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Monday, June 1, 2015

Anger and ADHD: Triggers and Solutions

By Dennis M.Ryan MC LPC

Introduction to ADHD

Like many young men across America, it was my job at home to mow and trim the lawn. While many sought to avoid this onerous work, none could equal my talents at avoidance. I’d take one sweep, two sweeps, maybe three and then sneak off to my room to read until my father would interrupt my solitude with his shouting and threats. I’m sure that one of the books was Tom Sawyer. I was never able to talk my friends into doing the whole thing the same way Tom was able to talk his friends into whitewashing the fence but they were always done with their chores before me and for some reason desired my company. So they pitched in. My ADHD was not officially diagnosed until my mid-fifties.

The central attributes of ADHD or Attention Deficit Hyperactivity Disorder include inattentiveness, hyperactivity or impulsivity, or both. There are a number of other symptoms as well. All “official” descriptions of ADHD are helpful but fail to paint the whole picture as ADHD manifests itself in as many ways as there are personalities. .

There are certainly many plusses to ADHD. While the need to multi-task can lead to flooding; there are times when it can be a valuable asset. One author on ADHD points out that ADHD may be a residual component of brain development from when we humans hunted to keep food on the table (the hyper-focus was a great contributor in the stalking process). Hence, many successful business people have the hyper-focus variety of ADHD. Creativity is often an ADHD asset. When the ability exists to minimize the problematic aspects of this disease, room is provided so these assets can evolve.

A Bit about Anger

 Anger is a natural healthy emotion. It is there to set boundaries, appropriately defend territory, and protect our lives. The problem is this: the anger emotion is easily distorted. Flooding or high adrenalin set for the ADHD person may create an elevated sense of endangerment. This gets coupled with the fact that the base of our brain stem that has to do with rage responses (sometimes referred to as “the reptilian brain”) does not have a quick way to differentiate between physical and non-physical threat. For those with ADHD the ability of the developed brain to override the misread nonphysical threat is greatly reduced. The outcome is similar to an individual with PTSD. The healthy brain’s ability to moderate anger is compromised and the individual with ADHD is left with either an over-response or under response (rage or shutdown).

Five Symptoms That Create Anger Triggers

Hot Temper: Paul Wender, a professor of psychiatry at the University of Utah School of Medicine, included “hot temper” as one of the symptoms of ADHD in his “Utah Criteria for Adult ADD”. 
Flooding is the experience of having too much floating around in your head at the same time coupled with an experience of over whelm. One form of stimulation can be added to the heap of swirling items in your head and the added item becomes the pin pulled out of the grenade. The person with ADHD feels like the neat little world that they have to struggle so hard to create is under attack. BOOM the anger explosion takes place.

Shame Relative to Recognized Inability to Handle the Basics of Life can trigger both depression and anger and resentment for the ADHD individual. This shame often is increased when the ADHD person seeks to self -medicate through using addictive substances or behaviors. The anger response is heightened when others are critical.

 Independent Assessment of Reality is created by frustration with not being able to do things in the established fashion and often developing “better” more creative ways of doing things. This can lead to not “suffering fools well.” An ADHD individual may tend to do things their own way in spite of cultural norms or organizational expectations. This can be a set up for conflict and the poor handling of anger.

Adrenalin Craving or High Adrenalin Set keeps those with ADHD more on edge than those in the general population. For some with ADHD adrenalin craving can cause them to seek out tension provoking situations or participate in dangerous behaviors to garner an “adrenalin rush.” For others being on edge is a way of life due to a high adrenalin set. Flooding helps maintain adrenalin. Any one of these three situations can be a precursor to poorly handled anger.

Strategic Interventions

Meditation is an excellent maintenance tool for those plagued with this disease. Unfortunately, many meditation disciplines are too involved for the beginning ADHD practitioner and the practice is often given up before it is even started. I recommend an easy three breath re-centering meditation for starters. When triggered or under stress…stop and breathe slowly and deeply with the mind’s eye focused on the breath going in and then out. Repeat this two more times. You will likely find yourself, at least momentarily, more centered. After learning this rudimentary breathing strategy one can expand to other meditation techniques keeping in mind not to impose perfection on the process.
Flooding awareness is an imperative strategy for managing anger. It is helpful to develop a way to scale the intensity of flooding. How over-whelming are feelings? Is there need to shut down momentarily in order to re-center? Is there extra difficulty gathering sufficient focus to accomplish things? These are all indicators that you are on the edge of handling your anger poorly.

Certainly the two strategies suggested above are not the complete answer in managing ADHD induced anger. Finding ways to reduce both shame and entitlement is a sound strategic path to follow. The following are important as well; trigger awareness, medication (if needed), appropriate recovery program for whatever addictions may exist, application of sound nutritional strategies and healthy use of exercise (exercise that is cross hemispheric is highly recommended).

I hope the comments I have made regarding anger and ADHD have been helpful to you. They are meant only to be a primer. For a more complete introduction to ADHD and strategies for management I highly recommend Driven to Distraction by Edward M.Hallowell and John J. Ratey.

Dennis M.Ryan MC LPC is a Licensed Professional Counselor specializing in men’s issues, anger management, and ADHD. He can be reached at ryantransform53@aol.com.Anger and ADHD: Triggers and Solutions