The ADHD Solutions Blog

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.

Closing the ADHD confidence gap

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.

Alternate your “shoulds” and “wants”

ADHD is a world of extremes.  Some days we can’t seem to do anything productive.  Other days we only allow ourselves to work on the things we should, at the expense of everything else.  Life becomes a drudgery.

There has to be a balance somewhere.  But how to achieve it?

Try alternating your “shoulds” and “wants”.  Whenever you accomplish a not-so-interesting task that needed to be done, reward yourself by working on something you want to do.  Something more fun.  Then choose another item from your “should” list and get that done.  And so on.  As long as you limit the duration of the fun stuff, you’ll probably get more done that way.   Rewards are a great way to motivate yourself.

A variation on this theme works if you’re trying to eat more healthy foods.  For example, I was dying for some apple pie the other day.  So I ate some carrots.  Then I ate the pie.  No, not the whole pie!  Just a small piece.  I ate less of it because I was full from the carrots.   And I ate the carrots because I knew they were the gateway to the pie.  A "should", then a "want".

A balanced life is like lasagna.  It’s all about layering.  If all the pasta was on the bottom, and all the sauce was on the top, it wouldn’t be very tasty.

My new blog at ADDitudeMag.com!

ADDitude magazine, one of the world's leading ADHD publications, has asked me to write a blog for their web site.  It's called "Works for Me" and is a mix of advice and personal experience from a coach's perspective.  Check it out!

Social faux pas

Everyone at the martial arts school I recently started attending is super nice and exceedingly patient.  The black belts cheerfully help the less experienced.  However, there is one particular black belt I’ve been terrified of ever since our introduction at my second class.  Not because she's dangerous (she is) but because I humiliated myself in front of her.

Towards the end of class that day, my brain was completely saturated.  I could not absorbs one more fact.  If you have ADHD, I know you know what I mean.  She introduced herself using what I later learned was her Korean title.  It had about 24 syllables (okay, maybe six).  I couldn’t begin to comprehend what she was saying.  I was finally able to mutter her name back to her after four or five embarrassing attempts.   Then I just looked at her blankly.  Didn’t even give her my name in return. 

On the way home, I thought, she must think I have severe brain damage. I’ll be she hopes to never have to work with me again.  I certainly didn’t want to work with her again. Well, we had to work together the other night. I was terrified.  I’m still slow to figure out what I’m supposed to be doing (you know, typical ADHD difficulty with multiple step instructions), but I was able to follow along pretty well.  She was smiling and patient, as if she had complete faith in me.  After class, she said to me, “I’m sorry, I should have introduced myself. I’m not sure we’ve met”. SHE DIDN’T REMEMBER! 

Oh, what relief! I’m not afraid of her any more. Lesson learned:  Sometimes what we perceive as a social faux pas is barely noticeable, or forgotten within five minutes.  It lives on in our own minds much longer than it needs to, mingling with faux pas past and becoming a gremlin that’s hard to tame.   The truth is, most people are too busy worrying about their own stuff to remember our minor mistakes.

Improve your focus with water

You know that water is essential to life.  But did you know that even mild dehydration impairs your ability to focus?  Estimates are that 75% of us are chronically dehydrated, so it's likely that this applies to you. Don't wait until you're thirsty to get a drink.  By that time, you're already mildly dehydrated.  Here are some other warning signs:

  • Headache
  • Fatigue
  • Dry mouth, throat, and/or lips
  • Dark urine
  • Heat intolerance
  • Lightheadedness or dizziness
  • If, when you pinch the skin on the back of your hand, it drops back slowly

Here are some easy ways to keep dehydration from affecting your focus:

  • Keep a large container of water, or a cooler, near your work area to increase the convenience factor
  • Bring a water bottle with you every time you get in the car. Finish it by the time you get to your destination.
  • Set a daily goal, and use a checklist to track the amount of water you consume.   You may be surprised at how little you're actually drinking.
  • Watch your caffeine intake, since caffeine actually dehydrates your body
  • Keep lemon or orange slices in the refrigerator and use them to add flavor to your water
  • Make getting a drink part of your break routine
  • In the winter, use a humidifier or set out bowls of water to decrease the amount of water you lose through your skin

I’m not suggesting that water can cure ADHD.  But staying well hydrated gives you one more way to fight it. I had one of the dreaded "brain shutdowns" in my martial arts class the other night.  I also had a headache, less energy than usual, and got lightheaded after a few strenuous drills.  Failed the skin pinch test.  Looking back on the day I realized that I had consumed very little water.  Was the brain shutdown a coincidence?  I don't think so.  I guarantee you I'll be well hydrated for the next class. I'll close with this question from comedian Lily Tomlin: The formula for water is H2O. Is the formula for an ice cube H2O squared?

Setting an example

My personal trainer is tough.

"Mom, have you seen your workout chart?"

"Yes, I moved it.  I got tired of looking at it on the refrigerator. (pause for a few seconds)  Oh.  Now I can't find it."

"That's what you get for moving something that has a home.  Now you have to do 40 pushups as a punishment".

Drats.  He's right.  Now not only do I have to do twice as many pushups, but I still have to find the dang chart.

I don't mind admitting that I was wrong and he was right... not so much, anyway.  But I do try to minimize it.  I'm supposed to be setting a good example here.  The kid is doing a fantastic job of using his checklist every day with no reminders, and here I am, putting things where they don't belong.  This is good incentive.

Uh oh.  Now I've been caught writing a blog post instead of doing pushups. Gotta go.

They're Not Controlling You, They're Controlling Themselves

Here's a terrific article by Dr. Ari Tuckman,  renowned author and ADHD specialist:

People with ADHD often feel others are trying to control them.  This includes family members, romantic partners, bosses, coworkers and friends.  Why won't they just get off your back? Don't they have anything better to do?

Attempts to exert control can be obvious, like when your spouse bans you from the checkbook, or more subtle, such as unsolicited advice.  I assume these actions are well intentioned, but that doesn't make them fun when you're on the receiving end.  So why are these people in your life so often trying to influence what you do?  Are they control freaks?  Do they enjoy bossing you around?

When I speak with family members and romantic partners of people with ADHD, I often find they're really trying to control their own anxiety.  They feel nervous when the bills aren't paid or when there's a lot of clutter.  They get on your case hoping to make themselves feel better by removing whatever's making them anxious or uncomfortable.  They don't intend to make you miserable, even when that's what happens.

There are two ways to deal with uncomfortable situations - external and internal anxiety management.  External anxiety management requires that you change the world around you to eliminate the source of the discomfort.  If your spouse is worried about late fees, she will ask you... repeatedly... to pay the bills.  Once the bills are paid, she doesn't need to worry about it any more.  Problem solved. However, while this works well in some situations, it doesn't work well in every case.

External anxiety management breaks down in situations that can't be resolved, or not immediately.  For example, you can't pay bills while you're driving.  We all encounter many situations where we must wait before acting.  The other potential problem is that being too insistent can strain the relationship.  Nagging may get the job done, but nobody is happy about it.  This is common when one person in a couple or family has ADHD - the non-ADHD person does a lot of reminding/nagging, and it's rarely appreciated.

By contrast, internal anxiety management is finding a way to be comfortable with something in your life that you don't have as much control over as you would want.  For example, the spouse without ADHD can decide that she will stop worrying over the occasional late fee because it isn't worth all the fighting.  She's not happy about the late fees, but she recognizes that being upset about them is making her miserable and ruining the relationship.  She decides to let this one go (for the most part) and focus her energy on things she is more likely to affect positively. For people with ADHD, this means that, although it can look like these other people are trying to control you, they're really just trying to control their own anxiety - using external anxiety management.  It may or may not be effective, but it probably causes more bad feelings than either one of you would want.

Usually, the best scenario is a balanced internal and external approach.  In therapy with a couple or family where one person (or more) has ADHD, I tackle the situation from both sides.  I try to help the person with ADHD be more consistent and reliable, so the other person indeed has less to worry about. But I also work with the non-ADHD person to learn ways to manage his or her anxiety internally. The non-ADHD spouse can reduce anxiety by picking battles that really matter, and tolerating things that aren't worth a battle.  By working it from both sides, there's less conflict and both parties can better deal with all the usual stuff that comes up in relationships, as well as the unusual stuff that comes up in couples where someone has ADHD!

The next time you're feeling controlled, remember that the other person may just be trying to control his or her own anxiety.  This might help you take a step back, calm down and deal with the situation more productively.  Of course, if you find yourself doing the controlling, consider whether an internal anxiety management strategy might give better results.

. . . . . . . .

Dr. Ari Tuckman is the Vice President of ADDA.  He is a psychologist in private practice in West Chester, PA.  His second book, More Attention, Less Deficit: Success Strategies for Adults with ADHD will be available in May 2009.

How to get out the door on time

All sorts of things conspire against our efforts to get out the door on time in the morning:  inability to estimate how long it takes to get ready, losing track of time, getting distracted, forgetting things that need to be done or gathered, etc.  Here are some strategies to improve your defense:

  • Create a morning schedule with “mini-deadlines”.  Figure out what you need to do in the morning, and when you need to be done with each thing.  For example, maybe your teeth need to be brushed by 7:30, you need to be out of the shower by 8:00, and your hair needs to be done by 8:15.  Having a checklist may help.  You can download a sample from the Resources page on my web site, www.adhdsolutions.net.
  • Check the time frequently.  Keep clocks or timers where you can see them – in the shower, at the sink, near the breakfast table.  Are you on track?  If not, you’ll need to move faster, fight harder to avoid distractions, or skip a step in your routine. Many people find that simply being aware of what time it is and where they are on the schedule helps them stay on task.
  • Adjust your routine.  If you find you’re consistently behind schedule, identify where you’re getting off track. You may need to allow more time for that item in your schedule.   That may also mean skipping something else on the list, getting up earlier, or preparing the night before.
  • Keep your keys, gloves, etc. by the door so you can grab them quickly when it’s time to leave.  Collect the things you need to take with you ahead of time (lunch, backpacks, etc.) and put them by the door too.
  • Don’t do anything not related to getting ready, like going on line for “just a minute” or throwing in a load of laundry.
  • Build extra time into the schedule for unexpected emergencies like cleaning up spills or printing the directions you forgot about.  If your morning is drama free, reward yourself by relaxing a little.  Or leave early.
  • Get enough sleep so you don’t hit the snooze button more times than you’ve scheduled, and you aren’t too groggy to focus.

A consistent, realistic routine is your best ally for reducing your morning chaos and getting where you need to be on time.

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