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| Source: istock photo: michaelpuche |
Tina*, a 27 year-old married graduate student, presented to my
office years ago when I first started my practice. She described chronic anxiety,
low mood, and trouble sleeping for the past two years. She had been struggling
with “keeping up with it all”. This included schoolwork,
relationships, a part-time job, and a one year-old baby.
In the past, she had been diagnosed with anxiety disorders and
depression. Her doctor tried her on two antidepressants that both caused
intolerable side effects. When I met with her, the top complaints were feeling
overwhelmed and discouraged.
After an extensive evaluation, I diagnosed her with ADHD,
inattentive type. She did not have depression or an anxiety disorder. She
responded extremely well to medication and his mood and anxiety improved as she
became more organized and competent in her life.
However, despite ADHD treatment with medications and therapy, she
continued to exert significant energy “just to keep up”. This is often true
with adults with ADHD. In addition to focus, procrastination, and
distractibility, ADHD affects a set of cognitive skills known as executive
functions. Executive functions include long-term planning, follow through,
prioritizing, strategizing, time-management and other complex thinking skills.
Deficits in executive function often persist despite ADHD medication treatment
and require both extra effort and specific coping strategies.
Therefore, people with ADHD often experience difficulty
maintaining their energy. Here are some tips to energize your life as you cope
with ADHD. I hope they help you on your journey to success.
1. OBSERVE
RUMINATION
Rumination is thinking about the same thing over and over. It
can sap your energy and take the “wind out of your sails”. People with Adult
ADHD may be more prone to rumination due to difficulty shifting gears.
Attempting to stop the thoughts can often make them persist.
Instead, label them as “ruminating thoughts” and turn your focus to another
activity. One technique that you may
find helping is saying, “Oh…there
is obsessing”, or “Oh…there is worry”. Just observe what happens when you name
the thought. Research has shown that this can lower the intensity and duration.
People with ADHD often struggle with a cluster of cognitive
skills called executive function such as time management, initiating tasks,
organization, follow through, and prioritizing. Challenges in executive
function can lead to anxiety and feeling exhausted.
Having a schedule or “game plan”, can help one feel
calmer. Using a calendar, either
paper or digital, can help structure tasks and time. This can help with
productivity and organization.
3. SELF-TALK
Many people with Adult ADHD often feel they never are going to
catch up or achieve their goals. This may be due to painful experiences in the
past. You may recognize some of the self-talk:
●
“I am always screwing things up”.
●
“I will never be good enough”.
●
“This will never work for me”.
This type of self-talk is often called the inner critic and can
sap energy similar to rumination. Often, I encourage my patients to do the
following:
●
Notice the inner critic.
●
As above, label it. “Oh….There is the inner
critic.”
●
Remind yourself: “I am a work in progress”.
This may just sound like positive talk or unrealistic, but
thousands of studies for many decades have shown that how we talk to ourselves
affects how we feel and behave.
4. IMPROVE SLEEP
There has been more attention over the past decade on sleep and
the impact of sleep deprivation.
Restorative and adequate sleep is important not only for energy but also
for cognitive functioning. Sometimes, ADHD symptoms may worsen during periods
of interrupted sleep, insomnia, or sleep deprivation.
Some tips to improve intermittent sleeping difficulties
include:
●
Avoiding electronic devices for three to four
hours prior to bedtime.
●
Establishing a consistent, evening routine.
●
Creating a calm, uncluttered sleeping
environment.
●
Using earplugs or a white noise machine if
needed.
●
Exercising during the day and not within three
hours of bedtime.
If you suffer from significant low energy during the day or
chronic insomnia, it is important to seek treatment from your doctor about
potential underlying medical causes of fatigue.
5. FUN
Often, people with ADHD feel so overwhelmed or without enough
time that fun or pleasurable activities are ignored. People may say, “I don’t
have time to relax or have fun” or “I don’t deserve to do that”. However, fun can energize you and help
you have a better outlook and be more productive. Fun can involve watching a
comedy, playing with your dog, visiting friends, or pursuing an artistic
passion.
6. SET GOALS
Just like a map, having specific goals can help you stay on
track. As you make progress in your goals, it can provide momentum and guidance
on your journey. I would recommend that you set several create both short-term
(e.g. one month) and long-term (e.g. one year) goals.
Effective goals usually have specific outcomes (e.g. increased
sales by $10,000 or eating meals with the family three times a week), a game
plan or strategy, and most importantly, a means to measure the outcome (e.g. a
chart or checklist).
7. CARDIOVASCULAR
EXERCISE
Cardiovascular exercise such as biking, running, dancing,
swimming and other activities are good for our overall health. In addition,
cardiovascular exercise can improve our sense of well-being and energy.
There are many hypotheses why cardiovascular exercise has this
benefit including releasing endorphins and increasing a “motivational
transmitter” called dopamine.
IN SUMMARY
Adult ADHD can be very challenging as you pursue
success in your personal and professional life. However, I hope these seven
ideas help to provide you the stamina and energy to achieve your potential.
If you would like to learn more about Adult ADHD and coping
strategies, please visit my website at www.scottshapiromd.com.
*Disclaimer: Details of cases have been
altered to protect the confidentiality of any and all individuals.
