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Emotional Dysregulation in ADHD: A Story of Hope and Healing
  • December 10, 2024
  • Comments: 69
  • Posted by: cbtkeadmin

Recently, a client I had not seen for nearly a decade reached out and asked me to write about emotional dysregulation in Attention Deficit Hyperactivity Disorder (ADHD).

When I asked why, she lamented, “Had I known earlier about the pain and suffering of emotional dysregulation in ADHD, I would still be in the meaningful relationships I lost over time.”

Merab (not her real name) shared how understanding the connection between ADHD, high-functioning depression, and emotional dysregulation had changed her life for the better. It had taken her a long time to accept the diagnosis. Initially, she believed ADHD was a condition that only affected children. However, once she changed her perspective and embraced the positive aspects of the condition, her life began to make sense.

I was convinced her story would help others struggling with ADHD, particularly those dealing with emotional dysregulation.

When I first met Merab, she was 35 years old and on the verge of divorce, dealing with custody issues in a volatile relationship filled with constant arguments and impulsive emotional outbursts, most of them hers. She was heavily self-medicating with alcohol and cigarettes to cope. She had lost her previous job and was barely managing her current one. Overwhelmed, she struggled to meet deadlines, often underestimated how much time tasks required, and took on more than she could handle.

At that time, Merab’s father was deceased, and her primary support system consisted of her mother, siblings, and husband. However, her constant emotional outbursts, unpredictable mood swings, and perceived overreactions during conflicts strained these relationships. She viewed her reactions as normal responses to outrageous occurrences and couldn’t understand why others found her behavior problematic.

Merab had also quit school just shy of completing a program she was passionate about and dropped out of therapy several times due to impatience and emotional outbursts. When her life felt like it was falling apart, she decided to give therapy another try.

During her initial sessions, she cited various reasons for her struggles but dismissed their relevance. After four sessions, I recommended a psychiatric assessment, but she declined, insisting she didn’t have a mental illness.

A year later, Merab returned to therapy. By then, she had started seeing a psychiatrist, been diagnosed with severe depression, and was on medication. She looked happier and reported significant progress. Her relationship with her estranged husband had improved they had agreed to separate to heal independently but maintained a healthy co-parenting relationship. She had regained custody of her son with minimal conflict and fewer emotional outbursts.

Her relationship with her mother and siblings was also improving. Curious, I asked why she had booked an appointment this time, and she seemed to be doing well. With a smile, she handed me a note from the psychiatrist: “Kindly evaluate ADHD.”

Despite her progress, symptoms of irritability, frustration, anxiety, and emotional outbursts persisted. She and her psychiatrist suspected ADHD was the underlying cause of her emotional dysregulation, but they had waited until her depressive symptoms improved before pursuing an assessment.

This time, Merab was eager to explore therapy. The assignment seemed straightforward: assess and refer her back for ADHD medication. However, her psychiatrist emphasized the importance of helping Merab and her family understand ADHD, develop adaptive coping skills and learn to manage emotional dysregulation instead of using ADHD medication.

Throughout her life, Merab endured immense pain and suffering. By the time she sought help, her life was on the brink of collapse. Outgoing and friendly, she had camouflaged her depression from most people, and only her husband knew of her diagnosis. Her life, however, was marked by a pattern of broken relationships due to emotional outbursts.

She had been labelled as “bipolar” or described as ‘’moto wa kuotea mbali’’ (unpredictable fire), labels she had come to accept as part of her personality. Her sister often joked that she “killed mosquitoes with a hammer.”

Unbeknownst to many, emotional dysregulation in ADHD causes disproportionate emotional reactions, impulsive decisions, intense mood swings, and difficulty calming down, even when the situation is minor.

Friends accused her of overreacting, being too emotional, or not listening. This dysregulation caused her to blow things out of proportion and end relationships impulsively, often for self-preservation. She couldn’t understand how seemingly stable relationships could end after one minor argument that could have been resolved through calm communication. She often believed the other person was at fault, not her.

Merab’s undiagnosed ADHD had led to a series of events culminating in severe depression. Accepting treatment and understanding ADHD helped her rebuild her life. She completed her course, graduated late last year with a psychology course, and began her Master’s program earlier this year. She is diligent and on track to complete it.

Merab no longer self-medicates and is applying cognitive behavioural therapy techniques to cope with her emotions better. She plans, prioritizes, and breaks down tasks to stay organized. She has a healthy co-parenting relationship with her husband and enjoys custody of her son.

The support of her family during therapy and treatment helped strengthen their relationships. As a result, Merab benefited greatly from therapy and medication, which her doctor later stopped once she established a reliable social support system and consistent therapy sessions.

ADHD, Cognitive Behavioral Therapy, Counselling services in Kenya, Counselling services in Nairobi, Emotional Dysregulation in ADHD: A Story of Hope and Healing
Author: cbtkeadmin

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