Adult ADD/ADHD: Managing Emotional Control.

Are your emotions sabotaging your life? 

Does it feel like you’re being picked on more than others? 

How many times do your memories keep you from moving ahead? 

Do you respond to frustration, stress and perceived criticism with anger or tears, and certainly denial and arguing? 

Do you just FEEL everything more than others seem to?

In my last blog I spoke about the significant influence the command center (Executive Function) of your brain has over your day-to-day feelings of success.  In addition to helping or hindering your ability to organize stuff, time, and activities, the Executive Functions also control your level of motivation, follow-through, memory and emotional control. Depending on the day and situation, the emotional control piece can take over your ability to manage the rest of the functions successfully. And with ADHD in the picture, all bets are off.

Interestingly, the various EFs (Executive Functions) impact each other. Notice that I mentioned memories. Previous “bad” experiences can strip your motivation and hold you back with feelings of frustration and dread. Which can lead to anger/tears and then, you’re off….another horrible day.

Conversely, forgotten (working memory issue) memories can lead to repeat performances of former unpleasant experiences. The outcome may be the same…more anger/tears, and again another horrible day.

And speaking of horrible days, could that be just a little exaggerated? Perhaps you got off track, or didn’t accomplish everything on your list. Or you had another disagreement with your kids (because they don’t see things your way, are disrespectful, don’t spend enough time with you). Annoying, yes, frustrating, yes. Horrible, no. Save “horrible” for IRA audits (heaven forbid), a car accident, lost job.  Get the idea?

When you overstate a negative situation it tends to stretch and grow in your mind, becoming much more important and all consuming. Your emotional responses become more intense, you have a harder time unhooking from the emotion, and it tends to define the day and interfere with other necessary tasks.

Strategies guaranteed to work for managing your emotions:

Journal/Record your experiences.

Moving your negative thoughts/experiences out of your brain to paper, computer screen or recording device accomplishes three (3) things:

1. By moving your thoughts to something concrete, you have helped your brain “let go” of the swirling, flooding and ruminating;  
2. You can review your thoughts in a concrete manner and see what’s what, without letting other ideas seep in;  
3. You also have a reference of thoughts/experiences that you can review if they should come up again. 

Check in with someone you trust.

If you feel that you’re constantly being criticized, ignored, have no friends or people are mean to you, have a conversation with a trusted friend or family member. Someone whom you believe will be honest with you about what’s really going on. Sometimes with ADHD, distorted thinking can alter the facts making it difficult to respond appropriately.

An ADHD Coach can be a good source for working through these situations.

Excuse yourself from the situation.

If you find yourself embroiled in a no-win situation and really want to unhook, give yourself permission to exit stage right. Perhaps it’s a bathroom break, or you’ve got to make a quick call. Creating an acceptable reason to escape before you blow is a perfectly appropriate tool for avoiding further confrontation and runaway emotions. You are effectively managing the situation and therefore controlling your emotions.

Teach others.

One of the best ways to learn a new habit, information or skill-set is to teach it to someone else. Remember that they have to want this help from you and together you establish a plan for execution.

Adult ADD/ADHD: Firing (Up) Your Board of Directors

My Board of Directors? Yup, everyone has one. 

It’s the great command center of your brain. It guides and directs some of the critical actions that can make all the difference in our everyday lives such as being on time or late, organized or messy, able to handle stress or too reacting with too much emotion, and in general feeling in or out of control.

Your board members have assigned roles and tasks that can include functions such as:

• Emotional Control: responding to a situation with the appropriate level of emotion; controlling your anger, frustration, and tears so you don’t appear to be out of control or childlike;
• Planning: looking ahead and anticipating what’s to come and when to do it;
• Organization: also thinking about the future, where should I put the things I’ll need later
• Working Memory: recognizing the cause and effect of actions for the future, filing away ideas, comments, conversations to be retrieved later;
• Shifting: ability to unhook from current thought, activity, plan to move forward on a likely basis; 
• Initiating Effort: getting started with a task that you need to get done  (no matter if you want to or  not);
• Task Monitoring: you have got the task in motion, take care to finish it properly and on time;
• Self Monitoring: recognizing and self-correcting when you are off-task, interrupting, arguing, operating outside social norms.

When any one or all of your Board of Directors is influenced by ADD/ADHD, their functionality can be challenged to such a degree that it can be almost impossible to get through the day and successfully meet your goals. That’s when your executive board members are working at cross purposes, and have failed you. When everything goes well, we can assume that the board had the right stimuli to work together to support you.

“Executive functioning” has become the common place term used to describe the cognitive skills and resulting behaviors assigned to your Board of Directors.  It represents a significant advancement in better understanding an ADHD diagnosis.  No longer are we limited to the three (3) characteristics of hyperactivity, impulsivity and lack of focus (inattention) in describing the wide reaching impact ADHD can have on managing life tasks.

Different experts, clinicians and researchers have their own definition, or list of executive functions that they subscribe to. Assume that’s just pride of authorship and take comfort in knowing that in fact the lists are more or less the same.  Working with your Coach to help you take control over your Board of Directors will bring about a level of satisfaction and stress-reduction like you have never experienced before. Next Blog in this Series: Managing Your Emotional Control.

Adult ADD/ADHD andThe 40 year old Meltdown.

Ever seen an adult man throw a temper tantrum?

When your spouse has ADD or ADHD, it’s a “not-uncommon, but, still a disturbing sight.” So says Kristen about her last grocery store excursion with her husband, Jason.  It was over ice cream. The flavor.  Having purchased an apple pie for a family gathering, Kristen was thinking vanilla would be appropriate.  But when she asked her husband if he was OK with getting something everyone liked, he blew up.

Looking back, Kristen realizes that the phrase “everyone liked” was the trigger to what came next.  Jason received the message that Kristen said that nobody liked his previous choice of Chunky Monkey. Jason whirled around, stamped his foot and sputtered out loudly “Everybody liked my ice cream, everybody ate it and loved it. I don’t know why you think my choices are bad.”  After that tirade, he stomped down the aisle. 

In their 25 years of marriage, Kristen and Jason have experienced many similar situations where Jason’s reaction to a perceived criticism, judgment or misunderstood comment has resulted in Jason’s over-the-top emotional response, closely aligned to a child’s meltdown.  To witness this behavior in an “adult” is startling and puzzling to say the least. To be the spouse of someone who takes this action it’s chilling. 

Carl is divorced with a college-aged daughter. He’s been managing his ADD for the past 10 years but is significantly challenged with the emotional self-regulation piece. Since the divorce, he feels like he’s lost his family. His daughter is away at school (within driving distance), and when she comes home she tends to stay with their mom who’s still living in the home she and Carl formerly owned jointly. It bugs him immensely that she seems to constantly choose his ex over him, except when it comes to asking for money.

In May, his daughter graduated from college. Carl had thought a lot about how the weekend would go, with dinners with his girl, hanging out, talking and setting up an apartment for her. Lots of good times with Dad.

What actually happened was an entirely different story. His ex was at graduation with her partner (who Carl detests), and her mother. All three kept their distance from him. Nobody recognized him in the way he pictured he would be, Father of the Graduate. He felt he had to beg his daughter to sit with him at dinner. She was torn between her mom and dad. She did not want to hang out with him (all the time) because she wanted to be with her friends. Carl felt like the odd man out and reacted by starting a number of arguments with his daughter, resulting in both of them crying and feeling miserable. Carl wanted a level of support and comfort from his daughter that would be more appropriate coming from another adult his age. His daughter does not want to be her father’s caretaker.

In both examples, this child-like behavior is a result of not being able to handle the stress of whatever is happening at the time. Emotional disregulation is a critically important executive function issue that needs to be recognized and addressed in an ADHD/ADD treatment plan.

Are You Really Losing Your Mind?

So, you can’t find your keys, your phone or your glasses…again.  You go into another room and can’t remember why.  At the store you have the feeling that you’ve forgotten something.  You call your grandson three or four other family or pet names before you land on the right one.  Your wife is visibly frustrated because you’ve asked the same question at least twice in the past few days.

Is it age related?  ADD?  What?  As a professional who helps adults with ADD manage their day-to-day lives, I frequently hear comments to the effect “doesn’t everyone have a little ADD?”  The answer to that question is, thankfully, no.  Adults with diagnosed ADD, a serious neuro-genetic disorder of development, struggle every day to keep their jobs, relationships and self-esteem from crumbling, not just on occasion.  In addition to chronically losing their keys and glasses, they wrestle with a multitude of serious cognitive challenges.  The key word is “chronic.”  

Faulty memory or lack of attention?  It’s more likely that you’re suffering from a simple case of “mindlessness”, spacing out or autopilot.  You’re really not paying attention to what’s going on around you.  Being on autopilot allows the brain to preserve mental energy as we perform habits by rote.  For example you come into the house from the car with your arms full from shopping and put everything on the kitchen counter.  Later you need to run an errand.  Where are your keys?  Hanging up, in your pocket, coat, purse, under the bags, in the ignition?  In getting the jumble of bags from the car to the kitchen, it’s likely that you were not paying attention to where you put your keys.  When you finally locate them you do a mental head-slap having remembered putting them “there” for safe-keeping.

Multi-tasking is a wonderful misnomer or myth about being able to do many things at once.  It makes us feel like we’re accomplishing a lot in a short period of time.  Racing around, we feel efficient and productive.  Turns out it’s a real attention-distractor.  In reality we’re shifting our attention really quickly from one activity to another, and really not doing anything well.  Talking on the phone while moving from room to room to pick up clutter, dust or even get a snack is almost a guarantee that you’ll put the phone down for “just a minute” and forget where you left it.

Stress, boredom or lack of sleep can make your forgetfulness seem worse at times.  These issues can cloud your reaction time and clarity of thought.  If focus is difficult it may be that you’re getting too much static (stress) on your brain’s channels.  Take notice of when you feel more scattered.  Are you expecting out-of-town guests who put a lot of pressure on you to entertain them, or are you dealing with aging parents?  Do you have too much spare time and no specific purpose or schedule?  That may lead to a “lazy” brain.  Without the stimulation of daily decision-making and problem solving the brain becomes accustomed to checking out and will be harder to rally when the need arises.  And the biggest contributor to lack of attention or focus is a sleep-deprived brain.  Sleep problems are getting more and more attention as studies reveal the significant negative impact lack of sleep has on adult performance in the areas of memory, learning and focus.  Insomnia, sleep apnea and snoring are all sleep interrupters that should be addressed with your physician.

A simple way to reduce incidents of forgetfulness.  In the last few years the practice of mindfulness has played a greater role in learning how to quiet your mind, side-step distractions, focus on the present and improve your cognitive functioning.  Here are some easy steps for incorporating this tool into your life:

·       Stop in-the-moment and noticing what’s going on around you;

·       Notice what you’re noticing;

·       Pay attention to what and where your attention is going in the moment: when you take your keys out of the car, stop and mindfully notice what you do next with them. Sit for a moment and let it sink in.

·       Do one thing at a time. “When I get out of the car, I will stop and put my keys in my left coat pocket.”

·       Pay close attention to your surroundings, the smells, lighting, temperature in order to jog your memory in multiple ways.  “I remember putting them in my left coat pocket because I recall the smell of the garage.”

·       Carry a small notepad and pen to jot down ideas as they come to mind, or tasks to be addressed.

·       Forget about always trying to retrieve your thoughts at a later date, that’s too much stress.

·       If the weight of your thoughts keeps you from getting or staying asleep, park them in your notepad.  You’ll be taking a mindful step toward holding onto ideas that you can act on if you choose to.

The next time that you find your memory slipping, try practicing mindfulness.  It doesn’t require a class, lots of instruction or an electronic gadget.  It comes from within so it’s free for you to tap into anytime, anywhere.  It’s a great way to train your brain to be more efficient, focused and less stressed.

So Much to Do. So Little Time.

From where I sit as an ADHD Coach, mom and wife of ADHD loved ones.


"I'm working so hard to get through the day, but I don't seem to get anything done.  Furthermore, no one seems to appreciate how busy I am."

"I get a lot of reminders from my boss about deadlines and unfinished projects. When I get home, my wife starts in about stuff that I've promised to do and haven't even started (like paying the bills this month, BEFORE they turn off the cable, again)."

"There just doesn't seem to be enough time."




The idea of being busy, and the evidence of getting timely results are often at odds when ADHD is in the mix. It can be a frustrating mystery to all involved as to why so much time can fly by with so little to show for it. 





Here are some clues:

• Clue #1. With ADHD, preparing to start the task is part of the actual execution. There's the talking about doing the task, the thinking time...thinking about starting the task, then the gathering of materials (sharpened pencils, paper, bills, checkbook, stamps, phone numbers, etc.), the coffee, water, snacks, the right lighting, chair, music, checking email, facebook, and... you get the idea. Whew! Exhaustion, boredom or distraction sets in before the actual task is begun.
• Clue #2. Having moved through the first phase of the task, it's time to actually initiate. Whoa, not so fast. There are plenty of reasons why pulling the trigger on the actual writing of the memo, proposal, presentation, research paper, bill payment, returning calls/emails, laundry, vacuuming, etc. fails to occur. Perfectionism (finding the right words to write), fear of the unknown (something scary might be in those billing envelopes), procrastination (it's not that important that I can't postpone it, or this is so important that I better wait until I can do it right and without interruptions), overwhelm (there's so much to do, I don't know where to start), and/or exhaustion, boredom or distraction. Hmmm. There's a pattern here.
• Clue #3. The chickens come home to roost, aka motivation. At some point in the process, there's an outside motivator that kicks things into action. Notice I said outside motivator. With ADHD the internal motivation driver can be inconsistent or non-existent except in unique circumstances. Someone/something has provoked action, usually in the form of a threat (spouse yelling, guests coming, job deadline, utilities turned off). The task gets done, but not without a lot of churning, stress and energy.

Mystery solved. 

Organize and Declutter Your Home for the Holidays

This article is from the 12.14.12 online issue of ADDitude Magazine.

How adults with attention deficit disorder (ADD ADHD) can organize and decorate the home at holiday time — without getting overwhelmed.

by Kathleen Nadeau, Ph.D.

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The holidays are upon us, and so is the pressure. It’s hard enough to be an adult with attention deficit disorder or a mom with ADHD during the rest of the year, but at holiday time, our stress and anxiety, sometimes triggered by seasonal blues or depression, often increase to the point where we can’t enjoy being with our family because we’re so busy cleaning and preparing for family gatherings or planning a party. Two things to keep in mind:

• You are not Martha Stewart! None of us is.
  
• You are not your mother! A generation or more ago, many women stayed home full-time and didn’t have to carpool their children from one activity to another. Suffice it to say, that era is over.

So instead of feeling overwhelmed this holiday season, get with the program — the one below.

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The Black Bag De-Cluttering Trick

1. In November — and perhaps again in December — set a goal to de-clutter your house in an hour. Supply everyone in the family, including the kids, with black garbage bags and grocery boxes, and have them deposit unwanted or unneeded things into them.
   
2. Use separate bags and/or boxes for each room — label them with masking tape and black marker, so that you know which room the items came from.
   
3. Use boxes to manage paperwork or anything fragile that might be damaged if tossed around in a garbage bag.
   
4. Place the labeled bags in your basement storage area or garage to be retrieved once the holidays are over.
   
5. Make it your New Year’s resolution to organize, give away, or throw away each one of the bagged items.

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Step-by-Step Tips: One Week Countdown

After de-cluttering, break down housecleaning and decorating into doable chunks. Each “chunk” should take no more than an hour to accomplish. Check it off the list when done.

• 7 Days Out: Gather and wash holiday serving plates, bowls, platters, and serving utensils for the big feast.
  
• 6 Days Out: Make room in the fridge for holiday dishes.
  
• 5 Days Out: Wash sheets, towels, and face cloths that guests will need. Stack them in the bedroom where they’ll be used.
  
• 4 Days Out: Vacuum and dust upstairs (the upstairs carpets won’t have time to get dirty again); dust main level.
  
• 3 Days Out: Clean all bathrooms. Start with the one that guests will use (do the master bathroom last).
  
• 2 Days Out: Vacuum and dust downstairs; clean kitchen (you’ll do a last-minute cleanup on the holiday).
  
• 1 Day Out: Empty trash baskets. Do a last-minute de-cluttering trip through the house with a black garbage bag.

Before company arrives, vacuum the main level and damp-mop the kitchen floor (save this for last, just before your guests arrive).

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Holiday Time Savers

1. Don’t waste precious time ironing a wrinkled tablecloth—throw it in the dryer, then shake out the wrinkles and put it on the table.
   
2. To provide instant ambiance, buy several pots of poinsettias and place them in the entry hall, living and dining rooms, and the guest bathroom. Arrange plain white pillar candles (they’re less likely to drip or tip over than tapers in candlesticks) on clear or holiday-colored plastic dessert plates. Don’t forget to arrange them around the fireplace, in the hall, and in the powder room.
   
3. Instead of wiping down a dirty oven, just clean the door with oven cleaner (after all, that’s what most people will see). Then line the bottom with fresh aluminum foil.
   
4. When company arrives unannounced, create a festive atmosphere by sticking one of those fragrant plug-ins into an outlet, lighting candles, and putting on a favorite CD of holiday tunes.

The four big sleep issues with AD/HD

This article comes from the February/March 2004 issue of ADDitude.

No scientific literature on insomnia lists ADHD as a prominent cause of sleep disturbances. Most articles focus on sleep disturbance due to stimulant-class medications, rather than looking at ADHD as the cause. Yet adults with ADHD know that the connection between their condition and sleep problems is real. Sufferers often call it "perverse sleep"—when they want to be asleep, they are awake; when they want to be awake, they are asleep.

The four most common sleep disturbances associated with ADHD are:

1. Initiation Insomnia
About three-fourths of all adults with ADHD report inability to "shut off my mind so I can fall asleep at night." Many describe themselves as "night owls" who get a burst of energy when the sun goes down. Others report that they feel tired throughout the day, but as soon as the head hits the pillow, the mind clicks on. Their thoughts jump or bounce from one worry to another. Unfortunately, many of these adults describe their thoughts as "racing," prompting a misdiagnosis of bipolar mood disorder, when this is nothing more than the mental restlessness of ADHD.

Prior to puberty, 10 to 15 percent of children with ADHD have trouble getting to sleep. This is twice the rate found in children and adolescents who do not have ADHD. This number dramatically increases with age: 50 percent of children with ADHD have difficulty falling asleep almost every night by age 12 ½ by age 30, more than 70 percent of adults with ADHD report that they spend more than one hour trying to fall asleep at night.

2. Restless Sleep
When individuals with ADHD finally fall asleep, their sleep is restless. They toss and turn. They awaken at any noise in the house. They are so fitful that bed partners often choose to sleep in another bed. They often awake to find the bed torn apart and covers kicked onto the floor. Sleep is not refreshing and they awaken as tired as when they went to bed.

3. Difficulty Waking
More than 80 percent of adults with ADHD in my practice report multiple awakenings until about 4 a.m. Then they fall into "the sleep of the dead," from which they have extreme difficulty rousing themselves.

They sleep through two or three alarms, as well as the attempts of family members to get them out of bed. ADHD sleepers are commonly irritable, even combative, when roused before they are ready. Many of them say they are not fully alert until noon.

4. Intrusive Sleep
Paul Wender, M.D., a 30-year veteran ADHD researcher, relates ADHD to interest-based performance. As long as persons with ADHD were interested in or challenged by what they were doing, they did not demonstrate symptoms of the disorder. (This phenomenon is called hyperfocus by some, and is often considered to be an ADHD pattern.) If, on the other hand, an individual with ADHD loses interest in an activity, his nervous system disengages, in search of something more interesting. Sometimes this disengagement is so abrupt as to induce sudden extreme drowsiness, even to the point of falling asleep.

Marian Sigurdson, Ph.D., an expert on electroencephalography (EEG) findings in ADHD, reports that brain wave tracings at this time show a sudden intrusion of theta waves into the alpha and beta rhythms of alertness. We all have seen "theta wave intrusion," in the student in the back of the classroom who suddenly crashes to the floor, having "fallen asleep." This was probably someone with ADHD who was losing consciousness due to boredom rather than falling asleep. This syndrome is life-threatening if it occurs while driving, and it is often induced by long-distance driving on straight, monotonous roads. Often this condition is misdiagnosed as "EEG negative narcolepsy." The extent of incidence of intrusive "sleep" is not known, because it occurs only under certain conditions that are hard to reproduce in a laboratory.