RECOGNIZE THESE SYMPTOMS?
+changes in energy level and sleep patterns
+frequent thoughts of death or suicide
+loss of interest or pleasure in activities
+noticeable restlessness or irritability
+difficulties in concentration or decision making
+changes in appetite, eating habits, or weight
+feeling sad, empty, hopeless, worthless, or guilty
Click here to take a screening test. **If your score indicates positively for symptoms, the clinicians at our practice NYC Cognitive Therapy can help. Call today to schedule an appointment, (347-470-8870).
Mental Health Screening Tools Click here to take a screening test.
Taking a mental health screening is one of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition. Mental health conditions, such as depression or anxiety, are real, common and treatable. And recovery is possible.
Parent Test (for child)
Alcohol or Substance Use Test
Eating Disorder Test
Work Health Survey
**If your score indicates positively for symptoms, the clinicians at our practice NYC Cognitive Therapy can help. Call today to schedule an appointment, (347-470-8870).
*Tools are provided by mentalhealthamerica.net.
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.
Today you need one vital ingredient to climb up the corporate ladder that is often overlooked: political savvy. You must be able to practice sensible and ethical office politics.
Have any of these things happened to you on the job?
- The promotion you expected was given to someone with less experience or expertise.
- You weren’t invited to the boss’s birthday party, but everyone else was.
- You were the scapegoat for someone else’s blunder.
- You were the subject of unpleasant gossip.
If so, you’ve been the victim of office politics. No longer just a power game, utilizing office politics for your benefit is now an important skill for developing a competitive edge and surviving in the marketplace. Build social capital.
Introduce yourself: Your mission, should you choose to accept it, is to become acquainted with everyone in your department. It is essential that you get to know everyone individually. Why is it so crucial that you make the rounds? It demonstrates that you’re a friendly person and that you have an interest in becoming part of the team.
Be friendly: Say “hello” first and greet everyone, from the mailroom person to the big boss. Aside from just being polite, normal, socialized behavior, it gives you an edge as it makes you seem approachable and open, which generally works to your advantage.
Be helpful: One of the best ways to build allies is by helping a colleague who’s overwhelmed with work. Anticipate ways to be helpful rather than waiting to be asked. Of course, this means extra work for you, but it also means that you’ve got some credit in the “favor bank,” that shadowy “one-hand-washes-the-other” network that makes the world go ’round on a business as well as personal level. (Occasionally, you’ll find people who won’t return a favor even though they gratefully received your help when it was offered. C’est la vie. You’re no idiot. If you give and don’t get, just don’t offer to help that person again.)
In my previous blog, I presented a survey to help you identify if anxiety/stress at work are a problem for you. After reading that blog you might have been saying to yourself, “Okay, Noah, so we’ve identified that I have a lot of stress and anxiety at work – Now what? What can I do about it?”
Here are some tips to reduce your anxiety and stress at work.
What can you change?
Pinpoint your stress triggers at work and then ask yourself to what extent you can remove or at least reduce the impact of that stress. In some cases, you don’t have the ability to eliminate some of the sources of stress at work: Getting the boss fired may not be likely; and asking for a raise the day after the company announces downsizing plans may not be in your best interest. What you can change, however, is you. It’s important to begin by recognizing what’s in your control and what’s not.
The fine art of delegating
One problem I frequently observe in my practice is that people create their own stress by taking on more than they can handle. This often happens because they fear that the job won’t get done as well as if they would have done it themselves. In fact, it may be the case that having a coworker or assistant to do the job results in a less than perfect outcome in terms of performance quality and effectiveness. However, that may not be such a disaster – the outcome may be quite satisfactory without being quite perfect. Sometimes lowering your standards, and settling for a less than perfect job, can result in less stress. Also, many times these assumptions aren’t accurate at all. The reality is that other people can be taught. You may be pleasantly surprised by the level of work that others can bring to a task or responsibility. Even if you’re right, and others don’t do the job as well as you do, you’re probably still better off delegating than taking on everything yourself and feeling incredibly stressed.
Here are some further tips for this:
Package your request for help in positive terms: Tell the person why you selected him or her. Offer a genuine compliment reflecting that you recognize some ability or competence that makes that person right for the job.
Don’t micromanage. After you assign a task and carefully explain what needs to be done, let the person do it. Don’t interfere unless you clearly see that things are taking a wrong turn.
Reward the effort. If the person did a good job, say so. And if he or she didn’t do it quite the way you would have but put a lot of effort into the task, let him or her know that you appreciate the effort.
Make your lunch break a stress break
Lunchtime isn’t only about eating; it’s a great time to work on lowering your stress. Try to get out of your work environment at lunch. Even if your outing is as simple as going for a walk around the block, go. Better yet, find a park, library – anything relaxing – that can put you (however temporarily) into a different frame of mind. Find your lunch-time oasis.
Coming home more relaxed (and staying that way)
When you get home, it’s important to have something relaxing planned to look forward to. Leave your work at work and take time to unwind and provide loving kindness for yourself. Here are some of my personal favorite relaxation activities:
– Take a relaxing bubble bath or shower.
– Have a drink (one will do).
– Sit in your favorite chair and simply veg.
– Listen to some relaxing music.
– Read a chapter from a good book.
– Take a relaxing walk.
Keep these tips in mind and you are now better prepared to cope with the chaos!
Click on the “Comments” tab and let me know what you think! What was the effect of trying these strategies? What changes did you experience? What additional strategies have you found helpful?
I help professionals in fast-paced New York City deal with the emotional effects of a stressful work environment. As a licensed psychotherapist, I have an insider’s view into how a demanding work environment affects a high-achieving person’s emotional and physical health.
How Does Work Stress Affect Your Emotional Health?
High pressure and job demands, a fast-paced work environment, and constant change and conflict increase stress, which in turn can lead to anxiety, depression and other emotional problems. In addition, you may be the type of person who is achievement-oriented and competitive, which makes you vulnerable to feeling like you must be perfect and to self-criticism and comparison to your peers. Your strengths at work may be impacting your emotional health and your relationships. When your thoughts, feelings, behaviors or relationships start to feel overwhelming, you may want to consult a therapist or counselor to help bring more balance into your life.
Common Goals of Counseling and Therapy for Anxiety and Stress at Work
- Learn to prioritize your needs and say no to achieve better work-life balance
- Reduce perfectionism and workaholism while still striving for excellence
- Increase positive emotions and reduce negative emotions
- Feel more engaged and alive with meaningful pursuits
- Learn stress management and relaxation techniques
- Enhance relationships in your personal, family and work life
Is Your Anxiety At Work a Problem? Take this self-assessment to find out:
Anxiety at Work Self-Assessment* Take the following brief questionnaire to see how anxiety comes up for you in the workplace.
Please complete all items, rating how true each statement is for you personally, on a scale of 1-5.
1 2 3 4 5
Less True More True
1. _____ I usually don’t feel satisfied with my work unless I feel it is done perfectly.
2. _____ I have high, rigid standards for the quality of my work.
3. _____ I sometimes fall behind on tasks because I spend so much time trying to do them just right.
4. _____ I am often highly critical of my work performance.
5. _____ I frequently doubt my abilities to be very successful in my career.
6. _____ In my job, I typically compare myself to others and find them much more impressive than I am.
7. _____ When I need to give a presentation at work, I become highly nervous.
8. _____ Speaking up in meetings is difficult for me.
9. _____ I try to get out of giving oral reports and other presentations.
10. _____ I typically expect the worst in my job.
11. _____ I am very anxious about messing up at work.
12. _____ I am more afraid of how my work will be evaluated than my coworkers and colleagues seem to be.
13. _____ It’s common for me to engage in behaviors to try to feel better at work, such as keeping my conversations short, planning what I am going to say, or mentally rehearsing conversations in my mind.
14. _____ When I’m nervous about doing something at work, I’ll often avoid that activity.
15. _____ I frequently seek reassurance about my work performance.
16. _____ Making professional contacts is intimidating to me.
17. _____ I get anxious when interacting with my boss or other authority figures at work.
18. _____ I frequently worry about how people will judge me in my job.
19. _____ I’ve turned down – or failed to actively pursue – promotions due to fear.
20. _____ As a boss, I feel like I am (or would be) a fraud – it all feels like an act or a front.
21. _____ I become nervous when I have to give employees feedback or reviews.
22. _____ I often worry about my job, even when I’m not there.
23. _____ Sometimes I can’t sleep because I am worrying about work.
24. _____ I think I worry about my job and career more than other people do; this worrying interferes with my life or is distressing to me.
SCORING Add up your answers in sets of three – first questions 1-3, then questions 4-6, and so on. Each three-question group targets a specific element of workplace anxiety. Any set of three with a total score of 8 or more is relevant to you, so for any set of questions in which you received a total score of 8 or more, read the relevant explanation below.
_____ Questions 1-3: Perfectionism. If you scored 8-15 on this set of questions, you’re likely to approach your work with perfectionism. While perfectionism can be beneficial at times, it is also often linked to anxiety. A higher score within this range indicates higher levels of perfectionism and anxiety.
_____ Questions 4-6: Self-defeating thoughts. If you scored 8-15 on this set of questions, you probably experience self-defeating thoughts at work. You may be very critical of yourself and experience anxiety as a result. A higher score within this range indicates more significant self-sabotaging thinking.
_____ Questions 7-9: Speaking anxiety. If you scored 8-15 on this set of questions, you’re likely to be someone who becomes nervous about public speaking in a professional setting. This is a very common fear.
_____ Questions 10-12. Fear of failure. If you scored 8-15 on this set of questions, you probably have a fear of failure regarding your work. A higher score within this range indicates greater worries about failure.
_____ Questions 13-15: Unhelpful behaviors. If you scored 8-15 on this set of questions, you probably engage in behaviors that you may think are helpful but actually aren’t. In fact, many of these types of behaviors fuel anxiety and cause and maintain workplace nervousness.
_____ Questions 16-18: Interpersonal discomfort. If you scored 8-15 on this set of questions, you’re likely to experience discomfort about interacting with coworkers. You may feel more uncomfortable in structured work situations or you may feel more uncomfortable in less structured, more social work situations.
_____ Questions 19-21: Being the boss. If you scored 8-15 on this set of questions, you’re likely to either feel nervous about your role as a boss, or have intentionally avoided being a boss altogether. People with this form of apprehension often feel like they’re not worthy to be in a supervisory role and worry about offending others and appearing self-centered.
_____ Questions 22-24: Worry about work. If you scored 8-15 on this set of questions, you’re probably a workplace worrier. You’re likely to be someone who both thinks a lot and whose thoughts often shift to fears and concerns.
* Reprinted from Anxious 9 to 5 by Larina Kase, PsyD, MBA