Therapist Reacts: Why Do Gamers TILT So Hard? ADHD and Emotions

[00:00] so

[00:01] let's start with this so anyone with

[00:03] adhd get overly angry at certain games

[00:06] so i get literal migraines when i lose

[00:08] at league if i lose two to three games

[00:10] my day is ruined until i go to sleep i

[00:12] did some research and recently found out

[00:14] that people with adhd have issues with

[00:16] emotional regulation wondering if anyone

[00:19] else has had this issue or if it's

[00:20] related or if it's not adhd related i

[00:23] love the game but the way it makes me

[00:24] feel after losses isn't normal i

[00:26] literally have to avoid my favorite game

[00:28] because of how angry i get so this is a

[00:30] really cool post not because this person

[00:32] unfortunately gets super angry when they

[00:34] play league but because first of all the

[00:36] person recognizes that they have adhd

[00:38] and they've done research about it and

[00:40] they've started to discover that oh like

[00:42] maybe my experience of life can be

[00:45] understood through like science and by

[00:48] understanding science maybe i can learn

[00:49] a little bit more about my situation and

[00:52] then like actually it can empower me to

[00:54] like move in the right direction so what

[00:56] we're gonna do today is talk a little

[00:58] bit about the relationship between adhd

[01:00] and emotional regulation so the first

[01:03] thing to understand is that people who

[01:05] play video games and rage in the video

[01:07] game that's completely normal if you've

[01:09] got adhd and it is worse for you than

[01:12] for other people there's plenty of

[01:14] evidence that one of the key features of

[01:16] attention deficit hyperactivity disorder

[01:19] is emotional dysregulation okay so if we

[01:21] think about adhd there are five

[01:24] attributes of emotional dysregulation

[01:27] that we kind of look for when we're

[01:28] thinking from a clinical perspective

[01:30] about adhd so that's mood lability and

[01:33] mood lability means high fluctuations in

[01:36] mood so what that sort of means is that

[01:38] one moment you're feeling this way and

[01:40] the next moment you're feeling a

[01:41] different way okay so it's fluctuating

[01:44] mood so a lot of people who say oh my

[01:46] god i'm so bipolar i'm happy one minute

[01:48] and then i play game of league and then

[01:49] i'm so pissed off i'm so bipolar that's

[01:52] not bipolar disorder that's mood

[01:53] mobility so rapidly fluctuating moods

[01:56] the second thing is irritability so one

[01:58] of the signs of of emotional

[02:00] dysregulation especially in adhd is that

[02:02] people are prone to a lot of

[02:03] irritability that can also turn into

[02:05] anger outbursts and what we call low

[02:08] frustration tolerance so your ability to

[02:10] tolerate things that are annoying is

[02:13] like quite low so people like it's easy

[02:15] to get under people's skin and this has

[02:16] been shown to correlate with adhd the

[02:19] last attribute of motivational i mean of

[02:21] emotional dysregulation is actually

[02:23] motivation deficits so in people who

[02:25] have adhd we see all five of these we

[02:27] see anger we see irritability we see low

[02:29] frustration tolerance we see rapidly

[02:30] fluctuating moods and we actually see

[02:32] motivational deficits as well and we'll

[02:34] get to that in a second in adhd

[02:36] unfortunately these things do somehow

[02:39] correlate with the disease and let's try

[02:40] to understand that for a second so when

[02:42] researchers look at emotional

[02:44] dysregulation within adhd the first

[02:46] thing that we that they kind of

[02:47] acknowledge is that these things happen

[02:50] in people with adhd but they're not

[02:52] exclusive to adhd and this is something

[02:54] that i've seen a lot whereas if you like

[02:56] if you look at like the normal

[02:58] population okay so let's just use paint

[03:00] for a second so let's say like here is

[03:03] the normal population in terms of

[03:05] emotional regulation and then here's

[03:07] like adhd

[03:09] so this is what it'll look like where

[03:11] emotion dysregulation is is worse in

[03:14] people with adhd than it is in the

[03:16] normal population but even in the normal

[03:18] population there's still this overlap

[03:20] over here of people who are

[03:22] maybe have adhd maybe normal but they

[03:24] have emotional dysregulation the more

[03:26] troubling thing is that we're seeing

[03:28] trends in society so the rate of adhd

[03:30] diagnosis is increasing even according

[03:32] to theories like ayurveda and stuff with

[03:34] technology addiction or vata is

[03:36] increasing i think what we're beginning

[03:38] to see

[03:39] is that the overlap between the regular

[03:42] population and the adhd population is

[03:45] shrinking

[03:46] so this is what it looks like now where

[03:48] there there's like the amount of overlap

[03:51] is increasing so these two curves are

[03:53] actually getting closer together this

[03:55] has been my experience so what i'm going

[03:57] to talk to you all about today about

[03:58] adhd and emotional regulation i'm going

[04:01] to cite studies and stuff from adhd

[04:03] research but it's been my experience and

[04:05] i think we sort of see this

[04:06] epidemiologically as well that the gap

[04:08] between healthy people and adhd people

[04:12] is shrinking that society as a whole is

[04:14] becoming more emotionally dysregulated

[04:17] that we're becoming our attention span

[04:19] seems to be shrinking we're having

[04:20] motivational problems and i think it has

[04:22] a lot to do with the effect of

[04:24] technology so let's try to dive in and

[04:25] understand a little bit about how this

[04:27] works so the first thing that i'm going

[04:28] to do is share with you all a couple of

[04:30] interesting tests that we use to study

[04:33] adhd so the first is the stop signal

[04:36] test which basically like you take

[04:38] someone with adhd and then you show them

[04:40] like a picture that'll say like go and

[04:42] when when the screen flashes with go

[04:45] they're supposed to start some task so

[04:46] start stacking blocks as soon as you see

[04:49] the screen flash go the screen flashes

[04:50] go people with adhd start they start

[04:52] stacking blocks and then what it does is

[04:54] it tells them to stop so then the

[04:55] screen's flashes stop and when you flash

[04:57] stop you're supposed to stop the task so

[04:59] if you look at the brain of someone with

[05:01] adhd versus the brain of someone who's

[05:03] normal or neurotypical let's say what

[05:06] you find is that both of them are really

[05:08] good at starting right away so as soon

[05:09] as you see the the screen flash go they

[05:12] everyone starts stacking blocks but then

[05:13] when the screen flashes stop a

[05:15] neurotypical person will stop right away

[05:17] whereas there's a lag time for the

[05:19] person with adhd so what people have

[05:21] discovered is that someone with adhd has

[05:24] difficulty restraining their impulses so

[05:27] you can start things easily but if you

[05:29] have to stop doing something and shift

[05:31] your attention somewhere else that's

[05:33] much more difficult in adhd the second

[05:35] thing that we're going to talk about for

[05:36] a second because this is going to relate

[05:37] to gaming okay second thing that we're

[05:39] going to talk about is the delayed

[05:40] gratification test so if you look at

[05:42] people with adhd they seem to have

[05:44] problems with executive function and so

[05:47] what executive function is the

[05:48] definition of executive function is

[05:50] self-directed actions needed to choose

[05:53] goals and to create and act and sustain

[05:56] actions towards those goals so basically

[05:58] what the internet is bad at right like

[06:00] the ability to self-direct create goals

[06:03] enact goals and sustain actions towards

[06:06] goals so people have found that their

[06:08] executive deficits and in researchers

[06:10] have found that their executive deficits

[06:12] and adhd right it's attentional problems

[06:15] so i'm not able to restrain my attention

[06:17] therefore i can't create goals and act

[06:19] towards them in a sustainable way so the

[06:21] way that we measure there's a there's a

[06:23] test here that becomes important as well

[06:24] which is like if you give someone with

[06:26] adhd let's say you say i'll give you a

[06:28] dollar now or i'll give you five dollars

[06:30] in five minutes for a neurotypical

[06:32] person it's easier for them to choose

[06:35] five dollars in five minutes it's easier

[06:37] for them to choose delayed gratification

[06:39] and for the person with adhd it's much

[06:41] harder to choose delayed gratification

[06:44] so there's something about the way that

[06:45] their brain kind of assesses choices

[06:49] that makes them default towards like

[06:51] instant gratification and this also gets

[06:53] explored in terms of impulsivity we're

[06:55] kind of not going to go into that

[06:56] because the neuroscience of adhd is like

[06:58] awesome and complicated it's so

[07:00] fascinating so these are kind of two

[07:01] tests that teach us a couple of

[07:03] important things the first is that

[07:04] people with adhd tend to go impulsively

[07:07] towards like easier things like low

[07:10] hanging fruit and secondly like their

[07:13] ability to restrain those impulses is

[07:15] relatively low so what does all this

[07:16] have to do with emotional dysregulation

[07:18] so let's talk about that very quickly

[07:20] okay we also know through research that

[07:22] people with adhd have difficulty

[07:24] regulating their emotions and there are

[07:25] a couple of important dimensions to this

[07:27] the first is that it appears that the

[07:29] brains of people with adhd are more

[07:31] sensitive to negative emotions so that

[07:34] means is that if something bad happens

[07:36] to two people and you have an adhd brain

[07:38] in their neurotypical brain that

[07:40] frustrating thing is more likely to feel

[07:44] worse in the brain of adhd and why is

[07:47] that that probably has to do with this

[07:49] executive dysfunction and this inability

[07:51] to like restrain impulses so there's

[07:53] some evidence that the frontal lobes are

[07:55] part of what restrains or suppresses our

[07:58] experience of negative emotion so when

[08:00] that pro that part of our brain isn't

[08:02] functioning what we sort of think of as

[08:04] neurotypically anytime an adhd person

[08:06] gets exposed to something that pisses

[08:08] them off like losing a game of league of

[08:10] legends their brain amplifies that

[08:12] negative emotion much more than a

[08:14] neurotypical brain the second thing

[08:16] about emotional regulation that's a

[08:17] little bit different for people with

[08:19] adhd is that they tend to be more

[08:22] unaware of their emotions so this is a

[08:24] really fascinating study that was

[08:26] published in neuropsychology about 20

[08:28] years ago but researchers essentially

[08:30] took neurotypical people and adhd people

[08:33] and they assessed their awareness of

[08:36] emotion and what they essentially found

[08:38] is that for a neurotypical person the

[08:41] more powerfully you feel an emotion the

[08:44] more aware you are that you feel it i

[08:46] know this sounds kind of weird but like

[08:47] if i lose a loved one as the intensity

[08:50] of my grief increases i'm more likely to

[08:52] be aware that like i'm grieving right so

[08:54] the more powerful the emotion is the

[08:57] more aware i am that i'm feeling it so

[08:59] like if i'm super super sad it's easier

[09:01] for me to detect sadness within myself

[09:03] so they found something really

[09:04] interesting which is that in adhd the

[09:06] more powerful the emotion is the more

[09:08] that the adhd brain becomes blinded to

[09:11] it okay which is a really interesting

[09:13] it's an interesting dichotomy and so

[09:15] it's a fascinating paper so this is this

[09:17] kind of becomes more important for adhd

[09:19] folks because as you begin to feel more

[09:22] intense emotion you kind of become

[09:23] blinded to it so like if you're playing

[09:25] a game of league of legends like even

[09:27] though you're starting to feel angry

[09:29] like you're not going to become aware of

[09:31] it the more angry you feel like it sort

[09:33] of like suppresses your ability to

[09:35] become aware of it and so what it does

[09:37] is kind of rises to the surface and then

[09:39] overflows like a volcano so this is

[09:41] really common in people with adhd who

[09:43] play video games is that their their

[09:44] sensitivity to the emotion is greater

[09:46] their ability to restrain the emotion

[09:48] from a frontal lobe standpoint and kind

[09:50] of like suppress it is weaker and their

[09:53] blindness to the emotion actually

[09:55] increases so it's really fascinating but

[09:57] it does appear like there are a lot of

[09:59] 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