Updated: Nov 3, 2021
Your computer dings again. 'Error.' Frustrated, you push back on your desk and spin your chair in a half-circle. How is this happening again? You've got so much work left to do! You press the keyboard and get the same noise. Angry now, you slap your hand on your desk. "I can't believe this; I followed instructions exactly!" Another colleague notices your frustration and suggests something you've already tried. Shortly you respond, "No, that's not going to work!" Sighing, you look around and suddenly realise everyone in the office is staring at you. Damn, was I really that loud? You look at your colleague who offered the suggestion. She looks a bit downcast. Oops, that was probably way too harsh. "Sorry," you say, wondering again how everyone else in the office seems to handle these technical errors so calmly.
For those of us with ADHD, this kind of experience can be a regular occurrence. While some neurotypicals go through life expressing only mild frustration, we will shift between anger, elation, and sadness, sometimes all in one day! A few weeks ago, we discussed how this was described as Emotional Dysregulation (ED) and could be related to Rejection Sensitivity Dysphoria (Adler & Silverstein, 2018; Bunford et al., 2015). This week we'll examine ED's relationship to anger and what the research says can be done to help support anger in those of us with ADHD.
It's clear that the link between anger and ADHD is well known, and anger was the most requested topic for our 2020 article. However, anger, like all forms of ED, is not included in the official ADHD diagnosis (Dodson et al., 2020; Kooij et al., 2019). One of the arguments for this is that not everyone with ADHD struggles with ED, and it can be hard to separate from other diagnoses (Skirrow et al., 2009).
Indeed, while it appears simple in its expression, anger is a complicated idea (Eckhardt et al., 2004; McDonagh et al., 2019). Theories of anger have included behavioural, emotional and cognitive components (McDonagh et al., 2019; Novaco, 1975). The purpose of anger is to prepare to engage in an aggressive act. When you feel angry, it triggers psychological arousal, reducing inhibitions on behaviours and supporting cognitive processes to allow aggression and aggressive decision-making to occur (DiGiuseppe & Tafrate, 2007; McDonagh et al., 2019). For those of us with ADHD related ED and impulsiveness, it's easier to get into this state.
One of the theories of ADHD and anger discusses it's link to rumination (Berry et al., 2005; Linden et al., 2003; Martin & Dahlen, 2005; McDonagh et al., 2019; Sukhodolsky et al., 2001; Wilkowski et al., 2010). McDonagh and colleagues (2019) argue that one of the reasons for anger in ADHDers was a tendency to ruminate on the offending situation and struggle to turn your attention away. Although there is no confirmed causal direction, these studies indicate that problems regulating attention away from frustrating stimuli might be one reason for more anger expression in those with ADHD. While neurotypical people can have a frustrating experience, they can also more easily focus on something else. In contrast, a person with ADHD may be unable to shift their attention, intensely ruminating on the frustrating stimulus resulting in that flooding feeling of anger and frustration.
But if those of us with ADHD are more likely to focus on negative situations and express anger more impulsively, what can we do to support that? Below I have outlined four supports for ADHD and anger that were identified in the research. As always, please remember I am a coach and researcher, not a therapist. If you feel like you need more in-depth emotional support, I encourage you to seek an ADHD therapist.
Strategies To Reduce Anger With ADHD
Many studies found various therapy or anger management classes improved the regulation of anger for adults and children (Bramham et al., 2009; Ramirez et al., 1997; Sacchetti & Lefler, 2017). Specifically, they found an improvement in cases where professionals provided support that focused on ADHD specifically. Within this overall support, here are a few methods which stood out.
This is a version of mindfulness which we discussed in our RSD article. Because so much of ADHD anger comes from not being able to switch attention or not feeling in control of how we respond, anything we can do to self-monitor is important. Even something as simple as taking a deep breath when you feel yourself getting stressed, or looking around and trying to count items in the room or describe physical sensations, can help you refocus on your actions (Cairncross & Miller, 2020; Deffenbacher, 1995; Ramirez et al., 1997).
2. Leaving A Stressful Situation
This was a self-regulatory strategy proposed by Gross & Thompson (2013; Skirrow et al., 2009). Walking away from a stressful environment or argument can give you a visual reset which helps move you out of hyperfocusing on the situation that made you angry. Examples of times you could walk away include: if technology in the office is playing up, if you're in a heated argument and need space away from the person to cool down, if you are in an overstimulating space (lots of noise, bright lights, etc.). Combining this with tip 1, self-monitoring, can help you take the actions you need to self-regulate when you start to feel frustrated.
3. Shifting Your Cognitive Framework.
This is very similar to our previous discussion on CBT in RSD. Our emotions can affect our thoughts (or visa versa), and that in turn affects our behaviours. In the case of anger, feeling intensely frustrated can lead to thoughts of frustration about a situation "Why is this computer not working again!", which can lead to behaviour, e.g. hitting the computer. In contrast, shifting our cognitive framework to something less stressful 'It's okay to lose some time to computer problems, my employer will understand', can avoid the behaviour of hitting the computer when it doesn't work (Skirrow et al., 2009).
4. Social Skills Training, Particularly Listening.
One of the most useful courses I took as a young student was Youthlines personal development and basic counselling skills. These courses taught me about emotional regulation strategies, and how to listen to others in a way that ensures they feel understood and I'm hearing them correctly. Although an ADHD diagnosis was still many years away at that point, Youthline provided me with listening skill training that I still use to this day. Researchers agree that these kinds of training can help ADHD people avoid frustration and instead interact with others in a more empathetic manner (Sacchetti & Lefler, 2017).
Overall, often feeling angry or frustrated can be part of the experience of having ADHD. Our tendency to be impulsive, emotional and hyperfocus can all be strengths. But they also have the downside of ruminating and reacting quickly to frustrating situations. Hopefully, this article has provided you with more knowledge about why you can feel frustrated as well as tips to regulate your emotions in the future. Keep making changes in the right direction and give yourself credit for trying.
Talk to you next week.
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Adler, Lenard., & Silverstein, M. J. (2018). Emotional Dysregulation in Adult ADHD. Psychiatric Annals, 47(7), 318–322. http://dx.doi.org.ezproxy.auckland.ac.nz/10.3928/00485713-20180607-01
Berry, J. W., Worthington, E. L., O’Connor, L. E., Parrott, L., & Wade, N. G. (2005). Forgivingness, Vengeful Rumination, and Affective Traits. Journal of Personality, 73(1), 183–226. https://doi.org/10.1111/j.1467-6494.2004.00308.x
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Cairncross, M., & Miller, C. J. (2020). The Effectiveness of Mindfulness-Based Therapies for ADHD: A Meta-Analytic Review. Journal of Attention Disorders, 24(5), 627–643. https://doi.org/10.1177/1087054715625301
Deffenbacher, J. L. (1995). Ideal treatment package for adults with anger disorders. In Anger disorders: Definition, diagnosis, and treatment (pp. 151–172). Taylor & Francis.
DiGiuseppe, R., & Tafrate, R. C. (2007). Understanding anger disorders. Oxford University Press.
Dodson, W., M.D., & LF-APA. (2020, July 29). New Insights Into Rejection Sensitive Dysphoria. ADDitude. https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/
Eckhardt, C., Norlander, B., & Deffenbacher, J. (2004). The assessment of anger and hostility: A critical review. Aggression and Violent Behavior, 9(1), 17–43. https://doi.org/10.1016/S1359-1789(02)00116-7
Gross, J. J. (2013). Handbook of emotion regulation. Guilford publications.