I’ve been thinking about my brother Sam lately, and the struggles he’s had. Having ADHD makes his everyday life a lot harder, especially when it comes to focusing, staying calm, and managing his emotional responses. I know how much you guys love him, and how hard you’ve both been working to help him manage his emotional reactions. Watching how patient you guys have been through his outbursts is really inspiring, and it made me wonder more about what actually helps kids like Sam and how different approaches might work together.
In my Writing 150 class, I did some research about how strong emotional reactions are a common symptom in children with ADHD, and what strategies can help the children deal with these strong emotions, or what is commonly known as emotional dysregulation. The American Journal of Psychiatry describes emotional dysregulation (ED) as difficulty controlling one’s emotions in healthy ways, often resulting in strong reactions that can lead to unhelpful behaviors (Shaw).
From what I’ve read, emotional dysregulation (ED) is common enough in children with ADHD that scientists have looked into it. One study found that nearly half of children with ADHD show some signs of emotional dysregulation (Stralen). This means that a good amount of kids have struggled with this, and have gone through a similar experience as Sam. This connection between ADHD and ED makes sense when you think about how impulsivity, attention, and emotional control all come from similar parts of the brain. It’s not that Sam intentionally wants to hurt others when he’s mad, but his brain functions differently in a way that causes his reactions to be much more intense.
In my research, what most stood out to me was the variety in approaches to help children deal with emotional dysregulation. Some respond better to therapy, some to medication, some with parental involvement and some with a combination of various approaches. The Clinical Child and Family Psychology Review highlighted how combining behavioral therapy and medication can “extend treatment gains,” (Bunford) meaning the benefits last longer and reach more areas of a child’s life. Another review from Science Direct emphasized the importance of parents in the child’s progress. Behavioral Parent Training (BPT) programs help teach parents strategies to reinforce positive behavior and help children learn to regulate emotions (Pfiffner). Together these studies suggest that there are a variety of methods that each focus on a different aspect that the child may struggle with. Medication balances their brain functions, therapy can teach them coping strategies, and parents can reinforce positive behaviors. Through my research I’ve come to believe that a combined approach of therapy, behavioral parent training, and medication would be the most well-rounded approach.
Except I know you guys aren’t a big fan of running to the doctors and getting medication thinking that it can “fix everything.” Instead, you started Sam in therapy, which has made a notable difference. I’ve seen him make more of an effort to stay calm or leave the room if he feels like he is getting mad. His outbursts have been less frequent, and his conscious effort to utilize the skills he has learned has proven fruitful. Therapy is definitely a strong approach, especially since you guys have been reinforcing the strategies and techniques the therapist suggests and practicing them at home. The consistency helps Sam to remember to actually use the strategies in real time. So, you’ve used both methods of therapy and parental involvement, the only one missing is medication.
I understand why you might feel hesitant about using medication to help Sam. A lot of parents worry about side effects or that it might change their child. According to Pharmacologic Management of Attention Deficit Hyperactivity Disorder, ADHD medications can cause things like trouble sleeping, loss of appetite, or mood changes (Brown). Those are valid concerns, and it makes sense to be careful. But what I learned is that when medication is used safely (meaning the doctor starts with a small dose, checks in often, and adjusts based on how the child is reacting) it can be safe and helpful. One study found that stimulant medication (when used properly) can help improve not just focus, but also emotional recognition, meaning kids can better understand and manage how they feel (Shaw). It’s not meant to replace therapy or parenting strategies, but to support them. When used this way, medication can help calm some of the brain activity that causes impulsive reactions, which gives kids like Sam a way to use the coping tools he’s learning in therapy.
In the end, it’s whatever you decide to do. Any strategy that is implemented takes a step towards helping Sam work though his emotional dysregulation. But through my research I’ve come to believe that a combined approach of therapy, behavioral parent training, and medication would be the most well-rounded approach. Children with ADHD and ED have challenges that come from multiple areas: neurological, behavioral, and emotional, so it makes sense that helping them might require support in all those areas too. Hopefully the information I’ve provided has given you more insight, and a future path to explore.
Have a wonderful day!
Lucy
Works Cited
Brown, Kelly. “Pharmacologic Management of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Review for Practitioners,” Translational Pediatrics, vol. 7, no. 1, pp. 36–47, Jan. 2018, https://tp.amegroups.org/article/view/16230/18308?utm_source
Bunford, Nora, et al. “ADHD and Emotion Dysregulation among Children and Adolescents.” Clinical Child and Family Psychology Review, vol. 18, no. 3, 5 Aug. 2015, pp. 185–217, link.springer.com/article/10.1007/s10567-015-0187-5, https://doi.org/10.1007/s10567-015-0187-5.
Pfiffner, Linda J., and Lauren M. Haack. “Behavior Management for School-Aged Children with ADHD.” Child and Adolescent Psychiatric Clinics of North America, vol. 23, no. 4, Oct. 2014, pp. 731–746, www.ncbi.nlm.nih.gov/pmc/articles/PMC4167345/, https://doi.org/10.1016/j.chc.2014.05.014.
Shaw, Philip, et al. “Emotion Dysregulation in Attention Deficit Hyperactivity Disorder.” American Journal of Psychiatry, vol. 171, no. 3, 2014, pp. 276–293, www.ncbi.nlm.nih.gov/pmc/articles/PMC4282137/, https://doi.org/10.1176/appi.ajp.2013.13070966.
