Weekly Research Updates for August 17, 2024

00:00 Introduction and funny Dad Jokes
02:10 Review of mindfulness meditation for teens with ADHD
04:14 Emotional dysregulation in adults with ADHD and effect of stimulant medication
09:54 Review of effects of stimulant medication on substance use disorders in youth with ADHD
11:04 Cognitive Disengagement Syndrome in children with depression or ADHD
14:03 Conclusion

Research Discussed in the Video

Hyped-up or meditate: A scoping review of mindfulness-based group interventions for adolescents with attention deficit hyperactivity disorder
L Tan, M Jones - Clinical Child Psychology and Psychiatry, 2024
DOI: 10.1177/13591045241272835

Emotional dysregulation and stimulant medication in adult ADHD
MS Greenfield, Y Wang, JP Hamilton, P Thunberg… - Journal of Psychiatry and …, 2024

Effect of methylphenidate on substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: a systematic review
A Coutinho, M Bento, D Cruz, J Chen-Xu. Portuguese Journal of Pediatrics, 2024.

A Comparison of Cognitive Disengagement Syndrome in Children with Major Depression Versus Attention Deficit and Hyperactivity Disorder
D Sevinçok, TC Özbek, MM Özbek - European Journal of Therapeutics, 2024

[thebigscore]

As an adult with ADHD, I have found I am better able to manage my emotions with medication.

[JoeCocozzella]

Dr. Barkley I am a practicing psychiatrist who has enjoyed your videos for years. One of my favorite dad jokes: "While moving I lost 20% of my couch. Ouch!"

[trishlehecka]

I find that I am not as easily manipulated by people when on my medication because I’m not as exhausted/ overwhelmed by the tasks of the day. I will advocate for myself instead of people please when on my medication.

[Nath-dp]

I would suggest that adhders/etc are less prone to emotional responses to a single stimulus, than non-adhders. I am going off of my personal experience here, but what is different is that we have more things that dysregulate us, and we are constantly bombarded with these things and it wears us down (but also, we have some baseline resistance, because, what is one negative stimulus when we are used to dealing with 20?). Additionally, since we are often depleted, we often do not have reserves of energy on which to draw. So the little thing that sets me off is merely the straw that broke the camel's back, after a day or week of negative feedback, or sensory issues, or RSD, or whatever

[Eric_Thompson]

For a moment I thought Dr. Barkley was about to say he had T-shirts for sale because I would be the first in line to buy one

[vbs_music]

Actually, after taking my stimulant meds I found that my flashbacks and intrusive thoughts are significantly less intense.

[JoshuaH]

My itch for substance use completely disappeared within 6 months of use. I do not even drink anymore, and my caffeine use is almost at nil

[p.i.vanblerk]

I bet the most of the ADHD test persons in the emotional dysregulation research haven't seen the pictures at all, they were just busy in their heads and all the measured emotions were actually related to the story that was playing in their heads, that is what would happen with me 😂😂

[ExistentialErika]

Improvement in emotion regulation was the biggest change I saw when I started meds. A secondary benefit of being less emotional and more logical was realizing that my boyfriend at the time was not good for me. Literally on Day 2 of starting stimulants.

[erinm]

Regarding emotional regulation. I have ADHD, and I definitely do struggle with emotional regulation. But I also have alexithymia--meaning that it's ofen very difficult for me to identify my own emotions, or even know that I'm feeling anything. I also have CPTSD, so that could be partly responsible for my alexythymia, but I have been curious how widespread alexythymia is in people with ADHD, and haven't been able to find anything one way or the other. People with autism tend to have alexythymia AND difficulty with emotional regulation, and there is so much overlap between autism and ADHD, I have been surprised to find this doesn't seem to have been studied.

To me, the alexythymia and trouble with emotional regulation feel connected. A big part of why I struggle with regulation is that I tend to not know how I'm feeling at all, until the emotion becomes so big that it is overwhelming and out of control. It feels like if I were able to become aware of the emotion earlier, when it was smaller, I'd have a much better chance of being able to regulate myself.

[LuiggiPachecoUPW]

Mindfulness meditation was hell at first, almost impossible, after many years of periods of inconsistent practice coupled with periods of intense practice it became an extremely reliable tool in managing my symptoms, to the point that my girlfriends or family would ask me "you didn't meditate today did you?" And after starting medicine I realized my medicated self was behaving similar to the meditated self, so I find the medicine amplifies your baseline wellbeing and gives you a reliable starting functional point (Wich makes sticking to the routines and systems easier and more consistently) and it works even better when you exercise, meditate, do therapy and sleep well, it's a feedback loop of wholesomeness, and the addictive tendencies were easier to battle with them but with methylphenidate it was a breeze, even sugar feels gross with it.

[tgamirov]

Dr Barkley, have you come across any studies on low blood pressure, vasovagal syncope and adhd? Thank you.

[HowndsOfDoom]

YES! Excellent stuff from Portugal and Turkey! And I can say from experience on the substance use review, my Cannabis use has plummeted since using Lisdexamphetamine, no idea why other than there are way too many negative effects from Cannabis since I've used Lisdexamfetamine. Thanks Doc!

[amy]

New Original Dad joke - What do you call a religious psychopath?

Mormon Bates.

[CrapUsername]

I’ve worked 20 years in a high-stress, high-risk, profession, and found that in the most extreme challenges I am calm and rational. But in day-to-day life, change some minor event last minute, say something which feels like an attack (RSD), interrupt me during a task, and I utterly overreact.

Calm under extreme and real pressure, and perform exceptionally well. Completely useless during ‘normal life’ events and challenges.

It’s very much like a binary switch. I could imagine that in this study, to most images I wouldn’t have much emotional response either, and I’d see them in a very detached and matter-of-fact way.

In real life, stimulants do seem to help me regulate my self. Just ask my Wife! It’s as if it just buys me a fraction of a second to actually assess what response to take, usually finding a ‘better’ reaction, as opposed to non-medicated where it’s much more binary. Chilled, chilled, chilled… tantrum!

[AFTERPUPPET]

Emotional dysregulation has ruined my life.

[yarntoast]

My stimulant medication prescription absolutely helps me with emotional regulation while also making my emotions more present to be felt. Not all in my trials did this, some made me agitated, but my current prescription provides a pause button so I can better control my reactions and I’m easily “verklempt” in a way I never was before. It feels wonderful to be able to regulate my response while also being emotionally present after a lifetime stuck in my head and is hilarious how easily I tear up when heros in my kids’ shows save the day.

[RoxanaApollonio]

Thank you very much for share with us this researches. Especially, the CDS.

[SomeChristianGuy.]

Intuitively, I doubt mindfulness will make a difference since the problem is not intent.

Whatever else it does help with, its not helping the ADHD itself.
Its easy to mistake things like diet or such therapies as assisting with ADHD is because managing your ADHD is a lot easier when other problems are successfully dealt with.

[Indiangrilldad]

Thanks Dr. Barkley! I am curious to know how stimulant medication would affect rejection sensitive dysphoria