The ADHD-Anger Connection

Let’s face it: the past 18 months have been rough. For young adults living with ADHD, there have been more challenges than ever in managing disappointment, frustration, and anxiety. As we transition to the fall and the COVID rebound, it’s worth learning how to deal with anger appropriately, feel less upset, and give a genuine apology. Regardless of who you are and how your brain is wired, everybody has those moments when a switch suddenly flips and a volcano of angry, negative emotions erupts. Before you know what’s happening, you say or do things that you’ll surely regret later, but can’t stop. Relationships, school, and work are all affected by this emotional dysregulation. Why does this occur and what can you do differently to cope with it?

When the amygdala (the fight-or-flight organ in the emotional region of the brain) becomes activated, it takes over running the brain and the prefrontal cortex (the seat of executive functioning skills, often referred to as our thinking brain) goes temporarily offline. Feelings rule the day as adrenalin courses through our bodies, ratcheting up the intensity of our reactions, our words, and our behaviors. To re-stabilize, you have to stop this flood by slowing down your breathing, heart rate, and blood pressure and power up the thinking brain. In ADHD brains where executive functioning challenges often outnumber strengths, the extra burden of effectively dealing with a rush of strong emotions can be especially tough. Folks with ADHD may react quickly with volatility instead of responding more patiently with consideration.

During an amygdala hijack, people need enough awareness about what’s happening to avoid falling into a tailspin. This is especially difficult for maturing brains with ADHD. Many older teens and emerging adults simply haven’t yet developed the ability to slow themselves down and exert impulse control due to having ADHD in the first place. It’s also difficult for many adults who struggle with emotional control and working memory because they can’t pull up other options for reacting fast enough from their stored bank of past experiences and lessons to make alternative choices.

Increasing awareness about the bodily signals that you are becoming dysregulated helps you manage these situations better. When you are not agitated, can you notice what occurs inside your body when you are heating up? Maybe your heart starts beating faster or you begin perspiring. Perhaps you speak louder or breathe very fast. When you can identify the signs of angry feelings building up inside, then you can identify and use strategies to slow down.

Research has shown that it takes the body 15 to 20 minutes to fully recover from an amygdala takeover. Many folks with ADHD have told me that they dislike the term “calming down” but prefer “slowing down” because it makes more sense to their lived experience with ADHD. In order for any techniques to work, though, they have to be practiced regularly and when you’re not in a crisis. This is why body scans, meditation, journaling, coloring, listening to music, jumping on the trampoline, listening to stories, etc. are important activities to engage in regularly. Once a day or a few times per week, establish 15 to 20 minutes of slow-me-down practice sessions or meditation sessions. Before bed can be a great time because you get a double win: building skills and slowing down before sleep.

In the moment of an outburst, you need a strategy. Having a plan for explosions gives you a much-needed sense of control and predictability about what to do when big, intense feelings occur. This plan promotes several executive functioning skills that you really need in these moments: impulse and emotional control, shift/flexibility, planning/prioritizing, and self-evaluation (metacognition). Improving your capacity to manage anger also depends on accepting that big feelings re-occur. Thinking that they won’t return after the last blowout is part of what gets you into trouble. You need to prepare for their re-appearance instead of being surprised and embarrassed each time emotions heat up. Shift from this frustration and shame to improved self-regulation and self-esteem by relying on my Stop-Think-Act-Recover (STAR) sequence.

The STAR Sequence

1. Stop: Stopping to take a pause effectively depends on knowing what triggers you. You can consider this better when you’re not in a meltdown. Rather than winging it in the middle of an escalation or making things worse, create a pre-determined plan to slow down. Then, you’ll have some good alternatives to blowing your top or withdrawing in a fury. Whether it’s listening to music, going for a walk or run, getting a glass of water, or my personal favorite, going to the bathroom to wash your hands and take a few deep breaths, you need options to settle yourself down immediately. This stop is often the hardest part of the STAR sequence. It’s familiar to keep revving things up; it can be satisfying in the moment to let out all of your pent-up anger; it may be hard to leave a provocative situation. Calling a pause in the action helps you avoid doing or saying things you will later regret and it takes time to learn this skill. Pick some self-soothing activities and put this list on your phone or post it in your room. You’ll need to rely on it quickly so keeping things simple is best. Practice this and expect slow progress. Remember that two steps forward and one step backwards still results in forward motion. This is your goal.

2. Think: Once the intensity of the emotional volcano has quieted down, you’re ready to move to the think phase. Notice what is going on inside and around you—assess your own thoughts and take stock of your words and behavior. You may cringe, you may wish you had acted differently, and that’s OK. It’s part of the accountability process. If your upset involved other people and you need to process it with them, speak about your experience with “I” statements that convey feelings, not criticism. For example, try “I feel mad when you tell me what to do because I didn’t ask for your opinion. I just want you to listen,” rather than “I feel that you’re really a jerk when you tell me what to do.” You can’t feel that someone is a jerk: that’s a thought that usually provokes a defensive response. State what was going on for you with honesty and clarity and without blame. Listen to what they have to say, repeat what you hear, and ask them to do the same. Once everybody feels heard, you can now strategize ways to deal with the situation.

3. Act: This is when you discuss and form an agreement about how to move on from this incident. Or, you make some realistic goals for yourself about how to handle similar triggers or frustrating situations in the future. If you are negotiating with someone, create a plan for checking back in. To enhance your working memory, make some notes or Post-its for yourself with tips or reminders about your mutual agreements and/or your personal goals. This is your time to pivot. You’ve slowed down and feel calmer, you’ve been accountable for your actions and reflected on why those happened, and you’ve figured out the path forward. Make sure there’s a fall-back plan in case the agreement isn’t followed.

4. Recover: Most people feel terrible after an outburst. It’s not comfortable to lose control, say mean things and then live with yourself afterward in a shame spiral. Practice self-compassion by reminding yourself that, when people experience a meltdown, it’s because they lack the necessary tools or personal resources in that moment to do something else. It’s not because something is wrong with you or you are fatally flawed. When you rely on compassion and practice forgiveness—for yourself and for someone else—you’re opening up the possibility of a different type of resolution to conflict. Instead of berating yourself, holding onto grudges, or giving apologies that seem more like throw-away comments, focus on doing things differently. An apology doesn’t mean much if you continue to repeat the problematic behavior. Learn how to give genuine apologies where you realize the importance of accountability, humility, and acknowledgment of your errors and map out a strategy for doing things differently. Brainstorm with a trusted friend, family member, therapist, or coach about what support you will need to make any desired changes.