- Introduction
- Hesitations
- Learn about ADHD
- Getting assessed for ADHD
- Post-diagnosis
- Compensating for ADHD
Introduction
Okay. You related a little too hard to ADHD memes and you weren’t sure where to go from there. Or maybe you got a diagnosis and then you were left to your own devices. Now what?
This guide is for you.
Hesitations
Are you on the fence about actually doing something about it?
I’m not the kind of person who has ADHD
I’m not qualified to decide. You probably aren’t, either. But if somebody sent you here, they recognized the magnitude of your struggles. You don’t have to know why something isn’t working to see that it isn’t working.
That being said, ADHD is poorly understood and represented by the media, and you might have absorbed some misconceptions about what it is and who can have it. See the Learn about ADHD section for more details.
Are my problems really bad enough to get help for?
- everybody pees, but it’s a problem if you pee too often
- many people procrastinate, but it’s unusual to procrastinate often to the point of losing money, worsening relationships (with friends, partners, teachers, coworkers)
- it’s normal to struggle with procrastination sometimes
- struggling with it often is less common and worth getting support for
- continuum: people range from 0 ADHD-ish traits to many
- the cutoff for disorder is “lots of symptoms (things expressed in thoughts and actions) AND causing impairments (adverse consequences)”
- ADHD is highly genetic. If a relative thinks the things you struggle with are totally normal….they might just have ADHD too!
Am I just lazy?
- is there a mismatch between your intent and what you actually end up doing?
- other people may mistake trying but not succeeding for not trying
- do you feel like you’re spinning your wheels but not getting anywhere?
- if trying harder hasn’t been working out all that great for you (burning out, little to show for your efforts), maybe it’s worth getting some outside help/perspectives
Learn about ADHD
What is ADHD?
- highly genetic neurodevelopmental disorder
-
causes inattention, hyperactivity, and impulsivity (not necessarily all of them)
- nearsightedness to the future
- underlying issue is inefficient/noisy brain circuits
- not caused by bad parenting choices
-
causes inattention, hyperactivity, and impulsivity (not necessarily all of them)
- symptoms may include
- often easily distracted by irrelevant things
- often making impulsive decisions
- often having trouble stopping activities/behaviours when you know you should
- often failing to follow through on promises and commitments
- often starting projects or tasks without catching all the important details
- often having trouble organizing tasks/doing them in the proper order
- often unable to sustain your attention
- everybody experiences these sometimes, especially when stressed
- what separates personal quirk vs disorder is
- frequency of symptoms. How often and in what settings?
- degree of impairment (adverse consequences from the symptoms)
Source: Taking Charge of Adult ADHD by Dr Russell Barkley
See the Learn about ADHD page for more.
Misconceptions
- The Misconceptions FAQ goes into more detail about how:
- you can be smart and have ADHD
- you don’t have to be hyperactive to have ADHD
- women can have ADHD
- adults can have ADHD
- you can focus on video games and books for hours and have ADHD: attention regulation issues can mean too little and too much (wrong amount of attention at the wrong time)
Getting assessed for ADHD
I don’t wanna do all this work only to be told I don’t have ADHD. How can I know for sure?
- if you’re relating hard to ADHD memes, you’re struggling with something
- it’s real and causing you problems and big enough to be worth fixing, whatever it is
- surviving isn’t thriving
- goal is to improve your life, not specifically to secure an ADHD diagnosis
- “not ADHD” does not mean “you’re just a shitty person and need to try harder”
- many possible explanations: one possibility is “I thought it was ADHD but it looks like it was actually CPTSD and now I’m working towards healing my trauma”
- “it’s not ADHD” is not the end of the world
Why not just self-diagnose?
- ADHD often comes with friends including but not limited to dyslexia, depression, anxiety, and bipolar disorder. It’s good to be checked for those, too.
- ADHD-like symptoms can be caused by other things too, including everything listed earlier, thyroid issues and sleep apnea.
- one of the criteria for adhd is “these symptoms are not better explained by something else”
- you are an expert on what it’s like to live with your symptoms: when they appear, what it feels like internally, how much trouble they cause you
- you are (probably) not an expert on ruling out alternative causes and may not be aware of all the other possible causes that result in a similar effect
- formal diagnosis lets you access more resources (see below)
How to get an assessment
Who can assess for ADHD?
| Job title | Provides therapy? | Can prescribe medication? | Other notes |
|---|---|---|---|
| Psychiatrist | Not usually | Yes | Specialist medical doctor with expertise in medication selection/management |
| Clinical psychologist | Yes | No | More training than master’s level therapists on diagnosing and treating mental disorders |
| Licensed Master’s-level therapist (like LCSW or LMFT) | Yes | No | |
| Your family doctor | No | Technically yes, may refuse | May have limited experience with ADHD and refer you to a psychiatrist |
Finding people who can assess for ADHD
- USA: CHADD Professionals Directory
- Canada: CADDAC ADHD Clinics Directory
- get referral from your family doctor
- ask ADHD friends or relatives where they got evaluated
- university medical school psychiatry dept
- university psychology/mental health clinic
Deciding who to see for assessment
- are you taking new patients?
- when is the earliest you could see me?
- how much will it cost/what insurance do you take?
- do you just assess and diagnose or do you handle on-going treatment too?
- what services/treatments do you offer?
- how many patients have you diagnosed/treated ADHD, roughly?
- what’s the ratio of adults to children?
What do I say at my first appointment?
- for each concern, describe:
- what the problem is
- what consequences have you faced? Did it affect your stress levels, financial well-being, friendships, academic performance, work performance, etc?
- how often it happens. Once a month? Few times a week? Almost every day?
- where it affects you. School? Work? Social life? Relationships/family?
- At what age did the problem start?
- is the problem still there in happy, unstressful times?
Okay but seriously what if they say it’s not ADHD and I think it is?
-
ask them to explain
- “how did you rule out ADHD?”
- “what are some symptoms of X that do not overlap with ADHD that you see in me?”
- “can you explain how you ruled out me having both X and ADHD?”
- you deserve to understand and agree with your diagnosis, whether this conversation ends in “ok, that makes sense. It’s not ADHD after all” or “they gathered more info and reconsidered their original diagnosis” or “I would like another opinion”
Post-diagnosis
Paraphrasing from Dr Russell Barkley:
- a diagnosis is an explanation, not an excuse
- you’re still responsible for the consequences of your actions
- it’s your responsibility to seek or build the equivalent of wheelchair access ramps for yourself
- don’t give up on your dreams
- your future doesn’t have to look like your past
Types of help you can get
Accomodation ideas
-
Workplace accommodation ideas
- organized by specific problem areas (impulsivity, time management, etc) and lists accomodations and strategies for each
- many are small, reasonable requests that you can make even without formally disclosing your diagnosis
-
Post-secondary school accommodation ideas
- assistance with breaking down assignments, time management, etc
- access to someone else’s notes
Coaching/therapy
- personal coaching
- help getting specific things done; deadline management, etc
- therapy
Medication
- typically, must be diagnosed by a psychiatrist (most therapists and psychologists are not allowed to prescribe medication)
- see the Medication page for more, including
- common concerns/misconceptions,
- realistic expectations about what successful treatment means, and
- what to bring up at a medication check-in with your prescriber
Explaining to friends/family/coworkers
- see the Learn about ADHD section of this guide for a Misconceptions FAQ
- some will be supportive, some will not be
- use your best judgment in who to tell. There is no undo
- sometimes people are unsure how to handle information about your diagnosis
- is this supposed to be an excuse for the hurt/frustration they’ve experienced in the past?
- are you looking for sympathy for your struggles?
- are you expecting the diagnosis to be seen as a good thing or a bad thing?
-
naming your condition doesn’t tell them how to help you, even if they want to
- most people are not aware of how ADHD affects adults
- most people think of the hyperactive boy stereotype
-
decide on your goal before telling people
- in an ideal world, how will they change their behaviour after you tell them?
- you may not have to disclose at all if your goal is to help your coworkers understand how to work with you
-
focus on what you’d like them to do differently
- “I struggle with big deadlines far in the future. Can we have more frequent meetings to help keep me on track?
- “I lose track of time. If you notice I’m not at a meeting when I should be, can you send me a gentle reminder?”
- “I have trouble with verbal instructions. If it’s important, can you send requests/requirements in writing?”
Compensating for ADHD
Common threads between strategies that work
- work smarter, not harder by understanding how your brain works and what specifically you struggle with
-
shortening the feedback loop
- break task into smaller pieces
- smaller rewards more often works better than big reward off in the distance
- this makes future consequences of your choices feel more real
-
externalizing information that you can’t keep in your head all at once by:
- verbalizing
- writing things down
- using visual reminders
-
interventions at the point of performance
- for example, a leave-the-house checklist posted on the door where you must see it on the way out
Getting started/procrastinating
- Tiimo blog: task initiation
-
the current step is too big if you’re getting stuck on it. Break it down.
- what tools/equipment do you need?
- are you missing any information you need to get started?
Distractibility
- accept that you will fall off-task
-
make it as easy as possible to get back on task
- visible alarm as a reminder that you intend to be focusing
- todo list to remind you of what to do next
-
adjust your environment
- music stuck in your head? Maybe you’re understimulated. Can you put on music or use a fidget toy?
- too loud, too hot, etc? Maybe you’re overstimulated. Earplugs? Turn on a fan?
-
reduce big distractions that are particularly hard to recover from
- can’t get rid of all distractions, but it’s worse to be distracted by tumblr for 3 hours than by a dog out the window for 1 minute
-
buy yourself time to think about whether you want to be pulled into a distraction
- put phone in hard to reach place
-
body doubling
- study with another person, clean the house with another person, etc
- makes you accountable to another person, who may gently redirect you if they notice you get derailed OR give you a reason to pause and reconsider pulling out your phone
Time Blindness
-
Tiimo blog: coping with time agnosia
-
“This disconnect between how much time we feel has passed and how much time has actually passed impacts other aspects of ADHD, including our ability to plan, estimate the length of tasks, or be on time”
-
Managing big feelings
- play the You Feel Like Shit game to guide yourself through some self-care that will make it easier to deal with the feelings
- emotional regulation 101: The 5-4-3-2-1 grounding technique
- how is the feeling reflecting in your body?
- clenched fists?
- tension in your belly?
- soreness in your jaw?
- scrunched eyebrows?
- what is the name of the feeling?
- brain dump: write or type out the worries, the what-ifs, the doubting thoughts, etc
- therapy can be a place to learn how to build your emotional awareness and regulation skills