Ask Dr. Saline: How Can I Stop Emotional Meltdowns As an Adult With ADHD?

angry manDear Dr. Saline, I’m an adult in my late 50’s and have finally been diagnosed with ADHD. One of the behavior patterns I’ve struggled with over the years is emotional meltdowns. I get easily overwhelmed by stress, worry, or uncomfortable social situations. At first I get irritable, then it builds up to anger and eventually I just snap and lose my temper. I know it affects my family life and would like to do better for them and for myself. Any tips? Thank you, Kevin

From Dr. Saline:

Dear Kevin, emoji blocksIt’s wonderful that you have been diagnosed and are working on making positive changes for yourself and your family. Anger is often a difficult emotion to manage for kids and adults with ADHD. Regulating intense emotions can be extra tough in the heat of the moment when your ADHD brain goes into overdrive. It’s hard to hold it together when you’re angry, frustrated or afraid. You may know you’re supposed to stay calm, take a break or practice breathing exercises, but that all flies out the window once you’re triggered. Instead, you may yell, cry or say inappropriate things which you’ll probably regret later.  You already have the self-knowledge and awareness about your emotional dysregulation at times of great overwhelm. So you’re most of the way there! In order to gain more control over your emotions in the moment, you’ll need to practice a 4-step process I call “STOP-THINK-ACT-RECOVER”. The basic idea is that you stop long enough to notice the oncoming emotional meltdown, think about what’s happening and what other choices you could make, take a different action or approach and set aside time to recover and integrate. Let’s take a closer look at this technique.

Regain Emotional Control with “STOP-THINK-ACT-RECOVER”

Self-regulation is tough for folks with ADHD. The swell of emotional triggers take over the portion of the brain that helps us regulate and remain steady. The ADHD brain, with its ‘now/not now’ switch, may not recognize the triggers until it’s too late, leading to emotional flooding. STOP-THINK-ACT-RECOVER is a technique which will allow you to learn to identify and respond to emotional triggers and manage angry outbursts more intentionally. Think of it as your internal GPS which will guide you away from the oncoming storm and toward quieter shores.

STOP:

hands making stop sign

In this step you practice self-awareness. You notice the physiological signs that you are activated. You may feel your heart rate increase, notice perspiration and hear your voice growing louder. Catch yourself as soon as you’re aware of your physical symptoms and mounting emotions and stop before you melt down. If possible, go to another room or step outside. Take yourself out of the environment which is creating stress. If you’re interacting with other people, it’s ok to say, “I’m feeling a bit overwhelmed and need to take a little breather to gather my thoughts.” 

THINK: 

woman thinkingNow that you’ve stopped the oncoming meltdown and put yourself in a neutral environment, take a pause long enough to regain your composure and gather your thoughts. Use metacognition to reflect on your thoughts and experiences. Take a few deep breaths and consider what’s most important right now. If you need to respond to an upsetting email, consider composing a few drafts to get your thoughts out. If you need to get back to a conversation, think about what might be a genuine response that isn’t offensive. Decide what the next right thing to do is.

ACT:

ACT graphicHere’s where you engage in doing that next right thing. You redirect your actions toward others in ways that are more constructive. These can include making repairs or simply moving onto something else. Either way, you are making a choice that is different from your typical reactions. Instead of yelling at your spouse or child, take the time to breathe deeply, speak calmly and share honestly.

RECOVER:

woman sitting on mountainGive yourself time and space to recalibrate. There is no need to rush and process anything. In fact, having some distance between an emotional meltdown and talking about it can be really helpful. Everybody has settled down and sometimes people have moved on or are more comfortable being accountable. After a few hours or maybe the next day, you (and those around you) will be better able to have an effective and clarifying conversation. ADHD or not, we are ultimately responsible for our reactions and behavior. We may not be able to control an unpleasant situation, but we can learn how to manage the ways we choose to respond. It’s the power of choice that needs to be the target of your focus, not self blame or shame. When you equip yourself with the necessary tools to manage anger, you will feel better about yourself, improve social relationships and increase productivity. And most importantly, you will help restore calm and connection within yourself and for your family.