Exercise and ADHD

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Starting Therapy as an ADHD Adult

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ADHD Emotional Regulation Plan For Adults

Do you need a plan?

If you are an adult ADHDer who has trouble with regulating emotions or holding back feelings when you want to be overly expressive, then I'm sure you've already experienced the embarrassment or guilt that can come from outwardly overreacting to something in front of the wrong people. This particular symptom tends to cost ADHDers their jobs, relationships, and credibility. This is one of the most devastating symptoms of ADHD, but there is hope.

What is the plan?

As adults, we must be tackling our emotions both before the explosion and after. Emotions eat up our executive fuel tanks faster than any other executive function, and when that tank runs out whoever is in closest proximity, regardless of that person's importance, is going to get the brunt of our anger. It could be a lover, a friend, a boss, or a store clerk. That person is going to get hurt, and if we are constantly putting our friends and family on the firing squad, it's emotional abuse.

If you struggle with other strong emotions like excitement or anxiety, these tips can help you come down from these, too.

Pre-blowout Plan

We as ADHDers must be keeping our executive function tank full. When our blood sugar or neurotransmitters start to run low, that can spell disaster. So we need to plan accordingly.

    1) Before you go to bed, make sure you plan for the next day and set anything you need the next day in a box or where you get dressed. This will save you time, energy, and frustration before you head out the door. If there are certain daily actions that you need to do, make a morning checklist, and set that on top of your items for the next day. If you use a bullet journal, it can be one of the pages in there, but it needs to be accessible.

    2) Plan for transitions between your tasks. If you don't always get to choose how long you work on something, but if you need to switch from one project to another, or you need to take a break, get up and go to the bathroom or get a drink. This will help you start to put your mind in the right place and let you come back to your chair without forcing yourself to switch over before you're ready. It will also help you refuel the tank a bit before jumping into another mentally taxing task.

    3) For long meetings, plan on having a sweet drink with you. Studies have shown that more blood glucose in the brain can boost executive function and keep you from zoning out as much. Try keeping individual drink mix pouches at your desk for a boost when getting up isn't an option.

    4) Use your break time to refuel your break with mindfulness or stretching. Studies have shown that exercise and mindfulness can help to boost dopamine, one of the chemicals that causes problems in ADHD brains. You don't need to run around the block, but going for a walk around your building or sitting on a bench and listening to a guided meditation will help you come back to work with less stress.

    5) Set a timer that buzzes periodically to remind you to check your emotional temperature (below) and make sure that you're staying in an optimal place for work.

When You Feel the Tank Running Out

If you can't walk away from whatever is causing intense feelings on any part of the spectrum, it's important to have a way to deal with those feelings. So, I've modified something that my son uses to help with his emotions to make it a bit more... well, adult. It ranks the energy behind your emotions and lets you find a strategy that works for you.

Emotional Temp.	Level of Listening	Examples of Emotions	Examples of Activities
Hot	Unable to Listen	Anger, Ecstatic, Aggressive, Afraid, Tense	Walk away, Take a Break, Exercise, Deep Breaths, Butterfly Hugs.
Warm	Partially Listening	Distracted, Excited, Overwhelmed, Playful, Frustrated, Annoyed	Deep Breaths, Seated Cat/Cows (Small Yoga), Mental Pep-talk, Sweet Drink, Fidget Tools
Cool	Fully Listening	Calm, Content, Focused	Work, Listen, Think Productively
Cold	Impaired Listening	Tired, Sad, Sick, Bored, Hurt	Stretch, Write Down Your Feelings in a Journal, Deep Breaths, Mental Pep-talk, Sweet Drink

You can pick your own strategies, but keep a copy of your own chart either near your desk or in your pocket so you can reference it throughout the day. The goal is to stay as close to "Cool" as possible.

How Your Feelings Affect Others

I want you to imagine that you and the people physically around you are rocks in a pot of water. If everyone in the pot is cool, the temperature doesn't change. If someone is cold, it lowers the temperature in the pot and makes everyone a little colder. If someone is warm or hot, that raises the temperature of the pot. When your emotions are uncontrolled, everyone else is involuntarily moved to whatever temperature you are at. That's not to say that they will have the same emotion, but if you are distracted (warm) and chatting with your neighbor who is trying to work they will become annoyed (warm). If you are sad (cold) then they may come over to comfort you and become sad themselves. The further someone is away from you physically, the less they change, but if it doesn't change over time it can affect the entire workplace.

Take Away

It's unlikely that an entire workplace will stay entirely "cool", but it's up to each individual to moderate their own temperature as best as they can. If you encounter someone whose emotional temperature isn't optimal, you can talk to them to try and help, or disengage if you feel your temperature moving too far in any direction. Check-in with yourself throughout the day and see where you're at, and whether it's the place you want to be in that moment. Use strategies to make sure your executive function fuel tank stays full before your temperature changes.

Hostility and ADHD (A Story From My Life)

Why do people look down on others with ADHD?

It's hard to imagine that not everyone's brain functions the same way when our outsides all look the same. Even among others with ADHD it can be hard for people to accept that someone has different symptoms or diagnosis than you do. Especially when the behavior that ADHDers exhibit from a small clip makes perfect sense. When your problem is self-regulation, it means that almost anything you do can be normal, but it's how the events are strung together that make the difference.

Even in people with ADHD we don't always understand another person who has our same condition because the severity and presentations are differently affected. Some people need medication, others are able to use practical or holistic approaches, and others (like my son and I) need a combination of both. If you need more or less help, some people will berate you. This is because they either feel they are better than, or that it feels like someone is holding up a mirror to their own flaws.

Many people who meet others have founded their belief in the world that everyone else who fits into certain boxes. (Race, Gender, Sexuality, Diagnosis...) When they meet someone who doesn't fit into a single labeled box, they become angry or upset. They lash out, which hurts everyone.

A Story

Keeping all of this in mind, I had an experience this weekend that I feel needs to be shared. I went to my new psychiatrist this weekend for my second appointment. I had talked to some people about anxiety and realized that what I had been experiencing was not, in fact, normal anxiety. At least, it isn't just normal anxiety, but someone else brought up a rare symptom in ADHD, called Rejection Sensitive Dysphoria, that had the jumbled reactions to emotions that I was experiencing (physical pain, strong emotion, and then having a thought connected to the emotion). Because I haven't done any research on it, or had heard of it until the day of my appointment, I figured I would ask about it since I was told that treatment for this symptom was vastly different than anxiety.

During my first appointment, I had told her a few side effects that I was having with one of my medications. It was something that my old psychiatrist (who moved practices and no longer takes my insurance) had been toying around with, but it just wasn't working. It was actually killing the little motivation I had to do things, and was making me uninterested in anything. Not sad, just glued to the bed and being dragged by hyper-focus.

When I walked into this second appointment, it started normal enough. She asked how I was doing, and I told her that I still wasn't doing well with the anxiety meds, but I was developing new coping skills that were helping me in other areas. I told her that I had found out about my odd emotional reaction sequence and asked if it was a good idea for me to be re-evaluated given this new information. I was expecting a yes, no, or "You're a fairly new patient, and I'd like to work with you a bit longer before making a decision." None of things would have offended me, but what I got was none of those responses.

This is where everything went wrong. ABSOLUTELY EVERYTHING. She told me that re-evaluations "simply aren't done" and that I was learning too much about ADHD. She asked why I was so invested in it and berated me for saying that up until a year ago I was practically non-functional. I explained that my knowledge was needed not only for myself, but for my son. This was something I needed to improve so that I could guide him in the right direction. "Why is is that bad? Why is researching coping mechanisms and figuring out how to help my child a bad thing?"

She dodged my questions and told me "I'm exactly the same as you. I was diagnosed with ADHD in my 30's. I have inattentive-ADHD and I have six degrees and a son with ADHD. There is nothing wrong with you."

To this, I want to make a few points. My brain is beautiful, but I don't fully understand it, and for me to be able to cope with that, I need to learn about it. I learn and problem-solve. This is how I cope with everything in my life. Finances, children, illness, everything. Every week I'm researching a new thing and learning about it. The reason I do this is 1) I have a problem with hyper-focusing which often affects the people around me (Yep, laying that on the table) and 2) I love learning about things because it makes me feel more in control by helping me find or create solutions.

Back in the appointment, I started crying. I was crying because as a mom who's job it is to make sure that her child succeeds in the world, I was terrified of the mirror she was holding up to herself. I immediately knew that the problem wasn't about me. It was about her seeing her own shortcomings. She asked me about how I had coped before I was married as an adult, but I was married right after after high school. Yes, in my late 20's I've been married for 10 years, to the same person, and he is my rock, world and everything. I don't think she could understand that I wasn't the same as her, and I wasn't fitting in her ADHD box. I don't think that she could compute that I could be in a stable relationship and work toward family goals despite my family being my job, just like psychiatry is hers.

I walked out of that office in tears. I set up the appointment she asked me to for two weeks later, but it was just in case I hadn't found a new provider over the weekend. I now have a therapist, a new evaluation, and a new psychiatrist. I'm dealing with the feelings of rejection that are coming from my symptoms not being accepted by a mental health professional and am trying not to wonder how this will affect me moving forward. A new evaluation and a fresh start are exactly what I need so that, hopefully, my new psychiatrist isn't tainted by someone who looked at me, not with an analytical eye, but an emotional one.

So what did I learn?

Providers are humans. They're subject tot their own biases and personal flaws, just like the rest of us. We all judge each other, and in some cases it can be a good thing (the guy holding up the bank probably isn't in a good state of mind) and others it can be a bad thing. We often do judge others based on our own experiences, but there needs to be a true acknowledgement that they aren't everyone's experiences. Despite being told to from others around me, I did not report her. She may very well be fantastic with other patients who don't hit so close to home for her. We're a similar age with children and the same diagnosis. I truly believe that she sees too much in me to think objectively and as it stands I understand that she is human first and foremost.

Your Child's ADHD Team (And why they need to work together)

The ADHD Team and Why it Matters

Your child's ADHD team is all of the professionals including your family, medical staff, psychiatric staff, and teachers/school helpers that work with your child. All these people work best when they're in-sync, but it's essentially been like pulling teeth to get permissions for them to talk to each other. Not only that, but I only had a vague understanding of what my son's school was doing in his OT and Speech therapy sessions. It made it frustrating when everyone was asking me questions about what everyone else was doing and my ADHD brain couldn't remember all the details, or I just didn't know. I have binders filled with all sorts of paperwork that made the school's head spin when I presented it all to them. So many different types of evaluations and medical paperwork. But no one reads all of that, and when you're dealing with psychological things it's an every evolving process.

We had lots of different people who had totally different plans and goals for G, and it was hard to keep the tools straight. It was to the point where I had picked one or two things and then was having him do things with each person separately. It wasn't working well for me, and it wasn't working well for G, because he only used certain tools once a week, or once every two weeks, and none of them really went together. Most of the tools were great, but I needed guidance and education to implement them at home, and an actual plan to have all these random pieces of information guide my son toward better executive functioning. I kept asking people for help on his team and everyone gave me tools, but we didn't have a good way to organize them. I didn't know how to interrupt a behavior without escalating my son, and neither did anyone else, because everyone was on different pages or even on an entirely different book in the series.

Coach Mom and Dad

I had finally realized that this team was basically a little league baseball team, and there was no coach. I had to be that coach, and I was failing at it. This failure was leading to me not being able to help my son as he was regressing from the pandemic. We weren't having meltdowns any more, but now we were. These had originally gone away with meds, but having this regression made me realize that he didn't have the coping skills I thought he had developed. So, I had to make a plan. I checked in with everyone on his team individually about my son's emotional regulation and found out that he had a system at school that I had never learned. It was a big part of the reason that he was doing better in school, but since I didn't know about it, I couldn't use it and I couldn't tell anyone else about it. This was a big problem, but it was also a big piece of the puzzle that I needed to make a plan.

Getting Everyone Together

When I finally had a framework, I was able to make a plan that was universal across everyone his team. I made a list of all the tools we had and found a way to piece them together in a way that made sense and was easy for G and I to work through without having to rely on my faulty working memory. I made the plan on a document and tagged everyone in his team so we could finally have a real plan. (More on this in an upcoming post!) Suggestions were no longer repeated and complimented the existing plan. When my son had problems with one of the steps in the plan, I had someone who could jump in and give us another tool that worked with it. Even though they weren't talking to each other, we were starting to be able to move together toward the goals we needed to reach and everything my son was working on (behaviorally) was starting to make sense to him. All these tidbits weren't random anymore.

Working as a Team

Now my son's various sessions are looking different. Yes, everyone still has their specialty, as it should be, but since we have a clear plan on how these bits fit together we can fix problems that need collaboration or give advice that touches into a different area. It means that many of the tools that we have could be moved into a simple chart that G and I could understand and hand out to family, as well as babysitters and teachers.

Sleep and the Hyperactive Mind (With Tips!)

Why is sleep so hard?!

It feels like everyone these days has some sort of sleep related problem. In fact, about 1 in 10 American adults have reported insufficient sleep on a nightly basis. So what makes this so special in ADHD? The percentage of people with ADHD who have sleep problems is almost 3 in 4. It's a big deal. So, I think it's safe to say that most likely you, or ADHDer you care about, have a sleeping problem, too. So let's talk about it.

What scientists currently believe is that there is a link between ADHD and sleep disorders, though they aren't really sure what that is. There seems to be some scientists who believe that sleep problems may be causing ADHD in some people. They believe that the racing thoughts and hyperactivity is your brain's way of preventing you from falling asleep, which, if you think about it, makes sense.

Something interesting to know though, is that in people with ADHD, they have found that their circadian rhythm (or your body's natural sleep/wake cycle) may be off by almost two hours. So when a normal adult goes to bed at 10-11pm, an ADHDer would naturally go to bed at 12-1am. This makes waking up at 6 to go to work really difficult and ADHD symptoms worse.

Hyper-focus: A Superpower and Curse of ADHD

What is Hyper-focus? Aren't people with ADHD just scrambled messes all the time?

The best example I can give of hyper-focus is one from my childhood pet beagles. Beagle dogs are hounds that are bred for their great noses, and a large portion of their brain is dedicated to the sense of smell. So, when a beagle picks up the smell of a rabbit it stops what it's doing and runs to it. Many of them won't stop even if they are hurt, injured, tired, hungry, or thirsty because all their brain is processing is that smell. The smell is its reward, and if we were hunting, it would have made it much easier to catch that rabbit. Growing up in the American southwest, we had lots of cactus around. That means that every couple of months we had to get tweezers, pliers, and soapy rags to pull cactus out of their paws and mouth.

That is hyper-focus and when you have ADHD it can be a blessing and a curse by catching the "rabbit" at a cost of time-blindness and unintentionally ignoring people you care about because your brain doesn't process their existence in this state. Sometimes it's not even something productive that we've been sucked into. It can be a hobby, TV show, or any other distraction like learning about dolphins... for 12 hours a day and then having a large crash at the end of it. The person experiencing it does NOT get to choose what they hyper-focus on.

So how can we interrupt it?

The methods of interrupting hyper-focus will be different as an outside observer and as an ADHDer. When you're an outside observer, and you find that you approach a very busy ADHDer who you need to talk to, or redirect, there is a bit of a process. I will say that this isn't 100%, but it's a gentle way to help them remember the goal and work their way out of it.

As an Observer:

1) Start by greeting them and asking a question. If you get an "I'm busy", one-word answer, or the beginnings of a long-winded discussion about the topic they are stuck on without eye-contact, it's most likely that they are in hyper-focus and don't even know that they've said anything or they've acknowledged your existence but can't process that you came over for a reason.

Example:    You: "Hey Jessica. Are you busy?" J: "Mmm-hmm."

                    You: "Alex, have you started your homework?" A: "Just a sec, mom. I'm about to beat this boss in my game..."

2) Walk up to them from the side, or someplace that you can be in view, acknowledge that they look busy, and ask them another question while touching their shoulder or arm.

Example:    "Jess, *arm touch* I know that you're working really hard on this paper, but have you eaten tonight?"

                    "Alex, *hand on shoulder* I can see that you're working hard on this game. Do you have any homework left tonight?"

3) Offer a small task to help them move to the area that their next task is in.

Example:    "Why don't you get a drink and we can talk in the kitchen about what we want to eat."

                    "When you finish this battle, let's get a snack and make a plan for homework tonight."

4) Give them a minute or two to wrap up what they were doing and gently remind them what the next task is.

                    "Hey honey, I think we're out of lemonade, but I got some soda at the store. When you get your drink, can you grab me one?"

                    "Hey! Great job on that boss. I'm trying to decide what snack to make."

As an ADHDer:

1) Make a plan for the amount of time you are going to spend doing the task. A good starting number is 10-30 minutes.

2) Choose something you can do for 10-15 minutes that is relaxing and moves you into the area of your next task.

3) Grab a pen/pencil and a piece of paper to write on after you finish.

4) Set a timer to remind you of your limit and get started.

5) Do what you tend to hyper-focus on.

6) When the timer goes off, write down the next thing (or 3) you would have done if you continued.

7) Get up and do your relaxation activity away from where you were focusing.

8) Start your new task.

The Good News:

In the title, I also mentioned that this can also be our ADHD superpower, and I do truly mean that. It's a type of motivation that people would spend big money on if it could be bottled up because it means that for certain tasks that are really interesting we can complete the work that someone without ADHD takes an entire day to do in just a few hours. We really do crack down HARD and have great blinders to distraction in this state, which makes us fantastic workers when we reach it.

When I worked at a costume shop, I was promoted to assistant manager in just 2 weeks because I was excited about the work and often came up with novel ways to inspire and train my coworkers as well as drive sales. ADHDers are also much more likely to start their own business and do well in delegating tasks that they find difficult so they can concentrate on the work that they excel in. All of that can come out of hyper-focus, and we can use it to our advantage.

How do you use it to your advantage?

The best way to promote useful hyper-focus is to make a plan that problem-solves in a new or interesting way. Invent something, become an entrepreneur, write, do some art, and make that something that you can do to contribute to the world. Everyone I've met who was diagnosed with ADHD as an adult has mentioned that the second they were suspected of ADHD (and told about it) they immediately dove into a hyper-focus around the research of ADHD and it's treatments.

Some people spent a few weeks on research before moving to something else, and others spent much longer... (I'm on year 3, but psychology has always been an interest of mine.) We can all agree that this researching period is beneficial, but it must have a balance with family, friends, work, and home maintenance.

Notes:

Breaking out of hyper-focus is a skill that I'm STILL working on, but I have found that doing the process above has so far worked about 80% of the time. I tend to lose the fight with ADHD the longer I allow myself to spend on the task, and if it doesn't have clear milestones to help me break out. If I'm writing here in the blog, it's easier for me to break in the middle when I finish a section or paragraph. However, if I'm just surfing the internet can be tricky to really feel a good stopping point, especially if you've started comparing things you want to buy.