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One of the toughest parts of ADHD is left out of the diagnosis

09.10.2026
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ADHD diagnoses are on the rise in the United States, but what if professionals are missing a key part of the disorder? In the 1970s, some clinicians recognized a lot of their ADHD patients had trouble with emotional regulation. But because it was easier to measure behavior rather than emotions, the criteria eventually fell off the radar. Today in the U.S., emotional dysregulation is not a part of the ADHD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Dr. Sasha Hamdani thinks that needs to change. In today’s episode, she talks about her book Too Sensitive, and explains what is going on in the brains of people with Rejection Sensitive Dysphoria. 
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Wender, P. H. (1971). Minimal Brain Dysfunction in Children. Wiley-Interscience. https://pubmed.ncbi.nlm.nih.gov/4581984/ 
Barkley, R. A. (2015). Emotional dysregulation is a core component of ADHD. In R. A. Barkley (Ed.), Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4th ed., pp. 81–115). Guilford Press. https://www.guilford.com/excerpts/barkley2.pdf?t=1 
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966
Faraone, S. V., et al. (2019). Emotional dysregulation in adults with attention deficit hyperactivity disorder: Validity, aetiology, and clinical implications. Neuroscience & Biobehavioral Reviews, 107, 132–142.https://doi.org/10.1016/j.neubiorev.2019.08.021
Bondü, R., & Esser, G. (2015). Justice and rejection sensitivity in children and adolescents with ADHD symptoms. European Child & Adolescent Psychiatry, 24(2), 185–198.https://doi.org/10.1007/s00787-014-0560-9
Cleveland Clinic. (2022). Rejection Sensitive Dysphoria (RSD): Symptoms & Treatment. Cleveland Clinic Health Library. https://my.clevelandclinic.org/health/diseases/24099-rejection-sensitive-dysphoria-rsd
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