Mark*, a 27 year-old married graduate student, presented to my office years ago when I first started my practice. He described chronic anxiety, low mood, and trouble sleeping for the past two years. He had been struggling with “keeping up with it all”. This included his schoolwork, relationship, a part-time job, and his one year old baby. He experienced similar symptoms throughout school, especially as the course load became more challenging.
In the past, he had been diagnosed with anxiety disorders and depression and his doctor tried him on two antidepressants that both caused intolerable side effects. When I met with him, his top complaints were feeling overwhelmed and discouraged due to struggling in most areas of his life.
After an extensive evaluation, I diagnosed him with ADHD, inattentive type. He did not have depression or an anxiety disorder. He responded extremely well to medication and his mood and anxiety improved as he became more organized and competent in his life.
However, despite ADHD treatment with medications and therapy, he 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.
2. INCREASE STRUCTURE
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.
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.
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.
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.
|About Scott Shapiro, MD, Helping Adults with ADHD
Scott Shapiro, MD, specializes in helping adults with ADHD. He is a psychiatrist in private practice who sees patients struggling with depression, anxiety, bipolar disorder and attention deficit and hyperactivity disorder (ADHD). He enjoys working closely with other high quality and personable specialists in providing comprehensive care. He uses evidenced based treatments including psychopharmacology, cognitive behavioral therapy (CBT), and schema therapy.
Have you heard about a new mindfulness/meditation App called, “HEADSPACE”? I just started the program, and I must say — It’s wonderful. Super easy, super accessible, and customizable to your individual needs.
What is it? Headspace is meditation made simple. Using the app and online techniques they make it easy-to-learn, fun-to-do, and relevant to your everyday life. Scientifically proven to help you de-stress, get more sleep, gain more self-control and worry less – the bite-sized exercises will help bring some calm and clarity into a very busy life.
HeadSpace includes a free 10-day program where you can learn the basics of meditation for just 10 minutes a day. If you choose to subscribe after that, you can get hundreds of hours of meditation of a variety of topics.
*The experts recommend meditating at the same time each day.
*Find a comfortable space – preferably an upright chair.
*Make it a priority.
To read an article in the NewYorker describing the App and its creator (a monk) visit link below.
You can download the HeadSpace App on your iPhone, or complete the exercises on your computer, here: https://www.headspace.com
Have you tried out the App? Use the comments box to share your feedback.