ADHD Mood Swings: Understanding and Managing Emotional Dysregulation

It's not unusual for kids with attention-deficit/hyperactivity disorder (ADHD) to have mood swings. Estimates vary, but roughly 30 to 70% of adults with ADHD say they have trouble keeping their emotions in check. It's important to learn how to prepare for and handle your child's mood swings. It's also just as critical to help them learn how to cope. 

Learn what causes these mood fluctuations, how to spot the warning signs, and ways to help your child deal with them.

What are ADHD mood swings?

Children with attention-deficit/hyperactivity disorder experience the same feelings as other children. However, their emotions tend to be more intense. The intense emotions occur more frequently and last longer for kids with ADHD. ADHD-related mood swings may also affect their quality of life.

ADHD vs. bipolar disorder vs. BPD

Other mental health conditions can result in mood swings, including bipolar disorder and borderline personality disorder (BPD). However, the triggers and the duration of these episodes differ.

When kids with ADHD feel overwhelmed, misunderstood, or frustrated, they have mood swings. They can also occur if they are hungry or tired. Depending on the trigger and how well they can control their feelings, these mood changes may last a few minutes or the rest of the day.

Children with bipolar disorder can experience bouts of mania that continue for several weeks or months. Symptoms of mania in children include elevated mood or euphoria. This is different from normal childhood excitement. They may seem “on top of the world,” for example. In children, irritability is more common than euphoria during manic episodes, and they may have extreme anger outbursts. Other symptoms include a decreased need for sleep and changes in eating patterns. 

Depressive episodes last at least two weeks. During these episodes, a child might have a persistently sad mood. They may sleep much more than usual. They may also have feelings of worthlessness or guilt. 

Stress, trauma, big changes in life, and lack of sleep can trigger both manic and depressive episodes in children with bipolar disorder. 

Children diagnosed with borderline personality disorder (BPD) go through strong emotional changes that often continue for a few hours to days. Triggers include conflict with other people, ideas, feelings, and their environment. Not getting enough sleep can be a trigger, too.

So, although all three diagnoses may deal with experiencing mood swings, ADHD symptoms are distinctly different from bipolar and BPD symptoms. Bipolar disorder and BPD come along with other symptoms that people with ADHD do not experience.

Causes of ADHD mood swings

There are several reasons why your child may experience mood swings. Some of the main reasons are problems with executive function, heightened sensitivity, low frustration tolerance, and having other conditions along with ADHD. Hormone fluctuations can also worsen mood swings in teenage girls.

Executive function deficits

Kids with ADHD have trouble controlling their feelings. They also tend to be more emotional than their peers of the same age. Neuroimaging studies report maturational delays or atypical development in prefrontal and related circuits in many children with ADHD. These regions are important for attention, inhibition, and emotion regulation.

Rejection sensitive dysphoria (RSD)

Children with ADHD are more likely to react strongly to rejection, experiencing rejection sensitive dysphoria, or RSD. This isn’t a formal diagnosis; rather, it's a phenomenon that commonly occurs with ADHD.

In these situations, a child may have difficulty controlling their emotions if a peer or caregiver corrects their behavior, even if it is done gently.

Frustration & hyperfocus

Many children with ADHD have a hard time handling frustration, known as low frustration tolerance.

This often happens when they struggle to switch tasks, especially if they are hyper-focused on what they are doing. Hyperfocus can make it difficult to switch tasks, leading to frustration and meltdowns.

Co-occurring conditions

Many kids with ADHD have co-occurring conditions. According to the CDC and other national estimates, up to 40% of kids with ADHD may also have an anxiety disorder. Children who may have ADHD and anxiety may find it extremely challenging to manage their emotions. Kids with ADHD have more emotional dysregulation. 

Anxiety plus ADHD together worsens emotional regulation. One reason is impaired emotional regulation. For this reason, it's important that children with ADHD also receive proper screening to rule out any co-occurring conditions that could worsen their symptoms.

Signs and symptoms to watch for

Recognizing the signs of an impending tantrum is vital for parents of children with ADHD. By knowing what to look for, you can intervene and reduce the impact of an outburst. Signs include:

• Quickly going from one strong feeling to another
• Fluctuating between hyperfocusing on a task and then being unable to focus at all
• Having sudden bursts of energy and then quickly becoming tired
• Experiencing fits of anger and strong reactions to small triggers
• They're impatient, defensive, and overly sensitive when corrected

Other things may contribute to these symptoms. Not getting enough sleep, feeling overwhelmed, and having other underlying conditions may exacerbate the situation. Side effects of ADHD medication can also cause mood swings. For example, a side effect of the ADHD medication methylphenidate (Ritalin) is mood changes. A lack of support from caregivers is also a factor.

Impact on families & daily life

Outbursts due to ADHD can make your child's life tougher. They can also strain your family's connections and create social challenges. Emotional outbursts at school can negatively impact your child's education. Disruptive behaviors, such as irritability and aggression, may interfere with learning.

Diagnosing emotional dysregulation

Estimates vary by study, but emotional dysregulation is common in ADHD, broadly reported in roughly 30–70% of adults with the disorder, depending on how it’s measured. ADHD is commonly diagnosed in childhood. It's important to have your child assessed early so they can learn helpful (and personalized) strategies to cope as they grow older.

Professional assessment

To diagnose emotional dysregulation, psychologists gather information from multiple sources. This includes parent and teacher rating scales, such as the BRIEF (Behavior Rating Inventory of Executive Function) inventory, checklists, interviews, and observations. This allows the psychologist to understand your child's ability to control emotions, any deficits present, and how they affect their daily life.

Monitoring with journals & apps

Writing in a journal can help you keep track of your child's feelings. You can track patterns, potential triggers, and the effectiveness of particular coping skills. You can also use apps to gather information. As your child grows, they can also learn how to use these tools themself to help them understand their emotions.

Strategies parents can use to help kids cope with ADHD mood swings 

Dealing with meltdowns can be tough on anyone. Here are several tips you can use to help your child better manage ADHD mood swings.

24-hour rule & emotional pause

Giving your child a 24-hour "time out" can prevent them from acting on impulse in reaction to heightened emotions.

Waiting strategies help keep your child safe from reacting impulsively in the heat of the moment. A couple of examples are quitting a sports team or making an expensive purchase.

In these types of situations, give them a mandatory 24-hour "cooling off" period. This gives them ample time to talk it out and consider the pros and cons of their choice. To help your child track their 24-hour cooling-off period, consider using a visual timer or an app.

Lifestyle interventions

Eating a healthy diet and staying active can help children handle big emotions. Research shows that a consistent sleep schedule can also support prefrontal cortex function, potentially reducing the frequency of outbursts. Walking around and physical exercise may also help your child stay focused on important tasks.

Mindfulness and journaling

Being mindful means recognizing your feelings without judging them. It's essential for your child to learn how to manage their emotions without impulsively acting on them. They can also practice these skills by writing in a journal. Writing about how they feel can help them take a break, calm down, and discover healthy solutions.

Structured routines and schedules

Children with ADHD do best in structured environments. Try to stick to a regular schedule that is consistent and predictable. Not having a set routine (or structure) can lead to frustration, which can quickly get out of hand.

Therapy options

Behavioral therapy that teaches your child skills like mindfulness and deep breathing can be extremely useful for coping with heightened emotions. Your child can apply these skills in many situations, especially as they grow older. They can also learn how to communicate with others more effectively and show their feelings more healthily.

Therapy can also teach kids how to manage their ADHD symptoms in general, and once these symptoms are under better control, emotional regulation may come more easily. 

Medication management

Adjusting your child's ADHD medication can help keep their mood swings from happening as often. A child and adolescent psychiatrist can help you weigh treatment options, determining which would be most helpful for managing symptoms. 

How Emora Health can help 

If you need help managing your child's ADHD mood swings, Emora Health is here for you. Our virtual mental health clinicians can work with your child to teach them useful emotional regulation skills, helping them thrive and cope with difficult feelings. 

Additionally, if your child hasn’t been formally assessed or received an ADHD diagnosis, we also offer comprehensive virtual ADHD testing. 

There are no waitlists, and you can start care in as little as 2 days. Begin the intake process to schedule a free consultation today.