Understanding Anger in Children With ADHD

ADHD and anger can be connected, and some kids with ADHD experience frequent outbursts of anger. Although common, these intense emotions can make it hard for a child to maintain friendships and behave in school, and they can put a strain on family life.

Understanding the causes of anger and frustration among kids with ADHD, along with some strategies for managing these intense emotions, can help prevent these short bursts of anger from causing long-term damage.

The Link Between ADHD and Anger

Children with ADHD often experience emotions with a greater intensity than their peers without ADHD. What's more, comorbid conditions such as impulsive aggression and oppositional defiant disorder (ODD), as well as medication side effects, may make it more likely that your child will feel bad-tempered, aggressive, impatient, and angry. Here are some of the most common reasons why kids with ADHD may exhibit angry outbursts:

Impulsivity

Impulsivity is a symptom of ADHD that is often caused by an inability to focus and control behaviors. The impulsive nature of ADHD means that if your child feels angry, they communicate it right away. They don't have a few seconds of lead time that a child without ADHD has, and they haven’t yet developed strategies that adults with ADHD develop.

More than 50% of preadolescents with ADHD experience impulsive aggression, which is also known as affective aggression, and is characterized by strong, unplanned emotions, usually anger, that often take place in the heat of moment.

Emotional Sensitivity

Kids with ADHD tend to be emotional, sensitive, and feel things very deeply. They also have a hard time regulating those feelings. This can cause them to cry easily (which can be very embarrassing for them) or feel intensely angry.

In fact, up to 50% of children with ADHD experience emotional dysregulation, or a poor ability to manage emotional responses or to keep them within an acceptable range of typical emotional reactions. This can refer to a wide range of emotions including sadness, anger, irritability, and frustration.

Moodiness and Mood Disorders

Moods change very quickly throughout the day when you have ADHD. There can be many episodes of happiness, sadness, and frustration—all in one afternoon.

In addition, kids with ADHD experience high rates of comorbid mood disorders that can cause irritability and fuel mood changes and flashes of anger, including:

• Anxiety disorders
• Bipolar disorder
• Depression

Frustration

Frustration is an emotion that stems from challenges that stand in the way of goals. The ability to deal with frustration is known as frustration tolerance. Low tolerance to frustration can mean that your child feels frustrated quickly, and this can quickly result in anger outbursts.

Poor Self-Esteem

It's common for children with ADHD to experience low self-esteem. ADHD symptoms can make it difficult for kids to experience academic achievement and make it difficult to make and keep friends, which can lead to a sense of isolation and lowered self-esteem. Low self-esteem and feeling anxious about a situation they can’t control can also lead to your child feeling anger.

Medication Side Effects

Sometimes children experience a difficult period when their stimulant medications are wearing off, resulting in increased meltdowns and tantrums. This is known as medication rebound, and is a result of the speed at which your particular child metabolizes the medication.

Let your doctor know if your child is experiencing medication rebound. Since it tends to occur more frequently with shorter-acting stimulants that can move out of your child's system quickly, your doctor may add a very small dose of immediate-release medicine about an hour before this rebound effect occurs so that the transition off the medicine is smoother.

A recent double-blind study found that children on stimulants had a reduction in irritability and tantrums after being given the antidepressant Celexa (citalopram).

Excess Energy

Excess energy, or hyperactivity, can present as physical and/or verbal overactivity. The energy and restlessness that comes along with ADHD may be too much to handle at times until it finally bubbles over into angry words or physical reactions.

Oppositional Defiant Disorder

Approximately one-third of all children with ADHD also have oppositional defiant disorder. Children with ODD display defiant, hostile behaviors towards authority figures.

They often lose their temper, frequently argue with adults, actively defy rules, blame others, deliberately annoy others, are touchy, easily annoyed and behave in angry, resentful ways overall.

Obviously, some oppositional behaviors are expected in children, and ODD is only diagnosed if the pattern of behavior is significantly more intense and frequent when compared to other children of the same age. If you think your child might have ODD, book an appointment with your pediatrician. 

How to Help Your Child

As a parent, it can be hard to see your child losing control. While you can’t make the anger disappear, you can help your child better manage these intense emotions. Here are a few tips to help.

Work With Your Child's Doctor

Working closely with your child's doctor is a crucial part of managing your child's anger. They can prescribe appropriate medication and recommend therapy, special accommodations, social skills, and lifestyle changes—and then it's up to you to keep them informed about medication side effects and what is and isn't working to help manage your child's anger.

Encourage Exercise

If anger is an issue for your child, be sure to provide appropriate outlets. Strenuous outdoor play and exercise can be very powerful releases for children with ADHD. Running, jumping, skipping, climbing—these basic physical activities will help release some of the tension, restlessness, and extra energy that often accompanies ADHD. Make sure your child is engaging in this type of play daily. 

Try Martial Arts

Consider enrolling your child in a martial arts class. Martial arts are an excellent exercise choice for an ADHD child. It helps develop self-discipline and self-control, which in turn helps with impulsivity. It also improves self-esteem and is an excellent way to release energy. 

Help Your Child Express Emotions

Encourage your child to "use their words" rather than act aggressively. To begin with, it might be hard for them because it is a new skill. However, with practice and a little help from you, it will become easier. Being able to articulate how they are feeling lessens their need to express themselves through anger. For example, "Jimmy took my red car and I feel mad."

Notice Patterns

There may be particular times of day that your child's anger appears to peak. Taking note of any patterns can ensure you're better prepared to handle these outbursts. For example, you may notice their anger is more intense:

• After school, when your child is able to let down their guard and release pent-up feelings
• When they are feeling hungry or tired
• When they are experiencing frustration with a task
• When their ADHD medication is wearing off

Limit Screen Time

Supervise the programs your child watches on television or on the computer. Much of the media on TV, movies, video games, etc. is violent, aggressive, and inappropriate.

Set Clear, Consistent Rules

Make sure you have clear house rules around behavior. When your child is settled and able to talk, sit down and come up with the rules together. Discuss expectations and consequences for behaviors, including a reward system. Then once they are in place, stick to them.

Don’t change the rules or make up consequences in the middle of an outburst. Be matter-of-fact: "If that happens, then this is the consequence." Strong boundaries are helpful for you both. If your child is working with a therapist or counselor, you may want to ask for recommendations of discipline strategies that work well for kids with ADHD.

A Word From Verywell

It's tough for both parents and kids when a child with ADHD loses control and struggles with anger. If your child has angry outbursts, and especially if these intense emotions interfere with their relationships, education, and quality of life, it's important to teach them the skills they need to deal with their feelings in a healthy way. Together, with guidance from your child's doctor, you can ensure that anger does not interfere with your child's well-being and success.