Meeting Your Goals When You Have ADHD

Meeting Your Goals When You Have ADHDAs someone with attention deficit hyperactivity disorder (ADHD), you probably know all too well the difficulty of accomplishing your goals. It can seem utterly daunting.

That’s because realizing goals taxes the executive functions in your brain, said Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School. These functions include everything from organizing to prioritizing to making decisions to managing time, he said.

Tedious tasks are especially tough. “Laundry, paying bills, attending business meetings — things that are not intrinsically interesting can put an adult with ADD into a tailspin of inaction,” said Terry Matlen, ACSW, a psychotherapist and author of Survival Tips for Women with AD/HD.

Lack of reward with long-term goals adds to the challenge.

“ADHD brains are low in dopamine, a neurotransmitter associated with reward, arousal and motivation. Because of this, ADHD brains are starving for instant stimulation and reward,” Olivardia said.

It can seem like the odds are stacked against you in meeting your goals. But while accomplishing goals might be more challenging if you have ADHD, the key is to find the best strategies for you.

That’s what Matlen and Olivardia have done. In addition to being successful practitioners and seasoned experts in ADHD, both Matlen and Olivardia have ADHD. Here, they share insights to help you accomplish your goals.

1. Brainstorm backward. First, write down your final goal, Matlen said, “then go backward from there, and write down [all] the steps needed to accomplish the goal.” While it might seem silly, do this for seemingly straightforward tasks, too, she said. Take laundry, for instance. It’s boring and repetitive, has many steps and no one pats you on the back when you’re finished, she said.

Matlen suggested breaking it down like this: Write down, “Do family laundry.” Next, write out each step, such as:

  1. Pick up laundry from every room, and put it in the basket.

  2. Take baskets to laundry room.
  3. Sort lights and darks.
  4. Sort cold water and warm water. And so on.

Write this list on a poster, and paste it in your laundry area. As Matlen said, writing out specific steps gives your brain a roadmap to follow.

Splitting your goals into steps also helps you realize that success is within reach. When you’re working on a big project, it can feel demoralizing to realize that you haven’t finished it yet, Olivardia said. But when you break your goal into steps, you’re able to say, “I completed 4 out of 10 steps,” he said.

2. Reward yourself for every step. “People with ADHD have a higher degree of motivation if they get rewards along the way,” Olivardia said. So consider how you can reward yourself for every step accomplished.

3. Just do it. People with ADHD struggle with procrastination, which becomes especially problematic when you think you need to be motivated to get started. You don’t, Olivardia said. “In fact, getting started can get you motivated,” he said. (Here’s more tips on getting motivated when you have ADHD.)

4. Set a timer for one hour. “Time is an amorphous concept to those with ADHD,” Olivardia said. Setting a timer gives you “concrete parameters to work from,” he said. Plus, after the hour, you might even want to do more work, he added.

5. Focus on the end feeling. Visualize yourself finishing the project – and how great you’ll feel once you do, according to both experts. “Sometimes we focus too much on the actual task, rather than how it will make us feel when it’s completed,” Matlen said. Focus, for instance, on how good you’ll feel after paying your taxes, she said.

“Since ADHD-ers can lose a sense of urgency or excitement around a task easily, you may need to keep that alive in your imagination,” Olivardia said.

6. Focus on self-care. Whenever people with ADHD hyper-focus on a task, they ditch healthy self-care, such as getting enough sleep or even drinking enough water, Olivardia said. You worry that stopping will sabotage your progress, he said. “However, being tired and hungry are the very things that will guarantee that you will lose steam,” he said. So make sure you’re taking care of your bare essentials, including sleeping and eating well.

7. Take breaks. If you’re getting distracted easily – also common in ADHD – Olivardia suggested taking a complete break for 10 minutes. Then return to your task.

8. Work with a partner. Partnering up is especially helpful for tedious tasks, Matlen said. “If bill paying is a horrifying experience, set up a time each month with a friend and do it together,” she said.

Having a friend who keeps you accountable for your goal also helps, Olivardia said. “Sometimes just knowing that you will be reporting your progress — or lack of progress — can provide you with the sense of focus to stick with it,” he said.

9. Get creative. Think of how you can make meeting your goals a more enjoyable or interesting experience. For instance, play music when you’re cleaning your house or use colorful stickers for filing, Matlen said.

10. Get help. Hiring outside help doesn’t just help you meet your goal; it might even save you money. For instance, if you hire a bookkeeper to pay your bills and balance your account once a month, you’ll likely save money on bank and other late fees in the long run, Matlen said.

11. Don’t assume that you can’t accomplish goals.  “Most importantly, never assume that you are not meant to accomplish great things because you have ADHD,” Olivardia said. “It can feel that way because you know that you are executing goals in a different manner from your non-ADHD counterparts,” he explained. But there’s nothing wrong with using a different strategy.

One size never fits all. The key is to find specific tactics that work well for you. And, again, don’t forget that even though meeting your goals might be challenging, as Olivardia said, you can absolutely accomplish great things.

USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health Concerns

USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health ConcernsUSA Today on Thursday published an editorial hopefully entitled, Editorial: Fix broken mental health system. Which would be fine as a stand-alone piece advocating more money, focus and resources for our nation’s patchwork system of mental health and recovery care.

Instead, they — like many well-meaning but apparently brain-dead newspapers — tie the need to fix our mental health care system — something others have been advocating for for decades — to recent headline-news grabbing acts of atrocious violence.

Only buried in this hypocritical, two-faced gutter-piece editorial do you find the truth — “Only the tiniest fraction of the mentally ill ever become violent, and then, usually when they fail to get treatment.” It’s even worse than that — statistically speaking, mental illness is a horrible predictor of violence, and nobody who’s read the research would ever suggest otherwise.

I have no problem with you advocating to help people with mental health concerns. I have a big problem if you’re doing so because of violence in America. The two have little to no connection with one another.

People let to get all riled up and angry when something tragic occurs. It’s one way many of us cope and try to figure out such events. But when we respond to tragic events with action, we’re likely to do so in a way that makes little sense in the overall, broader picture.

The fact is people with mental health conditions are no more likely to be violent than is the general population.
~ Wayne Lindstrom

For instance, every year in America, over 12,000 people a year are murdered — most by some sort of gun. Nobody gets upset at that huge number, or that 30,000+ people a year who take their own lives.

Instead, the thing that USA Today wants us to get motivated by are these horrific acts of violence that barely read in the overall number of deaths per year due to gun violence. USA Today doesn’t seem to care about the 30,000+ people each year who, because of untreated depression or other mental health concerns, choose to end their lives.1

Wayne Lindstrom, the CEO of Mental Health America, on the other hand, gets it right in his response to the crummy piece of what passes for “insightful opinion” at USA Today:

The premise that we can predict or prevent violent acts is unsupported. Even in the case of severe mental illnesses, mental health professionals possess no special knowledge or ability to predict future behavior.

The fact is people with mental health conditions are no more likely to be violent than is the general population. Continuing to link violence and mental illness only stigmatizes people and deters them from seeking care.

We whole-heartedly share and endorse these words. We stand proudly with Mental Health America and other organizations who’ve read the research and know that linking mental illness to violence is like linking terrorism to a specific religion — it’s a feel good strategy imbeciles do to make themselves feel better.

USA Today rues the good ole days, when we could lock up anyone society disagreed with or didn’t like the looks of in a mental hospital (nowadays referred to an inpatient psychiatric hospital): “Many states have become so strict that it is almost impossible to get people committed until they are in deep crisis, or try to commit suicide or harm someone.” Awww, what a shame — we actually have a reasonable, humane standard before trying to take someone’s freedom away from them.

USA Today should be ashamed of itself for publishing an editorial that only reinforces the discrimination, stigma and prejudice against people with mental health concerns. They continue to spread misinformation about the link between mental illness and violence,2 and suggest we have some sort of magical powers of foresight that would allow us to predict these kinds of incidents with such accuracy, it would be like the science-fiction story, “Minority Report” (we don’t have such magical powers, sorry).

 

USA Today crap editorial: Editorial: Fix broken mental health system

Wayne Lindstrom’s response: Opposing view: Don’t link violence with mental illness

Footnotes:

  1. Worse, they cite the example of Seung-Hui Cho — who actually had contact with mental health professionals!
  2. There really isn’t much of one, according to you know, the actual research.

Is Distance Treatment the Wave of the Future?

With advances in technology, distance learning on college campuses has exploded over the last decade.  And as time passes, the mental health community is taking note.

Students want to study when they want and how they want.  Distance learning makes education available to those who wouldn’t otherwise be able to get off of work, travel to class or spend hours in lectures.  

That same increase in convenience and availability could have a real impact for people seeking psychological treatment. Is distance treatment ready to take off?

People who must maintain jobs, care for children or aging parents, don’t have cars or access to public transportation or want to learn material that is not offered where they live can all benefit from distance learning. These are often the same reasons people struggle to access mental health services.

And there is a large body of research that suggests distance learning and traditional classroom learning provide the same quality of education. Distance learning is no longer considered a sub-standard educational option.

So, how can these benefits apply to receiving psychological treatment?

Treatment available online or at a distance could certainly help people with difficulties in getting to therapy sessions and incorporating treatment into a busy lifestyle. It would also enable people to access specific treatment modalities not otherwise available to them.

And, according to the American Psychological Association, psychologists have begun using electronic communication such as email, Skype and various forms of videoconferencing to augment treatment. But, while technology surges ahead, licensing laws and guidelines for providing safe and ethical distance treatment are still catching up.

A recent article reporting on the use of phone therapy in Monitor on Psychology suggests that talking on the phone with a therapist can provide the same, or even better, results for some.

In this study, conducted by University of Cambridge researchers, British adults with mild and moderate depression and anxiety disorders who received cognitive behavioral-based therapy via the phone benefited as much, if not more, than those who received face-to-face therapy. Those with severe symptoms did not see the same results.

This study also found that telephone therapy was less expensive than traditional therapy and was conducted as part of a national initiative in Britain aimed at increasing people’s access to therapy.

The telephone is only one of many options for providing distance treatment. The number of mental health tools available is rapidly increasing. And many in the field agree that it’s time for practitioners to embrace technology and what it has to offer in delivering interventions.

One-on-one treatment cannot be replaced.  Nor should it.  However, the need for treatment providers to meet the changing and growing mental health needs of the population has caused the ΑΡΑ Insurance Trust and the Association of State and Provincial Psychology Boards to launch a task force to develop guidelines for tele-psychology practice.

So what are some of the alternatives to one-on-one therapy?  According to a cover story in the APA Monitor they include the following:

  • Behavioral intervention technologies, such as those that deliver care via the Internet or mobile phones
  • Computer programs for depression and other disorders, which typically teach principles of cognitιve-behavioral therapy or some other evidence-based treatment

Although these treatment options are appealing and there is a growing body of research to suggest that many are effective, it is important to proceed with caution.  It is essential to ensure that individuals get the right treatment and that treatments offered have been studied and found effective.

13 Healthy Ways to Comfort Yourself

13 Healthy Ways to Comfort YourselfWhenever you’re anxious, sad or overwhelmed or simply need some soothing, it helps to have a collection of comforting — and healthy — tools to turn to.

But some calming activities don’t work for everyone.

For instance, some people are allergic to bath salts, while others can’t drink herbal tea because of possible drug interactions (e.g., blood thinners). Many of us also can’t afford manicures or massages. And most of us are pressed for time.

So we asked three experts for their take on how readers can truly soothe their minds and bodies without needing more money, time or anything else, for that matter. Below are 13 strategies anyone can use to comfort themselves when they’re having a bad day.

1. Stretch your body.

Anxiety tends to hijack the body. While everyone stores anxiety in different spots, common areas are the jaw, hips and shoulders, according to Anna Guest-Jelley, a body empowerment educator, yoga teacher and founder of Curvy Yoga. She suggested standing up and doing a full-body stretch. “Reach your arms overhead then slowly fold forward [and] slowly open and close your mouth as you do.”

2.Take a shower.

Taking a shower after a rough day always makes Darlene Mininni, Ph.D, MPH, author of The Emotional Toolkit, feel better. And she’s certainly not alone. Now research is illuminating why cleansing may wash away our woes.

Mininni cited this interesting review, which notes “a growing body of research suggests…after people cleanse themselves, they feel less guilty about their past moral transgressions, less conflicted about recent decisions, and are less influenced by recent streaks of good or bad luck.”

3. Visualize a peaceful image.

The image you pick can be anything from the sun to ocean waves to a furry friend, Guest-Jelley said. She suggested combining the visualization with breath, and repeating the sequence several times. As you inhale and reach your arms out in front of you, hold the image in your mind, she said. Then exhale and bring both hands to your heart, all the while thinking of the image, she said.

4. Speak compassionately to yourself.

Being self-compassionate boosts mental health, Mininni said. (Some research even suggests that it helps you reach your goals.) This means extending yourself some kindness as you would to a good friend, she said.

Unfortunately, being self-compassionate doesn’t come naturally to many of us. Fortunately, you can learn to treat yourself with consideration and care. Here are some ideas on being kinder to yourself and cultivating self-compassion.

5. Reach out.

Reach out to people you trust to support you. “We are wired to connect with others and to comfort each other through emotional and physical connection,” said Julie Hanks, LCSW, a therapist and blogger at Psych Central.

6. Ground yourself.

When stress strikes, some people feel lightheaded or like they’re floating outside their bodies, Guest-Jelley said. Making a point to feel your feet against the ground can help, she said. “Grounding your feet can bring you back into your body and help you navigate what you want to do next,” she said. “Visualize thick roots growing down from your feet into the center of the Earth, rooting you and giving you a firm foundation.”

7. Listen to soothing music.

“Create a playlist of soothing songs that help you to slow down or connect with memories or positive experiences,” Hanks said. We’ve mentioned before the benefits of listening to calming music. Pairing soothing tunes with deep breathing helps, too, according to one study, which found it lowered blood pressure.

8. Practice mindfulness.

To practice mindfulness, “You don’t need to sit like a pretzel,” Mininni said. Simply focus on what you’re doing right now, whether that’s washing the dishes, walking to your car or sitting at your desk, she said. Pay attention to the sights, scents and sounds surrounding you, she said.

For instance, if you’re washing the dishes, focus on the scent of the soap and the hot water cascading from the faucet and onto your hands, she said.

Mininni applies mindfulness to her feelings. In the moment, she asks herself what her emotion feels like. Doing this actually allows her to detach from her feelings and thoughts and simply observe them as if she were watching a movie. This helps you get out of your head and into your body, she said.

9. Move your body.

According to Hanks, “If you’re feeling tempted to engage in self-destructive behavior to calm down, engage in something positive and active, like exercise or playing a physical game.”

10. Picture the positive.

When we’re anticipating a potentially stressful situation, we start thinking of all the different ways it can go wrong. Again, you can use visualization to your advantage. “To pull yourself out of [an] internal dramalogue, try imagining the situation going well,” Guest-Jelley said. “Feel what you want to feel in the moment and see yourself disengaging from tricky conversations [and] situations,” she said.

11. Zoom out.

Look at the situation or stressor from a bigger perspective, Hanks said. “When you’re in the moment, current challenges seem enormous, but placing your situation into the ‘bigger picture’ of your life may help you realize that you may not need to give it so much emotional energy,” she said.

For instance, she suggested asking yourself: “Will this matter in one year? In fie years? When I reach the end of my life, how important will this situation be in retrospect?”

12. Practice alternate nostril breathing.

Breathing techniques are an instant way to soothe your body. Taking deep, slow breaths tells your brain that everything is OK, which then calms the rest of the body. Guest-Jelley suggested going through this series:

  • Using your dominant hand, “make a U-shape with your thumb and pointer finger.
  • If you’re using your right hand, press your right thumb into your right nostril, gently closing it. Inhale through your left nostril.
  • Next, press your right index finger against your left nostril, closing it, as you release your thumb from the right nostril – allowing yourself to exhale through the right nostril.
  • Repeat by inhaling through the right nostril, then closing it and exhaling through the left nostril.
  • Continue like this for at least 10 full breaths.”

13. Let yourself feel bad.

Remember that you don’t have to fix your feelings right away. It’s important to have a toolbox of healthy strategies to turn to at any time. But don’t feel guilty for feeling bad or fault yourself if you aren’t seeing rainbows and unicorns.

Mininni stressed the importance of giving yourself permission to acknowledge and honor your feelings and stay with them. “Sometimes it’s OK to just say I’m having a really crappy day,” she said.

Plus, “Feelings have a purpose,” she said. They send us important messages that something isn’t quite right, she said. When you’re ready to feel better, then reach for a healthy strategy, she said.

The Strange & Surprising Science of Sleep

The Strange & Surprising Science of SleepIn his book Dreamland: Adventures in the Strange Science of Sleep, author David K. Randall calls sleep “one of the dirty little secrets of science.” That’s because despite spending almost a third of our lives sleeping, we don’t really know much about the process of sleep.

In fact, Randall, a senior reporter at Reuters, notes that sleep is one of the youngest fields in science. Until the 1950s, researchers believed that our brains remained quiet during slumber.

But the discovery of the stages of sleep shattered this perspective. For instance, our brains are just as active in REM sleep — aptly named rapid eye movement because our eyes shift rapidly against our lids — as they are when we’re awake.

In Dreamland, Randall shares a slew of these fascinating, surprising and eye-opening facts, anecdotes and research studies. These are a few curious tidbits from his book.

Our Normal Sleep Isn’t So Normal

Today, we think that sleeping through the night is a sign of normal and healthy slumber. In fact, people who wake up around the same time every night think their sleep is fractured — and that something is wrong, Randall writes. And when they complain about this concern to their doctors, they probably walk away with a sleeping pill, he says.

But segmented sleep has actually been the norm for thousands of years — that is, until the advent of artificial lighting. In the 1980s and ‘90s, history professor Roger Ekirch began seeing interesting patterns in his book collection, which included tales and medical texts: references to “first sleep” and “second sleep.”

Psychiatrist Thomas Wehr also began seeing strange results in his sleep experiment: After participants, who were deprived of artificial light for up to 14 hours, caught up on their sleep and felt more rested, they’d wake up around midnight and lie awake for about an hour, and then fall asleep.

In another study, Wehr found that during that hour awake the brains of participants were churning out higher levels of prolactin. This hormone reduces stress and relaxes the body after orgasm, according to Randall.

Before Thomas Edison invented the light bulb, people would fall asleep after sunset. Then they’d naturally wake up around midnight for about an hour. During that time individuals might do anything from praying to reading to having sex. Then they’d naturally fall back asleep until morning.

Randall notes that other studies have confirmed that people naturally experience segmented sleep. And in areas with no artificial light, people still experience first and second sleep.

Naps Get a Bad Rap

In our society, naps are viewed as luxurious activities only reserved for the privileged or the lazy. That’s a shame, because research continues to show the benefits of naps and discredit these beliefs.

One study found that astronauts who slept for just 15 minutes had better cognitive performance, even when there was no boost in their alertness or ability to pay attention.

Another study found that participants who napped and experienced the deeper stages of sleep had more flexible thinking. They were able to apply information they memorized to a new task much better than participants who watched a movie instead of napping.

Randall also notes that participants who take naps outperform their counterparts who aren’t allowed to doze off on other various tasks. For instance, research has found that they’re able to finish mazes faster and remember longer lists of words.

Big companies have even made naps part of their workday. According to Randall, Google and Nike are just some of the companies that have created specific spaces for their workers to sleep. “The idea is that naps may allow engineers and designers to arrive at creative solutions more quickly than they would by staying awake all day,” he writes.

In Dreamland Randall explores many more peculiar issues surrounding sleep, from the purpose of dreams to the bizarre world of sleepwalking and “sleep crime.”

While sleep research is in its infancy, one fact is undeniable: Sleep is vital for everything from our survival to our success.

When functioning optimally, sleep can sharpen our thinking and help us problem solve (like golfer Jack Nicklaus did when he figured out how to tweak his swing in his sleep). When gone wrong – as in cases of sleepwalking and sleep deprivation – it can distort our cognitive skills, sink our mood and even make us dangerous.

As Randall notes, “Sleep isn’t a break from our lives. It’s the missing third of the puzzle of what it means to be living.”

 

Woman sleeping photo available from Shutterstock

Responsibility for Treatment Compliance

Responsibility for Treatment ComplianceOne of the most difficult challenges to overcome when dealing with a mental illness is the temptation of the excuse.

With a psychiatric diagnosis comes an excuse for everything. Any bad behavior, lack of motivation, or failure can be passed off as a symptom or the result of an episode. The excuse is always available. Don’t take it.

No one’s asking you to take responsibility for having a mental illness. That’s not your fault.

But you have to take responsibility for your actions and for your recovery. Sure, unexpected things happen as a result of serious mental illness, but most of our behavior is within our control, or at least our influence. And the behavior that most influences our wellness is treatment compliance.

If you have a treatment regimen that works, stick with it. If you had one and left it, get back on it.

While many of us bemoan the fact that we’ll never be well, treatment success rates for mental illness are very high. The National Institute of Mental Health has shown success rate of treatment for schizophrenia of 60 percent, depression, 70 to 80 percent, and panic disorder, 70 to 90 percent.

Compare this to treatment success rates for heart disease of only 45 to 50 percent. But treatment only works if the patient complies with the doctor’s orders. So take your medicine as directed, stay away from non-prescribed drugs and alcohol, exercise, sleep, and eat well. Manage stress. Chances are you will get better. But you’ll lose your excuse. Then you’ll have to start taking responsibility for your actions.

Responsibility brings a sense of control. This is important because one who feels he has control over key aspects of his life is most destined for success and well-being. If all things that happen to me, or if my very own behavior, is beyond my control, why should I bother?

But if prescribed treatment brings me a measure of control over events and my behavior, then I can positively influence what happens to me and those I love. I’ll have to get out of bed, get off the disability insurance, go to work, and suffer the challenges that everyone faces. Life may even be a bit more boring. But I can contribute, connect with others, and work toward dreams I may have long ago abandoned. Yes, this can be very hard. I may have to deal with side effects and limitations. I may have to say no when I want to say yes. And compliance can be costly. But wellness is possible.

Unfortunately, access to treatment is not available to everyone. Finding a correct diagnosis and a successful treatment regimen can take years.

But if you have access to treatment, you have a responsibility to work with doctors, counselors, social workers, and any family and friends available to help you to find a successful treatment regimen. And then you have a responsibility to stick with it. Health can be more challenging than illness, but the life that results is always more satisfying.

 

Running shoe photo available from Shutterstock