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Stimulant based insomnia

Feb 16, 2017

Too many doctors as unnecessarily afraid of dealing with stimulant based insomnia. It is actually one of the more manageable side effects. Most people on stimulant therapy have their sleep affected only by meds taken late in the day or by higher doses. Though I take high doses and am medicated late in the day, I know from when I first started medication almost three decades ago that if I take any Ritalin at all at any time during the day, I don't sleep that night… on my own.


I think about how much it would have wrecked my life if I had had a doctor who give up on stimulants at that point. Instead I happen to have one of the best ADHD doctors in the world. He tried many things to counteract the stimulants until we settled on Clonidine. I’ve taken it every night for 28 years and it simply cancels out the Ritalin and I go to sleep normally about an hour later. It’s not a sleeping medicine and may even help with my ADHD symptoms, though my doctor says that the short acting form that I take shouldn’t have any effect in that area.


Guanfacine is probably prescribed more now that Clonidine is, but they are related and both offer similar help in sleeping. And, there are several other meds that can help offset the stimulants. So, don’t give up the chance of being effectively medicated in the evening. Whether it’s homework time or your kids bedtime, the evening is part of your life too.


Note: As with all my entries pertaining to medication, I will remind everyone that I’m not a physician. I simply post about medication because it is so important, because I so often see people not being educated about all the options by their medical professionals, and because it is hard to find good information on our own. But, my thoughts on medication should in no way be a replacement for proper treatment by a licensed medical professional. (But, if they don’t know as much as I do… maybe you should think about finding someone else?)


Note #2: Don’t get me wrong, I would love to not have to take so many pills. It is never anyone’s first choice to have to take meds to chase the side effects of other meds. However, if we are truly “all in” in terms of addressing our ADHD as effectively as possibly, we may have to compromise. I would argue that it is worth it to be able to concentrate.


Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



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Do you have ADHD all the time?

Feb 10, 2017

I know I do.


Science tells me that you do to, that is to say, if you have ADHD, you have it all the time.


I am consistently amazed at how many medical professionals I am aware of who don’t seem to think ADHD needs to be treated all the time. Essentially, the definition of ADHD includes the concept that the symptoms are present in multiple aspects of your life. It’s not just about school, work, or social situations. Though it may be more or less of an issue in different areas of your life, it will always be there in one way or another.


I can’t think of another medical issue that doctors seem content to treat for a select few hours a day. No one would suggest that it’s okay to have high blood pressure as long as it’s only after 5pm. No one would tell me that I only need to wear glasses (for an astigmatism that affects my near and far vision) during my work day. I don’t think it would be prudent for a diabetic to manage their blood sugar Monday through Friday and take weekends off. How about being managing depression and anxiety during the school year but taking the summer off?


Of course the one caveat to this is if there are substantial side effects that don’t allow for being medicated full time.* In most cases, with a competent physician, side effects can be mitigated enough to allow ADHDers to be medicated the amount that they need to be.


Speaking only from my own experience, I need my medication to be the best version of myself in all aspects of my life. Yes,it allows me to be the coach that I want and need to be, and it allows me to be a better business owner. But it also allows me to be the husband, father, friend, and man that I know really am. Yes, sitting at my desk right now and typing blog entries take plenty of attention. But so does making dinner every night, planning my garden for this year, fixing the bathroom sink, playing tennis with my wife, going food shopping, getting myself to the gym, reading the same Berenstain Bears book three times in a row, putting my kids to bed.


It may not be as glaring how much attention is required for these activities as opposed to “work.” And it may be harder for a neurotypical person to understand how much attention all of life requires. But for those of us who aren’t born with the ability to concentrate at will, we deserve to pursue a solution that is effective for the whole of our lives, not just pieces of it, because it all take focus.


Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.


*This includes stimulant based insomnia. See next blog entry.



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Most effective ways to manage ADHD

Feb 23, 2017

  1. All the research shows that the best thing you can do to effect a positive outcome is medication therapy, provided it is consistent and effective.

  2. The second best thing you can do is engage in behavioral intervention. That would be Behavioral Therapy, Cognitive Behavioral Therapy, or Coaching. The best outcomes come from a combination of the two.

  3. I would argue that the third best thing you can do is practice good sleep hygiene. If you are not getting enough sleep, it is impossible to be optimally effective and attentive. I don’t know how much research there is into sleep and ADHD, but I’ve observed that the “brain fog” that accompanies sleep deprivation is not too dissimilar to the default state of our ADHD brains.

  4. There is a decent amount of evidence that exercise is an incredibly valuable part of overall ADHD treatment. I’ve never met anyone who could manage their ADHD fully with exercise alone. But, I can attest to the fact that consistent vigorous activity directly affects my attention positively. Incidentally, it also helps me manage my anxiety, depression, sleep, and general health.

  5. A well balanced life is key. If we are not getting the social interaction, intellectual stimulation, and whatever else we need like having a creative outlet or a forum for competition, we are not going to thrive. I imagine this is true for most humans, but we seem to be more in need of this balance than many.


Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



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Use it!

Feb 3, 2017

As several of my clients are applying to and often getting into their first choice college I’m reminded of a “fun” thing that happened to me. I remember the pressure and the stress of getting the applications done. I succumbed less to the stress of getting in than most. For some reason I rolled with that one. Anyway, my first choice was Brown. I knew I didn’t have the “resume” to get in, but I thought that my ADHD gave me an explanation as to why my “measurables” weren’t quite up to snuff but that if you looked at my total package I was a good candidate. Still a reach. Not getting in would have been a minor footnote in my life as it wasn’t that big a deal. For example, I can’t remember if it was Oberlin that wait listed me and Vassar that I didn’t get into… or the other way around. Who cares.


But Brown was different. My Dad is an Alumnus. So, when I didn’t get in, they sent him a letter offering him counseling, presumably because he should be so disappointed at his son’s lack of success. I have let this fuel me for the 20 years since. In fact, pretty much every time the world has told me that I can’t do “it,” I’ve made it my mission to do “it” anyway if it was really important. Or I’ve let that fuel me as I’ve gone in a different direction.


Standard Disclaimer:

In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



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Donation pick up & drop off

Jan 26, 2017

Two of my favorite resources to donate clothes, housewares, etc. are


THEY COME TO YOUR HOUSE. IT'S AMAZING!


The Vietnam Veterans of America:

http://scheduleapickup.com/


The Epilepsy Foundation of New England:

http://donateclothes.epilepsynewengland.org/massachusetts?utm_source=google&utm_medium=cpc&utm_term=donate%2520clothes%2520ma&utm_campaign=donate%2520clothes%2520ma


These are my two favorites because they are very easy to schedule, come to your house, and take more than most services. I’ve used them both and find them to be reliable about coming when they are supposed to. And, the Epilepsy Foundation has recently added drop off locations, if that’s your thing. You can also see a map of those at the above link.



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My outside the box SAT prep strategy

Jan 18, 2017

I deal with lots of kids who are super stressed about the SATs and the ramifications. A lot of them take classes, endless practice test, read books, make flash cards, and generally drive themselves crazy. I’m not saying that some kids don’t benefit from a little studying. But, the way most kids get wound up about the test can’t be helpful. I would wager that they lose more points from the test taking anxiety than they gain from much of the studying.


My philosophy was to be super chill about it. I had bigger fish to fry focusing on my classes. I figured I either knew it or not. I took the same approach to my SAT II’s and my AP. I never took a class, read a book, did a practice test, or made a single flash card. I just made sure to learn my stuff in school, get a good night's sleep and eat a solid high protein breakfast. The result was that I went into that room with no pressure, stress, or anxiety. And, that let my brain do its cognitive best without any interference.


Results:

World History SAT II - conveniently can’t remember because it was bad. Class hadn’t prepared me for it. My parents asked me if I wanted to study and retake it. I laughed.

SAT - Eng: 720, Math: 690

US History SAT II - 730

US History AP - 3 or a 4 can’t remember exactly, but a credit-earning grade either way

English/Writing SAT II - 780


I don't mention these scores to toot my own horn. I have always tested well. I honestly believe that if I had studied and got all wound up I may not have done as well. Unscientific, yes. But, sometimes I can color outside the lines.



Standard Disclaimer:

In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.



Share With Friends:
Direct Link


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