My Blog: ADHD Since 1978-

An army of one?

remember that slogan from 10 or 15 years ago? Probably not. They didn’t stick with it for very long. as patients, we are a sample size of one. I can’t remember if I posted on this before. But it’s a nugget that I didn’t want to let go for too long in case I hadn’t posted. large studies. Metadata analysis. Science. Odds and averages. All these things are super important to understanding the overall outline of a disease or impairment. But ultimately you are a sample of one. Trust yourself and maybe try to find a doctor who trusts you. Cuz some of us are outliers and there are a lot of ways you can be an outlier. But if you feel strongly that your experience is valid, even if it’s different from the conventional wisdom I would suggest you own that and don’t let anyone tell you that it’s not your truth… Maybe unless you’re a hypochondriac…

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Making decisions easier.

Decision making is not an executive function. But I’m sure I have posted in the past about how difficult decision making is for some ADHD people. It is definitely executive function adjacent. It really requires attention, working memory, managing anxiety, managing impulsivity, and sometimes other executive functions like organization and planning. So, pretty much, everything that we suck at. Congratulations! But I’ve had an epiphany recently that I’ve been sharing with a lot of my clients in regards to decision making. We know that in real estate it’s all about location, location, location. I always say that ADHD management is all about planning, planning, planning. I know I posted recently about the idea that the most important time you spend is the time you spend planning how to spend the rest of your time. (Feel free to reread that. It’s a mouthful. For me. Maybe an eyeful for you…) As I dive deeper into teaching planning to a variety of different kinds of clients, with differing emotional relationships to the idea of creating a plan or a schedule, I realize that decision making plays such an important role in our function or dysfunction. Decision-making will always be easier when we limit the decision set. We tend to get overwhelmed when we have to choose between everything and everything else. We get overwhelmed when we have to choose between a variety of very different things. And we get overwhelmed when we have to choose when we are not at our best. So how do we make choice easier? Planning! Really, what planning is, is front loading the executive function. So it may be uncomfortable or difficult to sit down for 15 or 20 minutes and plan your day. I am not saying that it’s not difficult. Especially at the beginning it…

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Squirrels & hamsters

I’m not sure where I’m going with this. But I had a client a couple weeks ago who made a remark that stuck with me. He said that, “everybody talks about the squirrel running by the window that distracts us. But nobody talks about the hamster wheel inside our own head.” Just in time I figured out where I was going with this. I do think it’s important to differentiate between internal and external distractions. I am the classic hyperactive boy. I am what society thinks about when they think about ADHD. My dad always referred to me as “shot out of a cannon.” But research consistently indicates that I am only one flavor of ADHD. But I don’t think it’s an accident that my flavor was noticed first. My symptoms, at least some of them, are very externalized. I am distracted by my physical being and the physical world around me. Whether it is someone talking behind me class, or even the soft tick of the second hand on a clock in an otherwise silent library, those things derail me. Internal distractions are just as difficult to manage. But they are happening inside an ADHD person’s brain in a way that you can’t necessarily see without visible hyperactivity symptoms. In the age of flat earthers, Holocaust denial, in general nincompoopery, it’s really important to remember that a lot of things exist that we can’t see with the naked eye. I think we are getting better at recognizing ADHD in inattentive but not hyperactive folks. But I still don’t think we really talk about what’s going on with those people. Enter the hamster. I think average neurotypical people would have a hard time understanding what it’s really like inside our brains. I don’t think they believe or could even comprehend…

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APSARD conference…

it’s an ADHD professional organization. Google it. just got back from 5-day conference. My brain is full of add information. I’m going to spend some time in the next few posts doing some takeaways from the conference. They will probably be in bullet points. And I will likely do some posts on specifics in more depth after having a chance to watch some of the recordings. I think I’m going to start with some personal takeaways. — sitting still and paying attention is hard. I believe that my medication works about as well as one can expect. And if obviously made a career out of managing my adhd. So, I didn’t expect it to be quite so draining. But unlike other conferences I’ve gone to, the slides were not available online. So I couldn’t follow along. Many of the lectures were overcrowded. So I was jammed on a tiny seat between other people. I did my share of standing up on the side. But there were definitely times I wish I could have sat on the floor against the wall and still seeing the screen. Reflecting, it was actually the sitting still in a small place that was harder than the paying attention. But the combination was a doozy. I actually broke the fidget toy that I brought. Apparently I squeezed it one too many times and it actually exploded. I’ll post a picture of that later. — my tried and true strategy of planning a workout in the middle of every day of lectures worked beautifully. There were actually two days I think that I worked out twice. A really hard hour on the spin bike or lifting weights between 3 and 1/2 hours of sessions in the morning and 4 hours of sessions in the afternoon was not…

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feeling stupid is irrelevant

so many of my clients have a difficult time admitting when they don’t know some thing. This often leads to missing opportunities or not succeeding at some thing. And that seems pretty silly to me, especially when there’s a legitimate and real solution right there. Ask the professor. Ask your boss. Check in with a colleague. Ask your dad. Phone a friend. If you need the information to move forward being embarrassed is a relevant. I’m going to a conference in a couple of weeks. It’s a super academic affair mostly for doctors. There were multiple words on the itineraries that I had to look up. And then I had to send the following email to one of the organizers. Susanne, Hi I have a couple more summer embarrassing questions about the conference in a couple of weeks. I am not particularly well-versed in the academic jargon of professional conferences. So here goes… Thanks in advance, Matt There was a time in my life when I would have put off sending this email because it made me feel uncomfortable that I didn’t know these things already. Thankfully, I have moved past that point in my life and I just don’t give a shit what anyone else thinks about me. And that’s really helpful. Because I’m gonna get the answers to these questions and be able to have a much better and lower stress conference experience

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Daily SCHEDULE 12/9/23

I’ve been promising my clients that I’d post a newer daily SCHEDULE. So here it is. For the record, it went like clockwork until we left basketball. Also, I didn’t anticipate needing some downtime in the middle of the afternoon. And putting my sons soccer rebounder together took a lot longer than I thought. Much more complicated than a goal when it comes to assembly. But the metric always is, did I get more done having a schedule than I would have without it? Absolutely! The other metric is, did I feel less stressed and more in control of my day and my time? Absolutely! Had a great low stress day with my nine year old and got a lot done. Sounds like a win to me. Seems more than worth the 12 or so minutes it took to make the schedule the night before.

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Rubber ducking

I’ve been meaning to write about this for months. I learned this from one of my clients who’s a programmer. Apparently when you’re stuck with a programming problem you’re supposed to talk it through with a rubber ducky. I’m unclear on whether or not it’s a real or metaphorical rubber duck. Either way, I love it! I know that I have talked about self-talk in the past. But this is another great opportunity to discuss it and think about why it works. And I feel a little validated that other people in the world do this enough that it’s a thing in computer science. Maybe I should start by explaining what it helps with before I go on to how it helps. As ADD people we have a tendency to get into the weeds, to use a restaurant term, inside our own heads. We can overthink things. We can use all or nothing / black and white thinking. We can catastrophize with the best of them. It can get ugly. I find that one of the most significant contributors to our feeling overwhelmed is when we let everything swirl around in our heads instead of letting it be real out in the world. Inside our heads thoughts can twist and magnify and cause more distress than clarity. Now if you had an anxiety it gets even worse. Not much can affect your functioning more negatively then the nest full of vipers inside your brain that is a clinical level of anxiety. So, we need to get those snakes out of your dome. How do we do that? Stop thinking and start doing. And even talking, writing, outlining can be ways to start doing. They are certainly ways to make your thoughts real. How many times have you said something out…

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How I’m posting today after not posting for 2 months…

first, it’s been a couple months since I posted. Partly that’s because businesses been good. Thank you to my clients. Partly it’s because home has been stressful. A quick note here. When I started my blog about 10 years ago, I promised myself that I would keep it up. I have been diligent and faithful to that intention for around a decade. However, there have been times where posting new entries has fallen a little lower in the priority queue. The reason I mention this is that I think it’s important to be intentional. But it’s also important to be flexible when life switches it up on you. I think I’ve learned three things in this regard. The first is that it’s important to be kind to yourself and recognize that it’s okay to temporarily reprioritize. That doesn’t mean you are never going to get back to something. The second is that it’s also okay to change your priorities permanently or at the very least acknowledge realistic external forces. Thomas Jefferson once said something to the effect of, “no one axiom can be deemed wise and expedient for all times and circumstances.” Any system or structure or intention that you have in your life that really works still doesn’t guarantee that it will work forever. I have strategies that I’ve been using since my late teens. But I’ve also had to make significant changes when I was a chef and working 80 hours a week, when I stopped being a chef and started my own business, when we had a child, when we had a second child, when our kids have had psychiatric crises. Without going off on a tangent, there are some inalienable truths about how to manage life, I think. But how you apply those things can change…

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Parenting children who struggle with ADLs

Activities of daily life are things like brushing teeth, bathing, brushing one’s hair, eating, drinking, getting dressed, etc. For an adult, you could group these things under the concept of automatic tasks or under the heading of self-care. Parenting children who struggle with these ADLs is tremendously challenging and thoroughly exhausting. Parenting is a hard job. Most people would argue it’s the hardest job. But, with neurotypical kids who are on a predictable path of development, everything gets easier. I think we all know when we have kids that the first year or two are going to be really hard. Sleepless nights. Diapers. Teething. Weaning. But, at some point, they start eating solid food. Eventually they are toilet trained. They probably sleep through the night. They only have so many teeth to come in. But we expect to have to brush those tiny little teeth when they come in. But I think we also expect our child to take over that task eventually. At first they need to be reminded. Eventually one would hope that it happens automatically. I don’t want to potentially stigmatize anyone by giving a specific developmental age for any specific ADL. It is important to remember that everyone is different. And there is often a pretty wide range of what is “normal.” I find it difficult to describe normal. But I don’t find it too hard to recognize things that are outside of the norm. So what happens when your kid has severe ADHD, or a significant mood disorder, or ASD, or sensory issues? I can tell you, from both personal and professional experience, that neurodivergent kids often struggle with ADLs long after what we would consider developmentally appropriate for a “normal” kid. And that will dramatically affect you as a parent. It’s exhausting when your…

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Not a fan of the DSM-5

Dr. Russell Barkley wrote a fabulous analysis of diagnostic criteria for ADHD in the latest digital issue of attitude. I posted a comment agreeing with Dr. Barkley and hopefully adding more to the conversation. Check out the link below to see the original article. And I will copy and paste my response below as well. ADHDCoachBostonOctober 20, 2023 at 2:42 pm I could not agree more with Dr. Barkley. I believe there are several underlying issues that make this whole conversation more complicated. First, I think that psychiatry suffers from certain delusions. It is not black and white. Yet the DSM has always sought to be the definitive answer to everything, without exception. I am a huge believer in science. I love duplicatable, peer reviewed research. Without science, people would still be making claims about red food dye or too much sugar causing ADHD, like they did when I was a child. But, I agree about the importance of looking at impairment. Because when you use science to exclude from a diagnosis, you can do just as much harm to the undiagnosed as you were doing good for those who neatly fit into the diagnostic criteria. I also agree that we need to re-conceptualize our concepts of ADHD and even of attention. I think it’s important to emphasize frustration tolerance, or lack there of as a symptom. I believe it is essential to understand how tedium and boredom are our neurobiological kryptonite. We need to get away from talking about lazy, unmotivated, and undisciplined. I would argue, what looks like all of those things is actually the core symptom of inattention. But I agree that getting at the heart of that symptom set is essential in accurate diagnosis. And to bring up a few related issues that are not…

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Why a diagnosis isn’t a “label”

I got super far ahead and writing blog posts. I think I’ve got several queued up to post the next couple weeks. But I just have to write about something when it comes up in my practice or my personal life and I get excited to talk about it. Today I want to talk about the idea of a diagnosis being a label, in other words, a bad thing. I have heard so many people, mostly parents refer to an add diagnosis as a label. They are deathly afraid of their child being labeled, categorized, maybe even stigmatized. I’ve had clients who were diagnosed as kids and their parents never told them. And they end up in my office trying to manage their ADHD wishing they’d had a chance to start that process 20 years earlier. I think it’s really important to talk about this A lot of this comes for the underlying societal bias against ADHD. Can you imagine a parent refusing to take their child to get an eye test because they were worried about them being found to be nearsighted and then stigmatized because they have to wear glasses? Can you imagine a parent not wanting to get their kid diagnosed with cancer as soon as possible so they can start treatment and live? Would you resist saying you were diabetic, if you were diabetic? I realized there is a certain amount of denial present in human nature. But the level to which I’ve seen parents deny ADHD and sometimes other psychiatric issues, blows my mind. I just can’t think of an instance where it’s not better to know what you’re dealing with and be able to fix it, treat it, face it head on. I think it’s time we fought even harder against the stigma of…

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Surprise! Clocks help us keep time.

I’ve written some pretty long posts in the last few weeks. So I’m gonna hit you here with a really quick tip. Have a clock in every room of your house. I know there are some people are gonna say, “Duh.” But I am consistently surprised by how many of my clients lose track of time in rooms that don’t have clocks. Of course, we need to actually look at the clock, which requires a little mindfulness and presence in the moment. But that’s another conversation. Start with the clock in every room, including the bathroom, and let me know how it goes. Standard disclaimer. As a person with ADHD, I made the decision when I started my blog, that I didn’t want it to be that thing that I avoided out of perfectionism. I made the decision to get my ideas out there with very little filtering and rarely any editing. Adhering to this philosophy means that I may never have put out a perfect blog post. But it also means that I put a really good blog post out most weeks for the last decade. So please continue to bear with me by overlooking awkward phrasing, typos, grammatical quirks, etc. In the meantime, I hope you enjoy the heck out of the contact. P.S. I’m not even gonna read this before I start slapping it on the end of my blog posts. Ha!

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