD brain is over reactive and motivated by instant self-gratification and the ADHD brain lacks adequate dopamine. (3 & 4) Because of the nature of ADHD, children especially are thought of as being disobedient, defiant and rude and often punished for their behavior. Studies have revealed a majority of children with ADHD are defiant, non-compliant with what is expected of them and have problems with authority figures. The truth is that children with ADHD can be quickly overwhelmed with emotion in reaction to someone else’s exaggerated response; they are difficult to rationalize with and they have difficulty distinguishing between what is a dangerous threat and what is perceived to be a minor problem. Social anxiety is often a chronic difficulty and both anxiety and persistent depression results from frustration, low self-esteem; feeling as if they are failures; feeling they can’t do anything right or they are always in trouble receiving negative feedback. Those with ADHD also may lie to keep from getting scolded and have frequent meltdowns due to poor frustration tolerance. The amazing thing is that these individuals are able to focus on a task they enjoy, but their ADHD makes them lose track of time due to disorganization. If a task is too difficult or there is lack of interest, that same disorganized mind gets frustrated and without the ability to self-regulate, if pushed to proceed with that difficult task, the child is likely to have a tantrum. The fact is that these children’s and adult’s brains are wired differently than brains absent of this disorder and therefore an accurate diagnosis is necessary in order to obtain the best treatment possible and to educated parents and teachers giving them tools to teach and encourage these individuals who experience from symptoms of ADHD.
- American Psychiatric Association (2013) DSM-V Diagnostic and Statistical Manuel of Mental Disorders, fifth addition.
- Forbes, S. (2017) What Is My ADHD Child’s Executive Function Age?
- Brown, T.E., Ph.D. (2017) Get A Grip On Tough Emotions
- Halpern, J.M. (2000) The Neurobiology of ADHD
DIABLO ASSESSMENTS INC - INTERNAL MEDICINE NEUROLOGICAL ORTHOPEDIC PSYCHIATRIC PSYCHOLOGICAL / NEUROPSYCHOLOGY TESTING RICHMOND SAN JOSE SACRAMENTO FREMONT ANTIOCH CA