My Blog: ADHD Since 1978-

A Schedule Gone Awry

I haven’t written anything about scheduling in a while. Nor have I posted the schedule. One of the reasons is that, after years of writing out schedules, I have internalized many of those skills and don’t often have to make a schedule. I work right off my to do list and achieve the same level of productivity. (By the way, I’m finally back to working on my book about the perfect ADHD to do list. So keep an eye out for that. My goal is to finish it this summer.) I do still make an actual schedule once in a while. Usually it is for a day where I have lots of “free time” but a whole lot to get done. I definitely still make a schedule on Thanksgiving. Otherwise, how would I know what time to start cooking? And I’ve got that down to a science. I don’t think I started cooking this year until 1 o’clock. Not counting the pie. Anyway, this was a similar day. I had a large culinary project to do. My annual double batch of strawberry rhubarb jam, plus an extra batch so I’d have something nice to give to the kids teachers as an end of year thank you. In the past, I have posted schedules that were a perfect 10 where I stuff the landing. And I posted schedules that did not go as planned. The idea is to show you that you can achieve a schedule that is accurate. But I also like to demonstrate that, even though I teach this stuff for a living, I don’t always nail it. So it is with much humbleness that I post this schedule for my jam making day, which went so far off the rails, it’s hard to believe I even made a…

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Carrot or Stick?

Parenting is hard. Parenting neurodivergent kids is harder. We absolutely need to provide our kids with consistency, structure, rules and accountability. But we also need to encourage them and be a positive force in their lives. As such, pretty much all the research shows that ADHD kids, and most people in general, respond better to rewards than to punishment. And finding ways to provide more wins in your ADHD kid’s life is no small thing either. So the carrot is the far preferred method of behavioral management for ADHD kids. We should only reserve the proverbial stick for when we really need it. But we need to be careful in how we use the carrot too, or the carrot can become just another stick. We need to provide our kids with rewards that are attainable. The rewards need to push our kids to an extent. That’s the whole point. But they have to be reachable without too much pain and suffering. The rewards also have to be reachable in a time frame that works for your kid’s level of development. If you make them wait too long or jump through too many hoops, they won’t buy in. Give rewards that are a stretch but are attainable. As the stretch becomes less, make the goal a little more aggressive. Not that you want to move the proverbial goal posts. You want to be clear and say something like, “Great. You’ve gotten really good at doing X. Starting next week let’s trying doing X on your own.” Eventually, they’ll do X on their own without a reminder. And so on. Remember that the goal is real and lasting behavioral change. It is also helpful to remember that there is a real difference between a reward and a bribe. A reward is something…

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The biggest calendaring mistake

Digital calendars are the bees knees. I am so grateful to be living in the age of the digital calendar. Specifically Google Calendar is the bedrock on which my life is built. I have no horse in the race, so to speak. Feel free to think what you want of Google. Evil? Not evil? Somewhere in between? Regardless, Google Calendar is the best. To be clear, I am a Mac guy, but also an Android guy. So, I’m more than familiar with iCal too. It sucks. Don’t bother. Though there may also be another calendar out there that is awesome too. The point is that a functional digital calendar is an amazing tool to manage life, particularly life with ADHD. As with any tool, user error can undermine the potential benefits. In my opinion, the greatest asset of a digital calendar is the reminder/alert function. The ability to not even think about an event until your phone/computer/watch reminds you that you need to do something is amazing. I am old enough to remember the stone age days pre digital revolution when you had to put an appointment in your planner and then ACTUALLY REMEMBER the appointment at the correct time in your day. For every appointment or event you had to get that Goldilocks warning or not too early, and not too late, but just right. The thing is that most people only fear the ‘too late’ problem. But too early is just as big a problem, maybe bigger. Remembering something too early, if you don’t have a system to remember AGAIN, is functionally just like not remembering at all. Not to mention all the brain energy that you will waste during your day trying desperately to not forget the thing. Because that brain power will only be relevant for…

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How many tires does your car need?

Studies have consistently shown that 80-85% of those of us with ADHD have AT LEAST one comorbidity. If you aren’t as accustomed to medical/psychiatric lingo as I am, that means that at least eight of of ten of us have at least one other psychiatric condition. This includes depression and anxiety. If you lump them together as one larger disorder, some studies have shown that as much as 65% of us have one or both. This overlap also includes, ASD, Tourette’s Syndrome, OCD, eating disorders, conduct disorders, mood disorder/bipolar, and just about everything else you could think of. We are also far more likely to have a co-occurring learning disorder like dyslexia, dysgraphia, expressive language disorder, and a myriad of processing disorders. We are also more likely to have sleep disorders and some other brain based or physiological issues like hypermobility or chronic inflammation. But, let’s stick with the brain stuff for now… So…Wow! That was depressing. Why bring this up? Well, because it is really important to treat everything. Those of us who have more than one issue working often end up in front of a medical professional who really, really wants to treat one issue and leave the others be. There are certainly times this this is the correct course of action. For example, you will generally need to get a mood disorder under control before trying stimulants. Stimulants are not contraindicated for people with mood disorders. But, if the mood disorder isn’t under control, stimulants can induce manic episodes. Likewise, severe anxiety and/or depression usually need to be addressed before ADHD can effectively be addressed with medication. And there is a certain merit to approaching medication with scientific practice by not changing too many variables at once. However, if you are suffering, and I mean that in…

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The Communication Saturation Culture & How It Affects Those of Us with ADHD

My dad was an English teacher for 30 years and, more relevantly, a department chair for much of that time. He’s been retired for about 20 years. So, his entire career was before the digital revolution. This means that when he wanted to communicate with a large group of people at work, he had to write a memo. He had to actually WRITE a memo on a memo pad or piece of paper. Then he had to go the the mimeograph machine and ‘run off’ copies of said memo. Then he had to either distribute those or have someone else do that. For all that effort, that better be an important memo. In other words, the effort involved in communicating set a bar that was pretty high in terms of what was worth communicating about. Fast forward a single generation and many of us are inundated with emails, texts, slacks, teams, and other avenues I probably haven’t even heard of yet. The problem with this is that there is no longer a serious barrier to communication. Of course, in some ways, that’s fantastic. We can share important information and broadly seek relevant resources more easily than any other time in human history. Unfortunately, that useful information often gets lost amongst the flotsam and jetsam of everyone else’s more trivial thoughts. Most people in a corporate environment don’t even ask themselves how OVER communicating might affect others. It takes discipline and executive function to ask one’s self if something is worth sharing or worth asking. Most people don’t ask themselves, “Can I find this answer in five minutes of doing my own work?” Maybe? But, often people default to asking instead of doing, sometimes by asking a whole group of colleagues. What they are really doing is trying to get an…

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The Wisdom of Children

I’ve written a decent amount over the years about our need to redefine the basic concept of ADHD. I generally feel that the way it is defined in medical circles is far too narrow and exclusive rather than inclusive of how those of us with ADHD experience it. It would be great if the medical world listened to the patients and try better to understand the patient experience. I’ve been doing this for 15 years. And I’ve had ADD for almost 48 years. And I am still pleasantly surprised once in a while when a client describes a symptom, or an experience, or an ADHD related feeling in a way that I’ve never heard before or never thought to articulate in that particular way. In this case, it was even more delightful when this description of ADHD came from a clients five-year-old daughter. This happened with a client yesterday. And I would definitely file it under the heading of, self-awareness is priceless, and it can come at any age. Apparently this smart and articulate self-aware little girl said the other day, “mommy, my brain is wiggly.” Brilliant! I have never heard anyone so accurately describe the feeling of internal hyperactivity, restlessness, under stimulation, psychic squirmyness that comes with ADHD that happens behind the scenes. Remember that wisdom and knowledge doesn’t have to come from someone with an MD or a PhD. It doesn’t even always have to come from an adult.

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Changing your narrative

It is almost impossible to not internalize much of the negativity that the world throws at those of us with ADHD. One of the best things you can do for yourself is change your language. Change the way you frame yourself and your struggles. I have so many clients who have been gaslighted by the world or even their doctors into thinking that all their struggles are personal failings. As such, they default to framing their struggles as problems with their “motivation,” “discipline,” “work ethic,” etc. I can’t speak for you. But if you are reading this, you are probably an intelligent person and a sophisticated consumer of ADHD information. So I’m going to assume that you are like my coaching clients. You are probably of above average intelligence. You probably want (maybe desperately) to make progress in your life. You probably spend a lot of time thinking about how to be “better at life.” You are probably acutely aware of most of your weaknesses. And, you are probably working way harder than you think, way harder than you give yourself credit for, and way harder than your neurotypical counterparts… to still feel less successful. People like that are not unmotivated. You are not undisciplined. You are not broken. You have a barrier. That barrier is the invisible barrier of ADHD. Owning that fact and moving away from blaming yourself and beating yourself up can start to change your life. Don’t allow your inner voice to tell you that you, “can’t seem to motivate to change.” Instead, notice that you want to change and want to do the work to change but your ADHD is getting in the way. Realize that you may be physically and intellectually capable of doing a thing, but if you are not “attentionally” capable of…

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ADHD multiplication factors

No symptom of ADHD is unique to ADHD. All the symptoms are pathological magnifications of aspects of human nature. Much like clinical depression is a pathological extreme of the sadness that we call experience from time to time, and generalized anxiety disorder is the pathological and maladaptive extreme of the anxiety/fear/worry that we all experience from time to time and that has held our species in good stead over the millenia by allowing us to survive. In addition to the magnification of “normal” aspects of being human, ADHD symptoms could always, in isolation, be attributed to at least one other psychopathology. Anxiety avoidance looks very much like ADHD “procrastination.” Challenges with initiation can be a symptom of ADHD but can also be strongly associated with depression, particularly dysthymic depression. Hyperactivity can look a lot like a manic episode. Of course, with at least 85% of ADHDers living with at least one comorbidity, often symptoms are being caused by two or more issues AT THE SAME TIME. And then there are other factors that can magnify our ADHD symptoms that have nothing to do with the core of the ADHD or another diagnosable psychiatric condition. I feel it important to differentiate other factors that may look like ADHD, create and ADHD-like “syndrome,” or simply multiply the symptoms and suffering of those of us with ADHD. For some time it was fashionable to blame ADHD on food dyes. Nothing could be further from the truth. But, there is also not much argument that a very, very, very small percentage of the population may have had a bad reaction to certain food additives that looked like ADHD. If you are looking in less knowledgeable corners of the internet, you will still find folks touting ‘curing’ their ADHD with supplements and all sorts of…

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The “NOW” Mindset

Those of us with ADHD often create our own emergencies by putting task off. Believe me, this does not come from a place of judgement. It is a fact. And, frankly, correctly treating your ADHD with right medication, dosage, delivery system, and covering as many hours in the day as possible will dramatically affect your ability to do less preferred tasks before they are emergencies. But even with the best meds, we need to cultivate the right strategies to be able to not put things off. I believe that all proactive behaviors start with the right mindset. Much is said about cultivating the “growth mindset.” I could not agree more with that concept. But I would add that it is important to adopt a “now” mindset also. Most ADHD folks ask themselves one question, “when is it due?” We are run by deadlines and the adrenaline fueled dopamine rush that allows us to perform in the face of them. Perhaps I’ll write more about this in my next post. But suffice to say that you leave yourself no room for error when you leave everything to the last minute. If you are always stretched and up to the last minute, it can get pretty bad when there is a real emergency on top of what’s already on your plate. I ask my clients to at least try to change their perspective and ask, “can I do this now?” Even asking this question is a major paradigm shift. But, if executed, even partially, it will give you more of a cushion when things don’t go right and it will give you more and better down time to enjoy without feeling anxious about the things you have put off until “later.” For example, say you have ordered something on Amazon that isn’t…

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How to turn your BATDL into getting things done.

The primary goal of the BATDL is to capture the task that you need to accomplish to move yourself and your life forward. That includes everything from food shopping to picking up prescriptions to scheduling a zoom with your best friend from college. The secondary use of the BATDL is to keep track of your progress and consolidate your victories. But, what then? This is where you need to think about time. I would argue that we are still talking about task management, not time management. As I’ve said before, I’m not sure time management is actually a thing. We ADHDers really need to cultivate time awareness, but maybe not management. Or maybe I’m making a semantic argument. After all, success happens at the intersection of tasks and time. So, to maximize the efficacy of your BATDL you may need a BADS. (BadAss Daily Schedule.) This is not a template that you use every day. It is a unique plan that you make for an individual day by slotting your to dos in to the time that exists around your fixed items like appointments, meetings, and other commitments. The next several posts will be about how to create a successful BADS. In the meantime, you can search my blog and see many BADS that I have posted over the years. Standard disclaimer: When posting my thoughts here, I feel that content is far more important than perfection. I try to practice what I preach that ‘done’ is better than ‘not done…perfectly.’ So, unlike with my book, I don’t edit much, if at all. I hope you can look past any small imperfections and find the content useful.

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Big Pharma?

I’m a big fan of Pharma. Of course, big Pharma makes mistakes. Most big things that are driven by profit make mistakes. But life saving and life changing drugs are amazing and wonderful. I just want to reflect on the enormous gains that have been made in treating ADHD since I was diagnosed about 37 years ago, so roughly a generation. When I was diagnosed in the late 80’s there were really two (good) options. There was Ritalin and Dexedrine. Dexedrine was less prescribed and largely thought of as a quick fix weight loss drug for women in the 70’s and 80’s. And all stimulants were pooh-poohed as drastic, crazy, dangerous, and untested. Of course that was untrue. But I digress. Ritalin was only available in the short acting or IR (immediate release) formulation. And Dexedrine was delivered in the same manner. So, for a kid like me, who needed to be medicated for the whole school day and for homework, I needed to take three daily doses of Ritalin that took about half an hour to kick in and only gave me peak efficacy for about 2 1/2 – 3 hours. They were a blunt instrument and didn’t make me feel great. I did go on Dexedrine for a while in junior high. The effect was about the same for me because they way the short acting meds are metabolized was about the same. Granted I was 10 years old and I can’t compare, apples to apples, what I take now because I’m a fully grown man now. But the technology has improved so much. Next came LA or long acting. Essentially, this was an IR Ritalin buried inside another IR Ritalin. So, it lasted about six hours and had two peaks. Better, but still not great. Though two…

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How many hours are in your day?

I’ve probably written on this before. It’s hard to keep track of 14 years of blog entries… But why is it that doctors don’t seem to understand that we need to treat our ADHD ALL THE TIME? I have so many clients who are prescribed 10 hours of medication, six hours of medication, or even only three hours of medication. I just can’t imagine how anyone could think that a human could live a rich and fulfilling life while only being able to be a fully functional person for that few hours per day. If you add up an eight hour work day, an hour morning routine, making dinner and doing the dishes, and parenting/bedtime for your kids, that already adds up to about 11 hours. Forget about any of the other things we all need to do to move life forward. Forget about nurturing your relationship. Forget about having the energy to see friends. Forget about quality time with the kids. I’m lucky. I had a wonderful doctor who understood this. I was prescribed THREE doses of short acting Ritalin at age 11. Even then everyone knew that I needed to be medicated for the morning, for the afternoon and for homework/life in the evening. And that was 36 years ago. Why has the medical establishment as a whole not figured this out yet? The answer is that we still do not define what it is to be ADHD anywhere close to accurately. Doctors don’t understand what attention is. They don’t understand what it really means to have ADHD and how it affects, literally, every aspect of our lives. So, keep pushing for what you need to be successful. Get the right medication. Get the right dose. And, for the love of God, get as many hours in your…

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Why the BATDL? (badass to do list)

Maybe I buried the lead with the BATDL. The whole point is to be EITHER more productive, more efficient, or less stressed. Likely you will be all three. I can’t say I have ever had a client who truly did the BATDL and didn’t reap all three benefits. The level of improvement varies from person to person. Though my experience has been that even a little more efficient, a little more productive, and a little less stressed are worth it, especially, considering the the relatively small amount of effort it takes to implement and maintain your BATDL. I do want to emphasize that I am not talking about productivity for its own sake. The ultimate goal is to have the time and energy to enjoy a rich and fulfilling life, to have time to spend with family and friends, the engage in self care to the extent that you need it, to sleep enough/well, and to enjoy enough down time. I often point out that my systems allow me to be “maniacally productive.” But I also always point out to my clients that (when healthy and not injured) I make time to work out five to six days a week. I spend a crazy amount of time in my garden in the summer. I have at least one movie night with my 17 year old every week. And I definitely watch every Patriots and Dortmund game when they are in season. (Dortmund is my “football” team. They play in the German Bundesliga.) It is wonderful to be able to watch a 90 minute soccer match and a two hour football game pretty much every weekend and NOT feel guilty about what isn’t getting done… because everything important IS already done. That’s the goal. It is about investing in your quality…

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