MY ADHD CHILD GETS ANGRY ALL THE TIME

Does anger and ADHD go hand in hand?  Parents of children with ADHD often describe their child as being angry or having angry outbursts.  What is it?  What causes it?  How can it be fixed?  These are all the questions running through a parent's mind as they try to figure out how to help their child.  It's frustrating, sad and as a parent you feel completely powerless.  What's worse is in the school setting the child is often misunderstood and punished for their emotional behavior.  What's a parent to do in this situation?

ADHD IS MISUNDERSTOOD

ADHD is a complex disorder and is often not understood by parents, school staff, and the child that has it.  If we all learn to better understand what ADHD is, we can come up with solutions and strategies to help a child learn, grow and do better.  We can give them the supports they need to reduce or diminish the undesired behaviors.   This can have many positive outcomes for all involved.  So how do we better understand the anger and ADHD connection?  

UNDERSTANDING ADHD

Dr. Russell Barkley is well known in the area of ADHD.  If you have not watched any of his videos or read his books, you should!  He is so insightful and offers a clinical perspective that makes sense.  It helped me understand why my child does what he does.  It helped me understand what his body is doing and how ADHD affects his mind and abilities.  With a better understanding on my part, I can better advocate for him at school and educate the staff on what he is going through and what he needs to be successful.  

One of my favorite videos is the video discussion on The Importance of Emotions in ADHD.  I want to share some key findings from that video with all of you.  My hope is it will give you a better understanding of your child so you know what you can do to help them.  The video is about 75 minutes but is worth taking the time to watch.  It's a lot of clinical information, but it offers a great perspective on what we are dealing with. 

HOW DOES ADHD AFFECT THE BRAIN?

ADHD is a developmental delay.  It affects working memory, failure of language to guide behaviors and motivation.  This can lead to little action to complete goals and challenges connecting behaviors over time towards goal progress or completion.  ADHD children also struggle with resisting distractions.  They actually react to distractions more than their non ADHD peers.  There is an inability to suppress their emotional responses to situations.  Once they are distracted, they are less likely to reengage.  They are also often impulsive which means they don't possess the ability to "stop and think" before they act.  All of these things in a classroom setting make a recipe for disaster as many of us know.  

EMOTIONAL CONTROL AND ADHD

When thinking about anger and ADHD,  you need to consider emotions too.  Emotional control is the capacity to voluntarily inhibit the expression of an emotion.  When someone feels an emotion, they should have an ability to  suppress the urge to respond.  Children with ADHD do not have the ability to resist that urge.  We all know what happens next.  There is an emotional outburst response which is often not aligned with the situation.  It's often appears immature or embarrassing because it just doesn't make sense to those of us that have the ability to to control emotions.  

ADHD children show emotions more than other people because they are emotionally immature.  They struggle with getting control of themselves and down regulating the emotions they feel.  Negative emotions are often much more intense than positive emotions, and create an even greater challenge for them.  

STEPS FOR EMOTION REGULATION

In an average person without ADHD, the mind quickly shifts through a process of controlling or managing emotions.  It happens rapidly and naturally without active thought.  It's almost like a reflex and it looks like this:

• Suppress the primary emotion that was provoked
• Self soothing and calming techniques
• Refocusing attention away from the situation that triggered the emotion
• Create another emotion instead of the negative emotion

Imagine not having that natural reaction or control over your emotions to situations.  If you said what you really wanted to say, how often would you be in trouble?  Would you still have a job?  How would your relationships at home and work look with no emotion control on your part?  Pretty bad!  Well, this is the world an ADHD child lives in.  As adults we can see how damaging that would be if left unchecked in our own lives so we NEED to figure this out for our kids especially when it comes to anger and ADHD.    

WHAT IS OPPOSITIONAL DEFIANCE DISORDER (ODD)?

Dr. Barkley talks about how children with ADHD often experience ODD too. Oppositional Defiance Disorder is a pattern of defiant, aggressive behavior where there is a willfulness to refuse to obey an authority figure.  Being defiant is not for the purpose of getting attention.  The motivation for the behavior is to get someone to back off from something.   According to Dr. Barkley it is the number one comorbidity to ADHD.    He suggests that 65-84% of children with ADHD have ODD on some level.  He further explains the two areas of ODD:

• Emotional Component - includes anger, hostility and temper
• Social Conflict Component - conflict with another person which includes refusing, denying, or resisting authority

He suggests that the emotional component of ADHD comes from the ADHD itself or a mood disorder (i.e. bipolar disorder), which is a biological condition. The emotional piece of ODD can lead to other related conditions such as depression and anxiety.  Both of these are highly common among children with ADHD.  The social conflict component of ODD comes from learning and parenting.  This can lead to a conduct disorder, anti-social behavior, crime or drug use if not addressed.  

According to his research:

25%-35% of ADHD children develop a conduct disorder

25% of ADHD children develop depression

25%-35% of ADHD children develop anxiety (the risk increases with age and 45% of adults with ADHD have anxiety)

IT'S ALWAYS THE PARENT'S FAULT, RIGHT?

Dr. Barkley indicates that ADHD does contribute to ODD, but disruptive parenting also contributes.  Great, so now it's my fault?  What is disruptive parenting?  How do I not be disruptive?  Dr. Barkley mentions that up to 35% of parents with ADHD children also have ADHD themselves.  That can cause issues in parenting.  He also says that emotional and inconsistent parenting can be disruptive.  So what parent has not been emotional and inconsistent in trying to parent their ADHD child?  Most of us are exhausted and frustrated a majority of the time.  So I guess this is the point at which I stand up and say "hi my name is Maria and I have a problem.  I am a disruptive parent".  Someone please join me in this confession so I know I am not alone!

HOW DO I KNOW IT'S ADHD AND NOT SOMETHING ELSE?

Many other conditions may look similar to ADHD.  It's hard to understand what is truly ADHD or something else.  As mentioned earlier, it is common for ADHD kids to also suffer from mood disorders. 

How do I know if it's a mood disorder or ADHD?

• Problems with ADHD are emotional and the emotions are a short duration;  in a mood disorder, moods are a long duration (hours, days, weeks)
• Emotions are provoked; environmental triggers emotional responses in ADHD; in a mood disorder, nothing triggered the mood
• Emotional reactions of ADHD are more rational; something provoked the emotional response and there is an inability to suppress the response;  in a mood disorder the response is irrational and makes little or no sense

TREATMENT

Dr. Barkley recommends medications and parental behavior training to treat ADHD in children.  For medications there are two types:

• Stimulants:  suppress the limbic system; some patients experience "emotion blunting" (makes them feel emotionless, numb or bland)
• Non-stimulants:  do not affect the limbic system; activates the executive managing of emotions; should regulate emotions better than stimulants; does not cause emotional blunting.

HOW DOES ADHD IMPACT MY CHILD OVER TIME?

When you see anger and ADHD, you wonder what will that mean long term for your child.  Kids often end up feeling demoralized and like academic failures.  They struggle and feel sad and lonely be peer rejection.  Making friends or keeping friends is hard.  Over time all of these negative emotions can cause a poor self image, little confidence, low self esteem and depression.  They dwell on negativity and bad situations and can't let it go.  They can't erase this history or the feelings associated with it.  

As a parent it is heartbreaking to watch this.  All you want to do is fix it, but you don't know how.  You are not alone.

WHAT CAN I DO?

I wish I had a concreate answer on this part.  There is not manual that has exact directions on how to fix this for your child.  What I can tell you is that you first need to understand what your child is experiencing before you can try to help them.  It takes reading and educating yourself on the components of ADHD and related disorders to identify which ones are most prevalent in your child.  Once you know that you can try to be more proactive in your parenting and advocating for your child at school.  

A few tips include:

• Predict where and when the emotional outbursts will occur
• Determine if those situations can be avoided at all
• Understand the triggers of the feelings that prompt the behaviors 
• Try to prepare your child with coping techniques in advance
• Try to diminish or avoid triggers when possible
• Talk with your child about what they can do next time to avoid that situation
• Talk with your child about how they could respond differently next time in a similar situation

IEP & 504 PLAN HELP

Don't let the school continue to send your child home for bad behavior.  Don't let the school try to punish the behavior out of your child with disciplinary actions or suspensions.  Behavior issues are REAL with ADHD children.  It is part of their diagnosis and disability.  You need to make sure your voice is heard at school when discussing your child's IEP or 504 plan.   Working with a special education advocate that truly understands ADHD can make all the difference in your child's school experience.

WRAPPING UP:

Parenting is hard, but anger and ADHD adds a little something extra special for us (insert sarcastic humor).  It's not always fun, but our kids mean everything to us.  Even through the hardest times, we love them unconditionally.  We can't give up on them, ever.  There is no "right way" to do this.  ADHD is a beast!  Just make the best decisions you can for your child and always know that you can always make a different decision down the road if needed.  Hang in there!  

If you are struggling with dealing with anger and ADHD and working with the IEP team to improve the situation, contact me!  I can help, not only as an advocate, but as a parent that has experienced this with my own child.  

Oh and if you are a "disruptive parent", leave me a comment so I know I am not alone!