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With ADHD, Anger May Be Genetic

Melissa Orlov on ADHD

Many adults impacted by ADHD have difficulty regulating their emotions. They may move quickly into anger, overwhelm or anxiety at unexpected times and in response to triggers that seem minor.


This emotional lability can be quite difficult for spouses and other family members to deal with. Spouses end up ‘walking on eggshells,’ uncertain when the partner with ADHD will over-react. The vigilance needed to be around someone with this sort of emotional lability leads to higher levels of stress, and anxiety about how to keep from triggering the ADHD partner, leading to a relationship that can feel unsafe.

Children with ADHD also tend to have greater emotional lability. As children grow older, many parents face unexpected responses and mood swings that cannot be attributed to puberty and aging alone.

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Research conducted by Merwood and colleagues explored the source of this emotional rollercoaster. Is it environmentally induced? Genetically linked to any of the many genes associated with attention and ADHD? Their findings, published in the Journal of the American Academy of Child and Adolescent Psychiatry in February of 2014, suggest that emotional regulation problems are a core feature of ADHD, and are genetically linked. The study was done with a sample of more than 1900 twins, ages 5 -18, and the emotional rollercoaster increased in magnitude as the children aged.

Though the research did not reach beyond age 18, my work with couples would suggest that the roller coaster continues, and perhaps increases, into adulthood and that it may be exacerbated by stress. The implications are this: adults and children with ADHD should not take their emotional swings for granted, or pass them off as “just another difficult day.” Rather, they should set emotional regulation as a target symptom in their treatment for ADHD. The improved emotional control that targeted treatment strategies can bring will help them succeed in a world that expects more even-keeled behavior, particularly from adults.

Some of the strategies that may help control emotional lability include mindfulness training; medications to treat ADHD (and can help calm the mind enough to provide a “pause” to determine whether or not to express an impulsive emotion); lessening overall stress levels by eliminating commitments; exercise; and meditation. In addition, partners of those with ADHD can contribute by learning communication strategies that account for the presence of ADHD in the relationship. This last is actually one of three legs of ADHD treatment (physiological, behavioral and interactive) that need to be considered to optimize the management of ADHD within the context of adult and family relationships.

Melissa Orlov is a marriage consultant who specializes in working with couples impacted by ADHD. She is the award-winning author of two books on the topic, and the co-founder of ADHDmarriage.com with Edward Hallowell, MD. Orlov’s new book is The Couple’s Guide to Thriving with ADHD (Specialty Press). Ms. Orlov has been interviewed about ADHD and relationships by the New York Times, CNN, Today and many more. She is a cum laude graduate of Harvard College.