How does dopamine dysregulation affect emotions in ADHD? 

Dopamine dysregulation plays a critical role in ADHD-related emotional volatility, affecting both mood stability and emotional reactions. According to NICE NG87 and RCPsych, dopamine and its balance with other neurotransmitters, like norepinephrine, underpins emotional regulation, stress responses, and impulse control in ADHD. 

The role of dopamine in emotional regulation 

In ADHD, dopamine helps regulate emotional responses through its action on the prefrontal cortex (responsible for self-regulation) and limbic system (involved in emotion processing). Dopamine dysregulation leads to difficulties in controlling intense emotions, frustration, and irritability. As described by NHS guidelines and RCPsych, this contributes to impulsivity and poor frustration tolerance, causing rapid mood shifts and emotional instability (NHS ADHD in Adults, 2025, RCPsych ADHD in Adults, 2025). 

The dopamine system influences reward anticipation and stress responses, making it harder for individuals to handle challenges like criticism, rejection, or frustration. This is why dopamine dysfunction often correlates with emotional lability, frequent mood swings and heightened emotional reactivity. 

Dopamine’s neurobiological mechanisms 

Dopamine’s role in the brain’s reward circuits is essential for emotional processing. Impaired dopamine signalling in ADHD impacts how emotions are regulated, especially during stressful or frustrating situations. Reduced dopamine activity in areas like the caudate and nucleus accumbens has been shown to correlate with impulsivity and emotional reactivity (Itagaki et al., 2025). 

Additionally, dopamine dysregulation impairs stress regulation by affecting the HPA axis, which is crucial for managing emotional overload. This can result in increased sensitivity to stress, further amplifying emotional reactions and irritability. 

Clinical evidence of dopamine’s role 

Recent research underscores dopamine’s central role in ADHD-related emotional dysregulation. A study in Frontiers in Psychiatry (2024) confirmed that dopamine deficiencies in fronto-striatal circuits lead to mood instability and poor frustration tolerance (Frontiers in Psychiatry, 2024). PET scans have also demonstrated lower dopamine transporter activity in ADHD brains, linking impulsivity and mood volatility directly to dopamine dysregulation (Itagaki et al., 2025). 

Treatment approaches for dopamine dysregulation 

Stimulant medications 

Methylphenidate and lisdexamfetamine are first-line treatments for ADHD, working by increasing dopamine availability in the brain, helping to improve emotional regulation and reduce impulsivity. NHS guidelines recommend these medications to balance dopamine levels and improve mood stability (NHS ADHD in Adults, 2025). 

Psychological therapies 

Cognitive Behavioural Therapy (CBT) and mindfulness are effective for building emotional awareness and coping strategies. These therapies help individuals recognize emotional triggers and implement adaptive coping mechanisms, improving impulse control and frustration tolerance. RCPsych and NICE recommend these interventions as part of comprehensive ADHD treatment (RCPsych ADHD in Adults, 2025). 

Takeaway 

Dopamine dysregulation is a central factor contributing to the emotional reactivity and mood swings in ADHD. Understanding this neurobiological foundation helps explain why dopamine-targeting treatments like stimulants and psychological therapies (CBT, mindfulness) are effective in managing emotional instability in ADHD. By restoring dopamine balance and improving emotional regulation through medication and therapy, individuals with ADHD can better manage their emotions and improve overall functioning.