When College & ADHD Collide
By Ali Idriss
Ali Idriss and colleague working on a school project together.
ADHD & DESR from a College Student’s Perspective
What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting about 11% of school-age children and almost 5% of adults. Common ADHD symptoms include inattention, impulsiveness, executive dysfunction, and hyperactivity. Most people can deal with these symptoms listed, but for those with ADHD, the problems are on amped up and persistent. These can then interfere with many aspects of life and cause serious consequences, including poor grades in school, family stress, relationship issues, substance abuse, and failing at work.
College can be a rollercoaster of emotions with all the different stimuli and new obstacles students experience. These can lead to a variety of emotions which come with certain behavioral and physiological responses. According to the American Psychological Association (APA), an emotion is defined as “a complex reaction pattern, involving experiential, behavioral and physiological elements.” The quality and type of the emotion depends on whether the experience or situation is personally significant. My goal is to discuss these emotions and behavioral responses, from the perspective of a college student with ADHD.
Emotional dysregulation is a major trait of ADHD; however, it is excluded from official diagnostic criteria and most symptom tests.
For those of us with ADHD, it can be quite difficult regulating our emotions, especially when a behavioral response comes into play. Emotional dysregulation is a major trait of ADHD; however, it is excluded from official diagnostic criteria and most symptom tests. ADHD expert, Russell Barkley, Ph.D., has coined the term deficient emotional self-regulation (DESR) to describe this fundamental trait. This new term, DESR, is used to describe the problem of impulsive emotions joined by emotional self-regulation difficulties. These problems are known to be associated with ADHD. Dr. Barkley believes that DESR is both an important and overlooked component of the disorder, which can be a vital tool in improving diagnoses and treatments of patients. He also discusses how DESR refers to deficiencies with four components of emotional self-regulation. The first component is the ability to inhibit inappropriate behavior triggered by strong emotions, which he calls emotional impulsiveness. The second component is the ability to self-soothe and down-regulate a strong emotion to reduce its severity. The third is the ability to refocus attention from emotionally provocative events. Lastly, the ability to organize or substitute more moderate, healthier emotional responses in the service of goals and long-term welfare. Deficiencies in these abilities are amplified by the executive dysfunction that is present in those with ADHD.
You can think of the ADHD brain as a two-level system, which is a concept I learned from Dr. Barkley. There’s the automatic brain controlling that fight, flight or freeze response, and then the executive functioning brain. Fight, flight, or freeze are the three well-known automatic responses we humans, and most living things, experience during threatening situations. ADHD Coach and Speaker, Jeff Copper, introduced me to this concept as he connected it to how we regulate our emotions. Jeff speaks on how important it is to engage our executive functioning brain to override these responses whether it is fight, flight or freeze. With these being such instinctive and spontaneous responses, it can be a tough time for those with ADHD to regulate, as executive dysfunction is a core facet of ADHD.
These three modes of response can be very prevalent with college students. Entering college can come with drastic life changes, from having new classmates to living in completely new city, state or even country. Entering college can be like hitting a reset button on your life. Just attending college even as a senior has its challenges too. As a senior in college myself, I am faced with preparing for graduation, applying to medical school, and building my career in medicine. These obstacles can turn into difficult if not bad experiences and then perceived as a threat, which can put you into either fight, flight or freeze mode.
Fight
When encountered by stressors, our body sometimes chooses to fight as our defensive response. For example, you may yell at someone who has skipped you in the grocery store line and cause a big scene. As you try to face the threat you might experience signs like tension, increased heart rate, anger, and crying. In the college setting, this can be seen as aggressive behavior towards your colleagues and professors when things don’t go your way. Once, my colleague lashed out on his dorms roommate for not cleaning after himself. This could have been solved if my classmate took a moment and thought of alternative solutions like discussing their concerns with their roommates and coming up with an organized cleaning plan as a team. Just understanding how your brain works is a step towards being more in control of your emotions. It is important for someone with ADHD who can tend to have emotional impulsiveness, to down-regulate these strong emotions.
Flight
Another response when encountering stressors is the flight response. This is when you avoid the threat at hand instead of facing it. For example, you may leave social gathering early because of all the new faces around which makes you uncomfortable. In college, there are many difficult situations that can lead to the flight response, whether it’s socially, academically, financially, or even health-wise. As a freshman in college, my organization skills were very poor. I would find out about an exam only a few days before it was scheduled and turn in my homework the last minute it was due. This was because I was not taking a pause and allowing my executive function to override my flight responses. With ADHD it can be difficult to organize or substitute healthier emotional responses in the service of goals and long-term welfare. Once I learned how to prioritize my tasks, organize my schedule, and find daily discipline, I stopped avoiding my classes, which were the stressors that triggered this flight response at the time.
Freeze
When one experiences the freeze response, their mind and body just go blank. For example, you may be preparing to speak at a conference, but once you are up on stage and need to speak, you just freeze up and fall into a state of paralysis. This state of paralysis can be caused by all the pressure built up on you. This pressure is seen as a threat by your body. A few semesters ago, I was preparing to present a research poster at my colleges research symposium. The week leading up to my presentation my colleagues recommended I practice presenting with them just in case I freeze up during the presentation. When I practiced with them, I did indeed have a few speed bumps and it was so important that I practiced ahead of time to prepare better. As a college student with ADHD, it is essential to be surrounded by a support team who can help you prioritize and tap into your executive function when getting schoolwork done.
To learn more about emotional self-regulation and the tools that could be used to help regulate your emotions, check out ADHD Power Tools, where I am the joined by my co-host Brooke Schnittman, MA, ACC, BCC. Brooke is a brilliant ADHD and Executive Function Coach. We have featured multiple guests, including Jeff Copper and will be featuring more in the future. ADHD Power Tools is produced by Different Brains 501(C)(3) and can be found on the Different Brains YouTube channel, social media platforms, and website (www.differentbrains.org).
The Author:
Ali Idriss is an intern with the 501(C)(3) DifferentBrains.org and ADHD self-advocate. He aspires to share his journey and help others with the tools that have allowed him to overcome many of the challenges along the way, as he co-hosts the webisode series ADHD Power Tools. Ali has also completed his bachelor’s in Biological Sciences at Florida Atlantic University and is currently completing his second bachelor’s in Neuroscience and Behavior as he is conducting both clinical and public health research. He is also an Emergency Room Tech/EMT aspiring to become a physician.