Beth Main is the featured speaker at the August 3, 2010 meeting of Harrisburg Business Women. The topic is Time Management: How to Make Room in Your Life for What’s Really Important. All Harrisburg area business women are encouraged to attend. For more information, visit ww.harrisburgareabusinesses.org/hbwgroup
Ah, the first backpacking trip of the season. The weather was perfect. The trail was uncrowded. Metaphors about gear and ADHD strategies floated through my mind like sparks from the campfire.
I was never really a tool person. It used to be there wasn’t much I couldn’t repair with duct tape, a kitchen knife, and a high heeled shoe. When I started hiking many years ago, part of the allure was that I didn’t need any special equipment. I could just get up and go. Now I’ve amassed several thousand dollars worth of backpacking gear that I have no idea how I ever lived without.
ADHD coping strategies are like gear. At first, you think you don’t need anything special. You can hike just fine in a pair of sneakers as long as you don’t go too far or over rocky terrain. But then you try to go a little farther. Rocks and roots press into the soles of your shoes. Your feet start to hurt. So you bite the bullet and buy a pair of hiking boots. They’re a little uncomfortable at first, and you think, is this really any better? But then you start to get used to them. Oh my! What an improvement.
Your new footwear enables you to hit steeper and more difficult trails. Being the adventurous type, off you go. You notice other hikers using fancy aluminum trekking poles. You laugh at them - what the heck would anyone need all that for? You begin to understand the value the first time you twist an ankle, or fall in a creek, or slide down an incline on your back. So you try out a pair. Like the boots, they’re a little hard to get used to. But soon you don’t know how you ever lived without them.
You are now a gear junkie.
It’s the same with ADHD coping strategies. A long, long time ago, I used to just get up and go, not worrying about how my day went. The farther I got from home, the steeper the hills were, the more I realized how hard life with ADHD can be. I got to thinking that there must be an easier way. So I started with one little strategy that changed my life: I bought a planner. At first it seemed cumbersome. I had to carry it around with me, and remember to write stuff in it, and look at it regularly. It was kind of a hassle, to be honest. But before long I was relying on it more than my left arm. How do people live without these things?!
Over time, I added more strategies to my ADHD gear closet. Now I am functioning quite well. It’s been years since anyone called me a derogatory name like Ditzy. But just like backpacking gear, there’s always some new tool I’d like to acquire. I hear about a new technique, wonder how I could possibly use it, decide to do something similar, figure out how, and integrate it into my life. Then it’s on to the next thing.
Where are you on your ADHD journey? What’s on your gear wish list? Leave me a comment.
I wrote the following “As I See It” op-ed piece that appeared in the Harrisburg Patriot News on Sunday:
What do you think of when you hear the phrase “Attention Deficit/ Hyperactivity Disorder”? If you’re like most people, you probably associate it with out-of-control kids who are given medication so they can sit still long enough to learn something.
Maybe you think it’s overdiagnosed or can be cured with a little discipline. But have you ever thought about what happens to these kids when they grow up?
They don’t disappear. They become working members of society. They become ADHD adults.
Although it’s usually thought of as a childhood disorder, about half the kids with ADHD will continue to struggle with it when they grow up. That equates to more than 10 million adults in this country with ADHD — roughly the same as the adult population of Pennsylvania. Because ADHD was virtually unheard of 20 years ago, many adults don’t even realize they have it. Or want to accept that they do.
People with ADHD are easily distracted and can’t control their attention. They have an inordinate amount of difficulty with tasks that involve planning and organization. They lose anything that isn’t tied down. They procrastinate. They lack follow-through. They’re restless and impulsive. They’re extremely forgetful. They tend to overlook details, leading to mistakes. They interrupt. They’re chronically late. They’re easily bored, thriving on novelty and instant gratification.
You might scoff and point out that everyone has these problems from time to time. While it’s true that everyone has some of the symptoms some of the time, most do not exhibit as many, or to the same degree. An ADHD diagnosis is warranted only when the symptoms cause significant impairment in daily functioning. Traits that are a minor annoyance to someone without ADHD are amplified to disability level for someone with this unique brain wiring.
And unique brain wiring is exactly what it is. ADHD is a neurobiological disorder. It’s not caused by bad parenting, laziness or lack of moral character. It’s caused by a deficiency of neurotransmitters in the brain. It’s been called an invisible disability because we can’t see it, like a broken leg or detect it with a blood test. However, differences in brain structure and activity can be seen on a SPECT scan, which shows how well each region of the brain is functioning. Several genes associated with ADHD have been identified, providing strong evidence that it’s hereditary.
There are good things about having ADHD. Many ADHDers are highly talented and creative. They’re spontaneous and not afraid to take chances. They can manage many projects at once and see things from different angles. Leonardo da Vinci, Thomas Edison and Albert Einstein were all believed to have had it.
Actors Ty Pennington and Howie Mandel have it, as do actresses Whoopi Goldberg and Lindsay Wagner. Athletes Terry Bradshaw and Michael Phelps have been diagnosed with it. Tommy Hilfiger overcame his ADHD and built a fashion empire. Activist Erin Brockovich used it to her advantage. JetBlue Airways founder David Neeleman appreciates the creativity that comes with having it. Charles Schwab considered it an asset.
I think it’s terrific that these public figures have acknowledged their ADHD. Their testimonies have gone a long way toward alleviating the stigma that ADHD holds for some.
Is there a cure for ADHD? No. But there are treatments. A lot of people think treatment means medication, but there’s a lot more to it than that. Other options include supplements, diet, exercise, sleep, stress management, neurofeedback, and behavioral interventions such as therapy and coaching. Although medication can certainly be part of a successful treatment plan, it can’t teach the planning and organizational skills that people with ADHD often lack. And it won’t make it go away.
The key to successfully living with ADHD is harnessing strengths and developing coping strategies for everything else. Like writing everything down. Using a planner, checklists and timers. Creating structure and routines. Wearing a watch that beeps, even if it’s ugly.
Accepting the need to do these things is a problem for some, because it means having to admit what they perceive to be a weakness. They self-stigmatize. Only by increasing public awareness will the myths and the stigma subside. Only then will people get the treatment they need and deserve.
About those out-of-control children? They’re good kids. They need our help and support. So do the 10 million ADHD adults who once were ADHD kids. They’re not lazy. They’re not stupid. It’s time to reveal the truth about ADHD and the people who live with it.
My colleagues at Absolute Wellness Group will present a FREE OPTIMAL HEALTH SEMINAR on April 22, 2010. Learn how all of the systems in your body are connected and how you can most effectively nourish them to reach your Optimal Health!
This educational and FUN hands-on learning event features free body composition analysis, gift bags, and a PRIZE drawing valued at $150! Featured speaker is Brenda Hoover, Certified ACE Personal Trainer and Certified Transitions Lifestyle Coach.
When: Thursday, April 22nd | 7:00 – 9:00pm
Where: Harrisburg University, room 121A, 326 Market St., Harrisburg, PA 17101
Cost: Free!
Guests are welcome. Seating is limited.
RSVP to Brenda Hoover: brenda@absolutewellnessgroup.com or 717-525-7037
Sponsored by Absolute Wellness Group, LLC
This post was written by guest blogger and unpublished fiction novelist Matt Chiappino:
As both a budding fiction writer and a person with ADD I’ve noticed a few similarities between the career and the condition. ADD can actually be a boon or a hindrance depending on the situation. In some ways the condition can almost prove helpful, as the ADD mentality is certainly creative in nature. I’ve found myself rattling off idea after idea once I get those creative juices flowing. It’s when the actual work part comes along, focusing on a single chapter, organizing and editing my manuscript, where problems start to surface. So even though I’m not an officially published author yet I thought I’d jot down a few thoughts I had on writing and the condition based on personal experience.
FOCUS: The hallmark of ADD. One day I could be doing great. I’m focused on what I need to be, my thoughts and mind zeroed in on that critical chapter or paragraph. The next day I might not be there at all, instead thinking about how I’ve going to have a bad day at work because someone called off and we’re shorthanded blah blah blah. Outside of medication, which works for some like me but not all, the best way to focus one’s mind is during those spare moments of open mental acuity when one’s mind is unencumbered by distractions. When I want to work but can’t blot out the day’s events past or present I might try taking a quick shower. Not only do I feel physically clean, it gives my mind a chance to eject the clutter and junk clogging it and let me refocus with a fresh perspective. Or might try to lay down and take a nap. Even if I sleep just an hour or two, the sheer fact of disconnecting from the junk lets me wake up fresh and renewed, like starting over with a clean slate. The key here is to get that instance of hyper-focus that comes every so often when are minds are latched onto something for a significant time and latch onto a subject of our choice.
PATIENCE: Yes, I know, that dreaded word we’ve all come to hate hearing. I’m no different. A huge part of writing anything though, is patience and persistence. Especially with the longer projects like novels, one has to keep plugging away, writing, rewriting, revising, several times over. Writing is a lengthy process that’s difficult for most people to see through to the end. With ADD thrown in, it can be even more frustrating. But it’s not impossible if one wants it bad enough and is willing to put forth the effort. The best way I’ve found to be productive writing is in small pieces. Don’t sit down and tell yourself it’s time to write the next best-selling novel or short story, it could very well lead to excess pressure or perfectionism. Just write a little bit at a time, say one page a day. It doesn’t sound like much, but think about it. One page a day is 365 pages in a year, a full length novel. Granted, it still takes time for revision and editing, but the bulk of the work, and focus, is already done. Turn creativity into part of the daily routine. Even if you can’t write a full page for whatever reason, just dedicating time every day to creative work does wonders for productivity. And when you do accomplish your goal for the day, treat yourself somehow. Make sure to remind yourself you’re doing well when you are and that every page, every hour spent working is another step closer to the goal. It does wonders for keeping up with the next issue.
CONFIDENCE: From what I’ve seen and lived, the insidious nature of ADD isn’t the condition in itself but the real world implications it often has on the person dealing with it. Unable to budget priorities, unable to get or hold down a job, feeling like a complete failure at life itself as you see your friends and family succeed with apparent ease while you struggle with basic survival, all that tends to devastate one’s belief in their own ability. And nothing kills a writing session faster than self-doubt. This sucks…no one’s going to like it…I’m going to fail again, that’s the ADD talking, don’t listen to it. With focus, patience, and confidence you will succeed. Don’t hope you will, know you will. Imagine yourself standing on a podium, answering a bazillion questions about your best selling novel or short stories or whatever, while getting your picture taken by the media. Healthy fantasies like that help keep people going during times of difficulty so don’t be ashamed to use them.
PUTTING YOURSELF OUT THERE: For a lot of people this is the most difficult element, not just with writing but anything creative in nature. Let’s face it, words can hurt, and negative criticism of something you’ve spent months or even years on hurts so much more. But as much as we all love positive feedback, as writers we need the negative feedback. We need to know what we’re doing wrong to learn from it in future. Take in the criticisms, not to heart but examine them rationally. Are they right? Are their points valid about my work? Some will give you constructive feedback that you can use to good effect in future. And others will just spit fire with no constructive use to the writer. You have to be daring, willing to face any fears of hurtful criticism or slander to make a writing career.
Case in point, I have a confession to make. Even though I’ve written and used the internet extensively I’ve never actually had anything posted for the whole world to see. The fact is I’m terrified of the world at large, but it’s a fear I have to conquer if I’m going to be successful. This very blog post you’ve just read is my own way of facing that fear. I hope you found it interesting.
And thank you so much Beth, for giving me the opportunity.
- Matt Chiappino
ADHD Solutions now has over 100 fans on Facebook!
We’re celebrating by giving away 100 minutes of free ADHD coaching to one lucky Facebook fan. Just tell us your favorite ADHD Solution (i.e. what works for YOU), and be eligible to win.
There are two ways to participate:
1. Send an email to contest@adhdsolutions.net. Describe in 150 words or less the ADHD coping strategy that works best for you. Please include your Facebook profile name in your email (see Rule #3, below).
OR:
2. Add to the discussion on the ADHD Solutions fan page. Same thing - describe in 150 words or less the ADHD coping strategy that works best for you. Log in to Facebook and click on the Discussions tab from the ADHD Solutions fan page.
Contest rules:
Back in January, I wrote about how difficult it is for people with Attention Deficit / Hyperactivity Disorder (ADHD) to make decisions. I suggested making choices based on who you want to be instead of who you’ve been in the past. That’s great advice for those big decisions like staying in college vs. going pro, but what about the small stuff? Like which GPS to buy?
There are two extremes when it comes to making decisions: People who shoot from the hip, and people who spend way too much time analyzing and ruminating, stuck in indecision. Surprisingly, the solutions are nearly the same regardless of which end of the spectrum you’re on.
Here are some steps you can follow to make better decisions more easily:
What are you having for dinner? What are you doing this weekend? What career will you pursue? Life is full of decisions. Here’s hoping these tips help you make them wisely.
Are you looking for holistic options to help you manage your Attention Deficit / Hyperactivity Disorder? Yoga and meditation are both excellent choices. They can help you increase your attention span and self control, while decreasing restlessness and tension.
I’ve teamed up with Tina Stroh and Ron Blouch, co-owners of the Just Plain Yoga Studio here in Camp Hill, to offer a three hour workshop on meditation, yoga, and ADHD. If you are even mildly affected by ADHD-like symptoms, including distractibility, impulsivity, and/or hyperactivity (which usually manifests as restlessness in adults), you won’t want to miss this one.
Here’s what you’ll learn:
This introductory workshop is designed for adult beginners. There are no prerequisites or advanced knowledge required. You don’t even have to be able to sit still for very long.
Date: Saturday February 27, 2009, 1:00 - 4:00 p.m.
Cost: $60
Location: Just Plain Yoga Studio, 1845 Market St. & 19th, Camp Hill, PA
Register online at www.justplainyoga.com or call 717.975.YOGA
Give me a call if you have questions or would like more information. I hope to see you there!
Want to start investing but aren’t sure how? You’re not alone. Many people with ADHD struggle to reach their financial goals. Here is an opportunity to learn a little more about the financial markets that might be of interest:
“Kim Lutes, a financial advisor with Waddell and Reed, will hold a free investment management seminar at Funck’s Family Restaurant in Palmyra on Tuesday, February 9th. Doors open at 6:00, the seminar begins at 6:20 and will last approximately 30 minutes with a 10 minute question and answer afterwards. A dessert buffet including cakes, pies, and cookies will be served along with coffee and tea. This will be an educational workshop where we will discuss five myths and truths of investing. We’ll show you sound strategies that can help you succeed in the financial markets and pursue your investment goals. A workbook will be provided. Please RSVP by February 2nd by calling 541-9606 ext 112 or email at klutes@wradvisors.com. More information can be found at www.klutes.wradvisors.com.
Mutual funds and variable annuities are sold by prospectus. Please consider the investment objectives, risks, charges, and expenses carefully before investing. The prospectus, which contains this and other information about the investment company, can be obtained from your financial professional. Be sure to read the prospectus carefully before deciding whether to invest.”
It was dark and rainy outside. I was cranky. Almost 10 a.m, and I hadn’t gotten anything done yet. The CD I play to help me focus better (Bach’s “Lute Suites”) was on its second time through and still wasn’t helping. I was starting to feel guilty for being so unproductive.
It was shaping up to be an ADHD kind of day.
Exercise would help, but I didn’t feel like it. What do you do when you know what you should do, but you just don’t wanna? It’s sooooo hard to get started.
I went over to the spot where I usually stretch and apathetically did a half sun salutation, my favorite yoga movement. I stopped and looked out the window. Still raining. Then I looked back at my computer, thinking about all the things that had to be done.
The phone rang. It was a client, checking in. She said she’d accomplished most of what she committed to and feels on track. Then she commented offhandedly, “I went for a walk yesterday. I think that’s a big part of why I did so well.” I expressed full agreement, being a huge proponent of exercise, diet and sleep to keep ADHD symptoms in check. She went on to say, “It’s always hard for me to exercise. I feel like I’m wasting time. There are so many things I should be doing instead.” I asked her about her productivity before and after the walk. “Oh, I got a lot more done after the walk. It totally rejuvenated me.” “Mmm hmm,” I replied. “I’m not surprised. Exercise is like that. It’s like medicine. It helps you focus and stay on task.” I went on to help her reframe it as an investment.
As I helped my client make the connection between exercise and productivity, I immediately felt more motivated myself. Sometimes what it takes to make you want to do something is to resonate with how great you will feel when it’s done. Not just to think “I should”, but to actually recall the clearheadedness, the limberness, the energy. Although I still wasn’t completely ready to exercise (did I mention it was dark and rainy out?), I was ready to take the next step. I pulled out the yoga mat. This is another one of my favorite anti-procrastination strategies: literally, physically touch the thing you are avoiding.
I was in the right state of mind, the mat was out, and I got moving. And sure enough, I was soon feeling better. By 10:30 I was thinking, this is shaping up to be quite a productive day.
When people ask me how I learned to manage my own ADHD, I often tell the story of a very supportive boss I had back in the 90s, who helped me develop organization, planning, and time management skills. That boss, Kent Frese, is now a nationally recognized expert in leadership development, strategic planning, business development, and operations process improvement as the president of Leadership Management Institute.
Kent is offering a time management workshop on January 28, 2010 at the West Shore Country Club in Camp Hill, PA. This workshop would be great for anyone who could benefit from an improved understanding of goal setting, focus on high payoff activities and good time management practices.
The cost is $249 and includes a 12-month My-Tyme planner.
More details are available on the LMI web site.
Decision making is something most adults with ADHD struggle with. We also tend to be time blind, meaning it’s hard for us to look back or ahead in time. We sometimes need a reminder to look in the right direction.
Some of the best advice I ever received about making decisions came from a fortune cookie. It read:
“Make choices based on who you want to be, not who you’ve been.”
This is a fundamental guiding principal that can lead you directly to the best answer. Think about where you want to be in the future. Which choice leads to that outcome? That’s your answer.
I just got married on New Year’s Eve. We bypassed all the wedding decisions by eloping - no guests, no cake, no dress. (That’s why you weren’t invited. 
) The only major decision was what to do about my last name. Should I stick with Prosser, so I still have the same last name as my son? Or should I use my new husband’s last name, Main, and hope that people can still find me? “What happened to that nice ADHD coach Beth Prosser, and who is this Beth Main person?”
I gave serious consideration to hyphenating for business and parenting reasons. But, five years from now, my son will be in college and won’t really care. My current clients will have moved on, and I will have met many new people using my new name. Why would I want the lingering connection to my ex? I don’t. I just want to be Beth Main. So I’m choosing to be Beth Main now.
It sure is going to be a hassle to change my name in 127 different places. But, five years from now, I won’t even remember the transition. I’ll just be happy with the decision I made today, because I made it based on how I want my life to be moving forward.
Keep your eye on the prize! And make your decisions accordingly.
The holiday season is a test of everyone’s patience. People with ADHD – adults and children alike – tend to be less patient than most. We hate waiting in line. We want everyone to get right to the point (although some of us struggle with that ourselves). We want our food right now. Dang it, where is that waitress?!
Maybe it’s our impulsivity. Maybe it’s our hyperactive minds. Maybe it’s because we have so many things going on in our lives, or our impaired sense of time. Regardless of the cause, our need for instant gratification can be highly irritating to ourselves and the people around us.
What to do? Here are a few suggestions:
• Always have something to keep yourself occupied. If you’re going to a place where you might have to wait, bring something to do. Perhaps a book, or a crossword puzzle, or a notebook to write out your grocery list or brainstorm ideas for your next project. Keep an audio book on your iPod.
• Run errands at non-peak times. The lines at the grocery store are much shorter at 8PM than they are at 5. Avoid the mall until January.
• Get an estimate. It can be excruciatingly difficult to wait for something when you have no idea when it will happen. You end up looking at the clock every 30 seconds. But if you know in advance how long it will be, you can go find something else to do during that time. Similarly, if you have to do something maddening, it can be much easier to tolerate if it’s not open ended. If you can’t get an estimate, make one up: “I’ll wait for ten more minutes, then I’ll go see what’s happening.”
• Ask for the bottom line. If you find yourself getting impatient with someone you’re listening to, there’s nothing wrong with politely interrupting and asking them to get to the point. “John? (pause and wait for response) I’m starting to get lost in the details. Can you just give me a quick summary please?” If you’re talking with someone who has a habit of rambling, you might want to have a separate conversation with him about his monologuing. You’re probably not the only one who gets impatient with it.
• Communicate your limits. If your kids – or coworkers - ask one maddening question after another, decide how many questions you’ll answer before you say “no more”. Tell them when the quota has almost been reached. Don’t be afraid to stand your ground if you’ve been reasonable and provided fair warning. This is much better than blowing up at them because you can’t take it any more.
• Release your grip. Accept that sometimes things will be what they will be, no matter what you do. Try to let go of the things you can’t control. As a Caribbean native told me years ago, “When you’re in a hot country, you’ve just got to move sloooooooooooow.” Prone to road rage? I like to think of slow traffic as more time to spend with my traveling companion.
• Remove the obstacles. If you’re impatient with your own progress, try to identify what’s slowing you down. Then figure out what you need to do to quicken the pace. This is one time when impatience can work in your favor!
• Find compassion. Try to understand why a person is acting the way she is, or why a situation is unfolding the way it is. There’s nothing like walking in someone else’s shoes to make you appreciate the complexity of the situation and be more relaxed about it. This goes for yourself too: Be compassionate when you find yourself impatient with your own ADHD.
I’ll end with this quote from a sign that used to hang in my godmother’s kitchen: “The hurrier I go, the behinder I get!”
I’m pleased to announce that I’ve been awarded the Certified ADHD Coach (CAC) credential by the Institute for the Advancement of ADHD Coaching (IAAC)! I’m the first ADHD Coach ever to receive the CAC designation, which the IAAC began offering in March of this year (see my blog post from March 31).
The IAAC is the only independent worldwide credentialing organization for ADHD coaches. It was formed to promote excellence within the ADHD coaching profession by providing credentialing, a set of core competencies, and ethical guidelines.
Getting this certification is a significant milestone in my career. The credential is important to me because I want potential clients and referral partners to know I meet an extremely high standard. It’s a milestone for the ADHD coaching profession too, because credentialing hasn’t been available until now except to the 66 coaches who were grandfathered in last year.
Here’s the writeup from the Central Penn Business Journal: http://www.centralpennbusiness.com/view_release.asp?aID=3328
I’ve always been an advocate of exercise in order to lessen ADHD symptoms. Here is a terrific interview with Dr. John Ratey, published by Medscape Psychiatry & Mental Health (www.medscape.com) on 10/08/2009. It’s long, but worth the read.
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Editor’s Note:
Attention-deficit disorder (ADD), also called attention-deficit/hyperactivity disorder (ADHD), is often surrounded by controversy over medication use and is perceived by many as a condition that is overtreated. John J. Ratey, MD, advocates that exercise should be included in the treatment regimen, and that exercise can even reduce or eliminate the need for medication. An Associate Clinical Professor of Psychiatry at Harvard Medical School, Cambridge, Massachusetts, Dr. Ratey is author of the book Spark: The Revolutionary New Science of Exercise and the Brain, as well as several related books in the popular press. He also has consulted on clinical studies pertaining to exercise and psychiatric conditions.
Medscape: Can you start with some background about ADD, and how exercise affects the brain?
Dr. Ratey: First, ADD affects at least 8%-10% of children, and almost as many adults. It’s now considered a biological brain disorder and may have genetic components.
There are 2 basic ways of thinking about ADD in relation to exercise: One is about the neurotransmitters norepinephrine and dopamine, both believed to be drivers of the attention system. Exercise increases the concentration of both dopamine and norepinephrine, as well as other brain chemicals. I have always said that a dose of exercise is like taking a bit of methylphenidate (Ritalin®) or amphetamine/dextroamphetamine (Adderall®); it’s similar to taking a stimulant.
Second, over time, exercise helps build up the machinery to increase the amount of neurotransmitters in the brain as well as their postsynaptic receptors. Chronic exercise eventually causes growth of the system. The more fit that you are, the better the system works.
Medscape: Where do these findings come from?
Dr. Ratey: Exercise has been one of the hot topics for the past 15 years in neuroscience. The initial studies on exercise and dopamine came out in the 1960s and 1970s. I’d like to add that exercise activates the frontal cortex in all age groups. Many ADD symptoms are related to the brain’s executive functions, which are located in the frontal cortex.
Medscape: Are there studies looking specifically at exercise and ADD?
Dr. Ratey: There are numerous studies about dopamine and norepinephrine and exercise, but when it comes to ADD, clinical studies with exercise are just starting.
Medscape: What got you interested this area?
Dr. Ratey: I had several marathoners for patients who had stopped marathoning because of injuries. These particular patients first got depressed, and then some presented with ADD symptoms for the first time in their lives. This was back in the early 1980s, before we really thought much about ADD — in kids or in adults.
Medscape: ADD isn’t something that can just materialize later on in life, is it?
Dr. Ratey: No. In the case of the runners, they would have had ADD before, but their exercise regimens served to keep it under control. What’s been observed over the past 30 years is that athletic people who played regular sports in high school went to college but stopped exercising, and then saw the first major signs of ADD. They may have had some hint of ADD in the past, but in college it came on like gangbusters.
Medscape: How do other people in psychiatry react to the idea of prescribing exercise?
Dr. Ratey: People are just beginning to pay attention to this. It was only 2 years ago that the American Medical Association (AMA) president, in his inaugural address, said that “exercise is medicine.” He said that every physician, no matter their specialty, should ask every patient at every meeting about their exercise regimen and encourage them to pursue this.
Neurology is paying more attention to exercise, with whole conferences looking specifically at exercise and Parkinson’s disease, for instance. If exercise can help protect against some of the symptoms in Parkinson’s disease, then it should also affect ADD, because the diseases have overlapping features.
Medscape: Is exercise starting to get respect as a treatment option?
Dr. Ratey: Yes. Historically, it started in cardiology studies. Then psychologists noted that the people in cardiac rehab were improving emotionally as well as physically. They looked at depression, anxiety, hostility, aggression, and stress in people who started an exercise regimen for cardiac protection or healing. Duke University researchers were leaders in measuring the effects of exercise on the emotional side. Exercise is now studied in practically every specialty.
Medscape: How often should patients with ADD exercise, and how intensely?
Dr. Ratey: There are a variety of exercise programs and regimens out there. Some schools have exercise breaks every hour or two, but other regimens may work, too. Someone with ADD could benefit from an exercise break of 10-15 minutes every hour or so. It helps everyone, not just patients with ADD.
Medscape: Does exercise need to be done several times daily?
Dr. Ratey: Yes, but it doesn’t have to be for very long each time. Just enough to get the heart rate up for at least a few minutes. Benefits persist for a while after exercise. We know there are improvements with low levels of exercise, such as walking for 20 minutes. Of interest, a number of people at various companies, such as Merrill Lynch and Google, now have standing desks.
Medscape: Dr. James Levine, a researcher from the Mayo Clinic, mounted his desk on a treadmill so that he can walk while he works. Would walking while working help ADD?
Dr. Ratey: That’s the Tread Desk and would be excellent for both adults and kids. It certainly has the potential to keep ADD in check.
Medscape: For Medscape readers, what advice should doctors give to patients?
Dr. Ratey: They should advise patients to exercise daily. Whatever medical treatment has begun, exercise needs to be included, too. It should be daily. Aerobic and strength training is fine. Balance training is important in patients with ADD and can be accomplished with yoga, tai chi, or balance exercises. Exercise needs to become a lifestyle, a habit.
Medscape: Would regular exercise affect the medication needs of patients with ADD?
Dr. Ratey: It often does. A number of the patients described in my book got off medication completely. In people who have trouble finding the right medication regimen, exercise can really help. The exercises chosen should be fun so that people will want to do them.
Medscape: Does exercise become a chronic medication?
Dr. Ratey: Yes. However, this isn’t for everyone. There is a spectrum of severity in ADD. There are plenty of marathoners who still need medicine, but maybe they need less than they would if they didn’t run. A number of superathletes have ADD. A prime example today is Olympic swimmer Michael Phelps who was diagnosed at the age of 9 and put on medicine. He found it impossible to stay still in school because of ADD. Then he began swimming. When he got up to 3 hours of daily exercise, he didn’t need medication anymore.
Many of these kids develop “learned helplessness syndrome.” They’ve failed so much in the past that they now expect to fail. They get depressed, use drugs, or play video games all day. Exercise prevents people from getting into that. Animal studies have shown that exercise makes it tougher to develop learned helplessness.
Medscape: Isn’t there a certain amount of positive reinforcement? If you’re running from point A to point B, when you get to point B you’ve gotten there. You’ve achieved something.
Dr. Ratey: Yes; the effects on self-efficacy are huge. Although exercise helps balance brain chemistry, there are helpful incidental effects, such as self-efficacy.
Medscape: It sounds as if patients with ADD can’t go wrong getting into an exercise habit.
Dr. Ratey: Them, and everyone else, although most patients with ADD will still need some medication. People can find out more from my Website www.johnratey.com.
Medscape: Thanks very much for your time today.
Interviewer: Pippa Wysong, Freelance Writer
Interviewee: John J. Ratey, MD, Clinical Associate Professor of Psychiatry, Harvard Medical School, Cambridge, Massachusetts
Medscape Psychiatry & Mental Health © 2009 Medscape, LLC
Are you looking for holistic options to help you manage your Attention Deficit / Hyperactivity Disorder? Yoga and meditation are both excellent choices. They can help you increase your attention span and self control, while decreasing restlessness and tension.
I’ve teamed up with Tina Stroh and Ron Blouch, co-owners of the Just Plain Yoga Studio here in Camp Hill, to offer a two hour workshop on meditation, yoga, and ADHD. If you are even mildly affected by ADHD-like symptoms, including distractibility, impulsivity, and/or hyperactivity (which usually manifests as restlessness in adults), you won’t want to miss this one.
Here’s what you’ll learn:
This introductory workshop is designed for adult beginners. There are no prerequisites or advanced knowledge required. You don’t even have to be able to sit still for very long.
Date: Saturday October 10, 2009, 1:00 - 3:00 p.m.
Cost: $45 by October 2, $55 thereafter
Location: Just Plain Yoga Studio, 1845 Market St. & 19th, Camp Hill, PA
Register online at www.justplainyoga.com or call 717.975.YOGA
Give me a call if you have questions or would like more information. I hope to see you there!
I learned a valuable lesson on vacation the other week. Even though it happened on vacation, it’s a lesson that applies to any journey away from home. Here’s the story…
Rhode Island was our destination. None of us had ever been there before and we were excited about going to a new place. Wanting to be spontaneous, we didn’t do much planning.
On the first full day of our trip, we had donuts for breakfast. What a treat! We then spent the day exploring the area. The roads were poorly marked and didn’t match the directions we pulled up on the mobile phone’s tiny browser screen. We were chronically lost and incredibly frustrated. I ordered what I wanted when we stopped for lunch: a cup of chowda and homemade white bread. Yummy! By dinner time, after getting lost a few more times, my brain was so overloaded that I had a great deal of difficulty coping with the unfamiliar grocery store. I hadn’t made a shopping list, so I didn’t pick up anything with nutritional value.
Can you spot my mistakes? I did, but only after recovering from a complete meltdown. Here they are:
All of this added up to a very unpleasant evening as my ADHD symptoms collided into one big emotional mess. Thankfully, my son and my boyfriend were extremely patient and supportive. Thanks guys! I was able to regroup the next day and enjoy the rest of the trip.
Don’t make the same mistake I did. When you go away somewhere – whether it’s vacation, a weekend getaway, a business trip, or off to college - remember to take your ADHD coping strategies with you.
“Take it one step at a time” is sound advice for anyone when things get overwhelming. It’s especially helpful for those of us with ADHD. If the whole project is too much to deal with, just identify the first step and focus on that.
I take this advice literally as a transitioning strategy. When I’m lying on the couch watching TV or reading a book, and it’s time to go to bed, it’s almost impossible to get up. Turning off the TV and making the arduous climb up all 14 stairs seems like way more than I can handle. So I procrastinate.
I know how important it is to get a good night’s sleep, though. I really want to be able to focus tomorrow. I won’t be able to do that without enough sleep. So I do what any responsible person would do: focus on my left foot.
All I have to do is put that one foot flat on the ground, next to the couch. It takes every ounce of energy, but I can do that much. Then I wait about 30 seconds to get used to this somewhat uncomfortable position. Then I focus on my right foot. I put it flat on the ground, next to my left foot. Do you realize how hard it is to lay on the couch with both of your feet flat on the floor? Yes, it’s very hard. It’s much easier to just sit up. And once you’re sitting, with just a little more effort, you can be standing. Does this sound crazy? Slightly ridiculous? Maybe. But it works for me every time.
Late night TV watching not your demon? How about the internet? I have one for that too: Just click the “X”.
Like the TV, it takes Herculean effort to resist the internet’s late night charm. If I think about stopping my research and making that arduous climb up all 14 stairs, it’s just too much. But I can focus on the little “X” in the upper right corner of my browser window. I just have to click it, and like magic, the internet is gone. And I can get some sleep.
Transitioning is hard for people with ADHD, especially when we’re hyperfocused and tired. This strategy just might make it a little easier.
Someone said to me recently, “I can only imagine how your results will soar when your confidence rises to the level of your expertise.”
Confidence? Hm? I haven’t thought of myself as lacking confidence for a long time. But he could be right. There are still times when I procrastinate, or avoid doing something entirely, because of self doubt. For example calling a nationally renowned psychiatrist to introduce myself. Or approaching the folks at ADDitude magazine about carrying my blog.
I’m an expert in my field, with years of training and experience. I get accolades from nearly everyone I work with. How could I still be struggling with this? Confidence issues are so high school.
Hm, high school. Maybe that’s the answer. I had severe undiagnosed ADHD (early ’80s, rural Pennsylvania, we’d never heard of it). My nickname was “Dizzy” even though I had an IQ of… well I won’t reveal that. My Mom was constantly asking me, “How can someone so smart be so STUPID?!?”
Naturally I grew up believing I was completely inept.
Let’s trace the confidence lifecycle of the typical ADHDer:
Infant: Doesn’t do much besides eat, sleep, and poop. She’s pretty confident she can handle those responsibilities.
Elementary school: Begins to take risks, begins to notice failures, begins to wonder why she’s different than other kids.
Middle/high school: Hits the wall. “Other kids don’t struggle like this, what’s wrong with me?” If an ADHD diagnosis is made, now she has a label, probably an IEP, and maybe a behavior chart. If the disorder is not explained thoroughly and compassionately to her and everyone she interacts with, self esteem issues are compounded. But happily, when she starts getting the help she needs, her confidence improves.
College and early adulthood: Finds her niche, discovers something she excels at. Confidence soars. But early wounds may still lurk beneath the surface.
How to improve confidence? I’m not a fan of avoiding the “f-word” (failure) to boost self esteem. There’s huge pride in failing at something, trying again (perhaps repeatedly), and eventually succeeding. If you only do the easy stuff, you aren’t going to feel very good about yourself in the long run.
Here are some ways to boost your confidence as an ADHD adult:
* Set up situations where you can fail safely. A martial arts class, for example.
* Stretch. Do something that’s just a little outside your comfort zone every day.
* Visualize your successes, past and future.
* Solicit and re-read testimonials and fan mail, even if they’re from your mom.
* Fake it til you make it. Act like you’re confident, and soon you will be.
* Dress the part. Wear clothes that make you feel powerful.
* Prepare. If it’s information you need, get it. Practice.
Try some of these tips before going into situations that require confidence, such as public speaking. Also call on them to help you take the chances in life that will move you towards your goals.
Looking for an affordable alternative to one-on-one ADHD coaching? I’m excited to announce a new group ADHD coaching program starting in June.
Coaching helps you overcome your ADHD-related challenges and thrive. It’s about discovering where you are, where you want to be, and actually getting there. You’ll develop the systems and strategies you need to be successful.
Here are the highlights of this innovative new program:
* Each group will have between three and six members.
* The group will meet twice per month.
* In addition to the group meetings, you’ll get two 15 minute, one-on-one “laser sessions” every month.
* Ongoing email support and accountability check-ins are included.
* As part of the registration process, each participant will complete an Issues Inventory to ensure that the issues and goals of all members are compatible.
* Cost is just $75 per month.
Two groups for adults are forming now:
* Every other Tuesday at 10:00 a.m. Eastern, beginning June 16
* Every other Tuesday at 7:00 p.m. Eastern, beginning June 16.
Working in a group has other advantages as well: you’ll meet people with similar issues, get different insights and perspectives, and know that you’re definitely not alone.
Click here for more information and to sign up.
