The ADHD Solutions Blog

Free investment management seminar on February 9, 2010

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."

Finding motivation when you just don't feel like it

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.

TIme Management Workshop on January 28, 2010

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.

Look ahead

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.

'Tis the season to be patient

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!”

Got my credential!

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

Exercise and ADD: An Expert Interview With John J. Ratey, MD

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

Workshop: Introduction to Meditation and Yoga for People with ADHD

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:

  • How yoga and meditation can reduce ADHD symptoms
  • Meditation techniques designed specifically for people who have trouble concentrating
  • ADHD-friendly yoga techniques that can calm the mind and body to help improve your ability to focus
  • Success strategies for integrating yoga and meditation into your daily life

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!

Take your coping strategies with you

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:

  • Junk food.  Since I was on vacation, I felt justified in eating whatever I felt like.
  • No exercise.  Similarly, I abandoned my exercise regimen.  Not that I could have exercised much in the car during the 8-hour trip.  But I could have a found a way when we arrived.
  • Insufficient sleep.  Not having exercised, and being in a strange place, it was hard to sleep the first night.
  • No supplements.  I failed to unpack my supplements and put them next to the coffee filters (so I bump into them in the morning) like I do at home.
  • No printed maps.  My coping strategy to avoid getting lost is to print and review maps ahead of time.  Since we were being spontaneous, we didn’t do that.  Can you believe that not one of the 47 maps in my glove box included the state of Rhode Island?
  • No planning time.  I’m very good at planning when I take the time to do it.  When I don’t, I get overwhelmed by an unlimited array of choices.

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 - literally

“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.

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