For many people with features of ADHD, either diagnosed, undiagnosed, or subclinical, the most troublese emotions is frustration. Frustration underlies many of the personality traits that develop with ADHD. Such frustration may arise from an impasse in their work, from having to wait in line, or making an error, and spikes quickly. The spike of frustration has a toxic feel, or may convert to depressed mood, which is why so many individuals with ADHD tend to become depressed , and over the long term, develop problems with self-esteem. Each time that frustrationn spikes, the individual's mood dips, and, worse, makes it more likely that frustration will again rise in the future. When I first worked with children, I noticed a high proportion of boys with ADHD were depressed--the presumption was that the highest demographic of depressed individuals was women. The boys, with a slightly higher proportion of the active type of ADHD, seemed hypersensitive to making an error. The goal was to help the child prevent the frustration, or, after the fact, to manage it. This meant reducing perfectionism, and the feeling of needing to rush. Methods also involved helping the child mentally taking a breath, or pause. Finally, a goal was helping the child learn cognitive ways of rehearsing cognitive ways of avoiding a descent into self critical or depressive thinking, every time they experienced frustration or setback.