ADHD: What is internal and external dysregulation?

Internal vs. External Dysregulation

Children with ADHD sometimes have a hard time regulating their emotions. This is a common symptom of ADHD, but often gets overlooked.

Emotional Dysregulation is a term used to describe the inability to control ones emotional experience and expressions, which results in an excessive emotional response.

Children with ADHD tend to have a harder time regulating emotions because of their poor executive functioning skills. Emotional Dysregulation can be separated into two categories: Internal and External. Internal dysregulation can be described as emotional responses that others cannot see, while external dysregulation is emotional responses that others can see.

When describing the differences to your child you can say that internal dysregulation is like being hyper on the inside and external dysregulation is being hyper on the outside and is what others can see.

Another way to think about it:

Internal dysregulation can be viewed as both a volcano or a tornado, dependent on how they are impacting the dysregulated person. Volcanoes are their anger response, tornadoes are the internalized anxiety, intensity, and inability to feel comfortable (and sometimes safe) sitting still.

External dysregulation can be viewed as a hurricane– it is the destruction of a large number of people and a large amount of space- everyone is impacted by the externally dysregulated ADHD person. A quick tip: ADHD is more often thought about as only external dysregulation- you don’t have just one though. There is way more going on than what you can see.

It is important to note that everyone experiences both internal and external dysregulation at times. The difference for kids with ADHD, it is near 100% of the time. They never get a break from it (even when medicated) and it is absolutely exhausting.

Children who primarily internalize their emotions will experience thought patterns and emotions in their minds. They may experience a thought pattern that gets them excited and makes them want to do “all the things.” You may not be able to tell that your child is having a moment, but they may become overwhelmed or stressed, which could send them into a meltdown without warning. It is not truly overthinking, it is more of too much on the mind, going too quickly, and losing touch with mindfulness. Kids with ADHD are often described as having ‘Ferrari’ brains. This is a great metaphor for what is going on. The brain is always revving its engine. It is a different type of anxiety than what most adults define as anxiety. It is not just a need to get things done, but a need to organize and control the stress of ADHD through thoughts and personal emotions. Internal dysregulation is a deeply personal experience. Kids and adults with ADHD will often struggle to explain what it is like. But to be straight forward- it is exhausting, overwhelming, and discouraging to be internally dysregulated.

Children that display external dysregulation may immediately react to stressful situations/triggers with outbursts or meltdowns. You will be able to see your child immediately become dysregulated. A quick tip: This is also due to Rejection Sensitivity Dysphoria. They could have crying outbursts or start making noises with objects. They are often destructive in these moments but the reality is many kids with ADHD also remain externally dysregulated 24/7 (sometimes even when medicated). This is known as impulsivity, hyperactivity, talking non-stop, poor social skills, etc. External dysregulation can be straight-up embarrassing. Imagine having minimal control over how your body is acting. You’re told to ‘get it together’ but your body is working against you- in fact, your body CAN’T ‘get it together.’ It is dysregulated and needs help.

For kids that are minimally dysregulated- here are some tips that may help:

  • Be a model – your child watches how you react to triggers; try to make them more positive
  • Practice calm down strategies – your child may benefit from breathing exercises to help regulate their emotions. Practicing mindfulness can help lower their dysregulation and is beneficial to be used anywhere they go.
  • Discuss emotional triggers – your child could learn to be a ‘trigger detective’. This will teach them how to look for triggers and steer clear of things that may upset them
  • Increase Emotional Intelligence – sometimes your child may not know the exact words for the emotions they are experiencing. It may help them understand their feelings more if they practiced their emotional vocabulary. This will help them better communicate their feelings with others and describe how they are feeling.

However, to be truthful, we have found that many families do require both parenting support and individual counseling for their child to master the switch for kids that are severely dysregulated (think out of control behaviors). This is an area we specialize in and are happy to retrain your child’s dysregulation into a happier, calmer state.

With any new strategy or technique, it takes practice or time to improve these skills. You may be stressed and upset while your child is having an emotional moment, but over time they will start to improve their emotional intelligence and regulation. And remember, we are here to guide you. Click here to get started in that process.

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