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Adult ADHD Survival Guide

Stressed WomanLiving life with ADHD is not easy, regardless of when you were diagnosed. Being a child with ADHD can make life extremely difficult. But adults with ADHD can also struggle.

Maybe you have always known on some level that things were more difficult for you. Maybe it has always seemed like you functioned a little different from the people around you.

We have all heard those vocal people who profess their belief that ADHD doesn’t exist. They sum people with ADHD up to people who simply make the choice to be lazy, unmotivated, or undisciplined. Perhaps you have even bought into this idea to some degree, making you unnecessarily tough on yourself at times.

THE COST OF ADULT ADHD

Life with ADHD has a cost. You might have noticed all the unwanted consequences that can come from ADHD.

Things like:

  • The tendency to say the wrong thing
  • Being in constant motion even when you don’t want to be
  • Disorganization in many areas of your life
  • Difficulty seeing important tasks through to the very end

Sound familiar?

These problems might have affected you in school, relationships with others (friends, family members, romantic partners), job performance, your career development, and reaching your true potential as an adult.

ADULTS WITH ADHD FACE A WORLD OF CHALLENGES

Some of the day-to-day challenges you may experience if you are living with ADHD include:

  • Managing the attention problems that often plague you.
  • Learning how to fulfill adult expectations, even with executive functioning difficulties.
  • Coping with the emotions and thoughts once you realize your brain works very differently than others.
  • Dealing with the societal and internal messages that resulted in poor self-esteem, low self-confidence, and decreased faith in your ability to problem solve.
  • Riding the highs and lows that come from the medication working and then wearing off.
  • Navigating the social world, whether it is your personal or professional life.
  • Figuring out how to tap into the capabilities you know you have inside and become the person you were always meant to be.

Let’s say that you might be someone with an understanding of how ADHD affects you. You have grown up with access to all the available support services. You continue to take your medication as prescribed. You’ve even tried all the “cures” that were suggested to you online or by well-meaning people in your life. Even if all of this is true for you, it is very normal to still struggle with ADHD as an adult.

MY ADULT ADHD TREATMENT APPROACH

We will start by exploring your individual experience with ADHD and how it impacts you personally. Early sessions will focus on a number of areas that an adult with ADHD may struggle. Areas such as:

  • Relationships (family, spouse/significant other, children, friends)
  • Job performance (or ability to run a business as an entrepreneur)
  • Managing money
  • Self-care (getting quality sleep, eating right, exercising, etc.)
  • Emotional well-being (coping with stress, handling emotions)
  • Paying bills and other responsibilities that have a deadline
  • Ability to deal with distractions (social media, video games, internet, streaming video)
  • Self-esteem, self-confidence, and setting/meeting expectations someone has for his or herself
  • Executive functioning skills (organization, stopping unwanted actions, planning, prioritizing, sequencing, adapting, sustaining and shifting attention, perspective-taking, problem-solving, completing a task, following directions, keeping information in memory, time management)

CORE THEMES OF THERAPY FOR ADULT ADHD

When an adult seeks help to deal with the implications of ADHD, the treatment typically centers around a few main ideas.

  • Identifying your goals, values, personal strengths, desired characteristics, and other components that make for a meaningful life.
  • Developing healthier ways of viewing yourself, the areas of life where you are having difficulties, and how you fit into the world around you. Often, developing a flexible mindset comes before you make any sustained changes to your lifestyle.
  • Learning skills and strategies to compensate for what continues to be a weakness for you. This could be self-control, organization, maintaining focus, remembering, or finishing what you start.
  • Not letting your ADHD (and how others may perceive it) define you as a person, even if it affects you every day and in a number of different ways.
  • Building perseverance and resilience to continue facing challenges daily, and doing so with a sense of bravery, self-compassion, hope, and optimism that you will achieve the life you want.

Techniques associated with Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) will help you learn how to handle setbacks and challenges in a healthy way and start to develop skills that bring out the best in yourself. You will start to see ADHD as a different way of living, one with the capacity for having both ongoing struggles and tremendous successes.

MEDICATION MIGHT NOT BE ENOUGH

If you have been prescribed ADHD medications you have probably found that they are far from a panacea. It does not solve for you all the problems that you face on a daily basis. No medication you have tried has been the magic bullet for all your struggles. You may also have experienced the even bigger challenges you face when the medication inevitably wears off. To this end, we work together towards making improvements in your self-management skills.

THESE MAY INCLUDE:

  • Modifying your environment when possible to be less distracting and support productivity.
  • Using available electronic devices and apps to reduce the burden on your brain’s executive functioning skills.
  • Developing systems that keep you organized.
  • Learning time management techniques to address “time blindness” (lack of awareness of how much time passed when engaged in an activity, not being able to predict how long something should take to complete, or using available time better)
  • Using rewards (social, experiences, or desired items) in a way that works to improve your approach and task completion.
  • Stress management skills (because stress is inevitable!)
  • Finding the optimal balance between time-on-task and planned breaks to maximize your performance.
  • Putting steps in place to prevent impulsivity, whether it be with relationships, spending money, or engaging those distractions.
  • Taking advantage of resources to ensure that directions were followed and deadlines were met.
  • Using naturally-occurring dopamine and adrenaline systems to your advantage.

COMMON QUESTIONS ABOUT ADHD IN ADULTS

Research studies that have been conducted over a long period of time have shown that the answer is…..yes and no. A child’s experience of ADHD will likely evolve as they get older. For many, the levels of hyperactivity and impulsivity may lessen over time. They may have improved to the point where they would no longer meet the full criteria for the hyperactivity-impulsivity presentation of ADHD.

Unfortunately, issues with inattention do not usually improve so drastically over time. For those with substantial attentional difficulties as children, they are very likely to continue having difficulties with attention into adulthood.

The brain is believed to fully developed at around age 25. (Some research claims this is just for men, as women’s brains are fully mature by age 21.) After this point, there is no further physiological improvement to be expected.

This is why we focus treatment on how to work with your current state and make improvements in the areas where you are struggling.

ADHD is largely determined by the level of impairment someone experiences, rather than through any type of systematic comparison. It is not as simple as “everyone else can pay attention for 10 minutes and you can only do 5 minutes, so you have ADHD.”

There is no benchmark of what “normal” should be when it comes to attention, hyperactivity, or impulsivity. It’s worth noting that there is a test that compares performance results to that of a non-ADHD group. Even when using that test it remains difficult to draw clear diagnostic conclusions.

To get the diagnosis right, which is key for getting the right type of treatment in place, the testing needs to be thorough. It can’t and shouldn’t be done:

  1. Whether a certain set of behaviors or characteristics occur at a level that negatively affects functioning in a significant area of life (socially, academically, job performance, etc.)
  2. Do these behaviors contribute to the experience of severe emotional distress.

It depends on your particular work situation, your comfort level with sharing that type of personal information, and your relationship with your supervisor. In some cases, disclosure and discussion about how ADHD may be affecting job performance can lead to increased understanding, fewer conflicts with management and co-workers, and appropriate modifications in how someone is allowed to complete their job tasks. In other cases, the outcome is far less positive (co-workers thinking someone is getting preferential treatment, increased scrutiny, only being seen as a label). It is a decision that should be weighed carefully.

The decision to address your ADHD without going down the traditional medication (stimulant or non-stimulant) route is a very personal one. If this is an individual’s preference, I acknowledge this and support it. Either way, it is important to make sure you get the best benefits possible using non-medication techniques.

The right self-care behaviors have been shown to help with ADHD characteristics (as they help with most emotional and behavioral concerns). These include getting enough sleep, exercising regularly, healthy eating choices, maintaining social connections, and taking time to engage in stress-relieving activities.

Issues like food sensitivities/allergies and gluten intolerance can affect someone’s experience of their ADHD symptoms (but do not cause ADHD). Just like if you got a poor night’s sleep or come down with a stomach virus, these could greatly impact your attention and activity level.

Unfortunately, natural ADHD treatments are not currently scientifically supported. (I apologize to all the essential oil and CBD enthusiasts out there, but the research isn’t there at the moment). Omega 3 is a noteworthy exception, as it does have some scientifically backed benefits.

This type of thinking usually develops as a result of negative judgments from others that become internalized. Do you notice any of these statements going through your mind at any time?

  • “I can’t get that done, so I’m not even going to start it."
  • “I’m stupid/unmotivated/damaged/incompetant/doomed/(and so on).”
  • “I can’t take care of myself, so how can I possibly be in a relationship or a parent?”
  • “Why try _______? It’s not going to work out for me.”
  • “I’m so far behind all my friends and will never be able to catch up.”
  • “I’ve been an underachiever all my life. That’s just who I am.”
  • “Everyone else seems to have this ‘adulting’ thing down but me.”
  • “I don’t understand why my life is still a mess.”

A FINAL WORD ON ADULT ADHD

ADHD often affects people’s lives into adulthood, impacting their lives every day and in a number of important situations. By developing the right mindset, skills, and strategies, we can work together to help you create the life you always wanted for yourself. You are full of potential, you just need to find the right way to unleash it.

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