The adult ADHD regulation crisis: Why you feel broken when your brain isn’t
Dr. Sasha Hamdani is a board-certified psychiatrist specializing in ADHD, author of “Self-Care for People with ADHD” and the forthcoming “Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply.”
ADHD isn’t an attention deficit—it’s a regulation disorder affecting motivation, energy, emotions, sleep, and appetite. Board-certified psychiatrist Dr. Sasha Hamdani reveals in a chat on the Mel Robbins Podcast that emotional dysregulation affects nearly 100% of people with ADHD, yet remains the most overlooked symptom in diagnostic criteria built around hyperactive young boys.
The six signs you’ve missed your whole life
Dr. Hamdani identifies six regulation domains that ADHD disrupts—far beyond the stereotypical inability to focus:
- Attention regulation: Difficulty sustaining or shifting focus appropriately
- Motivation regulation: Paralysis on important tasks despite capability
- Energy regulation: Wild swings between hyperproductivity and complete crashes
- Emotion regulation: Intense mood swings that feel like “a hurricane inside”
- Sleep regulation: Inconsistent sleep patterns and difficulty winding down
- Appetite regulation: Forgetting to eat for hours or binge eating for dopamine stimulation
DHD at its base is a regulation issue. Yes, attention is part of it. Difficulty regulating attention, but also difficulty regulating motivation, difficulty regulating energy, difficulty regulating emotion—that’s a huge one. Difficulty regulating sleep, difficulty regulating appetite.
— Dr. Sasha Hamdani
Why ADHD goes undiagnosed in women
The diagnostic criteria were developed by observing hyperactive young boys—highly external, disruptive behaviors that teachers and parents could easily spot. Women and girls typically present with inattentive ADHD: daydreaming, forgetfulness, internal chaos masked by perfectionism and overcompensation.
The criteria is not even built to look at girls. It’s not built to look at adults. They’re looking at these highly observable behaviors—kids disrupting classes. But what about all those other presentations where the only people they’re disrupting are themselves?
— Dr. Sasha Hamdani
This internal disruption gets misdiagnosed as anxiety, depression, or “just hormones” throughout puberty, postpartum, and perimenopause—when estrogen drops and dopamine regulation becomes even harder.
The Brain Science: Why you feel like a hurricane
ADHD involves three neurological factors working against you:
- Thinner, less responsive prefrontal cortex: The “smart” decision-making part of your brain under your forehead
- Hyper-reactive amygdala: The almond-shaped emotional center firing alarm signals constantly
- Weak connection between the two: Emotional floods overwhelm your ability to process and filter
You feel things strongly because that amygdala is like—alarm chemicals, something is happening—and that prefrontal cortex is sometimes slow to filter and figure out exactly what to do with it.
— Dr. Sasha Hamdani
Dopamine—the neurochemical for alertness, attention, and mood—isn’t necessarily low; it’s not in the right place at the right time, fluctuating with hormones, age, and stress.
Rejection sensitive dysphoria: The hidden symptom
Nearly 100% of people with ADHD experience Rejection Sensitive Dysphoria (RSD)—an intense, often physical emotional response to real or perceived rejection, criticism, or fear of disappointing someone.
Rejection sensitive dysphoria is this incredibly robust emotional response, sometimes physical, but mostly emotional response to real or perceived rejection or criticism or this fear of disappointing someone. It is this internal emotional response, flooding of neurochemicals that happens.
— Dr. Sasha Hamdani
RSD can look like panic attacks, depressive episodes, or rage—and keeps people from pursuing opportunities they’d love because the fear of rejection feels life-threatening.
The Three Types of ADHD
| Type | Key Features | Typical Presentation |
|---|---|---|
| Inattentive | Daydreaming, forgetfulness, difficulty organizing, task avoidance, forgetful | Most common in women and girls assigned female at birth |
| Hyperactive-Impulsive | Physical fidgeting, can’t stay seated, interrupting, blurting answers, impulsive speech | More common in males, the “classic” stereotype |
| Combined | Features of both inattentive and hyperactive-impulsive types | Dr. Hamdani’s own presentation |
Masking: The Exhausting Camouflage
Masking is the conscious or unconscious camouflaging of ADHD symptoms—something women do exceptionally well to avoid trouble or standing out.
Examples include:
- Physically restraining yourself from fidgeting (suction-cupping to your chair)
- Perfectionism and overpreparation to compensate for forgetfulness
- Staying late at work to overcompensate
- Avoiding conflict to protect emotional sensitivity
Eventually, that mask gets too heavy to hold.
— Dr. Sasha Hamdani
Is ADHD a superpower?
No. Everyone asked me that. I am so jealous of the people who say that it is… I feel like the analogy that I give is it’s like a superpower that I have very little agency over because it’s like you can fly now and that’s your superpower, but you can’t choose when or where. So, you’re just going to blast off into space at any given time.
— Dr. Sasha Hamdani
While hyperfocus can lead to achievements (book deals, social media success, career breakthroughs), the day-to-day limitations—procrastination, emotional crashes, inability to trust yourself to follow through—feel anything but super.
What to do if this sounds like you
Dr. Hamdani emphasizes: This episode isn’t meant to diagnose you—it’s meant to help you ask questions about your internal environment.
First steps:
- Approach with self-compassion: Good diagnosis comes from a shame-free place.
- Look for longitudinal patterns: Track symptoms across your menstrual cycle, life stages, and stress levels.
- Seek comprehensive evaluation: Rule out anxiety, depression, thyroid issues, and bipolar disorder—ADHD often coexists but is frequently misdiagnosed as these.
- Consider all treatment options: Medication can be life-changing for some, but cognitive restructuring, therapy, sleep, exercise, and nutrition are equally critical.
Your brain isn’t broken. This is just a different wiring. And it’s going to give you the language and the tools and the steps of where to go next so that you can actually start navigating this condition.
— Dr. Sasha Hamdani
The grief and relief of diagnosis
Many people feel both relief and grief upon diagnosis—relief at finally understanding themselves, grief for years of unnecessary self-hatred and wasted time.
That is normal. You are allowed to feel those things. That’s perfectly normal and there should be space for that.
— Dr. Sasha Hamdani
But that time wasn’t wasted: you were building routines, structures, and workarounds that will become valuable scaffolding as you learn to work with your brain instead of against it.
This recap is based on Dr. Sasha Hamdani’s appearance on the Mel Robbins Podcast. For the full episode, click on the YouTube link at the top or listen wherever you get your podcasts.
