Symptoms of ADHD - Emotional Dysregulation, Rejection Sensitivity, And Low Self-Worth
The emotional side of ADHD is one of the most neglected aspects of the condition.
Discussions on impairments in self-control and self-regulation usually reference goal setting, time management, and concentration. However, your self-regulation problems can also lead to mood swings, painfully intense emotions, and unexpected outbursts.
Emotional dysregulation is a core symptom of ADHD, but it is often overlooked because it is not described in the DSM-5 (golden standard for classification in the US). Throughout clinical history, emotional dysregulation has always been described as linked to ADHD, but it never received the spotlight despite the serious challenges it can create.
This article will offer a comprehensive view of how ADHD leads to emotional dysregulation, the consequences to your self-image, and the way it may affect your life.
Understanding Emotional Dysregulation
In many situations, people have good enough control over their emotions. They can add subjective meaning to their emotions, acknowledge they exist before letting go, and control the intensity of their feelings.
Unfortunately, the picture is very different if you have ADHD.
Say you are the captain of a ship. You can't bend the sea to your will, but you can stir the wheel and rely on your seamanship skills to navigate the waters. If you have ADHD, you are still the talented and capable captain of the ship. It's just that some days, you unexpectedly wake up tied to the mast of your ship.
It's as if you are only an observer while the ship goes towards rough and dangerous waters, and you can only watch with no way to stop it.
Your ADHD may not only strip you of control over the ship from time to time, but it may also make the weather much more extreme and unpredictable. One day, you are flowing along in peaceful waters, and the next day, you are struggling to stay afloat while a storm is trying to drown you.
Emotional dysregulation means a person can't control their emotions, re-define how they feel into more mature and socially acceptable reactions, re-interpretate their emotions to better cope with their feelings, and effectively acknowledge and let go of problematic emotions that weigh them down (1)
Other symptoms of ADHD tend to amplify emotional dysregulation. After all, to effectively regulate emotions, you'd need strong impulse control to not act on your gut reaction and let it define how you feel. Calming down requires strong regulation of your attention to focus elsewhere and a clear sense of your values, beliefs, and goals to anchor your reaction toward them.
It's not that others don't experience similar emotions.
Instead, the unfiltered intensity with which you feel them is unique because they flood your brain and block out any other thoughts and considerations. The reaction can often seem out of proportion to the situation. In that context, trying to regulate your emotions can sometimes feel like you are fighting with the forces of nature itself.
Emotional dysregulation can look like the following:
Intense mood swings where you may bounce from peace and tranquility to explosive fits of rage or a cascade of anxious and nihilistic thoughts.
Having days where you are totally mentally exhausted and emotionally drained, finding it impossible to get motivated and do work.
High sensitivity to stressful experiences, especially situations with many unexpected changes, twists, and turns, leading to breakdowns.
Being prone to severe burnout that lasts for days and weeks, leaving you unable to find excitement and desire for work or projects.
Every emotion is so intense it feels impossible to shake off or moderate, leaving you mentally and physically exhausted by the end.
An overwhelming sense of anxiety and panic when responsibilities begin to pile up, making it hard to get started and do the work.
Seemingly trivial tasks and activities lead to negative thought spirals that escalate into catastrophizing and meltdowns.
Getting sensitive and ruminating over what people think of you after an awkward or negative interaction.
Getting amused and laughing in inappropriate, sensitive, and serious social settings.
Falling in love so madly that everything else is forgotten for a short while.
All those issues with emotional self-control can manifest differently depending on your personality, environment growing up, social circle, and the context of the situation. One time, you can get too heated in a conversation and go off on a friend, while in another context, you may feel rejected and abandoned while making interpretations on a few text messages you got in a group chat.
Rejection Sensitivity Dysphoria (RSD)
Rejection sensitivity dysphoria is not an official symptom of ADHD because no clinical research has been done specifically for it yet. However, some specialists report that in their private practice, a significant percentage of their ADHD patients report symptoms of RSD.
Rejection sensitivity dysphoria leads you to experience excessive emotional pain from rejections and failures. It also leads you to perceive neutral conversations as negative experiences, creating feelings of shame from rejection. Finally, RSD can also lead to the irrational belief that confrontations, mild critiques, or constructive criticism are vicious insults attacking your character (2)
The pain can be especially intense if the social interaction happens with a friend, member of your family, or your partner since you deeply care about their opinion of you.
Rejection sensitivity dysphoria can look like the following:
Receiving some feedback on errors at work leaves you devastated and questioning your position at the company instead of focusing on it as an opportunity for growth.
Getting worried that your friends, family, or significant other don't like you, don't care enough, or are upset at you if they don't respond immediately.
Having a conflict resolution with your significant other leaves you overwhelmed, frustrated, and upset because you can't help but feel attacked.
Not going out to socialize with new people, not asking friends to hang out, or not asking out your crush on a date because of the existential fear of rejection and failure.
Obsessing over potential signs and cues that your partner or friends are losing interest in you and may be on the verge of abandoning you.
Having rejection sensitivity dysphoria can be extremely painful and crippling. To avoid the immense emotional pain, many people develop unhealthy coping mechanisms.
This can include avoiding confrontations with others to prevent getting hurt, people-pleasing to avoid being abandoned, rejected, or criticized, and increased apathy and emotional numbness since the most secure way not to get offended or rejected is not to feel anything at all.
Injustice Sensitivity
Do you get absolutely livid when someone wrongs you and treats you unfairly?
Have you ever reacted strongly to an injustice you've read about on the news or a story someone told you?
Cut off or significantly reduce how much you engage with a person and a friend group due to unethical behavior?
Sensitivity to injustice happens when you feel highly frustrated, angry, and upset when someone gets treated unfairly, especially if the unfair treatment happens directly to you or someone you care about.
This trait is very common among people with ADHD. Some theories suggest it happens because neurodivergent people are much more slighted, misunderstood, and mistreated, so they become more sensitive to acts of injustice and feel deep empathy for others going through the same.
You are likely to be sensitive to injustice if you think living in a sick society is not a measure of good health and deeply believe that we must try to make the world a better place no matter what.
For people in this group, simply being told that this is just the way the world is and you should focus on yourself is not enough to reassure them. A part of them can never accept that the status quo is full of discrimination, inequality, and unjust treatment.
Low Self-Worth
It's true that people with ADHD struggle with letting go of negative thoughts, moving past hurtful remarks, or overcoming shame, guilt, and feelings of inadequacy because controlling and regulating emotions can be much more challenging.
However, it's not only executive dysfunction that can wreak havoc on your mental health. How you value and perceive yourself has significant consequences on how you act, feel, and interact with others every day. Unfortunately, if you have ADHD, it's very likely that you don't have high self-esteem or confidence in yourself (3)
ADHD, especially one that is diagnosed after decades of operating in the shadows of your mind, is highly correlated with low self-worth (4)
Low self-worth is an inevitable result of neurodivergent people living in a neurotypical world.
The expectations you have imposed on yourself - social behavior, way of organizing your home and life, university and career choices, ability to concentrate, stay motivated, time management, etc. - will always be very challenging, if not impossible, to fulfill.
It's natural to feel you are not good enough if there is a constant gap between what you and others wish you were doing and what happens in reality due to the major differences in cognitive structure, brain chemistry, and mental skills that ADHD brings.
You are simply different, and it's not fair to judge your self-worth based on neurotypical standards. Unfortunately, if your family, friends, and working environment use only those different standards to measure success, it becomes very hard to think otherwise.
It can feel like there is a beast feeding on negativity in the back of your mind. Eager to take every instance of failure and rejection and use it against you. The more you mess up career opportunities due to careless mistakes, miss important events due to forgetfulness, struggle to maintain excellent grades due to inattention, and lash out to friends due to impulsivity, the more ammo it has to use against you.
Your sense of self-worth might be even lower if you got a late diagnosis because, for decades, you were programmed to believe that falling short was due to laziness, lack of discipline, or some other flaw in your character. When it's you who's entirely responsible for not being enough, it's very hard not to feel overwhelmed with shame for who you are.
Perfectionism
If you have ADHD, then you are also very likely to be a perfectionist.
Guilt for not doing enough and shame for not being enough are horrible feelings to experience. If you constantly feel inadequate, the natural response is to try and desperately over-compensate by working harder and trying to be as good as possible. Perfectionism is deeply flawed, but as a mindset, it reassures you that desperately trying to be perfect will save you from critique, rejection, and failure (5)
Ignoring for a moment whether being a perfectionist is actually useful, having such a mindset can be intensely draining and mentally exhausting. It requires a consistent effort to always over-compensate. It makes you feel like you could be doing better and not acknowledge your small victories and achievements for fear of stopping the hard work.
Maybe perfectionism could be worth it if it led to some results. Ironically enough, trying to be perfect takes you further from perfection.
Perfectionism creates immense pressure to always be perfect, which likely makes you feel stressed, anxious, and overwhelmed. Once the mind begins to get over-burdened and burnt out due to the pressure, it naturally turns toward distractions because just looking at the work you have to do can make you feel nauseous.
If the stress is not enough to make you procrastinate, then the high bar being set up will. Perfectionism means you expect yourself to be as flawless as possible.
As a result, productive procrastination, where you try to plan or prepare more before a task, is very normal because you fear starting work and not acing it from the very beginning. Furthermore, the higher stakes mean it's much more frightening and paralyzing to start since the quality must be very high.
By convincing yourself there is no room for failure, you are not allowing yourself to begin at all.
Finally, perfectionism combined with the tendency to hyper-focus creates a rather problematic all-or-nothing approach to tasks. You must do everything at once, or there's no point in trying.
It can feel like your brain is whispering how it's pointless to do anything at all unless you fully dedicate yourself and sacrifice your body, mind, and soul for the task. The perfectionist voice always comes up with plans to turn your life around, re-think and re-consider everything, and start with full dedication once again.
Having ADHD often feels like a constant switch between not doing anything, getting guilty and anxious, and suddenly desiring to do everything right in the most perfect way.
The obvious problem is that such a mindset is unsustainable and incompatible with the real world because it makes you abandon the hobby, activity, or work project the moment it deviates away from your perfectly envisioned plan.
For example, if you recently developed a passion for going to the gym and neatly followed a four-times-a-week schedule to perfection, then everything could be going well for six weeks or so.
However, the routine collapses when work becomes busier or you take on additional responsibilities at home. You could technically compromise and reduce the workouts or train from home in smaller segments, but that wouldn't be ideal, so it's not worth trying, according to the perfectionist brain.
Even if none of the problems discussed just now were true, one issue remains.
The fundamental problem is - even if perfectionism makes you more productive, effective at work, and successful, it doesn't fix your issue with low self-worth. Perfectionism is an engine that runs on dissatisfaction with yourself. Pushing the limits and over-compensating is done to make up for what you think is fundamentally wrong with you.
If that's the case, no success or achievement will be enough because your mind will just turn toward the next race or marathon that ought to be conquered. The shame and guilt don't disappear; you are just temporarily not paying attention to them while distracting yourself with work.
Key Takeaways
Emotional dysregulation is one of the main symptoms of ADHD that can significantly impact social interactions, professional success, and self-esteem.
The lack of space given to it in diagnosis and inadequate emphasis during treatment is a stark reminder that there is still a long way to go before people with an ADHD diagnosis receive optimal support for all aspects of their condition.
