It is no secret that ADHDers often have trouble with writing. But, as with most aspects of ADHD there is an element of counterintuitiveness with this struggle. Because this writing affliction strikes our population equally regardless of how well spoken and articulate we are. If you don’t understand how we’re wired, it will seem very strange that so many of us can speak clearly and articulately but when it comes to expressing our thoughts in writing we seem to lose our minds, get anxious, and can’t keep a linear train of thought. So what’s this all about? Since I have gone through this type of struggle myself and come out the other side, I’ve felt uniquely qualified to deconstruct my writing process in order to understand how I went from anxious, convoluted, and avoidant to confident, linear, and effective. As such, I’ve deconstructed my writing process to be able to teach it to other, similarly wired ADHDers. This is what I’ve learned about us… and writing in general. In order to write something good we have to do three things. We have to create content: ideas. We have to create structure: make it linear and understandable. And, we have to create language, craft the right words. Generally speaking, we as ADHDers, are pretty good at the first and the third things. But we struggle mightily with the structure part. Since organization is a core executive function and most of us struggle with executive functions in one way or another, this is a catch point. And, any topic of sufficient depth or complexity will require another key executive function, working memory, which is the ability to hold things in one’s mind and manipulate them. So, if you are sitting with a blank piece of paper or at a computer with nothing…

I added the last part. And, I’ll get to that. But I always thought that the first part was Shakespeare. Turns out, not so. It was most notably used by Alexander Pope, English poet and essayist in the early 18th century. But it roots may go back as for as Plutarch. (Thanks Gramarist.com.) But leave it to an ADHDer to start his post with a digression. My kids are pharmacologically… complicated. I do the Dr.’s appointments and run point on the meds, partly because being the “primary parent” is my role in the family and partly because that’s kind of my area of expertise. Well, it’s my area adjacent. So I know a lot about pharmacology. Not counting the one of every fourth week when I fill all of my pill containers for the whole month, I fill all my kids weekly containers on Saturdays. Depending on what they are currently on, if I’m packing stuff to drop off at school, that can be up to eight different weekly pill boxes plus four bottles to go to two different schools. Lately, we’ve been weening one of our boys off several meds that haven’t been working and may be making things worse. That’s a slow, multi-week process. And, our other boy is experimenting with some different stuff that we are trying to manage week to week as we judge the short term ramifications. I only give you this background to illustrate that over the last 6 weeks or so, I don’t think the kids have had their pill boxes fill the same two weeks in a row once. I know what I’m doing. I know the plan. All the boxes are in some way color-coded or labeled and when it gets really, really complicated, I take notes from our doctor’s appointments,…

I just turned 43. So maybe I’m just getting old. Maybe my brain plasticity is decreasing. Although… They used to say that adults had no brain plasticity. Now they say we do, just less than kids. They long ago figured out that the universe was expanding. I’m taking their word for it. Of course, I also took their word for the fact that it was expanding but slowing down. Now they tell me that the rate of expansion is increasing. Okay. Doesn’t really affect my life either way. So I’m going to roll with it. But it can get a little frustrating when science “changes its mind” about things that hit closer to home. I remember when it was a big revelation that the human brain wasn’t fully developed until age 25. This, of course, has huge implications for ADHDers, who generally lag behind in maturity and brain development. I’ve been telling clients and their parents this lovely stat for years. Well, today, I opened up my email and there is an article from ADDitude that says, “The brain’s frontal lobes, which are involved in ADHD, continue to mature until we reach age 35.” That seems like a major change. Honestly I haven’t even opened the article yet. It threw me for such a loop, I decided to just write this on the spot. It doesn’t even really surprise me. Looking back at my own life and at the late 20’s/ early 30’s clients who I’ve had, I could make an argument that for certain people, lags in impulse control, emotional regulation, and maturity persist beyond 25 disproportionately to other ADHD symptoms. Or is that just confirmation bias, now that I’ve read this? I don’t really know. I’m trying to think hard about it before I read the article and…

It is a pretty standard accomodation to allow students with learning, processing, and attention issues extended time on tests and quizzes. But many school systems fight the idea of giving extended time for homework assignments. This has always driven my crazy. When talking with a student client yesterday I was finally able to fully articulate why this stance is insane. Generally, school will give students with accomodations time and a half. Of course that seems pretty arbitrary to me. But let’s assume it takes a kid 1.5 times as long to finish a test. Why wouldn’t you then assume that it would take them AT LEAST 1.5 times as long to finish most of their homework? So imagine a day when that kid has homework in all six classes and they have soccer practice. That kid may have a three hour window of medicated time after school or after practice to do homework. On a normal day that might be enough. But on this day, that kid has three hours of homework (normalized for a neurotypical kid.) So that’s roughly 4.5 hours of homework for that kid. Would it not be a reasonable accommodation to allow that kid to finish some of that work the following day or over the weekend? Don’t we want that kid to go to soccer practice and get fresh air, exercise, and social interaction? Do we want him to live a balanced life. Our society fought very hard for an eight hour working day. But many of our kids are now working a six hour school day plus three to four hours of homework. Why are we asking our kids to work a ten hour day and then punishing them is they can’t do it? I think I’ll pick more up on this next week.…

It’s been a busy week and I’ve written some epic posts lately. So just a quick tip for this week. I’m not a big supplement guy. The vast majority of supplements just haven’t been proven to be effective. I would strongly encourage you to only take supplements that are doctor recommended and have a robust evidence base behind their use, particularly when it comes to your kids. But, when it comes to younger kids, supplements that are proven to work can be a great way to treat certain issues for a period of time, until the kids get a little older and will tolerate medication a little better. For example, studies done at MGH show that a combination of high EPA fish oil and inositol, which is a B vitamin are an effective non-pharmacological treatment for mania and also offer some relief for depression and anxiety. My oldest used this combo for a year or two until his symptoms progressed to the point where we had to move on to something stronger. But that’s not what I want to share. What I want to share is the company Natural Healthy Concepts. They have a fabulous selection of supplements. There prices are reasonable, considering the very high prices of supplements to begin with. Their customer service is great. And, THE BEST PART FOR ADHDers is that they can set you up with a super-reliable auto refill. I never had to worry about my son’s supplements. The came right on time. Each was set at a different interval. They shipped promptly. The interval was really easy to edit in my account if his dosing changed. Strongly recommended

Mindfulness. Being mindful. Being present. Living in the moment. Slowing down. Slowing the ADHD mind. Slowing the ADHD body. Meditation? Breathing? Focus? Stillness? How? How long? Is it even possible? What if I fail? There are many reasons that I always believed that meditation was beyond me as a hyperactive ADHDer. I considered my exercise to be my meditation, as that was the closest I got to clearing my head and “resetting” myself. And, I do still consider my working out to be somewhat mindful and definitely an ADHD management tool. But I have had my relationship with mindfulness change quite a bit in the last few years. Here’s the short version. I started meditating with my oldest son when he did a trail through our doctor at MGH of using the “kids calm” meditation on Head Space. I found out that a five minute meditation designed for kids works great for an ADHD adult. I’ve subsequently moved on to mostly doing semi-guided or unguided meditation. But I still enjoy doing the kids one with my kids when I can get them to sit still. What I learned is that meditation isn’t pass/fail and that you don’t have to do it for a half an hour to get a benefit. Sometimes I can get enough benefit from 7-10 minutes that I can control my anxiety enough that I don’t need an Ativan. That’s pretty powerful. And, no, I don’t think I’ve ever really cleared my mind. But, if I can get down to only thinking about one thing, instead of the 20 things I’m usually batting around between my ears, that seems like a victory. And how I feel afterwards would seem to back that up. So, I say, give it a try. Or do some research on other forms…

Decision making is not an executive function. Difficulty with decision making is not a symptom of ADHD. So why do so many ADHDers have difficulty making decisions? I think there are a few reasons. But the primary reason is that the actual process of making a decision is the perfect storm of Attention, Working Memory (Executive Function,) Managing Impulsivity, and Managing Anxiety. In short, to make a difficult or complex decision, we need to do all of the things that we stink at. So, what’s the solution? I have a few tips. Make the commitment to actually make decisions. Decide to decide. Don’t let yourself kick the can down the road. If I’ve learned anything from doing this for over a decade it is that NOTHING GETS BETTER BY PUTTING IT OFF. Occasionally things go away, but even that usually has negative consequences. Be intentional about making your decision. Separate the decision from any other related tasks that you have to do and isolate that as its own task. Give yourself time and space to make that decision. Do research if you need to, but limit yourself to a specific amount of research so it doesn’t drag on indefinitely. Recognize that there is often no perfect solution and no amount of research or thinking can come up with all the answers. Rarely are things 100%. Sometimes 51% has to do. Recognize that in many cases, there are more than one right decisions and/or the decision isn’t final or can be changed/fixed at some point down the road. Manage any anxiety you may feel with exercise, meditation, and/or self talk, especially if it is a big decision. Lastly, make sure you are optimal when you set aside time to make your decision and/or do your research. Be medicated, well slept, not…