Among one of the most commonly diagnosed disorders in children, ADHD has been a subject of controversy over the years, especially as it relates to the recommended prescribed stimulant medications. 7% of the population of the United States meets diagnostic criteria for attention deficit hyper activity disorder (ADHD), according to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V). The disorder has two specific subtypes: Predominately Inattentive Type and Combined Inattentive and Hyperactive/Impulsive Type. The criteria for both subtypes are based on the person’s behavior patterns over time. Given that ADHD affects the lives of millions of Americans, it is an important topic to consider during National Mental Health Awareness month.
Mainstream culture has criticized the disorder’s diagnosis and treatment, stating there are many reasons why children have difficulty focusing, and that all children are hyperactive and misbehave at times. But ADHD is a far more complex disorder that affects many other aspects of life, including social relationships, emotion regulation and mood, increased risk for addiction and other thrill-seeking behaviors, conduct problems, and difficulty forming healthy lifestyle habits. Most people outside of the mental health profession do not recognize the comprehensive toll that ADHD can take on an individual’s functioning and quality-of-life.
The purpose of this article is to discuss two of the major factors associated with ADHD which, unlike academic functioning, have not received as much attention: social-relational functioning and emotion regulation. Recognizing these components can empower those suffering from ADHD as well as their friends and loved ones. With therapy, individuals with ADHD can manage these symptoms and improve their capacity for interpersonal relationships.
Social Relationships: If you have ADHD, or know someone who does, you may have noticed the difficulty in navigating interpersonal relationships. Many individuals exhibit difficultly engaging in conversation: struggling with active listening or frequently interrupting others to interject their own thoughts. This is because the brain’s pre-frontal cortex struggles with self-control. They may also worry that they’re going to forget what they are about to say because of their trouble paying attention. Thus, frequently interrupting others, or being preoccupied with their own thoughts while others are talking, are common factors that may interfere with their ability to have quality conversations. This may transfer to interpersonal relationships, where they may forget a lot of information their loved ones tell them, and they may become frustrated by their forgetfulness. More serious challenges with social relationships may stem from the person acting impulsively and having trouble filtering their thoughts — so they hurt other people’s feelings — or struggling to make decisions in the relationship. These issues are well-documented by clients and through research studies. Cognitive-behavior therapy supports clients by teaching how to mindfully approach conversations rather than focus on their thoughts while interacting with others.
Emotion Regulation and Mood: One of the least known facts about living with ADHD is its impact on one’s ability to self-regulate intense emotions. Individuals with ADHD feel their emotions more deeply and for longer periods of time. In addition, they have difficulty regaining self-control after experiencing strong emotions. This is true for both children and adults living with ADHD. They may also experience triggers for intense emotions more often than individuals who do not have ADHD. This remains an important area for research and developments in treatment. Low frustration tolerance, another well-documented symptom of ADHD, has been studied, and it can be treated with both medication and effective coping strategies. Other intense emotional experiences, however, have only recently received attention from researchers. Meanwhile, therapists can teach clients coping strategies such as mindfulness techniques and cognitive restructuring (modifying negative thoughts that provoke intense feelings).
These issues raise the importance of combining therapy and medication as part of a comprehensive treatment plan. It is in therapy that individuals develop coping strategies, such as mindfulness and social skills training. Learning how to live successfully with ADHD is just as important as medically managing the symptoms with stimulants. Clients and professionals need to work together to improve education about all the ways ADHD affects functioning. Understanding that ADHD is not only about attention and hyperactivity may improve people’s willingness to accept the diagnosis and conceive of a more comprehensive plan of action.
If you, your child, or someone that you know has been diagnosed, or it has been suggested, consider the impact that it can have on their social and emotional functioning, as well as their performance at school or at work. Raising awareness of how ones interpersonal and emotional life can be impacted will hopefully motivate people to seek treatment for themselves or their children. While many intelligent persons who are self-motivated can get through school without actively treating ADHD, it is much harder to successfully regulate emotions or navigate social relationships effectively without identifying the problems and taking a solution-focused approach to addressing the challenges. Understanding how something affects us and being open about finding solutions can bring great freedom, reduce shame, and build self-confidence.