Unveiling the Impact of DSM-5 on ADHD: Missing Emotions Story

I don't accept the excuse "emotions can't be measured"

The main reason this blog was created is because I cannot accept the excuse the medical community gives for not addressing emotions in the DSM-5. This article is about Why Emotions Aren't in the DSM-5 for ADHD - The REAL Reason. The claim that "emotions can't be measured" does not justify why emotional dysregulation was removed from the manual when it was previously recognized as a key component of ADHD. Emotional dysregulation was a crucial feature of ADHD, yet it was not just downgraded to a general symptom; it was completely eliminated. This omission has led to countless misdiagnoses of people with ADHD, often mistaking their emotional struggles for mood disorders because ADHD no longer includes emotional issues in its diagnostic criteria.

This blog was created to explain and educate people on the importance of truly understanding ADHD and the real problems it causes for so many individuals. Most information available about adult ADHD focuses on the three main elements outlined in the DSM-5: hyperactivity, impulsiveness, and inattention or being easily distracted. These are crucial aspects, but they don't encompass the full scope of the condition, particularly the significant issue of emotional dysregulation, which the DSM-5 has regrettably omitted.

This blog isn't written by a doctor, psychiatrist, therapist, coach, or someone who barely falls into the ADHD spectrum. This is coming from someone who has grown up with ADHD. I've dealt with countless problems associated with ADHD: a speech disorder, slow processing speed, brain fog, being at a loss for words, and countless failures. I understand that ADHD doesn't just come and go; it is always a part of you. This blog aims to convey the lived experiences of those with ADHD and highlight the real, often overlooked issues that affect our daily lives.

As someone who has grown up having untreated ADHD, my opinion is not one of three symptoms listed for ADHD actually causes the most damaging aspect of having ADHD. 

Let me address what the DSM is and why it's important.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is highly significant to doctors and mental health professionals for several key reasons:

1. Standardization of Diagnosis: The DSM provides standardized criteria for diagnosing mental disorders. This consistency ensures that doctors across different specialties and locations can use a common language and set of guidelines to identify and classify psychiatric conditions.

2. Clinical Decision-Making: Doctors use the DSM as a tool to guide their clinical assessments and decision-making processes. By referring to specific diagnostic criteria outlined in the DSM, doctors can systematically evaluate symptoms, make accurate diagnoses, and develop appropriate treatment plans.

3. Treatment Planning: The DSM helps doctors match patients' symptoms to established diagnostic categories, which in turn informs treatment planning. Each disorder listed in the DSM may have specific recommended treatments or therapeutic approaches based on clinical research and consensus.

4. Communication with Peers: The DSM facilitates effective communication among healthcare professionals. When doctors use DSM criteria to describe a patient's diagnosis, it provides a clear and concise way to convey complex psychiatric conditions to colleagues, ensuring continuity of care and interdisciplinary collaboration.

5. Insurance Reimbursement: Insurance companies often require diagnoses based on DSM criteria to approve coverage for mental health services and treatments. Doctors' adherence to DSM guidelines can facilitate patients' access to necessary therapies and medications.

6. Research and Education: The DSM reflects current understanding and research findings in psychiatry. It serves as a foundation for ongoing research into mental health disorders, helping to advance knowledge, refine diagnostic criteria, and improve treatment outcomes over time.

7. Legal and Forensic Contexts: In legal and forensic settings, the DSM provides a framework for assessing mental health conditions relevant to issues such as competency, criminal responsibility, and disability claims. Doctors' use of DSM criteria in these contexts helps ensure fair and consistent evaluations.

The DSM plays a crucial role in the practice of psychiatry and mental health care by providing a standardized framework for diagnosing and treating mental disorders. It enhances clinical decision-making, supports effective communication among healthcare professionals, guides treatment planning, and contributes to ongoing research and education in the field of psychiatry. To be clear when a doctor might not have the training on ADHD they rely heavily on the information provided by the DSM on helping them come to a conclusion on what a person may be suffering from.

How this hurts people with ADHD?

Not having emotional dysregulation & RSD listed as a core feature or symptom has resulted in people being ruled out to having ADHD when someone says they have problems dealing with their emotions. Often, they are diagnosed with having a mood disorder. This leads to people not receiving the treatment they need to have a more productive life. Instead, these people spend years taking medication that doesn't provide any relief. 

The truth about core features

Let me tell you what the truth is......the listed core features in having ADHD are common symptoms you experience non-stop from childhood until you die. Being easily distracted, not paying attention, being hyperactive don't necessarily add up to having long term real problems in life.

The only one that could cause long term problems is being impulsive.

 Financial Instability: Impulsive spending can result in accumulating debt, insufficient savings, and difficulty in maintaining a budget.

 Another symptom that is hard to live with is forgetting. It's hard to cover up you have no recollection of what someone is talking about. These memory impairments consist of forgetting your wallet at home to not remembering names to not having any recall of a prior event ever happening. 

I find it irresponsible that the medical community doesn't even address the real problem that causes the most problems for people with ADHD. 

I realize the symptoms addresses in the DSM-5 are symptoms that can be visually seen, and this can help doctors determine if someone has ADHD. That doesn't excuse why important ADHD symptoms aren't addressed. 

I don't accept the excuse "emotions can't be measured"

It is irresponsible for the medical community to overlook the core issues that cause the most significant problems for people with ADHD: emotional regulation and emotional intensity.

While the DSM-5 focuses on symptoms that are visible and measurable, which helps doctors diagnose ADHD, it fails to address the crucial aspect of emotional dysregulation. I reject the excuse that "emotions can't be measured" as a valid reason for ignoring this issue.

It doesn't take a doctor to recognize an emotional reaction. When someone doesn't believe me, blames me, dismisses my symptoms, insults me, or ignores my emotions, the emotional impact is immediate and visible. Whether or not a doctor validates my reaction as genuine, the reality is that the emotional response is real and uncontrollable.

Even when I know someone is intentionally trying to provoke an emotional reaction, it doesn't matter—I will still respond emotionally because emotions aren't governed by logic. When I feel disbelieved, blamed, insulted, disrespected, or misunderstood, my emotions are on full display. You can see my mood shift drastically: my tone changes, my body language alters, and I may withdraw completely. The pain from feeling blamed, dismissed, or not taken seriously can trigger a full-blown episode of Rejection Sensitive Dysphoria (RSD), right before your eyes. This reaction isn't something I can control, even if I know it's coming. Logic doesn't mitigate these emotions; they occur automatically and powerfully.

I'm easily provoked with same outcome every single time. 

The medical community needs to recognize and address the profound impact of emotional dysregulation on individuals with ADHD. Emotional reactions are real and significant, and they should not be dismissed or ignored.

Emotions have a huge impact on everyday people

Emotions are fundamental to the human experience. They are the driving force behind our actions, relationships, and overall well-being. On the surface, emotions can seem simple and straightforward—joy, sadness, anger, love—but beneath this simplicity lies a profound complexity that shapes every aspect of our lives. Understanding this complexity is crucial, especially when considering how emotions influence both the positive and negative aspects of human behavior.

Emotions play a pivotal role in forming the bonds that make our lives meaningful. They are the invisible threads that weave the fabric of our social interactions, creating connections that can lead to deep, lasting relationships. Love, perhaps the most celebrated emotion, is a prime example of this. It drives people to form partnerships, build families, and create a sense of belonging and community. Love isn't just romantic; it encompasses the affection we feel for friends and family, fostering a network of support and mutual care.

Similarly, emotions like joy and excitement bring people together. Shared happiness can strengthen friendships, as people tend to bond over positive experiences. Celebrations, laughter, and shared moments of delight enhance our sense of connection with others. These positive emotions are vital for mental health, providing us with a sense of purpose and fulfillment.

However, the same emotions that can create beauty and joy in our lives can also lead to profound pain and destruction. When emotions are manipulated, betrayed, or not taken seriously, the consequences can be severe. Trust, once broken, can lead to feelings of betrayal and resentment, which are powerful emotions that can drive people to extreme actions.

Consider the impact of feeling manipulated or cheated. When someone feels their emotions have been used against them, it can lead to a deep sense of violation and loss of control. This is particularly true in intimate relationships, where emotional manipulation can erode self-esteem and trust, leaving lasting scars. Betrayal, especially by someone close, can trigger intense anger and a desire for retribution, sometimes escalating to violence.

The darker aspects of emotions are evident in their role in violent behavior. A significant number of murders, suicides, and other violent acts are driven by powerful emotions such as rage, jealousy, and despair. These emotions can overwhelm rational thought, leading individuals to commit acts they might never consider under normal circumstances.

For example, crimes of passion are often rooted in intense emotional experiences. When someone discovers a partner's infidelity, the resultant jealousy and anger can spur impulsive, violent reactions. Similarly, feelings of profound loss or rejection can lead to tragic outcomes like suicide, where the individual feels that ending their life is the only escape from their emotional pain.

Emotions also play a crucial role in mental health and the concept of being "broken." When people endure prolonged emotional distress—whether from abuse, trauma, or chronic neglect—they can become "broken." This term refers to individuals who feel fundamentally damaged, unable to trust others, or engage fully with life.

This emotional damage can manifest in various ways, such as depression, anxiety, or post-traumatic stress disorder (PTSD). People who have been emotionally betrayed or manipulated often struggle with self-worth and trust issues, finding it difficult to form healthy relationships. The emotional scars can influence their behavior and decision-making, sometimes leading to self-destructive actions or withdrawal from social connections.

Emotions ADHD

For adults with Attention-Deficit/Hyperactivity Disorder (ADHD), emotions can pose unique and significant challenges. ADHD is often associated with symptoms like inattention, hyperactivity, and impulsivity, but emotional dysregulation is a less discussed yet crucial aspect of the condition. Emotional experiences in individuals with ADHD are often more intense and can lead to various problems, exacerbated by factors like emotional dysregulation and hormonal imbalances. Understanding these challenges is essential for supporting adults with ADHD effectively.

Emotional Intensity

One of the hallmarks of ADHD in adults is the heightened intensity of emotions. People with ADHD often experience emotions more deeply and react more strongly than their neurotypical counterparts. This emotional intensity can be both a strength and a vulnerability. On the positive side, it can lead to passionate engagement with interests and activities, fostering creativity and enthusiasm. However, the downside is that this heightened emotional sensitivity can also make negative experiences more overwhelming.

For example, an adult with ADHD might feel extreme frustration over minor setbacks or profound sadness from perceived slights. These intense emotional reactions can complicate everyday interactions and relationships. What might seem like a trivial issue to others can trigger significant emotional turmoil for someone with ADHD, leading to misunderstandings and conflicts.