Tuesday, June 30, 2015

ADHD: Don’t Like the Name? There's Still Hope!

by Jeff Copper, PCC, PCAC, MBA

People seeking an ADHD diagnosis often ask, “Can’t they change the name?” Others find the term ADHD so off-putting that they refuse an evaluation, even when life isn’t working very well.

Authorities on ADHD understand completely. After all, they became ADHD professionals to help people. But could there be reasons to keep the name intact? Let’s take a closer look.

Look up the word “deficit” in the dictionary and you’ll find definitions that include phrases like “falls short,” “a disadvantage,” “a loss,” “a lack.” Look up “disorder” and you'll find phrases like “lack of,” “irregularity,” “a disturbance.” “Deficit” and “disorder” make up half to two-thirds of the labels “attention deficit disorder” and “attention deficit hyperactivity disorder.”

How negative can you get? Both terms bully the mind of the innocent and ignorant away from hope and toward despair. They blind people to hope and possibility and suggest giving up.

Hope inspires; it propels and ignites. Despair victimizes and disempowers. So, why don't we change the label? Why not pick a new name? Simple solution, right? Wrong!

Dr. Russell Barkley’s executive function deficit disorder construct focuses on ADHD as a self-regulation issue and not so much as strictly a deficit of attention. In an interview with Dr. Barkley on Attention Talk Radio, I asked him, “Why not change the ADHD label, just change the name?” He responded:

Well, I doubt that it will be changed. I know in DSM-5 it won’t, but there’s a very practical reason for that. It’s not because science hasn’t shown this isn’t an executive disorder. It is.

It’s that the term “ADHD” appears in so many laws and regulations and rulings and protections and in schools and in the Americans with Disabilities Act and in the IDEA [Individuals with Disabilities Education Act], the Social Security Administration, that if you change the name of a disorder those laws don’t apply any more to the people with the new name, and you can disenfranchise them from a lot of these hard-won protections and the civil liberties and the entitlements they’ve won over the last twenty years. So, we don’t change names of disorders too quickly, because we know that there are legal, political, and just practical side effects from doing so, and we don’t want to be too cavalier about that.

I have to admit this wasn’t the answer I was looking for, but his argument has merit. While the Americans with Disabilities Act doesn’t have a Rosa Parks-like figurehead, this was a major effort by many individuals, some of whom faced personal hardships to move this forward. The protections, civil liberties, and entitlements hard-won over the last twenty years have changed lives! They have enabled countless individuals with ADHD to live fulfilling lives more easily.

If you are affected by ADHD you are being asked to “take one for the team” and to make a sacrifice for the greater good by accepting this name. Most likely ADHD has caused you or your child some inconvenience. Will one more inconvenience be that much of a bother, if it would “un-do” protections put in place for those with ADHD?

In the end, we don’t despair over the ADHD label, for there is hope. There is hope for a better tomorrow in the ADHD community.

We’ve come a long way... even though we aren’t so thrilled with the name!

This post originally appeared in Attention magazine. Join CHADD and receive every issue!
Join the conversation about adult ADHD on Attention connection, your social network for all things ADHD!

A certified ADHD and attention coach based in Tampa, Florida, Jeff Copper, PCC, PCAC, MBA, specializes in coaching adult individuals and entrepreneurs who have been diagnosed with ADHD later in life. He is the host of Attention Talk Radio and Attention Talk Video. Learn more at digcoaching.com.

Tuesday, June 16, 2015

Breezing into Summer, Part Two: Get into Vacation Mode

guest blog by Terry Matlen, MSW, ACSW

Last week's blog talked about transitioning into your summer routine at work. But summer also means family vacations, which are supposed to be relaxing. Camping trips, beach outings, a week in the woods... it’s something you dream about all year, and as the time draws near, you’re practically jumping out of your skin, raring to get out of the rat race and into your bathing suit. But jumping out of your daily routine into vacation mode can literally make you feel like a fish out of water.

Adults with ADHD have a notoriously difficult time dealing with transitions, even good ones. Going on vacation means switching out of work mode to days of nonstructured, free time. At work, you typically know what’s expected of you, and at home, you and your partner keep the whole family on schedule and manage all the details of daily life. When you’re on vacation, you’re still to trying to “manage”—but without the routine—and the change can be unnerving. What time should you wake up? When do you eat lunch? What do you do with all your free time? Read? Hike? Swim? Your hyperactive brain is searching, but it no longer has a road map to guide you.

Transitioning from work to play can be difficult for anybody, but for the adult with ADHD, the initial feelings of being lost can be more intense, and the adjustment period is often longer. It’s ironic how the one thing you crave—time off—can actually backfire and cause you stress whether you have inattentive ADHD (body in slow motion/brain in overdrive) or hyperactive ADHD (brain and body in overdrive). If you struggle with hyperactivity, relaxing might not be part of your makeup. When you’re used to full days at home and at work, and then suddenly find that there are no demands, no places to go, no one to answer to, and you’re suddenly “doing nothing” (such as reading or strolling the beach), it can feel like stepping off a cliff into a gaping void. The change is that drastic. This “free falling” can kick off some serious anxiety and/or depression.

Your ADHD brain needs to focus on something. It craves stimulation. If you’re an inattentive type, you may go more inward, but you still need something to focus on outwardly, like writing, painting or some other quiet activity. If it doesn’t find some sort of focus, it can succumb to negative thinking, such as ruminating, worrying, or obsessing.

Then just as you’ve settled into vacation bliss, it’s time to transition back to work and home, thereby stirring up the anxiety pot again. It seems that you just can’t win. The good news is that there are a few things you can do to help make your transition into summer go more smoothly.

Tips for transitioning into summer vacation

Here are some suggestions to help you ease into your summer vacation.

•    Be sure your vacation matches your temperament. If you are drawn to excitement, go for high-adrenaline activities. If you crave solitude and tranquility, consider peaceful surroundings with quiet activities. Try to balance your active time versus kick-back time.
•    If possible, plan ahead so that you don’t have a massive heap of work waiting for you when you return to work. This might mean taking on a bit more work before heading off on vacation.
•    Remember that though you’ve left your home and work behind, you’re still traveling with your ADHD brain. You need to take into account that change can be difficult. Few adults with ADHD will admit that taking vacations can sometimes cause more stress than staying at home: There’s the planning, packing, traveling, settling in... all things that may be difficult. There’s the expectation that you are going on vacation to have fun, so when you find yourself struggling to switch out of work mode into vacation mode, don’t beat yourself up. Be patient and give it some time.
•    Plan ahead. Before heading out to your destination, make a list of things you’d like to do once you arrive. This added structure will prevent you from letting the days fly by without a plan and will help minimize potential anxiety and/or depression. Be sure to include downtime in your schedule!
•    Acknowledge that it may take you more time than it takes others to transition. Let your body gradually get used to the time and rhythm change.
•    Try to keep certain things consistent, like sleep schedules and mealtimes. These can be your constants to help keep you grounded.
•    Build in other routines throughout the day, such as a walk after lunch.
•    Coming home is yet another transition, so be easy on yourself. Upon returning home after vacation, ease back into it. Don’t plan any big events or important meetings as soon as you return. Allow yourself to gradually get back into your routine the first few days back home.

Following these tips should ensure an easy transition to and from vacation so that you can enjoy your time off to the fullest.

A longer version of this post appeared in the June 2014 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about managing adult ADHD on Attention connection, your social network for all things ADHD!

Terry Matlen, MSW, ACSW, is a psychotherapist, consultant, and writer, specializing in ADHD. She is the author of Survival Tips for Women with ADHD: Beyond Piles, Palms and Post-Its and The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done and the founder and president of the popular website, ADDconsults.com. A nationally recognized speaker on ADHD, she is immediate past coordinator of the Eastern Oakland County CHADD chapter in Michigan.

Tuesday, June 9, 2015

Breezing into Summer, Part One: Easing the Transition at Work

guest blog by Terry Matlen, MSW, ACSW

 Summertime, and the livin' is easy... or is it? One would think that a slower pace at work, while bosses and coworkers are taking their vacations or enjoying long weekends at the beach, would be just what the doctor ordered for the stressed-out adult with ADHD. Less chaos and office politics to deal with, a quieter environment, a slower pace, right? But for many, transitioning into the slow, quiet summer days at work or taking off on family vacations doesn’t always equate with “easy” and often causes more anxiety, not less. How can that be? There are a number of reasons for this.

As an adult with ADHD, you may need the energy from those around you to help you stay charged, attentive and on track. It can be extremely difficult to stay focused on work-related projects and meet important deadlines without the routine and stimulus of having colleagues around you. Knowing your boss or supervisor is in close proximity and/or checking on your progress can help provide the accountability you need to keep plugging away until the job is done. But when the boss is away, the mice will play. Your ADHD brain needs structure and external expectations to hold you steady.

No two people with ADHD look the same or have the exact same symptoms. The person with the hyperactivity component might struggle more when things are too quiet and calm, whereas the person with the inattentive type of ADHD might find the calmness around her helpful in getting more work done, but there’s still that need for accountability. Not having that stabilizing force around can leave you feeling lost at sea.

Though most people without ADHD jump at the chance to slow down during the summer, either at work or by going on vacation, it’s not always easy for the adult with ADHD. Changing routines is often difficult, in general, and summertime is no different. Recognize that you will need to prepare ahead of time for these transitions so that you can maintain your productivity at work or enjoy a happy, carefree vacation.

Tips for transitioning into summer at work

Here are some suggestions to help you ease into your summer routine at work.

•    If your boss or supervisor is ready to head out on vacation, clarify with him/her what is expected of you while s/he’s gone. If there are upcoming projects with deadlines, mark them in your planner.
•    Make a visual schedule to give you additional structure. Post it where you can see it throughout the day.
•    Use a checklist system to give yourself immediate positive reinforcement for tasks completed.
•    Utilize electronic reminders to help you stay on track. Smartphones have beepers and messages you can program. Computers have software programs to help you stay on task.
•    If you’re comfortable, buddy up with a coworker who can help you stay accountable.
•    Schedule in physical activity such as taking a brisk walk three times a day.
•    Use this time to get out and make new contacts or sales. Plan ahead to attend conferences, do on-site visits, networking events, and/or other activities that are structured and will enable you to interact with other people.
•    Turn off the sound indicator ("ping") on your email and the ringer on your phone to cut back on distractions.
•    Set specific times of the day to read email, such as morning, just after lunch, and at the end of the day so you don’t get lost in the email/Internet abyss.
•    Use a timer for tasks and give yourself a reward when you finish a task, such as taking a walk to the water cooler or having a short chat with a coworker. Just be sure that you don’t become a source of distraction for others in your efforts to keep yourself stimulated!

A sudden change in the surrounding workflow can be unsettling to say the least, but planning ahead and feeling prepared can make all the difference.

NEXT WEEK: Tips for Transitioning into Your Summer Vacation

A longer version of this post appeared in the June 2014 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about managing adult ADHD on Attention connection, your social network for all things ADHD!

Terry Matlen, MSW, ACSW, is a psychotherapist, consultant, and writer, specializing in ADHD. She is the author of Survival Tips for Women with ADHD: Beyond Piles, Palms and Post-Its and The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done and the founder and president of the popular website, ADDconsults.com. A nationally recognized speaker on ADHD, she is immediate past coordinator of the Eastern Oakland County CHADD chapter in Michigan.

Tuesday, June 2, 2015

Try a Goal-Oriented Summer

guest blog by Abigail Levrini, PhD

 Ah, the lazy, carefree days of summer: barbeques and impulsive eating that lead to weight gain, frequent shopping and vacations that lead to debt, irregular sleep cycles that lead to exhaustion… sounds fun, right? Yes, summer should be fun, but not in that self-destructive sort of way!

Why not use the summer months to accomplish something, whether you continue working on old goals or set new ones? Instead of feeling stressed and depressed come fall, by setting your summer goals now and creating a plan, you will feel much better once the leaves start to change—and you can still enjoy the occasional barbeque as a guilt-free reward for your hard work.

With my adult ADHD clients, I find much of the year is spent on goals related to executive function either in the workplace or at home. Goals linked to time management and organization are the most popular during fall, winter, and spring, when people are under pressure in their workplaces to meet deadlines and children are in school (also under pressure to meet deadlines).

Then comes summer. For an adult with ADHD, it’s a little bit like going from the rigorous routine of boot camp to the free-for-all of spring break in Cancun. Fun, yes, but it can leave you hung over and full of regret.

Looking at it from another angle, summer is a perfect two- to three-month time frame to set and reach those goals you aren’t able to focus on during the rest of the year. Improving exercise and nutrition, developing good sleep habits, nurturing relationships, spending time on a hobby, improving your financial outlook, or planning for the future are examples of good summer goals.

Golden rules for goal-setting

The first step toward improving the ability to set and reach goals is to learn how to create an effective goal. In Succeeding with Adult ADHD: Daily Strategies to Help You Achieve Your Goals and Manage Your Life (APA, 2012), Dr. Frances Prevatt and I offer the following golden rules for creating an effective goal:

1.    Make your goal measurable.
2.    Make your goal process-based.
3.    Make your goal time-sensitive.

Let’s start with the first golden rule. In order to make goals measurable, you need to define them in such a way that after a period of time you can produce an evidence-based yes or no answer to the question, “Did you accomplish your goal?” In other words, how will you know whether you have exercised more, eaten better, improved sleep habits, spent time on your hobby, and so forth?

Secondly, making a goal process-based ensures you will consistently monitor and focus behavior in a way that will not only help you to achieve the goal, but more importantly, learn to understand your behavior along the way. For example, it is not enough to say that you will run a 5K by the end of the summer if it means you will sit on the couch eating potato chips until the night before the race, and then lay on the couch in pain for weeks afterwards. Instead, focus on the process. What will you do on a weekly and even daily basis to make sure you achieve your goal with quality results?

Finally, make the goal time-sensitive. Simply put, you must include a deadline by which time your long-term goal should be accomplished, otherwise it is left out in oblivion to dangle forever and ever. The trick here is to be realistic. Don’t think that although you haven’t read a book in two years you will be able to read nightly for the next month. People commonly make this mistake when it comes to things like exercise and nutrition as well (an important part of ADHD symptom reduction). If you haven’t set foot in the gym for five years, don’t aim to run that 5K in three weeks. It’s not going to happen. Remember, any amount of goal-directed behavior you engage in is most likely more than you were doing the week prior, and that is something of which to be proud. A realistic goal may be to get to the gym once a week all summer long, which may not be ideal but is better than not going at all.

Breaking goals down into smaller steps

Once you have created your goals, the next step is to begin the task of breaking down your goals into smaller, weekly “baby steps.” Because a two- or three-month summer goal can seem big and overwhelming, now that it has been recorded, put it aside. Now focus on the very first step you will need to take in order to eventually reach your goal. Think small. Think easy.

For the first few weeks, your job is to set (and complete) objectives that are well within your capabilities. By doing this, you will increase your confidence, enabling you to slowly take on more and more challenging objectives. For example, if you created a relationship goal centered on reducing arguments and communicating better with your spouse by summer’s end, your first week’s objective may be to record what are the current pitfalls in your communication. If you created a goal to exercise more frequently, maybe your first week’s objective is to talk to two active friends about athletic activities that they find fun and interesting.

When writing down your weekly objectives, be as specific and detailed as possible. It is not enough to write, “Run two miles.” Instead, attempt to specify how, when, where, and what you are going to do: “After work, take twenty minutes to change and stretch. At 6:30, go for two-mile run from home to the high school and back at an easy pace.”

Don't feel you need to work on every summer goal every week. Tackle your top-priority goals first. You may also have more than one objective pertaining to only one goal. The art of creating weekly objectives that are “not too big and not too small” can be a challenge for anyone. Don’t hesitate to enlist the help of a coach, counselor, or friend to help you map out your goal-directed behavior.

Finally, but perhaps most important: Reward yourself for meeting your weekly objectives and your overall summer goals. Relax poolside with a glass of lemonade after swimming several laps to work toward your exercise goal, watch a movie with the family after your vacation planning session, or enjoy a glass of wine on the deck after you and your spouse spend some time practicing “active listening.”

For achieving your overall summer goals, indulge in a slightly loftier reward you can look forward to all summer long—one that will help you stay motivated. Dance the night away at an outdoor concert or have a fun, carefree, relaxing night on the town. After all, fun is what summer is all about, right?!

A longer version of this post appeared in the June 2014 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about managing adult ADHD on Attention connection, your social network for all things ADHD!

Abigail Levrini, PhD, is a licensed clinical psychologist and ADHD specialist with nearly a decade of experience as an ADHD coach and counselor. She has published numerous scientific articles on ADHD and presented her coaching model in professional settings throughout the country. She is a recurring speaker for CHADD and served as the board president for the DC/Northern VA chapter of CHADD 2009-2012. She has been a featured expert on NAMI's Ask the Doctor podcasts and is coauthor of Succeeding with Adult ADHD: Daily Strategies to Help You Achieve Your Goals and Manage Your Life (APA, 2012).