Since I was young I have always had quick temper but as I grew up these angry outbursts became much worse, causing serious conflicts with my parents, my brothers, and partners. I very rarely ‘lose it’ around others unless they are very close to me; family, partner, trusted colleagues, etc.
The ‘explosive rain of rage’ cycle goes something like this;
- out of nowhere I become intensely angry and instantaneously begin to communicate and behave in an aggressive and violent manner (not towards people, mostly towards inanimate objects or myself)
- within a few minute I am aware that I have behaved in a damaging way, and begin to feel terrible that I have once again gone rogue and created havoc and pain for those around me, however I’m still angry and feel out of control of my behaviour.
- This phase used to go on for hours! I knew I had behaved irrationally however couldn’t admit to myself that I was out of line. I couldn’t understand why I would behave this way if I was not justified in doing so, and I didn’t know that this wasn’t ‘normal’ behaviour; Teenagers are supposed to be horrid right?! Since learning that I have ADHD and thanks to medication supported therapy, I am able to calm myself and accept what is the reality much faster, which helps move things onto ‘normal’ again much quicker.
- I still always feel so guilty and ashamed for behaving so badly. These outbursts are so explosive that they are exhausting for me and others who are around when it happens. It can take a few hours to recover when it happens.
What causes these angry outbursts?
Emma Atkins (Lived Experience expert | Web & Community Manager ADHDFund.com)
Rage outbursts are a very common reported problem with ADHD, as is a general feeling of emotional instability. Clinical research shows that about 90% of adults with ADHD recognise frequent mood swings and rage outbursts, often beginning in childhood.
Rage outbursts are a severe form of emotional instability. When you experience a sudden increase in irritability and cannot stop it, you behave in the ‘typical’ ADHD way! We say ADHD is a disorder of inhibition, people with ADHD find it hard to find the brake pedal, let alone step on it! In emotional situations this leads to these explosions that you describe.
The following ‘typical’ ADHD behaviours all get involved in the rage attack; impulsively saying or shouting things, needing to be moving/unable to sit still and think through the problem rationally, frustration with not being able to explain what you are thinking as your thoughts are racing. You cannot inhibit this response, though as you state you may regret the actions taken and words spoken afterwards. These emotional outbursts and instability can lead many women with ADHD to first be diagnosed with Borderline Personality disorder. Emotional problems with ADHD seem to be far more severe in women as compared to men. In the general population twices as many women report dealing with depression and as irritability in children with ADHD has also been linked to depression, mood instability and irritability with ADHD may also be be increased in women as well.
As with all ADHD behaviours we believe the key cause to be a relative shortage of the neurotransmitter dopamine in the brain, as stimulant medication improves ADHD symptoms through increasing dopamine levels in the brain. So as you have noted, mood swings and anger outbursts often diminish with stimulant medication, by helping putting on the brakes on all symptoms: movements, impulsivity, inattention and mood swings. Medication makes it possible to learn practical skills in how to handle your emotions and to identify triggers for these outbursts.
As ADHD also has a whole host of friends that come along for the ride, depression, anxiety, sleep disorder, it’s easy to see how base levels of irritability can be much higher in someone with ADHD, easily creating the perfect conditions for these outbursts. Therefore when ADHD comorbidities are adding to the problem, treating these (such as antidepressants, or sleep aids like melatonin) can make all the difference.
dr. Sandra Kooij (Psychiatrist | Adult ADHD expert)