Preliminary Theory: ADHD as a Nervous System Dysregulation Disorder and Its Role in Emotional

Collapse Among High-Functioning Veterans

Preliminary Theory: ADHD as a Nervous System Dysregulation Disorder and Its Role in Emotional Collapse Among High-Functioning Veterans Author: Theresa Alfonzo Abstract: This theory proposes that adult Attention-Deficit/Hyperactivity Disorder (ADHD) is fundamentally a disorder of nervous system dysregulation rather than simply a cognitive or behavioral deficit. In high functioning individuals, particularly within veteran populations, this dysregulation manifests as emotional suppression, functional collapse, and suicide risk. The theory also asserts that Rejection Sensitivity Dysphoria (RSD), a severe emotional response pattern often co-occurring with ADHD, acts as a neurological vulnerability to perceived social failure or disconnection. This vulnerability—when combined with trauma, emotional neglect, and the high-performance culture of elite military environments—leads to what has been historically misunderstood as treatment-resistant PTSD or mood disorder. This theory is intended to bridge gaps in existing psychiatric models and proposes a new lens for prevention, screening, and treatment.

Theory Statement: ADHD should be reframed as a disorder of nervous system dysregulation that impacts attention, emotional regulation, sensory processing, and autonomic reactivity. Emotional dysregulation in ADHD is not a secondary symptom; it is a core feature driven by a volatile interaction between executive dysfunction and heightened limbic response. In high-functioning veterans, this presents as a pattern of emotional isolation, identity loss, and episodic shutdown—often misdiagnosed as PTSD, Major Depressive Disorder, or treatment-resistant conditions.

Key Propositions:

1. ADHD is a state-dependent disorder of arousal and regulation that impacts an individual’s ability to self-soothe, sustain focus, and emotionally rebound.

2. Rejection Sensitivity Dysphoria (RSD) is a symptom of nervous system overload, not a personality flaw. It represents a neurobiological panic response to perceived emotional invalidation or failure.

3. Veterans with undiagnosed ADHD often experience long-term nervous system dysregulation due to the combined effect of trauma, emotional suppression, and lack of adaptive coping frameworks.

4. Traditional PTSD-focused treatments often fail in veterans with underlying ADHD because they do not address baseline nervous system dysfunction or emotional processing deficits. 5. Operator Syndrome and similar multi-domain diagnoses provide useful clinical context but often omit ADHD as a primary factor in long-term functional decline.

Implications: - Veterans should be routinely screened for ADHD using emotionally-centered, adult-relevant diagnostic tools. - RSD and emotional dysregulation should be recognized as primary treatment targets in ADHD care models, not as secondary mood issues. - Trauma-informed care models should be modified to include neurodivergent profiles. - Suicide prevention frameworks should incorporate ADHD-specific interventions for emotional collapse and nervous system overwhelm.

Conclusion: This theory urges the medical and psychiatric communities to reconsider ADHD as a whole body disorder with significant implications for emotional health, suicide risk, and treatment resistance. In high-functioning veterans, this reconceptualization may explain persistent collapse patterns that have eluded traditional clinical understanding. More research is needed to validate these observations through longitudinal and interdisciplinary study.