I ran across an article of this topic which is one I am still learning more about.  The one thing that I do know for sure is that this is one of those things that is hard not to notice sometimes especially with anger.  That seems to be the problematic one that everyone can see including us (ADHD'ers) when that happens.  But as I have now come to understand better....this is directly related to executive functioning and the ability to control your emotions.  As it is stated very well in this article...the emotional responses may be appropriate to the situation....but the response or how they are expressed or come out are bigger, louder and longer than what would be considered normal. 

So it seems.....it's not only anger we're talking about....it's all strong emotions and even weaker less noticeable ones.  Less noticeable for you that is if you don't have this.  We notice them for sure even if you aren't aware of them in a more self aware mindful way meaning......a lot of our (my) behavior is geared towards dealing with this and this is learned over your entire lifetime with ADHD.  Without realizing it and not knowing anything different.....how we learn to manage this and how other people react to us will definitely become a pattern of behavior that is specifically designed in dealing with this phenomenon to the point....that it is part of our personality as much as the rest of things that come into play.  Again.....this was really telling.

I know I made a post a while ago stating that we (ADHD'ers) are use to being this way.  It's all we know.  Everyone else however.....not so much! lol  This really is where we have trouble seeing ourselves compared to others sometimes and why other people are left scratching their heads going......what the...huh???????

When I read this I went....wait a minute.  This was me when I was a kid growing up but I learned how to dampen it down after enough criticism and embarrassment with enough time and practice.  It occurred to me in context to this article for professionals to use with patients having suffered a brain injury....that they are talking about a person who went from not being this way and all of a sudden...finding themselves in the same boat with people with ADHD.  The big difference is that we have been this way all of our lives and have had a lot of time and practice in getting use to it and adjusting to it even though....it's still there and we still run into the same problems just less often and in more extreme situations when we have more difficulty controlling it.

I went....mmmmmmm. Fascinating?  In context to this article and explaining it in terms of a head injury out of the blue and this being the follow up to those in this situation....as read through the suggestions for others to follow and the reasons why...........

I went (again).....wait a minute?  I learned to do this on my own a long time ago but it is the exact same things I do already to the letter under the same exact circumstances. 

And again.....I do this and don't expect other people to do this for me because when I don't.....I'm back to square one when I was a kid and I know that one all too well!! lol

Anyway...for what it is worth.  This really is what it is like having ADHD from the inside looking out and vise versa.  I thought this would be useful for others to use for the same reason....to simply understand what the hell is going on sometimes with us! lol

Understanding Emotional Lability

Acquired brain injury can change parts of the brain that regulate or control emotional behaviour and feelings.

What is emotional lability? Emotional lability refers to rapid, often exaggerated changes in mood, where strong emotions or feelings (uncontrollable laughing or crying, or heightened irritability or temper) occur. These very strong emotions are sometimes expressed in a way that is not related to the person’s emotional state.

What causes emotional lability?

Emotional lability occurs because of damage to parts of the brain that control:

Awareness of emotions (ours and others)
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Ability to control how emotions are expressed – so ability to inhibit or stop emotions coming out.  When a person is emotionally labile emotions can be out of proportion to the situation or environment the person is in. For example, a person may cry, even when they are not unhappy – they may cry just in response to strong emotions or feelings, or it may happen “out of the blue” without warning.  A person may have little control over the  expression of these strong emotions, and they may not be connected to any specific event orperson.Following brain injury an individual may also lose emotional awareness and sensitivity to their own and other’s emotions, and therefore their capacity to control their emotional behaviour may also be reduced. They may overreact to people or events around them – conversations about particular topics, sad or funny movies or stories.

Weaker emotional control and lower frustration tolerance, particularly with fatigue and stress can also result in more extreme changes in emotional responses.  The person may express their emotions in situations where previously they would have been able to been restrained or in control (in quiet situations, in church, listening to a concert).

These behaviours can be confusing, embarrassing, and difficult to understand for the person with brain injury and for others. 

Emotional responses after an injury.  

Emotional reactions may be appropriate in the situation, but the behaviour or expression maybe stronger, louder or last longer than would be usual for that person.

side note:  I can't tell you how many times someone has asked me if I was really upset or angry about something.   It was simply because the volume level of my voice goes up at times even when it's not a big deal or I am feeling even remotely upset at something.  Maybe only slightly annoyed or irritated.... but simply because the volume goes up is why people ask me about this or are confused?  And in turn.....I'm even more confused why they ask me in the first place?   More like...."No?....Why?....are YOU really upset about something? I figured you'd have to be or you wouldn't be asking me? " I'm sooooo confused! lol

For example, a person may be genuinely happy, but once the laughter has started they may be unable to stop or regulate the behaviour, laughing too loud, too much, or for too long.  After brain injury an individual may also show extreme but genuine emotional responses,including sadness and grief, despair, frustration and irritability, anger, anxiety and depression,and even joy, happiness, and pleasure. These may be appropriate and normal emotional responses but more out of scale.

Coping with Emotional Lability

Become aware of triggers.  Be aware of triggers for emotional lability and try to avoid these when you can. Triggers can include:
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excessive fatigue or tiredness
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stress, worry or anxiety
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high stimulation (too demanding, too noisy, too many people) – too much pressure
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strong emotions or demands from others
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very sad or funny situation (such as jokes, movies, certain stories or books)
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discussing certain topics e.g. driving, loss of job, relationships, death of a family member
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speaking on the telephone or in front of a group or where a person feels under pressure

Have a Break

Have a short break away from the situation so the person can regain control of emotions, and to give the opportunity for emotions to settle.
Sometimes a break of a few minutes or a longer period is enough to regain control of emotions –taking a short walk, doing a different activity all can help to cope with these strong emotions.

Ignore the behaviour.

Try to ignore the emotional lability as much as is possible.

Try to get others to ignore it too and continue on with the conversation or task.Focussing on the lability or giving the person too much attention when it is happening can reinforce and increase the problem. It is important that other people don’t laugh too, as this will also reinforce and increase the behaviour. 

Change the topic or task Changing the topic or activity (redirection and distraction) can reduce stimulation or stress (particularly if the topic was a trigger).
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Try to distract or divert the person’s attention by engaging them in a different activity or task.

Provide information and education.  Uncontrolled crying or laughing can be upsetting,frightening or confusing for other people if they don’t understand.

Provide simple explanations or information to other people about the lability, for example, “I cry a lot since I had my stroke ...don’t worry about it” or “Sometimes when Iam nervous I get the giggles”.

Tell people what they should do, for example “Just ignore me and it will stop”

Plan ahead
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When there is severe emotional lability, one-to-one, brief and fun activities in a quiet environment will be better.Try to avoid putting the person in stressful situations or environments e.g. noisy, busy,high levels of activity or that are too demanding.  

Plan activities that are within the person’s ability. 

Plan more demanding activities or appointments after rests, or when the person has the most energy.

Plan for rests between activities. 

Use cognitive techniques

Some simple cognitive strategies can also assist in managing emotional lability: 

Relaxation and breathing exercises to reduce tension and stress

ƒUsing distractions – thinking of something else, imagining a peaceful image or picture, counting
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Doing an activity (going for a walk)

Cognitive and behavioural strategies such as thought stopping could be discussed with a Psychologist.Counselling and support.

Sometimes a person has had many losses and changes to cope with after the brain injury – loss of work, ability to drive, independence, changes in relationships or finances, changes in the quality of their life.

All these changes happen quite suddenly with little chance to prepare or get ready.

These feelings of sadness, grief, anger,frustration, disappointment, jealousy, or depression after an injury are common and  maybe very difficult to cope with.

If there are other emotional adjustment and coping issues, referral to a counsellor such as a Psychologist, Social Worker or Psychiatrist maybe helpful. Families (parents, siblings, children),friends or carers may also benefit from support and care to help them understand and to cope with these changes

An amazing thing happened over dinner a couple of nights ago. J Jamieson had been talking recently about denial - and how tricky or impossible it is to get into some topics when denial is at play. He had suggested going through the back door so that the denial is not openly confronted - allowing your partner to feel safe and not attacked. I couldn't tangibly get the concept but it has stuck in my mind. So back to dinner. We were having a lovely dinner and then out of no where my H launched into the usual 'victim' attack about everything that is wrong and how poorly he has been treated all his life. Something must have triggered it but he had gone into the red zone and I couldn't reach him. At that time all you can think of is 'damn - here we are back to stage 1'. We went back to our room and J Jamieson's advice about coming in the back door or doing something totally different to what you have tried before came to mind. Normally I would either get angry, or withdraw.

So instead I showed love. I gave him a hug, said that i loved him, and said I was going to lay on our bed and read my book, and when he was ready I would appreciate it if he joined me and gave me a cuddle. Absolutely amazing outcome. His anger went, he actually apologised, and that blip on the radar hasn't spoiled our week. Showing love allowed him to recover with dignity and respect for both us.

Not too very long ago, I tried to express to my spouse why I changed my behavior.  Most changes surround new boundaries put in place to keep my distance from behaviors directed at me that I will no longer accept.  

Two things came to light that really surprised me.

I cannot speak verbatim, but I can share as I remember our conversation - but only from Liz's end.  I was talking about my actions over the years of being a People Pleaser.  How Liz took responsibility for everything that was wrong in our relationship.  How Liz made part of her life's work the job of keeping her spouse happy, which included giving in too much, and letting go of my hopes and dreams.  My learned response to anyone else's displeasure towards me was:  "Oh, oh; they are mad/angry/disappointed in me.  I must be screwing up."  I developed a pattern of responsive behavior to an angry look, a raised voice, an out-n-out accusation - I shut down my voice; smoothed the water; kept others happy.   That behavior worked to keep the peace, but NOT to address the issues.

#1 - my spouse saying that I accused him of being a monster.  No matter how I racked my brain, I couldn't find that accusation.  I don't call names.  I have made a life choice of No Character Assassination - Not Ever. I raised my children with that important guideline for our home.    It seems a conversation happened where I was explaining how I had always changed MY behavior in a misguided attempt to control HIS behavior - and since my action created this monster, my actions had to disassemble it.  

As a result, I can see how he interpreted my words.  I meant a "Monster of a situation".  I apologized for that - now he has to choose to hold on to that misinterpretation to justify his anger at me, or he can choose to try to figure out how the voices of his past had filtered Liz's words into something they were not meant to be.  

This gal had lots of warts and hang-ups and problems. This gal also worked damned hard, for a really long time, to get to a place of feeling comfortable and - Taa Daa - most times quite wonderful inside my own skin.

#2 came to light during a conversation surrounding parent/child dynamics.  I fully realize how my own Mothering behaviors towards my spouse had a negative impact on our marriage.  I also started to understand how those same parenting dynamics happened in reverse - from my spouse towards me.  I understand the value of his rescuing me when I first met him.  Unfortunately, that dynamic of relating to each other has not been able to change.  I DO NOT want to be rescued any more.  I do not NEED to be rescued any more.  I do not want a father, I want a man with whom I can share my life.  My spouse was sharing with me how angry he was that I had "Defied his wishes. . . . . . ."  My response was, "You are not my dad, you are my husband.  We are adults and we need to compromise.   You did not want to share our RV, and I did. Your 'wishes' were not the final say in the conversation."  My spouse's responses were surrounding the fact that he did not drink and on and on bringing up some poor choices MY Dad had made when I was a child. So there it was - I meant DAD in the figurative form of the word, NOT specifically MY Dad.  My spouse also had been getting that same image when I would say "I am NOT your Mother."  Wow! I never meant HIS Mom, just the Mother Dynamic:

"a parent-child marriage is defined by the inequality of the partners.  In order for a relationship to thrive, partners must be just that - partners!  Both must work at sharing equally in the burdens and success of the relationship.  Typically both spouses must change to be respectful, supportive, and flexible in their relationship with one another.  Neither is a "parent" or "child" to the other.  Instead both are adults."

So, Liz can see this.  I can only hope my spouse will choose to see it.  

I do NOT like feeling controlled.  

Oh, folks, I am not perfect.  I still mess up.  I try my best.  I recently had a conversation with my adult daughter.  She mentioned her disapproval at some behavior she witnessed when I walked away from  a conversation with my spouse when it started to turn ugly. She said, "Mom if that was me when I was growing up, I would have had to write a long essay."  And there it is - the big difference.  A parent is supposed to train up a child, and let them know when their behavior is not respectful of an adult.  There is a big difference between maybe saying "Shove it up your bum" and walking away, versus saying, "I refuse to participate in a conversation where I do not feel respected."  

It gets VERY hard to express my own actions, NOT be accusatory towards her Daddy, hear her, yet not allow the conversation to get to' Daddy is right, Mommy is wrong, and Mommy needs to change her behavior to keep Daddy happy.'  Because, sadly, that is what I modeled for her when she was growing up.   What I can do today is take responsibility for my own actions, and now that I know better, I do better.  

Liz

This is what I am struggling with now. It's sad and it's something I can't control. It is a reaction to his lack of effort. Good guy, big heart but does not emotionally fill my needs and it seems that he doesn't have any emotional needs for ME to fill which makes me realize that all these years, I have worked so hard for something that wasn't going to make a dent anyway. He is a robot, sorta speak. He has physical needs though, and I still have to fulfill those. He pays attention when he needs that but the feeling isn't one of romance just one of duty. This was coming down the pike. In 2007 I told him he was losing me and every year of our marriage I told him I felt lost and lonely. So I have grown up now, learned to accept, fill my void with friends and things I love to do but the feeling is one of compassion, being faithful, and loving since he has been a part of my family 25 years. How can I be in love with someone who chooses tv, IPAD games and his laptop at 11:45 PM and I sleep alone and then at 2:45 AM comes to bed and wants to pay me attention...only because he wants something? He is not evil and I don't hate him. I just don't feel like I couldn't live without him. The day has come when I have to figure out how to live with a friend and brother when I really only wanted a husband and a normal marriage. The butterflies are gone and the rush to get home to be together is slowed to a crawl. I no longer take days off to be together because its stressful and we don't do vacations because it's not romantic and he is hyperfocused on his gadgets and makes driving with him irritating and makes me anxious. He is always negative and stressed. It's just not who I am. 25 years and I am finally allowing myself to emerge and not trying to fix anything in him anymore but the result is still the same. He can be so neglectful and yet untouched emotionally. I am the only one suffering since I am wired correctly. Yes, all I can do is take care of me, fill the void. My God, this is hard. While I sleep alone and fill my void, I know that some other guy somewhere if lonely too and would love to be my husband. My husband loves to say "I love you" and I believe him, but love is not enough for me. I am not leaving physically but everyday since 1990, I have been slowly leaving emotionally. He has seen it and says that he IS making effort but that is only the effort HE wants to put in and to me its imaginary. He feels that telling me he loves me is effort. I stay so he doesn't break apart. I feel like I am taped together with Duct Tape because I have been so strong all these years. I am grateful to be resilient. Anyone else feel like they love their mate like a brother/sister?