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ADHD: Why You Have to Say How You Feel

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If you live with ADHD, you know there’s a storm inside. A tension, a restlessness, a pressure that migrates through your limbs. It doesn’t stay quietly in your mind. It wants out.

When you feel something especially something heavy or negative that emotion carries weight. It carries energy. For many people with ADHD, that energy has to move. It needs a channel. We feel a powerful internal urge to express to voice what’s inside.

In this post, I want to explore why that need is so visceral, what happens when you suppress it, and the complexity that comes when you try to express to people who don’t truly care. I want to walk with you through the push and pull the physiological, psychological, and relational terrain of emotional expression in ADHD.

1. Emotional Dysregulation in ADHD: More Than Just Mood Swings

First, it helps to ground us in what emotional dysregulation means in the context of ADHD. It’s not just being moody or reactive. It’s having difficulty modulating emotional responses especially negative ones so that they flood you.

Research suggests that 25–45% of children with ADHD, and 30–70% of adults, also struggle significantly with regulating emotions.

In other words: emotional regulation is not a side issue it’s deeply woven into many ADHD experiences.

People with ADHD exhibit greater emotional reactivity (stronger and quicker emotional responses), and often less capacity to modulate or slow down those responses.

Some studies show that those with ADHD rely more on expressive suppression (trying to hide or block feelings) and less on cognitive reappraisal (reframing or changing the meaning) and that those tendencies contribute to more emotional dysregulation.

So when you feel negative emotion anger, hurt, disappointment, shame it isn’t a casual “bad mood.” It is an activation. It is energy stirring in your system, demanding a response.

2. The Physiology of Needing Release

This is where I lean into the body: that “storm inside” I mentioned. Negative emotions in ADHD don’t stay mental they reverberate in the body through tension, restlessness, agitation, racing thoughts, perhaps muscle tightness, shallow breathing, heart pounding, or a constricted chest.

Because ADHD brains and nervous systems tend to respond intensely and sometimes unpredictably, the energy associated with the emotion accumulates. Holding it in is like compressing a spring. It becomes harder to contain.

When you express whether by speaking, writing, movement, or tears you provide an outlet. The energy can move. The pressure can ease. Your body begins to calm. You breathe more deeply. The tension releases. You can shift from a sympathetic (high arousal) state toward a more regulated internal balance.

From a neurobiological perspective, emotional regulation involves both “bottom-up” systems (like limbic, amygdala responses) and “top-down” control (prefrontal, executive function). In ADHD, that balance is more fragile, so letting emotion move rather than suppressing it becomes a key coping pathway.

So yes: when you do say how you feel, you’re not indulging drama you’re serving your physiology. You’re working with your system, not against it.

3. The Consequences of Silence: What Builds Inside

But what if you hold it in again and again? That’s when the internal cost begins to accumulate. Below are the common consequences I see (and hear) repeatedly and that I want you to know are real, valid, and painful.

a) Preoccupation and Rumination

You replay the moment, the words you wished you’d said, the tone, the what-ifs. You turn it over and over in your mind. That preoccupation is exhausting, consuming mental bandwidth you can’t spare.

b) Overthinking & Mental Problem-Solving

Your mind becomes a workshop: “What if I said this? What if they responded like that?” You try to solve it in your head, sometimes cyclically, but your brain never closes the loop because the emotion was never discharged.

c) Anxiety and Emotional Amplification

Because the matter remains unresolved internally, anxiety builds. The emotional signal becomes louder. You might catastrophise the scenario, fear rejection, or feel shaky. The suppressed emotion almost becomes a ghost in your system, haunting you.

d) Sleep Disruption & Insomnia

At night, your mind refuses to rest. The thoughts replay. The tension persists. You lie awake thinking “I should have said…” or “Maybe tomorrow I’ll try.” Sleep becomes elusive and the cycle continues.

e) Physiological Stress

Your body doesn’t easily forget. Elevated cortisol, muscle tension, jaw clenching, headaches, digestive upset these are side effects of long-term emotional unexpressed tension. Your autonomic nervous system stays keyed up.

f) Emotional Outbursts or “Meltdowns”

Eventually, the pressure may burst. A small trigger suddenly feels enormous, and the reaction appears disproportionate to others. But for you, it’s the accumulated energy flooding out. The suppressed emotion had to escape somewhere.

So, suppression isn’t neutral. It’s not passive. It pushes, presses, and eventually erupts or it corrodes your internal balance over time.

4. The Complexity: When Expression Feels Unsafe or Misplaced

All this said: it’s not as simple as “just speak.” There is a painful tension in when, how, and to whom you express your feelings. For many with ADHD, there is a history of speaking up and being ignored, ridiculed, dismissed, or misunderstood.

This is where rejection sensitivity dysphoria (RSD) often enters the picture: a deep, emotional sensitivity to perceived rejection, criticism, or dismissal. You may feel compelled to express to tell, to be known but also terrified of rejection. The risk of being dismissed or invalidated is real, and that makes emotional expression dangerous in your emotional economy.

So sometimes you feel a desperate urge to share with someone who doesn’t truly care or can’t emotionally contain you. You are hungry for understanding, but if that person isn’t capable, you risk being hurt again.

Thus you face a paradox:

  • If you stay quiet you accumulate stress, anxiety, internal pressure.
  • If you express you may face rejection, lack of empathic response, or further emotional injury.

This is the painful complexity many with ADHD live in. You are constantly weighing the internal demand for release against the external risk of emotional harm.

5. What Expression Looks Like (Safely)

Given that complexity, how can one express while protecting emotional wellbeing? Below are strategies I often teach, and ones I use myself.

1. Express to the Right People – Share with those who’ve earned your trust and can offer empathy rather than judgment.

2. Use Non-Immediate Channels – Journaling, voice memos, or letters not meant to be sent.

3. Label & Ground First – Name what you feel and regulate before expressing.

4. Use “I” Language – Speak from experience, not accusation.

5. Boundaries & Timing – Protect your emotional space.

6. Release Physically – Movement helps the energy leave your body.

7. Seek Support – ADHD-informed therapy or coaching can provide containment and strategies.

6. Your Feelings Deserve Release Even If You’re Not Ready to Share

It’s okay if you can’t express everything, everywhere, all at once. The point is not perfection. The point is fluidity: letting emotion move rather than trapping it indefinitely.

When you feel something intense, your body is trying to communicate with you. The urge to express is not weakness, but a survival impulse. Holding it in may keep you “safe” socially, but at the cost of internal peace.

You don’t have to tell every feeling to everyone. You get to choose the time, the manner, and the person. But don’t deny the release altogether.

If expression feels emotionally unsafe due to past wounds, trust methods of release (writing, voice memos, therapy) to lighten the internal pressure first. Over time, you build a stronger muscle for emotional honesty and peace replaces preoccupation.

Conclusion

If you have ADHD, you have to express. You need to say how you feel not as a dramatic gesture, but as an act of self-regulation and self-care.

Your nervous system, your body, your sense of being all require it. Silence is not strength. Silence is pressure compressed.

Not everyone will understand your depth. Not everyone can meet you there. But the right people, the safe spaces, and your own self-awareness can make emotional expression a path toward healing, not harm.

So next time something stirs inside you breathe, feel it, and find a way to let it move.

You deserve to express. You deserve peace.

About the author

Dr Becky Spelman is a leading HCPC registered Paychologist from Ireland who’s had great success helping her clients manage and overcome a multitude of mental illnesses.

***If you feel that talking to a professional could help with the issues discussed in this article, we offer a FREE 15-MINUTE CONSULTATION with one of our specialists. This session is designed to help you explore your options and find the best path forward. Book your consultation here

References

Bunford, N., Evans, S.W., & Wymbs, F. (2015). ADHD and emotion dysregulation among children and adolescents. Clinical Psychology Review, 36, 1–14. Retrieved October 10, 2025, from Link

Hirsch, O., Chavanon, M., Riechmann, E., Christiansen, H. (2019). Emotional dysregulation is a primary symptom in adult ADHD: Evidence from emotion recognition and regulation. Frontiers in Psychology, 10, 1092. Retrieved October 10, 2025, from Link

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. Retrieved October 10, 2025, from Link

Sung, J., Woo, S.Y., & Lee, S.H. (2023). Emotion regulation strategies and emotional dysregulation in adults with ADHD. Journal of Affective Disorders, 327, 94–102. Retrieved October 10, 2025, from Link

Surman, C.B.H., & Wender, P.H. (2020). Rejection sensitivity and emotional dysregulation in adults with ADHD. CNS Spectrums, 25(3), 450–457. Retrieved October 10, 2025, from Link

Categories: ADD/ADHD, Anxiety, Mindfulness, News - By Dr Becky Spelman - December 24, 2025

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