My Blog: ADHD Since 1978-

under selling attention as a society as it relates to the stimulant shortage crisis

I have seen a lot of things change in the almost 35 years since I was diagnosed with ADHD. Almost all of them have been for the better. There was a lot of, “I don’t believe in that, that’s not a real thing.” When I was younger. Seriously, people would have no problem telling me that to my face when I was like 13 years old. I think this is one of the reasons that I so strongly identify with lgbtq+ folks. Despite growing up white, suburban, and reasonably privileged, I was pretty consistently and fundamentally told, “No, you’re wrong. You’re not actually right about what your experiencing. I know better than you. As a matter of fact, in fourth grade, one of the two teachers had a master’s in special Ed. So they gave her all the kids with adhd. The first week of school in an IEP meeting she told my parents she didn’t believe in it. That was one of the worst years of my life. I still get a lot of, “I think we all have a little bit of that.” And this is progress. But it’s kind of sinister in its own way. It’s really a way of unpathologizing a legitimate medical issue to a matter of severity of something normal that everybody deals with. That would be like if you told someone you were clinically depressed and their response was, I know everybody gets depressed sometimes. No. Everybody doesn’t get clinically depressed sometimes. Everybody gets sad sometimes. Everybody gets anxious sometimes. Everybody has a hard time being in charge of their attention sometimes. But that doesn’t mean they have clinical depression, generalized anxiety disorder, or adhd. There are clinical standards for these particular psychopathologies. When we don’t distinguish them from everyday feelings we do…

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ADHD & Anxiety & Depression

I subscribe to an ADDitude newsletter for ADHD professionals. It’s not super sciencey. Frankly, I often wish it were more in depth and cited the actual papers so I could at least read the abstract, conclusion, or methodology. But, I guess it is what it is. But the thing that baffles me is how little new is reported from reportedly new studies. I’ve been an ADHD professional for 12 or so years. I’ve been a person with ADHD for 44 years. I’ve know I had ADHD for about 34 years. And, I’ve done my best to learn about ADHD in one way or another for about 20 years. And I’ve taken part in studies on ADHD since I was 12. So, I know a lot about ADHD. I keep reading article that announce finding of stuff I already know like it’s new news. I understand that we need to build a concensus in science and medicine. But, maybe use the word “confirms” instead of “determines?” Today’s take away from January’s ADDitude for Professionals: “As many as 80% of adults with ADHD have at least one co-existing psychiatric disorder.2 According to a recent ADDitude survey of 1,500 readers, anxiety and depression are the two most common comorbid conditions diagnosed alongside ADHD in adults, with co-diagnosis rates of 72% and 70%, respectively.” I’ve been telling my clients this for over a decade. There have been scores of studies to prove it. Who cares about an anecdotal sample of a very specific 1,500 readers? But they are the two most common comorbidities. That’s been established for years. We all benefit from the prodigious amount of research done on ADHD. But, let’s break some new ground? Or maybe I’m just getting old and cranky?

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Overcompensating for our ADHD traits

whether consciously or unconsciously, many of us identify pretty early in our lives some of the ADHD trades that we would like to minimize or eliminate. It might be impulsivity, disorganization, being late, or any number of other things. Of course, there are trades that we can’t control. Otherwise ADHD wouldn’t be a legitimate diagnosis and we could just “try harder.” but there are usually some things about ourselves which, through sheer force of our will or because of overwhelming anxiety, we can work very hard to get better at. But I think we often overcompensate. It can be helpful to recognize that it can be healthy to realize our achievements and our progress and come back to a constructive middle ground. in an effort to be less esoteric, I’ll give you a couple examples. A prime example in the area of impulsivity is spending money. I think many of us have had issues with impulsive spending at some point in our lives. My dad used to tell me that money would burn a hole in my pocket when I was a kid. Not that I couldn’t delay gratification and save up for something if it was really important. But most of the time I’d spend it as soon as I got it. as I got diagnosed in medicated, as I got older and more mature, as I recognized what I wanted to improve about myself, I worked hard to be less impulsive with my spending habits. I worked to delay gratification. I worked differentiate between want and need. But all that’s easier said than done. And to a certain extent, I developed a lot of anxiety about spending money. Of course this was some time ago when I realized it was an issue. I’m not sure we were fully…

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Getting Back on the Horse

So I had covid about 4 weeks ago. I was really really sick for about 36 hours. And then reasonably sick for about a week after that. I was also stuck at home with a disregulated not very sick but covid positive 8 year old. There’s also a lot going on in my household in terms of mental health with both of my kids. And thankfully, business is good. So I’ve been digging out of the covid hole for the 3 weeks since. But I would be lying if I said that that was the only reason that it’s been a month since I posted a blog entry. If I’m completely honest, the further away I get from posting the harder it is to start again. I know this about myself, so I know that it’s not going to be a forever thing. But, there is a psychological barrier to coming back after not posting for a while and not putting in a particularly robust effort. So I make more of it than I need to and it gets a little harder to do. And then the longer I wait the better I feel it needs to be. And then it makes it harder to do. Quite the vicious cycle. Many years ago, this is the kind of thing that would have derailed me for quite some time and could have been the thing that truly broke a habit. This is the kind of thing that plagues many of my clients when it comes to consistency on any number of topics, including writing, working out, self improvement, mindfulness, whatever else you can think of. So I decided that the best way to get back into posting was to post about getting back into posting! Step one is to take the…

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meet yourself where you are.

It’s a principle of management. It’s a principle of parenting. It’s probably a good principle of conflict resolution. It’s a cornerstone of good teaching. You have to meet people where they are. But I find that my clients consistently forget to meet themselves where they are. As ADHD adults, we tend to be harder on ourselves than anybody else’s. Which is funny because the rest of the world often thinks that we don’t care and we’re not trying that hard. But the reality is that every little failure, mistake, misstep, or faux pas, whether real or imagined, it’s just another opportunity for us to beat ourselves up for our shortcomings. I’m not saying we don’t need to work on ourselves. I’ve more or less made a career out of working on myself and then teaching others to do the same. I think working on ourselves is an essential part of being a good human and a happy human. But understanding how to work on yourself in a productive and self-loving way is so important. if you constantly have expectations for yourself that are unrealistic you will consistently set yourself up to fall short, experience failure, and not succeed in the way you want to. But if you set realistic expectations for yourself and focus on succeeding that can be a foundation to be a little bit better and then a little bit better and then a little bit better over time until you’ve reached the place you want to be, even though you’re not there yet. I joke with my clients that my success in life is based on setting a low bar. The reality is, I think my success is based on setting a realistic bar, achieving what I can, and then figuring out how I can raise the…

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More thoughts on ADHD and decision making

I have this weird analogy that I’ve always used to explain decision making. Imagine you’re on a river floating down in a raft. On one side is a sheer cliff. You’re not going that way. On the other side is the jungle. It may be dangerous. It may be your salvation. And then there’s the river. Better things could lie ahead. Or you could be headed straight for a waterfall. I imagine most people who are reading this blog wouldn’t have much of a frame of reference for deciding whether or not the jungle is a good idea or whether or not the river is going to turn into white water and smash you on the rocks. So in that sense, maybe this isn’t the best analogy. But let’s assume that you have some jungle and River experience. You’re going to have all sorts of information from the world about that jungle and about that River. And you’re going to need to make a decision about what to do. And you’re going to have three choices. You can intrepidly March into that jungle with your machete and cut a swath to… Maybe something better? Or you can grab a paddle and head down that River in search of your salvation, whatever that looks like to you. But there’s always a third choice. And that third choice is to do nothing. in this case, that third choice looks a lot like the second choice. Because both of them have you going down that River. (Fyi, I don’t know why voice recognition keeps capitalizing River. I’m going to choose not to care about it and move on with my life.) The difference is when you do nothing you have abdicated your choice. And when you approach that waterfall and realize there’s nothing…

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IEP’s

it’s IEP review season in my house. We just did my younger son’s and are going to do my older sons in a little bit. We put that off because he’s got a little bit on his plate right now. And so do we as parents. But it made me think that it might be a good idea to cover the topic briefly on my blog. IEPs are a wonderful and mysterious thing. They allow your children with neurodiversities, mental or physical health issues, learning differences, and other issues to get a more fair and equal playing field when it comes to learning at school. In theory. Unfortunately, they’re largely unenforceable without the backing of a a large reservoir of knowledge, a will of steel, and an expensive lawyer. That is, if your school system or your individual School is not of the mind to be helpful. Yet, on the other hand much can be accomplished with cooperation without a formalized declaration of accommodations. Unfortunately, this is just another area of disparity in our society. Though it doesn’t always fall on racial and socioeconomic lines, too often it does. Cities and towns with fewer resources tend to be less accommodating and fight parents almost on principle. My general feeling is the first question we have to ask is: what is the point of school? Last time I checked it should be about learning. And maybe there should be a little bit of social justice, standing up for the little guy, and fairness thrown in there. And when I say fairness, I mean real fairness, not the fake fairness that school systems talk about when they say that everybody needs the same rules even though everybody is different. the reality is that you can ask for anything in your kids IEP…

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The Cost of Ownership

As ADHDers we are clutter prone. There is no denying it. There are many reasons why. I think I’ll probably cover that in another post. But, as you move through life and accumulate things, think about this: everything you bring in to your life has some cost after the initial cost of purchase. Even if the acquisition is free, you have to store said item. You may have to maintain it. You may have to clean it. If you move, you’ll have to move it. I am not a proponent of not having things. I have plenty of things. But I think I can offer some guidelines as to what you should bring in to your life and why that may make your things more enriching and less of a collective albatross around your neck. Maybe it’s a good time to answer the question you are surely asking yourself, why the heck has he posted a picture of wet wooden spoons. First, I’ll correct you and point out that they aren’t wet. They are glistening with mineral oil. Five out of these six spoons are almost 18 years old. We got them through our registry when we got married in 2005. You can see that there is a chip in the slotted one where I got a little to “intense” when making pesto in the blender. And some are getting a little worn at the tip. If you don’t know, I’m a classically trained chef. The spoons get quite a workout on a regular basis. I’ve included a picture of them… because an oiled, glistening, well-worn Olivewood spoon is a magnificent sight to behold… and because it nicely illustrates the first few points about what to bring into our lives. I’ll leave you with this. I was once working with…

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the cost of caring for children with mental health issues

first a note. It came to my attention that when my website change over to a new host, my blog no longer got sent out to subscribers. I think I have that situation fixed. So, if you are a long time subscriber and get this post, and it’s the first one you’ve gotten in a while, please please go back and read all of the stuff that I’ve been writing for the last 6 months. I’ve been doing it for you! Also, if you wouldn’t mind shooting me an email and letting me know that you’re getting it now, that would be a huge load off my mind. now, on to the good stuff. Or maybe it’s not so good. I’ve written on this topic before. But I think it’s worth reiterating. It certainly a thing that is front and center in my life. I’d like to be as honest as I can be without spotlighting my kids too much. I will just say that my youngest continues to struggle with a variety of mental health issues the take a severe toll on both him and the rest of the family. And my oldest began an intensive outpatient program for his own mental health concerns this week. as part of the intensive outpatient program, my wife and I are required to participate in three hour and a half long parent groups or DBT groups weekly. I had my first parent support group yesterday. The staff member who is leading it made a very interesting point when the topic of family medical leave was brought up. Without any judgment, he referenced the type of psychiatric issue that my son is dealing with as having a higher mortality rate than adolescent cancer. But he asked us how many parents would take a…

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Procrastination is not a real thing

When new clients come to me, almost all of them list procrastination as an issue that they would like to work on. I don’t believe in procrastination I think it is a word that we use to describe a behavior that we don’t understand. It’s a throwaway term that damages us by labeling us as somehow inferior and maladaptive. Nobody gets up in the morning and says to themselves, “I have a really important thing to do today and if I don’t do it I’m going to be totally screwed. But you know what, I’m not going to do it anyway.” Quite the opposite. As human beings, particularly those of us with ADHD, we two opposing forces working on us at all times. We have motivating forces and we have demotivating forces. For example, I may want to be skinny but I may also want to stop at McDonald’s everyday for lunch. I may want to be able to play the guitar but I may not be interested in practicing enough to get good at it. Of course, these are pretty simplistic examples. Now you have to layer on the fundamental attentional dysfunction that comes with adhd. What neurotypical people don’t understand about ADHD is that it is almost physically painful to do tedious, repetitive, unengaging tasks. So as much as we may want the end result, if we don’t have the attention available to initiate and follow through on a behavior the force pushing against us doing it is often greater than the force incentivizing us to do it. Fundamentally, this also means recognizing that for those of us with ADHD easy isn’t always easy. Sometimes easy is really hard. All the things that normal people take for granted as being easy, if they’re boring or tedious, challenge us…

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ADHD and decision making

How do account for decision making in your productivity? Do you account for it? Perhaps you should. Here’s the case for why. In my experience, when my clients are struggling with something on their to-do list and avoiding it, one of the biggest contributors is that there is a decision that needs to be made. How can you do a thing, if you haven’t decided how to do it? How can you do a thing if you’re not sure what the steps are? And how can you do a thing if you haven’t really decided if you want to do it? I would argue that you can’t do something under those circumstances. And my experience bears that out to be true. So what’s with ADHD people and decision making? Well, I believe that decision making is the perfect storm of all of the things that we’re not great at. In order to make a decision we have to pay attention deeply, use our executive function, specifically are working memory to weigh the options, we have to manage our impulsivity, and many of us have to manage anxiety that may or may not be an overcompensation trying to deal with the aforementioned impulsivity. All of this conspires to make decision making a thing that many of us struggle with. So what’s the answer? I believe the answer is to simply account for the decision making as a separate task. We need to have time, attention, and mental space to devote to that decision. Most of the time, if we simply see a task on our list that has a decision behind it our brain sort of short circuits. We may be mentally and attentionally available to do the task, but not make the decision. Because the decision may actually be a…

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psychiatry IS medicine

today’s topic is a bit of an opinion piece. In my opinion, psychiatry has always been a grab bag. Often referred to as part of the “soft sciences,” even though it’s a medical discipline. I don’t know if it will ever be the hard science that many medical disciplines are. We’re certainly a very long way off from blood tests, genetic testing, DNA testing or anything like that to diagnose or guide treatment for most psychiatric disorders. Those technologies are really in their infancy and are only of use and very specific cases if at all. and in a discipline that is not so cut and dry, many mistakes have been made over the years. Off the top of my head, the pathologizing of homosexuality. Reliance on dream interpretation and psychotherapy. In fact, until the DSM-5 it was not kosher to diagnose a child with autism and ADHD. Of course, we now know, that if you have either of those conditions, you’re more likely to have the other than the general population. personally, I think psychiatry has suffered from I need to overcompensate the fact that it’s not so cut and dry by trying to create very strict structures, guidelines, do’s and don’ts that are often two black and white and miss the gray of what psychiatry is at its heart. but I think that we are now at a crossroads with psychiatry. What we refer to as psychiatric disorders we are finding more and more are neurobiological brain disorders. That means they’re physiological. Much like space, and the deep ocean, the brain is largely unexplored and under understood. But what we do know, is that there are biological underpinnings for ADHD, for schizophrenia, for bipolar, for depression. whenever I take a new client through my ADD ucation session, I…

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