If only I could stop thinking about it and just do it!
This is just one thing we hear from ADHD adults all too often. Some others include:
I bounce from task to task to task, either nothing gets finished, or I end up elbow deep in something completely different than what I originally started.
Even when I’m not doing anything, my mind is racing with all of the things I should be doing.
I feel my emotions so intensely they’re tough to control. Or - Everyone says I’m too sensitive.
What is wrong with me??
I’m either late to everything, or I’m an hour early (because I’m scared of being late).
I either feel frozen or frantic. There is no in between.
I actually like to organize! I spent all day making a new schedule/calendar/color coded system. I just can’t keep up with using it!
I just need to stop being so lazy…
These statements, among so many others, are so often accompanied by chronic feelings of overwhelm, shame, guilt and anxiety. There is incredible frustration surrounding the perpetual struggle to keep up with life, of wanting to be “on top of things,” but feeling like your brain is working against you. It’s exhausting.
What we really want? Peace. Calm. Quiet. Both in our daily lives as well as inside of our minds. A moment where relaxation actually feels relaxing, rather than like collapse or disconnection. We want to feel capable of choosing what to do and then actually doing it. To be productive, yes. But also grounded and present.
Yep, this is me! Let’s talk!
What is ADHD?
ADHD is neurodevelopmental; it is a neurological difference that impacts how the brain develops and functions in day-to-day life. It falls under the commonly used term neurodivergence, or “diverging” from what is socially and culturally perceived or accepted as “typical,” or neurotypical.
When talking with clients or their families, one of the first things that we explain is that ADHD, or Attention-Deficit/Hyperactivity Disorder, is incredibly poorly named. ADHD folks do not in fact have a “deficit” in attention, rather struggle to regulate attention (among other things). It is more useful to think of ADHD as impacting executive functioning and self-regulation. These executive functions include:
Self-Awareness
Inhibition
Non-Verbal and Verbal Working Memory
Emotion Regulation
Motivation Regulation
Planning and Problem Solving
When we look at ADHD through this lens, it becomes clear that ADHD is not in fact “just a kid thing,” and that teens, women, and other adults deserve to be taken seriously and receive thorough assessment, support and treatment.
Traits that fall under “inattention” include difficulty self-directing organization, planning, problem solving and prioritization. They would also include time management and self-directed motivation. This can lead to difficulty sustaining attention and action over time, managing distractions, starting or returning to (completing) tasks, and forgetfulness.
“Hyperactivity” can be understood more broadly, and includes difficulty with self-restraint, inhibition of thoughts, desires or urges for the sake of longer term benefit (impulsivity), and emotional regulation. Physically this may look like restlessness, fidgeting or difficulty controlling physical reactivity, verbally it can present as chattiness, interrupting or blurting out, and cognitively it may include making snap decisions (i.e. impulse spending, speeding) and difficulty suppressing thoughts that are irrelevant to current tasks.
For girls, women, teens and adults, behaviors associated with physical impulsivity are often decreased as restlessness becomes increasingly internalized. As diagnostic criteria for hyperactivity focuses heavily on physical behaviors, this is particularly important to understand.
What does treatment for adults with ADHD look like?
Diagram is adapted from Russell Barkeley’s treatment recommendations for adults with ADHD.
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Not everyone who identifies with the quotes or executive functioning challenges above has ADHD. We cannot overstate the importance of talking with a mental health professional who is specifically trained and specialized in ADHD and Neurodivergence. ADHD is often mimicked or accompanied by other mental health conditions, and being able to tease these apart is a nuanced and essential part of planning treatment. Spending the time to learn about how your brain works is a vital first step.
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An ADHD diagnosis can feel like an incredible relief. At the same time, it can be difficult to truly accept and incorporate this information, and there is often doubt and grief that come along with this.
We have yet to meet an ADHD teen or adult who doesn’t carry shame. Years of being criticized more than their peers, struggling with every day tasks that “should” be simple, feeling misunderstood by friends, family and peers, and frequently not understanding why. This is where we utilize therapy modalities such as ACT and CBT to move towards greater self-acceptance.
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Building specific skills and strategies to scaffold challenges with executive functioning is a critical part of treatment. Often times what works for our neurotypical peers doesn’t quite work for us (“have you tried using a planner?” ugh!), so learning what works for you and your specific needs with someone who gets it can be literally life changing. This is often the focus of ADHD or Executive Functioning coaching.
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Research consistently shows that stimulant medication for ADHD is one of the most effective for the highest percentage of patients when looking at psychotropic medications. As psychotherapists we do not prescribe or recommend medication, however we can discuss potential risks and benefits of medication, how to effectively advocate for yourself with potential medical providers, and recommend providers who specialize in working with ADHD if this is something that you decide to pursue.
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While typically the challenges are what bring folks through our doors, ADHD comes along with some pretty incredible strengths as well. For example, ADHDers tend to be great under pressure or in crisis situations, can “hyperfocus” and accomplish a lot in much less time than our neurotypical peers, can be super passionate and empathetic, are often deep thinkers, creative in various ways and can be super fun to be around! Harnessing these strengths and learning to work with them can be an empowering and life changing part of the therapy process!
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This may sound self explanatory, but social struggles are part of many ADHDers’ realities. Finding your people, building confidence socially, and accepting support from those positive people in your life are often easier said than done!