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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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.

Read MoreHow to turn your BATDL into getting things done.

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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You are still a sample size of ONE.

it’s important for you to understand and own your individuality when beginning treatment for anything, especially ADHD. What is written on the insert with your new prescription is hardly a comprehensive list of effects or side effects. It is simply a summary of what was realized by the patient or observed by the clinician during a very limited period of time in a very controlled setting with a very small group of people who probably don’t represent cross-section of society or substantial genetic diversity. human brains are incredibly complex. The more we know about the human brain, the more it puts into perspective how little we really know about it. I want to briefly share and experience that a client had when trying a new medication. As a successful woman in midlife, no one would’ve thought of ADHD 30 years ago. Even now, I don’t think that it is a slam dunk that that is the primary issue. However, there are ADHD symptoms present. Recently, while doing a very low-dose trial of an effective drug in the Ritalin/methylphenidate family she had a side effect that I have never heard of or read about. Most stimulants suppress appetite to a certain extent in most people. How severe and how long lasting the suppression is varies from person to person. And there are people who don’t experience this side effect. But I have never heard of anyone becoming ravenously and almost obsessively hungry when taking stimulants for the first time. Yet, that’s what happened to this particular client. She immediately knew that this was not the right drug. Thankfully, her doctor accepted her report of this side effect and they moved onto the trial of a drug in the Adderall/amphetamine family. Granted, this was a very stark and noticeable side effect at…

Read MoreYou are still a sample size of ONE.

We are all a sample size of ONE.

A few years ago, at an ADHD conference, a doctor who was presenting on non-stimulant therapy noted the effectiveness statistic of stimulants and non-stimulants. Historically, almost every study has shown that 80 to 85% of people with ADHD respond to one or both families of stimulants. That would be the Adderall/amphetamine family and the Ritalin/methylphenidate family family. Whereas non-stimulants, primarily Strattera/atomoxetine are roughly 20 to 25% effective. Of course, percentages of efficacy can be a guiding principle in terms of treatment. But he was also careful to point out that we are all a sample size of one. Statistics talk about population. But what works for you, is what works for you. As a sidenote, I do think it’s important to challenge the findings of studies. We have to ask what the metric is for, “effective.” Often studies are judging mild, moderate, and robust response. But nobody wants to take a bunch of pills every day for a mild response. So it is important to note whether studies are talking about robust response or lumping all three categories together. Of course, who has time to read studies? I struggled to find the time, and it’s my job. At a time when our society is more and more looking to dismiss science, it is even more important to invest in it. Because even what we know, should be challenged. Studies can be redesigned. New data can be discovered. Metrics can be changed. And conventional wisdom can shift overtime. This is one of the reasons that it’s so important to have a competent and experienced prescriber. Because what the book says is an aggregation of what has been shown and what is thought to have been proven in large groups of people. But you are a sample size of one. And for…

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Step 10 to a BATDL

Celebrate. It is essential that you celebrate your victories. And every task that you cross off your BATDL is a victory. Unfortunately, I find that most of my clients attach what I call “Yeah, buts” to most of their successes. I got that done but… It took me too long.… I had to work late… It could’ve been more perfect… I had to be reminded… I didn’t get something else done… Regardless of whether or not these other things are true, it doesn’t take away from the victory. the reality of life with ADHD is that everything is harder for us than our Neurotypical counterpartss. And I don’t mean harder as in the traditional sense of difficult. It’s the boring, tedious, repetitive, every day things that are our kryptonite. It is significantly more difficult for me to muster be initiation and detention to do the laundry or empty the dishwasher than it is for my Neurotypical wife. This is not an excuse. I still expect myself to pull my weight in my relationship. It just takes more of my resources to do that. So whether it’s a big thing, or a small thing, I celebrate everything that I get done. I suggest you do the same. It’s very difficult to work hard to accomplish something and immediately attach a negative to it. That does not in sent you to work hard to do the next thing. But if you take a moment to celebrate your success, to truly experience feeling good about accomplishing something, you consolidate that good feeling into your sense of self and you feel accomplished. And that feeling will encourage you to accomplish more. And that will lead to more good feelings about yourself. And that will encourage you to accomplish more things. I think you see…

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Step Nine to a BATDL

CROSS ITEMS/TASKS OFF YOUR BADASS TO DO LIST! Crossing completed tasks off your BATDL in something like real time is practically and psychologically important. From the most literal and practical standpoint, crossing items off your BATDL means that YOU ARE BACK IN YOUR BATDL. The is the crux of the behavioral change you are trying to make. You do one to three tasks on your BATDL. Then you go to the BATDL and assess what to do next and why. Cycling through this behaviour throughout the day is the way to leverage your new BATDL to achieve peak efficiency. If you aren’t in and out of your BATDL all day, it will become less, and less relevant and eventually have little bearing on what you are actually doing. In that scenario, it can’t really help you. There are two really important ways that crossing items of your BATDL will greatly aid you psychologically. The first is very straightforward. It will show you that you are, in fact, accomplishing tasks. This is why I hate list apps that mysteriously move your crossed off tasks to a “To Done” list somewhere in fairyland. I can’t think of anything more demoralizing that a list that only shows the task that I haven’t completed day, after day, after day. I like progress. I like victories. If my list icon shows 20 task yet to do, I love being able to see that I’ve actually crossed off 22 items today. Sound like a good day, to me! The other best think crossing off tasks on your BATDL can do for you psychologically is to not just show you that you have gotten “something done,” but give you a real record of your progress. As ADHD people, (and probably humans in general,) we tend to not…

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Step Eight to a BATDL

EVERYTHING ON YOUR BADASS TO DO LIST MUST BE ACTIONABLE! Your BATDL is not a vision board. Your BATDL is not your five year plan. Your BATDL is not a compendium of all your hopes and dreams. Your BATDL is not a place to use magical or wishful thinking. Your BATDL is about the task you NEED to complete to make your live move forward. As such, every task on this list has to be actionable… now. Obviously, that doesn’t mean that you have to complete every task now. That would be nuts. You can only do one thing at a time. But all the items on your BATDL very much have to be discreetly actionable items. A few quick but very different examples. Laundry. I would argue that you can’t put “laundry” on your BATDL. It is not really a task, in and of itself. Laundry is made up of these tasks in my household: Sort laundry, strip beds, start laundry, make my youngest’s bed, make our bed, fold laundry, and put laundry away. Yes, the breaking down of this larger item in to actionable tasks may be filed under No. 7, breaking things down into pieces. But the way you might know that it needs to be broken down is because the item itself is so broad as to not really have a meaning and is not actually doable. There are also times in life when we forget what I call, “the prerequisite tasks.” Our tendency is to just put that last task in a chain on the list. Generally speaking, when our brains see that task on our list and know there are several other, not accounted for task we need to do first, we tend to freeze and avoid. But if you can notice this as…

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Life lesson about loss.

This is not specifically an ADHD topic. Though our particular wiring may make it more relevant. I don’t know. I’ve been a person with ADHD and mostly work ADHD people. And, this will be a one week hiatus from the BATDL topics. My mom has untreatable COPD, despite never being a smoker or around second hand smoke much at all. If you don’t know, COPD basically makes it so that your lungs don’t work. She has deteriorated quite a bit in the last six months. And she started home hospice last week. My wife, kids, and I have said goodbye. But there could be a month left. The not knowing is really hard. The last week has been very difficult. My attention has been dreadful, largely because my mood has been awful. I’m not a big cryer. I’m more of a “handle logistics now and be classically sad later” kind of guy. So, I’m not wandering around weeping. But I’m not myself. I has taken me all week to feel like I have enough attention to sit down and bang out some blog posts. And, I couldn’t even go through my inbox Monday, Tuesday, and Wednesday. It has also been difficult being 100% present with my clients. I haven’t told any of my clients because I don’t want to make their sessions about me. And, I don’t think that they would notice how much harder I have to work to be present. But everything has been a challenge. This leads me to the lesson that I learned when I was in my early/mid 20’s. I was working for a brilliant but very, very tough chef named Carmen at a restaurant in the financial district called The Vault. It was an intense and gruelling job on the best days. One day,…

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Step Seven to your BATDL

CHUNKING: BREAKING TASKS DOWN INTO THEIR CONSTITUENT PIECES. The easiest way to explain this is to say that, big things are scary and small things aren’t. Buy a house is scary. Get prequalified, decide on towns to look in, figure out your price range, get a realtor, make a list of “must haves,” etc. aren’t so scary. Maybe a little scary, but not nearly as much. Even, “get a realtor” might seem scary. Ask your friends and neighbors for recommendations is even more straightforward and less intimidating. Bear in mind that the primary job of your list is to capture items in the moment. So, don’t worry about breaking things down in the moment. That will feel overwhelming at least some of the time. If you feel overwhelmed by using your BATDL, you won’t use it. Just get it captured and then break the larger task down later, when you are more optimal. Know that this will make your BATDL many times longer. Just remember that all those steps are actually tasks that you need to accomplish anyway. And the number icon on your list…is just a number. In fact, having so many actionable tasks to cross off will make you love your BATDL even more as you see how often you get to cross things off. 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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Step Six to a BATDL

Before I start with today’s entry, I want to celebrate for a minute. I finally finished my book last week. 209 pages of really good stuff. When I say finished, I mean version 4.2 or something like that. A relatively polished version that is ready to be edited. So, hopefully I can have a final version in a matter of weeks. If anyone knows a publisher… Back to the post. The sixth step to a BadAss To Do List is very closely related to Step Five. Now that you know that your list consists ONLY of the important tasks in your life, you will need to be diligent about putting ALL your important tasks on your list. This might seem obvious to some of you. But almost every one of my clients mentally ‘silos’ their task into, BATDL “worthy” tasks & NOT BATDL “worthy” tasks. Each client might have a different definition for each of those silos. Regardless, it is a mistake. The job of your BATDL is to capture ALL of the tasks you need to complete, so that they are in one centralized location. Don’t forget that, floating around in your head, is a place. You may not be leaving random scraps of paper all over your kitchen or putting Post-it notes all over you office. But when you divide your tasks between BATDL and your working memory, you are still dividing. Any task that there is any possibility of your forget, OR any task that would cause you to lose efficiency by forgetting, even for a short time, at the moment when you need to remember it need to go on your BATDL. That voice in your head that says, “I’ll remember that. I don’t need to put that on my list.” is lying to you. Even…

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