Anger is part of the natural emotional spectrum — a part researchers say has helped humans and animals survive. This powerful emotion can motivate you to make a change, to confront problems and resolve them, and to defend essential boundaries.

But as normal — and even healthy — as anger can be, it can harm your health, your self-esteem, your career, and your relationships if you express it in unhealthy ways or in ways that aren’t in line with social expectations.

For people with ADHD, there are particular challenges to managing anger in a positive way.

Once, anger was part of the definition of ADHD. In the United Kingdom, for example, ADHD was known as a “disorder of anger and aggression.”

Anger isn’t one of the criteria used to diagnose ADHD anymore, but many healthcare providers recognize that anger can keep you from functioning well at home, in school, at work, and in your social life.

Children, teens, and adults with ADHD often have a hard time managing strong emotion. Researchers call this condition emotional dysregulation. Around 70 percent of adults with ADHD have some degree of emotional dysregulation. It’s a result of a difference in neurodevelopment.

Emotional dysregulation can include experiences like these:

  • You feel a persistent, low-grade hum of irritability.
  • You feel grumpy, as though something unpleasant is brewing inside.
  • You feel impatient when you’re under stress.
  • You feel a sudden surge of anger when you’re frustrated in pursuit of a goal — whether it’s a major life goal or an everyday goal like trying to get a lid unstuck or a solve a complex math problem.
  • You feel emotions intensely. Sometimes, the degree of emotion you feel is out of proportion to the situation that sparks it.
  • You may have explosive bursts of anger.
  • You might have a hard time expressing your anger verbally, which can lead to even more frustration.
  • You might not notice other people’s feelings, or you might misinterpret them.
  • You might find it easier to feel and express anger or sadness than you do other feelings.

If you have other conditions such as anxiety, depression, or oppositional defiant disorder (ODD), you might be even more likely to feel angry, irritable, or upset.

Lots of recent research has focused on irritability, which is sometimes described as a mood in which people tend to feel some degree of anger. When you’re irritable, changes in your environment can make you feel angry. If you expect things to go a certain way and they don’t, you might get angry quickly.

Irritability and ADHD appear to go hand in hand. In one recent study involving 696 children with ADHD, 91 percent had at least one symptom of irritability. In this study, researchers found that irritability was associated with both anxiety and depression symptoms.

The connection between irritability and depression symptoms may be genetic. Researchers have found that irritability has a genetic connection — and the genes that are related to irritability overlap with those related to depression.

If you experience irritability, it’s important to talk about it with your healthcare provider. If irritability is common for you, getting treatment could prevent other problems down the road. Studies have shown that irritability can affect:

  • your physical health
  • your earning ability
  • your risk of anxiety and depression

Medication and psychotherapy have both been effective in calming irritability in people with ADHD.

ADHD can prime you for frustration. You have goals, drive, and energy, but issues with organization, distraction, or time management can make follow-through difficult.

In children

ADHD makes it a real challenge to finish tasks that demand persistence. In one study, students with and without ADHD began a complex task. More of the students with ADHD quit the task than students without ADHD, leading researchers to think they may have had a lower tolerance for frustration.

That may be because frustration causes such a strong reaction. When researchers talk to children with ADHD about how they feel when they’re frustrated, they describe an intense emotional experience, even long after the frustrating event is over.

In adults

Of course, frustration isn’t limited to children. Adults with ADHD are exposed to lots of daily frustrations. Take driving to and from work as an example. A 2012 study measured responses to frustrating road conditions during a driving simulation.

Drivers with ADHD had about the same number of angry thoughts as drivers without ADHD. But drivers with ADHD who expressed more of their anger while driving tended to make more tactical driving errors and had more collisions than other drivers.

Researchers said the driving errors weren’t because of distraction but because of frustration and negative emotion.

Anger, like other emotions, has a kind of sliding scale from mild annoyance to frustration to rage. For some people, ADHD can speed up the shift from one level of anger to another.

Researchers have defined aggression as “the immediate intent to cause harm” to “self, others, objects, or property.” Aggression can feel powerful in an immediate sense: People may do what you want them to do when you get angry. But aggression isn’t a healthy response. It damages relationships, it can cost you your job, and it can do lasting damage to your health.

Sometimes people with ADHD become aggressive as an impulsive reaction to something that happens — a frustration, a provoking comment, or stress. Experts think that aggressive behavior may come from an avoidance of angry or hurt feelings. The aggression is an attempt to rid the self of negative emotion.

Other times, aggression isn’t a quick reaction. It’s planned to accomplish something the person wants. Both kinds of aggression are possible for anybody, with or without ADHD, but impulsive aggression is more common in people with ADHD.

Aggression in children

For children who have difficulty resisting impulses, anger can sometimes trigger aggression. Researchers have found that among pre-adolescents with combined presentation ADHD, around half are prone to aggressive behaviors when they’re angry.

Aggression in children with ADHD may be related to neurological differences, as well as environmental ones. In a 2015 study”>2015 study, researchers conducted brain scans of 30 children with ADHD and 31 without.

They found differences in the neural circuitry between the two groups. Those differences were linked to aggression, but not the other symptoms of ADHD in children, such as impulsivity and inattention.

In 2014, researchers at Ege University in Turkey studied 476 school-age children with ADHD. They identified several environmental risk factors that predicted aggression. While researchers acknowledged that genes play a role in aggression tendencies, they noted that the family environment was also influential.

These factors made a difference:

  • family attitudes toward aggression
  • parenting style that emphasizes punishment
  • rejection or criticism from parents

The researchers also found that children with verbal skills that were less developed tended to be more aggressive. This finding makes sense given that children resort to acting out physically when they can’t effectively communicate their needs or feelings verbally.

Aggression in teens

Changes in adolescent hormones and sleep patterns can sometimes worsen ADHD aggression in teens. If your teen is having an increase in impulsive aggression, it’s important to recognize and treat it because these behaviors can lead to a wide variety of negative outcomes, both short-term and throughout life, including:

  • risk of rejection by friends and coworkers
  • ADHD symptoms that persist into adolescence and adulthood
  • risk of engaging in illegal behavior
  • risk of substance use disorder

If your teen uses alcohol or cannabis in response to anger, they may also be more likely to engage in sexual activity without barrier methods such as condoms, which increases the risk of a sexually transmitted infection (STI).

Aggression in adults

About two-thirds of those who are diagnosed with ADHD as children outgrow the diagnosis as adults. If you do have ADHD as an adult, managing your mood and your feelings may be an ongoing challenge.

Impulsive aggression can be a symptom of adult ADHD, but if you have another condition, it may be harder to tell if the aggression is related to ADHD or something else.

Some research shows among adults with ADHD symptoms that include hyperactivity and impulsiveness, there’s a risk of self-injurious behavior or suicide attempts and attempts to harm or injure others. Researchers were careful to point out that in some cases, violence might have stemmed from other disorders.

It’s important to understand that aggression doesn’t have to be physical: There are indications that adults with ADHD may be more prone to use verbal aggression, too.

If you’re having persistent ADHD symptoms, including irritability, anger, and aggression, it’s important to talk with a healthcare provider about treatments that could help, including medication and different kinds of psychotherapy.

There are a number of treatments and strategies that can reduce anger and help you learn to manage it in healthy ways.

Medication

There’s evidence that the stimulant medications used to treat ADHD may also help lower irritability. Selective serotonin reuptake inhibitors (SSRIs) and some antipsychotic medications have also shown promise in treating irritability, but more research needs to be done.

Self-regulation training

Self-regulation training can help you learn concrete strategies to manage anger constructively. You could learn:

  • to avoid or remove yourself from situations that cause anger
  • to set clear boundaries so you prevent conflict
  • to think about how you can change a frustrating situation in advance
  • to change the way you look at upsetting situations
  • to plan and organize yourself to prevent frustration
  • to develop new responses to anger

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a psychotherapy approach based on identifying and changing unproductive thinking patterns. For example, a therapist can help you learn to:

  • monitor your level of anger
  • employ relaxation techniques
  • reframe thoughts that lead to emotional excess
  • use social skills to solve problems in ways that are appropriate to the situation

These strategies can be helpful to people of all ages.

Child-centered play therapy

Another type of therapy that can help children with ADHD is called child-centered play therapy. A trained therapist will use playtime as a way to connect with the child and help them to process feelings and inner experiences.

There is some evidence to support the idea that it can help with certain ADHD symptoms, such as oppositional behavior.

Parental training

Tantrums, explosive rage, and chronic irritability may be challenging for parents to handle. If your child has ADHD and anger issues, you may find that some additional support is useful, especially in helping you find methods that are positive and effective.

Behavioral parent training (BPT) can equip you with skills that are known to improve children’s compliance and lower parent stress.

In one recent study, group therapy among parents and children with ADHD had positive results. Using CBT techniques, the study participants improved their ability to function and regulate emotional ups and downs. Their depression symptoms improved, too.

Mindfulness meditation

Mindfulness meditation helps people with ADHD improve their ability to regulate emotions. While meditation on its own may not be enough, when used with medication and psychotherapy, it can be an effective supplemental therapy.

Exercise

Physical exercise has positive effects on a number of ADHD symptoms, especially inattention, impulsivity, mood, and thinking abilities. The research on whether exercise is helpful in getting rid of excess anger is mixed.

Some studies have found that hostility, which is an attitude that motivates aggressive behavior, decreases after exercise (but not anger). A recent review of the research found that exercise improved social behavior and unintentional aggression, but it didn’t have an effect on self-control or intentional aggression.

If you’re parenting someone with ADHD, you can help by:

  • noticing which events and times of day are hardest for your child
  • acting with empathy when your child is angry
  • providing opportunities to talk about frustrations
  • teaching your child how to self-monitor feelings and walk away when necessary
  • allowing your child to have appropriate boundaries
  • helping your child plan and organize to avoid frustration
  • talking with healthcare providers about treatment options
  • work to regulate your own emotions when your child is angry
  • use a calm voice and try to name for your children what they might be feeling

If you’re an adult dealing with ADHD and anger, you can:

  • Notice your triggers and consider new ways to respond to them.
  • Give yourself permission to walk away if you feel emotions rising.
  • Work with a therapist to build your self-regulating skills.
  • Get plenty of rest and exercise.
  • Learn more about how to set and keep healthy boundaries.
  • Talk to your healthcare provider about what treatments might be right for you.

If irritability, frustration, and anger are interfering with your relationships or your ability to function every day, or if they’re affecting your self-esteem, it is a good idea to talk to your doctor about treatment options.

Getting angry is part of the human experience. ADHD can make anger more intense, and it can impair your ability to respond to angry feelings in healthy ways.

Medication and psychotherapy can help you manage anger more effectively. Self-regulation and parenting training can help you build a healthy toolkit for responding to anger constructively. Meditation and exercise an also help.

Though ADHD presents extra challenges, there are treatments and strategies available that may make it easier to deal with this powerful and potentially useful emotion.