[0:00] so
[0:01] let's start with this so anyone with
[0:03] adhd get overly angry at certain games
[0:06] so i get literal migraines when i lose
[0:08] at league if i lose two to three games
[0:10] my day is ruined until i go to sleep i
[0:12] did some research and recently found out
[0:14] that people with adhd have issues with
[0:16] emotional regulation wondering if anyone
[0:19] else has had this issue or if it's
[0:20] related or if it's not adhd related i
[0:23] love the game but the way it makes me
[0:24] feel after losses isn't normal i
[0:26] literally have to avoid my favorite game
[0:28] because of how angry i get so this is a
[0:30] really cool post not because this person
[0:32] unfortunately gets super angry when they
[0:34] play league but because first of all the
[0:36] person recognizes that they have adhd
[0:38] and they've done research about it and
[0:40] they've started to discover that oh like
[0:42] maybe my experience of life can be
[0:45] understood through like science and by
[0:48] understanding science maybe i can learn
[0:49] a little bit more about my situation and
[0:52] then like actually it can empower me to
[0:54] like move in the right direction so what
[0:56] we're gonna do today is talk a little
[0:58] bit about the relationship between adhd
[1:00] and emotional regulation so the first
[1:03] thing to understand is that people who
[1:05] play video games and rage in the video
[1:07] game that's completely normal if you've
[1:09] got adhd and it is worse for you than
[1:12] for other people there's plenty of
[1:14] evidence that one of the key features of
[1:16] attention deficit hyperactivity disorder
[1:19] is emotional dysregulation okay so if we
[1:21] think about adhd there are five
[1:24] attributes of emotional dysregulation
[1:27] that we kind of look for when we're
[1:28] thinking from a clinical perspective
[1:30] about adhd so that's mood lability and
[1:33] mood lability means high fluctuations in
[1:36] mood so what that sort of means is that
[1:38] one moment you're feeling this way and
[1:40] the next moment you're feeling a
[1:41] different way okay so it's fluctuating
[1:44] mood so a lot of people who say oh my
[1:46] god i'm so bipolar i'm happy one minute
[1:48] and then i play game of league and then
[1:49] i'm so pissed off i'm so bipolar that's
[1:52] not bipolar disorder that's mood
[1:53] mobility so rapidly fluctuating moods
[1:56] the second thing is irritability so one
[1:58] of the signs of of emotional
[2:00] dysregulation especially in adhd is that
[2:02] people are prone to a lot of
[2:03] irritability that can also turn into
[2:05] anger outbursts and what we call low
[2:08] frustration tolerance so your ability to
[2:10] tolerate things that are annoying is
[2:13] like quite low so people like it's easy
[2:15] to get under people's skin and this has
[2:16] been shown to correlate with adhd the
[2:19] last attribute of motivational i mean of
[2:21] emotional dysregulation is actually
[2:23] motivation deficits so in people who
[2:25] have adhd we see all five of these we
[2:27] see anger we see irritability we see low
[2:29] frustration tolerance we see rapidly
[2:30] fluctuating moods and we actually see
[2:32] motivational deficits as well and we'll
[2:34] get to that in a second in adhd
[2:36] unfortunately these things do somehow
[2:39] correlate with the disease and let's try
[2:40] to understand that for a second so when
[2:42] researchers look at emotional
[2:44] dysregulation within adhd the first
[2:46] thing that we that they kind of
[2:47] acknowledge is that these things happen
[2:50] in people with adhd but they're not
[2:52] exclusive to adhd and this is something
[2:54] that i've seen a lot whereas if you like
[2:56] if you look at like the normal
[2:58] population okay so let's just use paint
[3:00] for a second so let's say like here is
[3:03] the normal population in terms of
[3:05] emotional regulation and then here's
[3:07] like adhd
[3:09] so this is what it'll look like where
[3:11] emotion dysregulation is is worse in
[3:14] people with adhd than it is in the
[3:16] normal population but even in the normal
[3:18] population there's still this overlap
[3:20] over here of people who are
[3:22] maybe have adhd maybe normal but they
[3:24] have emotional dysregulation the more
[3:26] troubling thing is that we're seeing
[3:28] trends in society so the rate of adhd
[3:30] diagnosis is increasing even according
[3:32] to theories like ayurveda and stuff with
[3:34] technology addiction or vata is
[3:36] increasing i think what we're beginning
[3:38] to see
[3:39] is that the overlap between the regular
[3:42] population and the adhd population is
[3:45] shrinking
[3:46] so this is what it looks like now where
[3:48] there there's like the amount of overlap
[3:51] is increasing so these two curves are
[3:53] actually getting closer together this
[3:55] has been my experience so what i'm going
[3:57] to talk to you all about today about
[3:58] adhd and emotional regulation i'm going
[4:01] to cite studies and stuff from adhd
[4:03] research but it's been my experience and
[4:05] i think we sort of see this
[4:06] epidemiologically as well that the gap
[4:08] between healthy people and adhd people
[4:12] is shrinking that society as a whole is
[4:14] becoming more emotionally dysregulated
[4:17] that we're becoming our attention span
[4:19] seems to be shrinking we're having
[4:20] motivational problems and i think it has
[4:22] a lot to do with the effect of
[4:24] technology so let's try to dive in and
[4:25] understand a little bit about how this
[4:27] works so the first thing that i'm going
[4:28] to do is share with you all a couple of
[4:30] interesting tests that we use to study
[4:33] adhd so the first is the stop signal
[4:36] test which basically like you take
[4:38] someone with adhd and then you show them
[4:40] like a picture that'll say like go and
[4:42] when when the screen flashes with go
[4:45] they're supposed to start some task so
[4:46] start stacking blocks as soon as you see
[4:49] the screen flash go the screen flashes
[4:50] go people with adhd start they start
[4:52] stacking blocks and then what it does is
[4:54] it tells them to stop so then the
[4:55] screen's flashes stop and when you flash
[4:57] stop you're supposed to stop the task so
[4:59] if you look at the brain of someone with
[5:01] adhd versus the brain of someone who's
[5:03] normal or neurotypical let's say what
[5:06] you find is that both of them are really
[5:08] good at starting right away so as soon
[5:09] as you see the the screen flash go they
[5:12] everyone starts stacking blocks but then
[5:13] when the screen flashes stop a
[5:15] neurotypical person will stop right away
[5:17] whereas there's a lag time for the
[5:19] person with adhd so what people have
[5:21] discovered is that someone with adhd has
[5:24] difficulty restraining their impulses so
[5:27] you can start things easily but if you
[5:29] have to stop doing something and shift
[5:31] your attention somewhere else that's
[5:33] much more difficult in adhd the second
[5:35] thing that we're going to talk about for
[5:36] a second because this is going to relate
[5:37] to gaming okay second thing that we're
[5:39] going to talk about is the delayed
[5:40] gratification test so if you look at
[5:42] people with adhd they seem to have
[5:44] problems with executive function and so
[5:47] what executive function is the
[5:48] definition of executive function is
[5:50] self-directed actions needed to choose
[5:53] goals and to create and act and sustain
[5:56] actions towards those goals so basically
[5:58] what the internet is bad at right like
[6:00] the ability to self-direct create goals
[6:03] enact goals and sustain actions towards
[6:06] goals so people have found that their
[6:08] executive deficits and in researchers
[6:10] have found that their executive deficits
[6:12] and adhd right it's attentional problems
[6:15] so i'm not able to restrain my attention
[6:17] therefore i can't create goals and act
[6:19] towards them in a sustainable way so the
[6:21] way that we measure there's a there's a
[6:23] test here that becomes important as well
[6:24] which is like if you give someone with
[6:26] adhd let's say you say i'll give you a
[6:28] dollar now or i'll give you five dollars
[6:30] in five minutes for a neurotypical
[6:32] person it's easier for them to choose
[6:35] five dollars in five minutes it's easier
[6:37] for them to choose delayed gratification
[6:39] and for the person with adhd it's much
[6:41] harder to choose delayed gratification
[6:44] so there's something about the way that
[6:45] their brain kind of assesses choices
[6:49] that makes them default towards like
[6:51] instant gratification and this also gets
[6:53] explored in terms of impulsivity we're
[6:55] kind of not going to go into that
[6:56] because the neuroscience of adhd is like
[6:58] awesome and complicated it's so
[7:00] fascinating so these are kind of two
[7:01] tests that teach us a couple of
[7:03] important things the first is that
[7:04] people with adhd tend to go impulsively
[7:07] towards like easier things like low
[7:10] hanging fruit and secondly like their
[7:13] ability to restrain those impulses is
[7:15] relatively low so what does all this
[7:16] have to do with emotional dysregulation
[7:18] so let's talk about that very quickly
[7:20] okay we also know through research that
[7:22] people with adhd have difficulty
[7:24] regulating their emotions and there are
[7:25] a couple of important dimensions to this
[7:27] the first is that it appears that the
[7:29] brains of people with adhd are more
[7:31] sensitive to negative emotions so that
[7:34] means is that if something bad happens
[7:36] to two people and you have an adhd brain
[7:38] in their neurotypical brain that
[7:40] frustrating thing is more likely to feel
[7:44] worse in the brain of adhd and why is
[7:47] that that probably has to do with this
[7:49] executive dysfunction and this inability
[7:51] to like restrain impulses so there's
[7:53] some evidence that the frontal lobes are
[7:55] part of what restrains or suppresses our
[7:58] experience of negative emotion so when
[8:00] that pro that part of our brain isn't
[8:02] functioning what we sort of think of as
[8:04] neurotypically anytime an adhd person
[8:06] gets exposed to something that pisses
[8:08] them off like losing a game of league of
[8:10] legends their brain amplifies that
[8:12] negative emotion much more than a
[8:14] neurotypical brain the second thing
[8:16] about emotional regulation that's a
[8:17] little bit different for people with
[8:19] adhd is that they tend to be more
[8:22] unaware of their emotions so this is a
[8:24] really fascinating study that was
[8:26] published in neuropsychology about 20
[8:28] years ago but researchers essentially
[8:30] took neurotypical people and adhd people
[8:33] and they assessed their awareness of
[8:36] emotion and what they essentially found
[8:38] is that for a neurotypical person the
[8:41] more powerfully you feel an emotion the
[8:44] more aware you are that you feel it i
[8:46] know this sounds kind of weird but like
[8:47] if i lose a loved one as the intensity
[8:50] of my grief increases i'm more likely to
[8:52] be aware that like i'm grieving right so
[8:54] the more powerful the emotion is the
[8:57] more aware i am that i'm feeling it so
[8:59] like if i'm super super sad it's easier
[9:01] for me to detect sadness within myself
[9:03] so they found something really
[9:04] interesting which is that in adhd the
[9:06] more powerful the emotion is the more
[9:08] that the adhd brain becomes blinded to
[9:11] it okay which is a really interesting
[9:13] it's an interesting dichotomy and so
[9:15] it's a fascinating paper so this is this
[9:17] kind of becomes more important for adhd
[9:19] folks because as you begin to feel more
[9:22] intense emotion you kind of become
[9:23] blinded to it so like if you're playing
[9:25] a game of league of legends like even
[9:27] though you're starting to feel angry
[9:29] like you're not going to become aware of
[9:31] it the more angry you feel like it sort
[9:33] of like suppresses your ability to
[9:35] become aware of it and so what it does
[9:37] is kind of rises to the surface and then
[9:39] overflows like a volcano so this is
[9:41] really common in people with adhd who
[9:43] play video games is that their their
[9:44] sensitivity to the emotion is greater
[9:46] their ability to restrain the emotion
[9:48] from a frontal lobe standpoint and kind
[9:50] of like suppress it is weaker and their
[9:53] blindness to the emotion actually
[9:55] increases so it's really fascinating but
[9:57] it does appear like there are a lot of
[9:59] things about video games that really
[10:01] like interact with the adhd brain in a
[10:03] very specific and unique way so if we
[10:05] kind of go back to like delayed
[10:07] gratification and and that kind of stuff
[10:09] the stop signal test we can also see why
[10:11] people play league of legends and get
[10:13] really frustrated right so the adhd
[10:15] brain is like looking at my options for
[10:17] the day and like literally my brain is
[10:20] going to overvalue things that offer
[10:22] immediate gratification i'm more likely
[10:24] to be impulsive and not be able to
[10:26] restrain my decisions so i can apply for
[10:29] a job today which my brain is going to
[10:31] like devalue because of literally the
[10:33] way that it does calculations and it's
[10:34] going to emphasize things like playing
[10:36] video games because those have very
[10:38] immediate gratifications so that's why i
[10:41] start to play the game as i play the
[10:42] game and i start to get emotional
[10:44] remember that my brain is a little bit
[10:46] more prone to emotional dysregulation i
[10:49] have low frustration tolerance that
[10:51] probably has to do with my frontal lobes
[10:52] as well and then as i start to get angry
[10:55] i start to become blinded to that
[10:57] emotion which then lets me perpetuate
[11:00] and not restrain and adjust my behavior
[11:03] causes the anger to compot compound kind
[11:06] of builds on itself and then it kind of
[11:07] overflows and then you wind up with
[11:09] headaches so for this person who's
[11:11] saying is it normal like as have other
[11:13] people experience this like what you're
[11:15] experiencing is completely in line with
[11:18] what we understand about adhd in video
[11:20] games which is like low frustration
[11:22] tolerance blindness to your emotion and
[11:25] experiencing emotion and raging more
[11:27] than a neurotypical brain another
[11:29] important caveat to remember is that
[11:31] remember as is the difference between
[11:33] neurotypical and adhd starts to shrink
[11:35] we start to see people who may not have
[11:37] adhd start to manifest with some of
[11:39] these behaviors and so you know people
[11:41] will sort of ask okay like what do i do
[11:43] about it and this is interesting because
[11:45] the first thing that you have to do is
[11:47] understand the emotion that you
[11:48] experience there's a model of emotional
[11:50] regulation which basically breaks
[11:52] emotional regulation and the value of
[11:54] emotional regulation into five steps
[11:56] okay so what's the value of emotional
[11:59] regulation and like how do i get it the
[12:01] first step to emotional regulation is
[12:03] situation selection and this is where we
[12:06] are our emotions influence
[12:09] which situations we'll let ourselves go
[12:11] into situation modification which is
[12:14] changing relevant aspects of a situation
[12:17] based on how it could like how i could
[12:19] feel emotionally if i'm gonna be anxious
[12:21] by going to a party like i may not go to
[12:23] the party because other people are there
[12:24] i may go to a small gathering right so
[12:27] my emotions and my anticipation of how i
[12:29] feel emotionally will select the
[12:31] situation that i go into the second
[12:33] thing is situation modification so if i
[12:35] do go to a party and i'm anxious if i'm
[12:37] aware that i'm going to be anxious i may
[12:39] bring a friend with me so it reduces my
[12:41] anxiety attentional deployment is the
[12:43] third piece of kind of emotional
[12:45] regulation and that's once i'm at the
[12:47] party what am i going to choose to focus
[12:48] on because if you know this if you have
[12:50] social anxiety that your mind like is
[12:52] paying attention to the 20 people who
[12:54] are like who may be thinking things
[12:55] about you and what you're wearing and
[12:57] you can't restrain your attention and
[12:59] actually like attend to the conversation
[13:00] that you're having so that actually has
[13:02] to do with emotional regulation as well
[13:04] because our emotions will dictate where
[13:06] our attention is deployed another aspect
[13:08] of emotional regulation that's really
[13:09] important is reappraisal so this is
[13:11] altering the way that we think about a
[13:13] situation so that our emotions are not
[13:15] like really influencing it so if i'm not
[13:17] aware of emotions like if i'm filled
[13:19] with shame and i go and i like try to
[13:22] get a job and then i get i don't get the
[13:23] job what's going to happen is like that
[13:25] shame will appraise that situation in a
[13:28] particular way the way that i make
[13:29] judgments about that situation are going
[13:31] to be due to my emotional appraisal
[13:33] right so i'll conclude oh you know i'm a
[13:35] terrible person they're gonna have far
[13:37] more qualified candidates whereas like
[13:38] there are a thousand reasons why i may
[13:40] not get a job it may have nothing to do
[13:41] with me but i have to be aware of that
[13:42] emotional contribution to my judgments
[13:45] and then the fifth thing is response
[13:46] modulation so p people who have a high
[13:48] degree of emotional regulation can
[13:50] literally modulate their emotional
[13:52] responses when i rage in a game of
[13:54] league of legends like how do i regulate
[13:56] it how do i modulate that response so i
[13:58] don't get as upset so these are kind of
[13:59] the five components of emotional
[14:01] regulation and people with adhd tend to
[14:03] be not great at those and so the
[14:05] question becomes okay how do i fix this
[14:07] how do i like regulate my emotions and
[14:09] it all starts with being able to
[14:11] recognize emotions and so i know it
[14:12] sounds kind of unsatisfying but to a lot
[14:14] of people what i'll say is like just
[14:16] notice your emotions like you can't
[14:18] start anywhere except for noticing your
[14:20] emotions and there's good evidence that
[14:22] people who train themselves in
[14:24] understanding their emotions will
[14:26] improve in all five of those domains and
[14:28] this is what's kind of interesting is if
[14:30] you're listening to that solution and
[14:31] you're saying like that's not enough i
[14:33] need to modulate my emotions i'm not
[14:35] like understanding emotions feels
[14:37] insufficient that's probably your adhd
[14:40] brain like looking for a short term
[14:42] solution and devaluing like a long-term
[14:45] solution that doesn't appear to
[14:46] immediate gratification right so it's
[14:48] kind of interesting because even if you
[14:49] say that's not enough that's not what i
[14:51] want
[14:52] where is that judgment coming from
[14:56] [Music]
[15:02] you