Executive Functions and Emotionality in ADHD

Once it had been established in the mid-1990s that bipolar disorder affects around 1-1.5 percent of children and adolescents, child mental health researchers who study this disorder had a new problem--how to differentiate the emotional volatility associated with bipolar disorder and that found in ADHD. While not included in the core definition of ADHD, a significant number of children and adults who have ADHD have difficulty regulating their emotions.

To further complicate matters, there is a significant amount of comorbidity--or, two separate disorders existing together in the same person--between ADHD and Bipolar Disorder. Around 80-90 percent of children with bipolar disorder also have ADHD. Among young people with ADHD, as many as 10-15 percent also have bipolar disorder. (ADHD is the far more common of the two: Around 4-8 percent of people have ADHD, while only around 1 percent have bipolar disorder.)

Here, in an interview conducted following his Grand Rounds presentation at the NYU Child Study Center on June 22, 2012, Steve V. Faraone, PhD, discusses the link between executive functions and emotionality in ADHD. Executive functions control the brain's ability to plan, organize, rein in impulses and generally get things done. Dr. Faraone discusses the connection between deficits in executive functions, and the emotionality associated with ADHD, in which people have a hard time keeping emotional responses in check. Just as with issues with attention, hyperactivity, and impulsivity, those with ADHD may have trouble controlling behavior.

Dr. Faraone is the director of child and adolescent psychiatry research, and the director of medical genetics research, as well as professor of psychiatry and of neuroscience and physiology at SUNY Upstate Medical University.

[Jokaanan]

Regarding the video description: the answer is that you should not be describing executive dysfunction, emotional lability, and impulsivity as "bipolar disorder". These symptoms are usually better described by the Borderline/low Emotional Stability model. There is a lot of overlap between BPD symptoms (or "borderline personality trait") and ADHD.

Bipolar disorder refers to long-lasting mood swings causing personality shifts so extreme as to fall under the umbrella of a psychotic disorder. You should not be diagnosing kids with a psychotic disorder such as bipolar disorder just because they have poor executive function and trouble controlling emotions. Most kids have a variety of emotions they express in a variety of ways, and unless someone exhibits a striking resemblance to the bipolar model, it is unhealthy to teach young people to boil down the complexities of their experience into "depression" and "mania". It is certainly unhealthy to teach them that their happiness is a form of psychosis.

For context, one study found that 40% of people who met criteria for BPD had been previously misdiagnosed with Bipolar II although they did not meet criteria for bipolar. (Ruggero et al. 2011)

[Dancestar]

Lots of people not hyperactive it’s not an Inattentive problem it’s that the attention is just interested in other things

[buffplums]

I thought that said Sunny Upskirt … lol

[conman]

So what is the difference between executive function disorder and ADD/ADHD?

[IbrahimHoldsForth]

i'm the biggest loser in the universe. i hate my life. no woman will ever want me.