Presentaion by Kate Carr Fanning "Emotions, Relationships, ADHD at HADD Information Evening 21 September 2011 as part of ADHD Awareness Week 2011

1. Emotions, Relationships, & ADHD Kate Carr-Fanning Vice Chairperson, HADD Ph.D. Candidate, Psychology in Education, Trinity College Dublin September 2011 1

2. Contents What is Adult ADHD? Executive function deficits. Emotion & ADHD. Neurobiological & psychological explanations. Relationships & ADHD. Why relationships are difficult for pwADHD. Professional treatment. Coping strategies. Self-awareness. Managing stress. Communication. 2 Potential Issues Possible Solutions

3. What is Adult ADHD ??? 3

5. What are Executive Functions ??? “... deficits in self-regulation, impairment in the ability to organize behaviour towards present & future goals & difficulty adapting socially & behaviourally to the environment ...“ (Barkley, 1994). “The symphony of the brain” (Brown, 2006)

6. Emotions & ADHD 6

7. Emotions & ADHD “Affective Liability”: Emotional volatility is not diagnostic core symptom but frequently seen (esp. in adults). Co-morbidity (co-occurrence of mood disorders). Commonly Reported Examples: Frustration / irritability. Sensitivity. Impatient. Anxiety and depression. Motivation and perseverance. Changeable. 7 (Barkley, 2001, 2003, 2006; Lewis, 2010; Wender, 1987, 1995)

8. Neurobiology of Emotional Disregulation Two Sides to the Story: Barkley’s (1997) response inhibition. Brown’s (2006) modulating emotions and managing frustration.

9. Psychology behind Emotional Disregulation History of negative experiences. Perceptual sequencing difficulties & anxiety. Repeated failures. Living in a state of tension. Underdeveloped skills &/or coping mechanisms. Unrealistic self appraisal &/or goals. 9

10. Relationships & ADHD

11. Relationships Relationships are difficult for pwADHD: Higher divorce rate, quickly falling in and out of love / intense relationships, frequent arguments with friends and family quickly get out of hand, etc. Biggest problems for spouse / partner of pwADHD Sharing responsibilities. Doesn't listen & never remembers. Social skills. Getting into trouble. Disorganized, messy, & collecting things.

12. Relationships The relationship we have with ourselves: Confusion and anxiety. Self-blame and loathing. Inadequacy. Processing emotional information.

13. ProfessionalTreatment

14. Professional Treatments Psychiatric and psychological treatment for emotional disregulation: Medication. Psychological therapies: Cognitive Behavioural Therapy (anxiety). Talk therapy &/or couples / family therapy. Getting help getting your physical world in order (e.g., OT, life coach) can have a big impact on how you feel.

15. Practical Coping Strategies Self-Awareness Managing Stress Communication

16. Self-Awareness Self-awareness is the key!!! Who am I, what do I want & value,? What are my strengths & weaknesses? How does my ADHD affect me? How does my ADHD affect others?

17. Why is Self-Awareness SO Vital ??? SELF SOCIAL Self Awareness Social Awareness RECOGNITION Relationship Management Self Management REGULATION

18. Developing Self-Awareness Strengths, capabilities, and talents: Start from a strengths based model - we often get stuck on what’s wrong with the person, & ignore what’s right with them. Positive aspects of ADHD. Consider realistic applications and options. Acceptance: Mindfulness vs. externalizing or blocking of emotions / difficulties. Don’t get stuck in the tyranny of the “should”. Develop and implement strategies. Evaluate effectiveness of strategies &adapt: Trial and error where error is your friend. www.authentichappiness.sas.upenn.edu/Default.aspx

19. Managing Stress Finding the Balance: Extreme ‘all-or-nothing’ living & emotional imbalance; e.g., over-working, over-drinking, over-sleeping, etc. Time management; Hyper-focusing on one area of life & letting all the other aspects on life. Holistic. Organization Skills: ADHD brain is an exciting, disorganized, & unpredictable place - so make your physical environment as predictable & calm as possible e.g., de-clutter your space & your life, make plans & lists, have a routine, don’t over commit yourself, etc.

20. Managing Stress Counteracting Impulsivity: Impulsivity (immediate reaction) to emotional stimulus = problem! Stress is when there are too many demands placed on us relative to our actual capacities and resources. Since people with ADHD lack certain capacities certain parts of life are going to be much more stressful for them than for others. So be aware of what this means for you (know your weaknesses) and plan ahead!

21. Communication Develop Understanding: Not always easy for someone with ADHD to communicate their thoughts and feels. But educating each other is so important in relationships: If you don't know why you'll make up your own story and it will not be pretty. What is “Fair”? “You don’t care” Faking flaky is more trouble than it’s worth! “You’re wrong” Often there is no right or wrong - it’s all about perception.

22. Communication Some Helpful Communication Tips: Sitting on the couch whining about ‘our relationship’ might not be the most productive things - try the walk and talk approach. “I feel” statements. Give lots of examples (make it real and tangible). Active listening. No drifting off, interrupting, or offering solutions. Positive communication aids - figure out structures for remembering without nagging. Set clear limits and expectations. Reasonable & realistic – don’t set up more failures. Collaborate on finding solutions.

23. Thank You For Your Attention Contact: carrfank@tcd.ie