Wednesday, December 15, 2010

And To All—A Good Night’s Sleep!

Personal health is often a low priority for people with ADHD. Lack of organizational skills and an inability to prioritize make it difficult to establish and maintain the structures and routines needed to sustain good health habits. Because staying healthy has a positive effect on everyone—especially people with ADHD—it needs to be a goal, and strategies for achieving and sustaining a healthy lifestyle need to be incorporated into your life.

But even if you’re determined to live a healthy lifestyle, along come the holidays to interfere with established routines. For many people, it becomes even more difficult to keep up with things like getting enough sleep, exercising and eating regularly, eating healthy foods, taking medications regularly, and keeping up on personal hygiene.

Sleep can become especially challenging during this busy and sometimes overly exciting time of year. But it’s estimated that up to 80 percent of people with ADHD experience sleep problems anyway, even when it’s not the holiday season. You can find a lot more information on this subject in the article by Gina Pera, “ADHD Never Sleeps, But Children and Adults with ADHD Can,” in the December 2010 issue of CHADD’s Attention magazine.

Here are a few strategies I recommend to my clients that can help at any time of year. You may find them particularly helpful now when there’s even more temptation to burn that midnight oil.

Create (and stick to) wind-up and wind-down routines.

Waking up on time hinges on going to bed on time and getting a good night’s rest. Set routines to help you “wind up” in the morning and “wind down” at night. They can consist of anything from showering and watching the nightly news each night, or having coffee and reading the paper each morning. The idea is to ritualize the routines you have created around getting up and going to bed.

Wake up and go to bed at set times.

Establishing consistent times for sleeping and waking really works! Don’t keep irregular hours, even on the weekends—especially during the holidays. Wake up and go to bed at the same time each day. This will increase the quality of your sleep by letting your body enter into a rhythm, and help to de-stress you by knowing when your day starts and ends. Not everyone requires the same amount of sleep, but consistency is the key, so establish a routine and stick to it.

Know what your traps are.

Problems with transitions can contribute to the struggle of going to bed and waking up. Because people with ADHD struggle with ending one activity and starting another, it’s important for you to know your traps and be vigilant in avoiding them. If you know that talking on the phone, watching TV, or checking e-mail keeps you up past your bedtime, post signs reminding you to stick to your schedule. For example, don’t allow yourself to go on the computer or answer the phone past nine o'clock at night. Ask for help from those around you so they know not to distract you from your goal. I had one client who knew he would sit and read for hours in his home office, losing track of time, so he bought light timers and set them to turn off all the lights in his office, jolting him into closing his book and going to bed.

Set a bedtime alarm.

Use a wristwatch with an alarm or set an alarm clock in your home to go off one hour before bedtime so you have time to get ready.

Have a system for waking up and staying up.

Always have a back-up system—use three alarms if necessary! Set one in the bedroom, one in the bathroom, and one in the kitchen. If you turn off the one by your bed, you’ll still have the other two ringing, forcing you to get up and turn them off. Or switch off with a friend, calling each another in the morning, and commit to it. The buddy system works.

Other strategies some of my clients use involve their senses: pre-setting their coffeemaker to go off so the aroma can reach them, or purchasing alarm clocks with dawn lights that gradually fill the room with bright light. Some even sleep with their shades open so the morning light will wake them up.

Whether you're trying to stay on a healthy track this season, or just beginning to recognize how good health habits improve your ability to manage ADHD, I hope you'll find these strategies helpful. Here's to healthy and happy holidays!

Tuesday, October 12, 2010

Part Two: More Strategies for Maintaining Spiritual and Mental Wellness

Ever notice what happens when you don’t adhere to personal boundaries, curb impulsivity, or keep emotions and negative tapes in check? If you, like many people affected by ADHD, face challenges in these areas, you may find it difficult to maintain spiritual and mental wellness. When you give support to your internal life, you improve your “external” life as well. This month I will share seven more strategies that can help you maintain your “inner” health.

1. Hold yourself back. Learn to say NO!

The word “yes” flies out of our mouths way too often, and we end up over-committing and stretching ourselves way too thin. Each day, say “no” to something, no matter how big or small, so you get comfortable saying it. Create a variety of dialogues that will help you hold yourself back from various situations. For instance, if your friend or colleague asks you to make plans for the upcoming weekend, say, “I’d like to give this some more thought before I commit. Can you check back with me tomorrow?”

2. Keep perspective. Be comfortable in the grey zone.

In times of crisis or stress, your sense of clarity can be skewed and the desire to make things “black or white” can be very compelling. Be sure to be flexible with yourself and others. Allow yourself time to be in the “grey zone,” especially if there is a crisis that is out of your control, like a death or divorce. Recovery can’t be forced, so let your emotion run its course. In time, the fog will lift, and your energy and clarity will return.

3. Journal your emotions.

If you frequently deal with “runaway emotions” or “negative tapes,” you probably get locked onto thoughts or issues, unable to let go. By keeping a problem-solving log, you can defuse emotions by distinguishing what they are and what they are associated with. Write in the log whenever your emotions are preventing you from moving forward. The log can lead you through a series of questions that you ask yourself, such as, “What specific situation triggered my sadness?” “What specific action did I take in the situation?” “What could I have done differently?” “What specific action can I take now?” Answering questions like these can help you step back, see the issue in perspective, and recognize that you have the power to deal with it. This helps you let go of the feelings you are overwhelmed by, gain a new perspective, and move on.

4. Plan in advance for potential emotional upheavals.

To help prevent or minimize emotional upheavals, make detailed plans for any times you find potentially volatile, such as holidays or unstructured time. Write out or go over dialogues in your head of what you will say in particular situations and how you will say it. Have an “escape” plan. For example, I have a client who gets in her car and goes to sit in a parking lot for a little while to take a break from the traditional Christmas Day celebration with her extended family each year. She returns renewed and more able to participate in the holiday festivities.

5. Create a history and future for yourself.

Keep a journal of past accomplishments, future goals, and plans. Review it regularly. Typically, individuals with ADHD live in the moment, which lends itself to a host of problems: not thinking of consequences before acting on thoughts; forgetting past accomplishments as well as past failures; not thinking of the impact of current choices on a future goal, even a short-term one. The feeling of being perpetually trapped in the present can often lead to feelings of emptiness and lack of direction. Having a list of past accomplishments can help to shift your focus to the success you’ve already achieved. It can also encourage you to believe that you can succeed again and achieve what you set out to do!

6. Beware of let-downs after completing big projects or accomplishments.

Many of my clients immediately go into a depression after they complete a large project. All of a sudden the pressure is off and nothing seems exciting or relevant. Know this can happen, and put a plan in place to compensate for the downtime. For example, immediately after I completed the Boston Marathon, I couldn’t escape the sense of “I haven’t done anything with my life; I’m a total loser.” To counter this, I put together a photo album of the marathon and started sharing my recent “win” with everyone so it would stay alive in my mind and help me remember that I wasn’t a “loser.”

7. Take a daily inventory.

Take time each day to reflect on your life and how you are living it. What do you want to change? What will it take? What are you willing to give up to get there? How were you of service today? How can you live a more purposeful life? Asking yourself these questions at the end of each day will help you focus on the things you can and cannot change in your life. That way you can begin to focus more on the positive instead of the negative.

These strategies and the ones I wrote about last month have made a difference for many of my clients who cope with ADHD. If one doesn’t work for you, try another. The key is to find something that helps you keep yourself in balance, use it for as long as it works, and try something new when you need to.



Wednesday, September 15, 2010

Maintaining Spiritual and Mental Wellness - Seven Strategies

Maintaining a healthy mental or spiritual life is contingent upon balancing work with play, taking time for yourself, and giving back to the community. Failure to adhere to personal boundaries, to keep emotions and negative tapes in check, and to curb impulsivity can contribute to diminished spiritual and mental wellness. When you give support to your internal life, your external life will also be better. Here are seven strategies:

1. End the shame and blame.

The only way to stop blaming yourself for your ADHD is to learn as much as you can about it. If you can understand the neurobiological roots of ADHD, you will be better able to separate yourself from the disability and do something about it. The way to end the shame and to start to build self-esteem and move forward is to make friends with your brain and develop strategies to bridge gaps in performance.

2. Make a date with yourself.

Block out “sacred time” weekly to rejuvenate. Don’t allow anything to creep into this space. For example, if you’ve decided to use this time to read and relax, don’t allow yourself to clean your house instead because you have a day off. To help put boundaries around this sacred space, make a list of what is permitted in that space and time, and what is not. Post it! Review it and practice sticking to it!

3. When you say yes, you also mean no.

Often, we don’t think of the consequences of saying “yes.” Stop and think before committing. When you say “yes” to something, what are you saying “no” to? For example, if you say “yes” to doing an extra project at work or helping a friend move on a Saturday, are you saying “no” to spending more time with your family or to taking time to exercise? What are you saying “yes” to in your life? What are you saying “no” to? What is it costing you? Try to ensure that “yes” adds something to your life.

4. Identify your energy rhythms.

People with ADHD are often unaware of when their bodies are worn down. It’s important to learn not only what types of projects create energy for you, but also which ones drain energy. That way you can plan the most demanding activities during your peak energy times, as well as gauge when to stop working on a project and rest.

Keep a calendar or a log of your energy rhythms for a period of several weeks. This works best if the system is simple. For example, use a scale of plus or minus signs to depict high or low energy times, and write them beside different activities logged in a daily calendar.

5. Pre-plan for bad brain days.

Can’t concentrate? Distracted? My clients call this a “bad brain day.” For these days it’s important not to push yourself too hard and to have a failsafe plan in mind by knowing what works for you. Take a break and walk around the block, have a cup of tea, or call a friend. Then get back to work. One of my clients says he gives himself a “time out” by going to a cafĂ© near work to just “sit and chill” for an hour. The key is to know when these days hit and take action by doing what works for you.

6. Practice relaxation exercises.

People with ADHD often live in a state of constant stress. It’s important to learn how to slow down and de-stress, both mentally and physically, at any given moment. Learn relaxation techniques and methods to center yourself at any given moment. Practice slow breathing techniques, or join a yoga or meditation class. If you are spiritual, make daily prayers a priority.

7. Give thanks.

One of my clients has made a habit of ending each day by writing down one thing for which she’s grateful. She does this right before bed each night as a way of reflecting on the day she’s just lived through, and a way of de-stressing before sleep. I’ve tried it, and I agree with her. It’s amazing how you can learn to accentuate the positive!

What do you do to keep yourself in balance? More strategies to come next month!



Tuesday, August 10, 2010

Eight Strategies to Help You Get Moving

For many of us with ADHD, personal health is often a low priority. Lack of organizational skills and an inability to prioritize make it difficult to establish, implement, and maintain the necessary structures and routines to sustain good health habits over time. Things that seem simple for others—like getting enough physical exercise—become monumental tasks.

But exercise has such a positive effect on people with ADHD! Here are eight strategies that have helped me and many of the people I coach.

1. Do it for your brain’s sake! Knowing that exercise is good for your body is only half the story. Growing evidence shows the benefits of exercise to your brain. It’s simply foolhardy NOT to exercise these days with the amount of stress we endure, with or without ADHD. Forget about looking good. Make your goal feeling good!

2. Make it doable. All too often we set ourselves up for failure with goals that are way out of reach. If your goal is to exercise for one hour a day, seven days a week, don’t expect to fulfill that goal immediately. This “all or nothing” approach is a recipe for discouragement and failure. Be realistic and start slowly. The key is making the goal attainable, and to be able to do it on a regular basic.

3. Set a minimum and a maximum goal. Identify the absolute minimum you would require of yourself—say jogging one time per week. Next, identify the most realistic number of times per week you could jog, a number that you could reach without too much stress—say three times per week. Your exercise goal would then be jogging once a week, minimum, and three times a week, maximum. You’ll most likely meet your minimal weekly goal or even exceed the maximum goal. What a great feeling it is to exceed your personal goal!

4. Create accountability through partnerships. If you know that working in partnership works for you, and that doing things on your own doesn't, invest in a personal trainer. If you’re unable to do that, find other ways of accountability, like joining a running group or asking a friend who is a dedicated exerciser to join a class or gym with you. It’s sometimes harder to disappoint others than it is to disappoint ourselves.

5. Be prepared at all times.
If you tend to skip exercising because of forgetting your gym bag, keep an extra one packed with exercise gear in the car and at your office, one that is always ready to go when you are. A personal favorite of mine is to sleep in my (clean) exercise clothes. When I wake up, I can’t escape remembering what I was going to do that morning—EXERCISE! I have my clothes on and I’m ready to go!

6. Keep a scorecard. Because the ADHD brain lives in the present, it’s easy to forget past accomplishments, even if they’re only a few days old. To combat this, make progress measurable by creating ways to track your progress. On the five days each week that he runs, for example, one of my clients writes on his calendar in black magic marker the number of miles he completes. Or you can use your calendar as a “scorecard.” Mark an "E-Y" (“Exercise-Yes”) on the days you exercise and an "E-N" (“Exercise-No”) on the days you don’t. The point is to see your progress and monitor whether or not you’re reaching your weekly and monthly goals. Essentially, you’re charting your own personal history of successes. The key is to make your tracking system visible and simple.

7. Adopt a “no excuses” attitude. Consider the time you have to exercise as an appointment with yourself and do not break it. When you travel, call ahead and find out the hours of the hotel gym. If you catch yourself negotiating with yourself about whether or not to exercise, stop and simply walk out the door to the gym. Even if you go for ten minutes, that’s a win.

8. Create flexible structures.
I use a system of “structured flexibility” when it comes to exercise. It’s simple. I make sure I never miss more than two days in a row without exercising. I MUST go on that third day, no matter what. This guarantees me flexibility as well as exercising a minimum of two to three times per week without fail.

I hope these strategies will help you, too. If you have learned other strategies that work for you, please share them with the rest of us!


Tuesday, July 13, 2010

Working Together When a Spouse or Partner Has ADHD

Does ADHD—your own or your partner's—impact your loving relationship with that person?

Tomorrow I will participate in an online Ask the Expert chat on the difficulties couples face when one or both of them have ADHD. I'll also offer strategies that can help improve the difficulties couples face when one or both of them have ADHD. The chat begins at 3 PM Eastern Standard Time and it's sponsored by CHADD and the National Resource Center on ADHD. To join, click here at about 2:45 and follow the instructions.

This short selection from my book, The Disorganized Mind, describes some of the things I've heard from clients.

Brad ran through a litany of his wife’s ADHD behavior when I asked him what living with her was like. “I have to prepare myself every time I walk in the house,” he said immediately. “It’s a perpetual soap opera. Will she be in tears because she hates herself today? Will she be laughing with a new best friend she just met at the market and dragged home? Will she even be home? Will there be smoke billowing from the kitchen from the latest dinner she’s burned? Will there even be dinner?” He often felt worn down by the patience her unpredictability required. “It’s hard not to lose it with her sometimes,” he said, “if you know what I mean.”

I do know. I’ve heard variations of his comments so often that I can almost write the script for them. “I communicate with him mostly by e-mail,” was how the wife of one client put it. “I’ve given up on expecting him to sit and have a conversation with me. He just gets up and walks out of the room. I swear I see his back more than his face!”

Even children weigh in on their parents’ ADHD. “I can understand how my parents got divorced,” one teenager told me, “but not how they got married in the first place. My dad is so normal but my mom is really crazy.” He was talking about his mother’s impulsive, distracted behavior, the way “she forgets things all the time, like me, even,” and the toll it had taken on the entire family.

Things don’t have to become intolerable. Families can learn to function, and function happily. Family members, like the individuals with ADHD themselves, can educate themselves and create strategies for coping. In many ways, it comes down to understanding and to expectations.

Even though they can appear self-absorbed and can definitely be exasperating to others, I have yet to meet anyone with ADHD who wants it that way. My clients haven’t wanted to use their ADHD as an excuse for inexcusable behavior, either. What they want is a way to work through the problems that their ADHD causes. They want family members to be there with them, everyone helping in whatever way possible to make the family unit strong. But just as families of those with physical diseases or addictions need advice and support from others in similar circumstances, people living with partners with ADHD also need to know how others cope.

Does any of this sound familiar? Has coaching helped? What strategies did you find helpful? Please share your stories!



Thursday, June 17, 2010

Getting There from Here: Easing Transitions with ADHD

A large part of my coaching is to help people identify their ADHD challenges and devise strategies to meet them. In order to do this, I explore the reasons why each person gets stuck. I have found that what appears to be procrastination or distraction may actually be a problem with making smooth transitions. The cues that it might be transition trouble is when my client says, “I get stressed and overwhelmed when I have to stop one task and move to the next” or “I can never seem to make it anywhere on time without having a meltdown in the process.”

Transitions require the brain to shift its focus and attention. The ADHD brain often overreacts to this discontinuity by going into a “startle” state, making the person anxious and stressed. Since I was young, I too have struggled with transitions, especially those that require me to travel. So I identified with Judy’s story when she came to me for help.

Judy loved her job, except when she had to travel. The thought of having to pack brought on panic attacks. She found it hard deciding what to take with her on a trip. She stayed up all night packing and repacking, a routine that repeated itself before each trip. Judy was so frazzled and exhausted with each transition that her performance at work suffered.

Through coaching, we developed some strategies to help make travel easier for her. First, we posted a calendar and wrote out her travel schedule so she could prepare her mind for the trip. By seeing when her next trip was, she was able to visualize the process and plan ahead. She developed a routine of putting the suitcase in the middle of her bedroom three days before each trip, which forced her to start packing. She also purchased a second set of toiletries and identified a standard set of “travel clothes,” so she didn’t have to make last-minute decisions about her wardrobe.

Timeliness was also a hurdle for Judy. She found it hard to go from one environment to another. She continually arrived late to work and became disorganized and anxious when leaving her office to attend meetings. Judy also found it hard to pull herself away from a task at the end of the day, fearful that if she stopped working on it, she would never “get her head back into the project.”

Her trouble with transitions was pervasive, and it was also affecting her home life. Her husband was tired of her not being home for dinner and not participating in making plans for the weekends.

The antidote for transition troubles is to first identify the struggle, understand the underlying ADHD causes, and develop strategies to minimize the brain’s startle response. Strategies for making smoother transitions focus on making the transition more gradual and lessening the panic. Many of my clients have adapted the following strategies to their particular needs:

Recognize the problem

Know that you struggle with transitions, and take time to determine the causes of it. Whether it’s difficulty going from work to home, or adjusting to guests in the house, there are always ways to make life more manageable. Develop strategies to make your life, and the lives of those around you, less stressful.

Use the Power of Visualization

When making transitions, no matter how big or small, do “dry runs” in your head. Visualize every detail you can in making the transition. Sketch out times for ending each activity and starting the next. You need not follow the times exactly, but have an idea of when you will need to be switching gears. Visualize each action in as much detail as possible. See yourself moving from one activity to the next.

Learn to Let Go

To transition successfully from one project to another, you need to learn to “let go” of the first and move on to the next. Many of my clients are perfectionists when it’s time to move on to another project, and they find it hard to wrap up what they’ve been doing. If you do this, set a specific stop time, then allow yourself 15 more minutes. No more! You can go back to the first project later, but the idea is to keep moving forward.

Plan Ahead

Always plan out the next day before going to bed. This way you’ll have in your mind what you are going to do, when, and how. You will wake up more directed and centered.

In order to have smoother transitions, you must be able to see beyond the moment. I even suggest to clients to sketch out detailed plans for three days at a time. This can help you (1) see more clearly what is coming up and (2) identify priority items. Remove items from your schedule that can wait, and adjust accordingly when “unexpected” things crop up.

Create a “Wind-Down” Routine for Transitions

This strategy is particularly useful for those who have assistants. Ask your assistant to call you two hours before your scheduled meeting. Have him or her call again an hour and a half before, and then an hour before, telling you exactly how long you have until the meeting.

If you don’t have an assistant, use a stopwatch and set “wind down” goals for each time juncture. For example, two hours before your meeting, start wrapping up whatever you’re working on; an hour and a half before, prepare your files for the meeting; an hour before, finish everything you need for the meeting. If necessary, write out this plan on paper with designated times, and check off each step as it comes up.

Separate the set-up from the task

If you are having difficulty approaching a project, your coach can help you learn to set up for the task before actually beginning it. Set-up is usually brief--10 minutes or less—and is done as a separate activity in advance--the night before or before a break which precedes beginning the actual task. This helps eliminate the confused feeling of “Where do I start?” For example, the set-up for cleaning your desk might be setting out file folders and putting them next to the desk; the set-up for ironing is getting out the ironing board and laying out the clothes to be ironed. Doing the set-up as a separate task can break through the grip of procrastination, giving you the mind-set of being ready to begin. This strategy can be very effective if you are facing a particularly anxiety-provoking task.

Make it a routine

Turn tedious chores into a routine. Lay out your clothes for the next day the night before. Make sure your presentation for tomorrow’s meeting is saved on your laptop. The little things you do today, pay off tomorrow.

Stay a step ahead of yourself

Know your tendencies. Do you find yourself checking your e-mail five minutes before you have to leave the office—and winding up returning 20 e-mails you should have left for the next morning? Shutting down your computer a half hour before you plan to leave might solve the problem. Recognize what gets you in trouble, and find preventative strategies to bail you out.

By understanding that her challenges with transitions was due to her ADHD, Judy was able to identify the situations that triggered problems and devise practical solutions to help her move more smoothly through her day.

Nancy A. Ratey, Ed.M., MCC is a strategic life coach specializing in coaching professionals with ADHD. Nancy lives in Charlestown, Massachusetts.

Monday, May 10, 2010

Stress Less! Coaching Tips to Turn AD/HD Chaos to Calm

In our fast-paced world, we all experience stress and find our own ways to minimize it. For a person with ADHD, normal daily stress becomes debilitating. This is mostly due to the way the ADHD brain is wired. Because our brains have a faulty attention system, they are unable to slow down, block out, or prioritize stimuli. What’s more, adults with ADHD, especially when it has gone undiagnosed, often have poor self-esteem. They dwell on past failures or feel as if they haven’t lived up to their potential and expectations, or those of others. This causes them to approach situations pessimistically or to avoid tasks altogether, increasing their stress levels.

So why are many people with ADHD known as “stress junkies?” In my coaching practice, I see many clients who wait until the last minute to finish a project or to leave the house for an appointment. They can’t say no, and take on too much responsibility at work or in their social life. Creating these pressure-filled situations has served them well by helping stimulate their under-aroused ADHD brain. But the repercussions can take a toll on their health, adversely impact their family life, and put their job at risk. Talk about stress!

When Janice first came to see me, she was about to lose her job: She was often late for meetings, and she wasn’t prepared once she arrived. Her stress was so high she would break out into hives and couldn’t sleep at night. She was frustrated by the fact that she couldn’t get things done unless she had a gun to her head. She admitted to me that she would have been fired a long time ago if she hadn’t been quick on her feet.

As we talked, Janice learned why she waited until the last minute—the eleventh-hour pressure stimulated her ADHD brain, enabling her to finish the job. She also recognized that she continually fooled herself into believing that “I could pull it off this time,” only to fall short again. Her brain would get stuck in the moment, causing her to forget the past consequences of her actions and her present goal of not repeating those self-defeating behaviors.

We developed a middle-ground strategy. Because Janice needs a certain amount of pressure to jump-start her brain, she set up false deadlines with her boss to help her divide projects into smaller pieces. By doing this, it was easier to chunk down the project instead of waiting until the last minute to finish the whole thing.

I have other clients whose brains don’t have “brakes.” This causes them to over-respond to everyday situations. Simple things—transitioning from one task to the next, going from work to home, packing for a vacation— result in “mini-panics.”

One of my clients, George, struggles with transitions, especially leaving the office to go home. He lives close to his job, so his commute time is short. Within minutes of arriving home, his wife, Helen, asks George to help her with the kids or to assist in another task. George, still unwinding from the pressures of the job, is overwhelmed and storms out of the house. All these arguments have put their marriage on the rocks. Helen sees George’s behavior as resistance to helping around the house. George feels guilty and demeaned.

George and I worked on solutions. He now walks home from his office, so he can decompress from his day’s work. Helen smoothes the transition by calling his cell phone or e-mailing him with things that need to get done when he arrives home. George can visualize what will be expected of him before he walks in the door. The end result? Less stress for all.

People with ADHD already spend a lot of time and energy compensating for their neurobiology, so they have less of both to combat stressors in healthy ways. This ongoing pressure from all sides can result in chronic stress, which can harm the body and brain, create hopelessness, and lead to substance abuse. A person with ADHD needs to develop appropriate strategies to manage stress. Here are some that work for my clients. Maybe they’ll work for you!

Acknowledge Your ADHD

Understand and accept that your neurobiology is different. If you don’t know how your ADHD affects you, you can’t work on ways to help yourself fend off stress.

Keep Your Brain in Shape!

Exercise! Exercise! Exercise! It’s key to peak mental performance, and to gaining focus and control! Don’t skip it, ever. Physical activity delivers lots of benefits: It can make you feel good, look good, and promote longevity. It is also good for your brain, increasing beneficial neurotransmitters and other chemicals that help the brain work at its best. If your brain is frequently overwhelmed, keeping it in shape will enable you to better handle what life throws at you.

Make Structure Your Friend

Plan out the next day before going to bed. You will wake up more directed, centered, and be better prepared for any transitions or curve balls thrown your way.

Observe Yourself

People with ADHD are not good self-observers. This often results in not knowing you are stressed and burned out until after you get sick. Be aware of your body and how you feel. Pulling all-nighters won’t help you; it will only compromise your performance.

Remain Vigilant

One of the hallmarks of ADHD is forgetting that you have the condition and thinking you don’t need strategies and structures to improve your wellbeing and combat stress. Wrong. Send reminders to yourself, post notes, and ask friends and family to reinforce the importance of using strategies. And don’t let down your guard!

Take Time to Play—Recess for the Mind!

Slot down time, play time, “you” time into your planner, just as you would a deadline for a report that is due at work. Read, eat cookies, journal, do art, sit on the floor of a bookstore and talk, change your location, cook—whatever. Do what you love without guilt. The cost benefit of not taking breaks from today’s ultra-busy lifestyle sets you up for burnout and loss of control.

Create Book Ends

Get up and go to bed at the same time each day. Establishing regular body rhythms, as well as predictability and consistency in your schedule, will help increase efficiency and reduce overwhelm and stress.

Think in Terms of Three’s

Ask yourself which three pressing items you can complete that will give you a sense of accomplishment. They do not have to be big items. Returning a phone call, filing several papers, and filling up your car with gas will do. Write them down and keep the list in front of you. Cross off each task as you complete it. Then move on to the next three items.

Stop Avoiding

A well-known author once told me, “You become the first thing you do in the morning. If you want to be a writer, write.” People in general know what they leave to last or what they are avoiding and it’s generally the most important task! Post a note by your computer asking, “What am I avoiding right now?” Then do it first. That is the first step is gaining control!

Park It

Distracted by random thoughts? Write them down on a piece of notepaper, so you can stay focused on the task at hand. You will reduce the noise in your head, and can go back to these items later. I have found that these distractions are often not priority items.

Create Boundaries

Give yourself permission to ignore “shoulds”—those imposed by other people and those imposed by you. Learn to say no. Ask yourself, “If I say yes to this, what am I saying no to?”

Try these tips and I’m sure your life will become calmer and more fulfilling.

Until next time!

Warmly, Nancy

Tuesday, April 13, 2010

Strategies for Those Living Without the “H” in ADHD

I was excited when Nancy asked me to be the guest blogger this month to blog about inattentive ADHD. So often it is not recognized, and yet it impacts lives as much as ADHD does in general. I am pleased to be giving this topic a small amount of the attention it deserves!

I first want to make a distinction: this is not about inattention as a symptom but about predominantly inattentive ADHD. Understanding and thriving with inattentive ADHD requires its own set of strategies that overlap with strategies for the general ADHD population but depart from them as well. I write and think a lot about the inattentive experience, and while it is unique for each person, I can offer some general strategies that can help to build a center and understand this experience and create a path to thrive with it. These strategies are meant to offer a starting point to living with, and beginning to thrive with inattentive ADHD.

1. Understand that you and your experience are different from that of people “with the H” in ADHD. Many of my coaching clients have said to me that

  • They don’t recognize themselves in the books they have read about ADHD.
  • They don’t easily relate to very hyperactive people with ADHD
  • Hyperactive people may overwhelm them

The strategy here is to acknowledge and validate for yourself that neither are you that person people immediately spot with ADHD nor is your set of challenges the same.

Read about ADHD and compare yourself; acknowledge where you are the same or you are very different from what is described. The end result will be a much better awareness of your ADHD and how you work. Look at examples of our cultural understanding of ADHD and see how you fit and how you don’t.

Some ADHD experts and researchers have even proposed that “predominantly inattentive” ADHD be redefined as separate disorder. I am not here to argue the case one way or the other, and I certainly see overlap in the hyperactive and non-hyperactive (which I will get to some more later) but to point out that this suggests that your experience will indeed be very different from your hyperactive peers.

2. Understand that the inattentive experience is largely invisible to others.

As new as our limited understanding of (especially adult) ADHD is, our understanding of the inattentive side of things is that much newer and more limited. Just as people may not have picked you out as having ADHD because you are not hyper, and were not disruptive as a child in school, etc, etc, your experience and challenges are invisible and unfamiliar to other people. But this is not just because it is newer to our understanding; it is also because people can’t see what is going on inside your head. And often times, for the inattentive ADHDer, that is the only place ADHD is visible. Because of that, it is important that you get a good picture of what’s going on for you. That if other people don’t see it, or even don’t understand when you explain it, that you know what your ADHD looks like; know how it affects you; know when it feels like it is who you are and when it feels like it is getting in the way of who you are.

3. Know when your mind is “hyperactive” or “hypoactive.”

Since our experiences of ADHD are different and are tied into so many aspects of our lives, it is hard to pinpoint strategies (and struggles) in a nutshell. But one I often like to start with in people with inattentive ADHD is what I call the hyperactive mind (or on the flipside, the hypoactive mind).

Do your thoughts proliferate and travel along paths unfocused by you? To me this seems the parallel to physical hyperactivity. Know if this is something that happens to you. Know when and how it happens. Practice stepping back. Or does your mind go too slow, like you can’t get it going? The same self-knowledge is key. Some people report a hyperactive mental experience; some a hypoactive one; and some report both. The core here is lack of control of focus or attention (as in all ADHD) and this includes your internal experience.

As you build awareness you can build strategies to work with, prevent, and respond to what happens in your internal experience. It is only the beginning of thriving with inattentive ADHD, but it is a needed start.

Becca Colao, MA, ACT, SCAC, lives and coaches in Waltham, MA. She specializes in inattentive ADHD and regularly writes about it at She can be contacted at

Tuesday, March 9, 2010

Feels Like Spring! Is it time to get organized?

Feels Like Spring!
Is it time to get organized?

Guest blog entry by Kathy Peterson

When I started coaching people with ADHD 15 years ago, I noticed that many of my clients struggled to get organized. I wanted to help them. Even though I have ADHD, too, getting organized is easy for me. It has been an important compensatory strategy for me in dealing with my attentional issues.

I realized that when my clients try to organize their physical environment, it is very helpful if I participate with them at their home or office. When we do this work together, my client learns organizing skills, which are best acquired by doing. After all, people with ADHD often learn best experientially.

Many people with ADHD find it hard to get and remain organized. Here’s why:

  • They find it hard to manage time and tasks. They often leave items out on the counter, desk or floor to remind themselves of tasks that need to be done. Over time, this can lead to a very cluttered environment.
  • They often multitask, which can lead to disorganization, especially in one’s office.
  • They often move impulsively from task to task, never finishing any of them. Chaos can follow in their wake.
  • Some grow up in a chaotic household, with one or both parents having ADHD and possibly substance abuse problems. They don’t know what it’s like to live in an organized environment.
  • They often struggle to make decisions and follow through with plans. Indecision leads to disorganization and problems with clutter.

Another barrier to getting organized is “black and white” thinking: in other words, in order to be organized, all systems have to be perfect. A person with this mindset may alphabetize cooking spices and CDs, line up shoes neatly in the closet, and divide files into precise categories. The problem is rigid systems can be hard to follow. Organizational systems need to be simple and flexible in order to work over the long haul. It is important to find a middle ground, and not to strive for perfect order.

The point of organizing your space is to have it work for you. There isn’t one right way. The space should be easy to move around in, visually pleasing (based on your tastes), and tailored to the activities that take place there. You should be able to put things away easily and to find them at a moment’s notice.

One thing you should understand: Being disorganized is not a moral failing. Organizing is a skill that is easier for some to acquire than others. The good news is you can get help to learn these skills, and employ them to meet your needs, as well as those of coworkers and family.

Many people are ashamed about being unable to deal with clutter on their own. They often feel judged by others and judge themselves harshly for their deficiencies. I feel their pain. If you want to learn the skills that will help you get organized, you may need to work with a professional organizer. A good organizer will not only help you reduce the clutter but also help you overcome your feelings of being judged.

You and the organizer are a team. As you sort through the clutter, the organizer helps you figure out which things you value and want to keep in your life. This can take many hours over several weeks. During this process, you and the professional organizer will establish new organizing systems. You will practice new ways of doing things between organizing sessions, and the organizer will check in with you on how systems are working. The organizer will also modify the systems, if they are not working.

Here’s how the organizer-client relationship works:

Step 1: As you work with an organizer, she will want to understand the following:

  • What is the goal? What has precipitated your desire to get organized? How do you want to use this space? Create a vision for the desired result, in terms of function and appearance.
  • What systems are working—and not working? Often one can’t tell by just looking at the space how functional it is. Some spaces look great when you walk in, but then you discover that things have been jammed into drawers and closet shelves to get them out of the way. The reverse can be true, too.
  • What factors contributed to the disorganization?
  • What have you done to get organized, and with what results?
  • What are your preferences for visual stimulation? Many people feel that if things are put away in drawers and behind closet doors that they have gone missing. For them, if it’s out of sight, it’s out of mind. However, leaving everything in view is often too stimulating and makes it difficult for the client to focus. Others find that a simple, calm visual environment works best for them.

Step 2: Now you and the organizer are ready to dive in and work through the clutter—papers, clothing, and objects of all kinds. You start in one room, or a small corner of one room, and sort the mess into a few broad categories: Keep, Donate, Throw Away. The organizer doesn’t push you to get rid of things at this point. You may eventually discover that you have many of the same items—10 pairs of black slacks or a dozen snow shovels—and the organizer may suggest you keep only your favorites.

It takes time to go through accumulated stuff, but client and organizer learn a lot as they do it. The team works on chunks of the project at a time, so that they can put things away in between sessions. Also, if you are ready and willing, the organizer will identify tasks you can do on your own to speed the process along and save money.

Step 3: Once you know what stuff you want to keep, you and the organizer think about function. The goal is to store things close to where they are used, making it easy to access and put them away. In some cases, you may need to purchase furniture or containers for storing items. It is best to know what you want to store, and where, before doing so.

Step 4: You and the organizer may label and/or create routines to support you in maintaining your newly organized space. Maintaining your space with the systems that have been put in place is important. During the weeks of working together with an organizer, the client practices putting things away and using systems and routines for the flow of items and information. If needed, the organizer will improve the systems and routines to help them work even better for you. An ADHD coach may help you with accountability, and you may schedule maintenance sessions with your organizer.

To get organized, your first step is to acknowledge that disorganization is causing problems, and that you are willing to work on finding solutions. There is hope. With effort on your part and by partnering with a professional organizer—possibly in combination with a coach—you can learn the skills to de-clutter your life.


Kathy Peterson has been coaching adults and college students with ADHD since 1994. She also works as a professional organizer with a small number of clients. Kathy has a BS degree from Columbia University. Kathy had a successful career in corporate sales and marketing before becoming a coach. Kathy received life coach training from the Coaches Training Institute (CTI), and ADHD coach training from the National Coaching Network with Nancy Ratey and Sue Sussman, co-founders of the ADHD coaching field. She lives and works in the Boston area.
For more information visit .


To find a professional organizer near you, contact:

National Study Group on Chronic Disorganization (NSGCD;

National Association of Professional Organizers (NAPO; )

Books to Read

ADD Friendly Ways to Organize Your Life, by Judith Kolberg and Kathleen Nadeau, Ph.D.

Conquering Chronic Disorganization, by Judith Kolberg

Monday, February 8, 2010

Jumping Jack: How Coaching Can Help Curb Impulsivity

Jumping Jack: How Coaching Can Help Curb Impulsivity

Jack told his friends he left his corporate job as a salesman to start his own business, but the truth was that he was fired for swearing at his boss. This was not the first time he had done something like this. In fact, he lost several jobs for cursing or telling someone off. Although he was always seen as a valued employee for his out-of-the-box thinking, his impulsive behaviors undercut the company’s high opinion of his abilities.

Impulsivity and erratic behavior also took a toll on his personal relationships. His friends no longer invited him over for get-togethers, fearing that he would insult their spouses or say something outrageous in front of their kids. Jack’s wife was at her wit’s end. She was tired of all his excuses for losing jobs and friendships. But mostly, she was fed up with his unpredictable behavior. Jack’s litany of “I’m sorry’s” didn’t cut it for her any more.

Jack’s impulsivity affected every facet of his life—he jumped from project to project, task to task, and acted on thoughts that just popped in his head. If he drove past Home Depot, for example, he would stop and shop, thinking, “I wonder if there is a sale on lumber? I’ve wanted to build a deck for years!”

To a person without ADHD, Jack’s story might seem made up or exaggerated. Believe me, it isn’t. Such impulsivity is a challenge for many of my ADHD coaching clients. Jack might exhibit impulsivity differently than some other clients, but the consequences and outcomes are the same—the pain of feeling out of control.

Jack sought my coaching services shortly after his son was diagnosed with ADHD. Jack noticed that he struggled with some of the same behaviors as his son. He also saw that medication helped his son manage his symptoms. Jack’s wife, Linda, suggested Jack talk to a specialist about his challenges. After an evaluation, Jack was diagnosed with ADHD. His doctor advised that he work with a coach, along with taking ADHD medication, to learn strategies to improve his focus and to stay in control.

In the initial coaching intake, Jack told me that he knew ADHD was causing his struggles, yet he didn’t know how to stop himself before he, as he describes it, “jumped” into the fire. Although impulsivity can be one of the most difficult ADHD symptoms to manage, medication and coaching can be effective in helping a client take control of them. Acknowledging that there is a problem—and having a strong desire to change—is a key component to making progress.

Jack found it difficult to admit that his impulsivity was a problem. It was part of what had made him such a successful salesman: He was a risk taker and a dynamo, pushing forward to close the deal when others would hesitate. He also saw himself as a “truth teller.” He told me, “Hey, I told my boss he was an idiot because he was making a bad business decision!” As we talked, Jack realized that insulting his boss, no matter how true his words, was never a good move. He desperately wanted to learn ways to be more aware of, and to better manage, the negative aspects of his impulsivity.

Medication gave Jack the ability to slow down and to take stock of what he was doing before acting rashly. But he needed strategies to stop himself long enough to consider alternative actions—to consistently control his impulses.

Many coaching strategies can help clients accomplish this, but as with all successful client-coach relationships, those strategies need to come from the client. Jack and I discussed in detail the situations in which he acted impulsively, and we developed strategies to do slow down and to evaluate the potential consequences of his actions.

It’s important to remember that coaching is not one size fits all, so what worked for Jack might not work for you.

1) One of the keys to reining in impulsivity is being able to self-observe. Jack came up with the idea of going through the day as if a camera were monitoring him. He called it his “third eye.” This helped him to be more conscious of his actions.

2) Jack also discovered that using a mantra helped him slow down. During the day he would say to himself, “Do not engage.” Or he’d ask himself, “What will the consequences of my actions be?” or “Is this what I really want to be doing right now?” This allowed him to stop for a second and evaluate the potential consequences of his actions—getting fired, getting divorced, offending a friend.

3) To curb his urge to “do it now,” he learned to park his thought. He would write down the thought he was about to act on in a notebook, or he would text it to himself on his cell phone or call in to his voice mail. This simple act of writing or calling helped him from acting rashly.

4) Jack frequently flew off the handle when talking with friends or colleagues. To prevent flare-ups, I suggested he form a “committee of trusted advisors” to whom he could vent—in person or on the phone. This allowed him to get over his impulsive anger without feeling the need to follow through on actions.

5) Through discussion, Jack and I were able to identify some of the triggers of his impulsivity—instances in which someone didn’t see things his way would upset him—and put plans in place for alternative actions. He realized that taking a short break—a brief walk or a trip to the men’s room—gave him the time to reconsider what to do—or not do.

Over time, and through continued accountability to me, Jack learned to stop, create space between his thoughts and his actions, and consider the consequences. He also learned to remember the pain that his impulsive actions had caused him in the past and to keep his goal in mind: to be more in control of his impulsive behaviors and eventually to learn to manage them himself.

Until next time!

Warmly, Nancy

Tuesday, January 12, 2010

Mining for Motivation

Guest blog entry by Ose Schwab

Do you have a hard time getting yourself to do something you know you should or want to do? Do you forget your goal or let overwhelm dim your desire? You are in good company.

Many of my clients, intelligent adults with ADHD, struggle to access the drive that will get them started and keep them going. Even with a compelling goal, they forget, feel overwhelmed, get discouraged, or shift their attention to more immediate rewards.

One such client – we’ll call him Steve – came to me for help to be more productive at work and to publish a book. Steve wanted to write about his experience with depression. He felt distant from this goal and did not schedule time to write. Steve also confessed that he wasted time at work. Projects languished in lieu of urgent requests from colleagues. He checked the Internet too often. Overall, Steve felt frustrated with his performance and lack of motivation.

Another client, a college student I’ll call Joe, also struggled with motivation. He came to me out of desperation. He had almost failed the previous semester and his parents were looking to me to “fix him.” The winter semester was at hand, and he was scared he would procrastinate away his last chance of parent-paid tuition.

Joe and Steve needed some help to hone their drive and remove obstacles from forward momentum. To this end I began to mine for motivation by asking them questions.

Questions stimulate thought, feeling, and action. Questions activate neural pathways in the brain. They clarify your desire and understanding of self. Questions can remind you of past successes. They inform your plans with understanding. Questions help you design sustainable drive that will help you fulfill your goals.

What do you want?

Motivation that sustains you is internal – that is – born of autonomy, mastery, and purpose. It starts with desire. Successful adults with ADHD and/or learning disabilities have desire. They want to achieve something meaningful. They want to be successful in their own way. To access desire, ask yourself the question, “What do I want?”

Joe and Steve had to reframe outside expectations and goals into language that they could respond to. Joe, my college student, knew he did not want to relive the agony of isolation and shame he had experienced during the semester prior. However, he had not given thought to what he wanted out of college. He said he wanted to do well if he was going to be there. He also said he wanted to figure out how he might be able to use his particular inclinations – though still relatively undefined. Talking about this helped him to clarify a short-term goal. Joe decided he was going to strive for all A's by handing in assignments on time, attending every class, and reaching out for relationships.

Steve was sure he wanted to write a book about his experience with depression. Further discussion about this project allowed him to connect with its importance. He felt more strongly about it than work, but considered that there might be ways of weaving this project into work.

He told his boss about the book. This bridged work to book. He also began to consider ways that work could equip him to complete the book. In addition, he considered other people at work he could talk to about the project. This gave life to the day-to-day-grind he often felt.

Steve reframed work projects using words that resonated with his values. For Steve, an idealist, it was important to consider how these projects could help people in meaningful ways. Reframing the work helped motivation to increase. Steve’s attitude and focus subsequently improved.

What excites you?

Individuals with ADHD need the right balance of stimulation to experience optimum motivation. Too much can lead to overload or shutdown. Too little starves it. Boredom will tempt quick fix stimulation to distract you away from the goal.

Asking what excites you can help inform what plans you need to make to keep the motivation flowing. Steve loves the thought of hope. His book is about hope. Talking and thinking about it is a thrill. Overcomers’ stories; words of inspiration; reminders of how people struggle – these fuel his desire to work on it.

Joe remembered his participation in a project to help a rural family build a house. Last to leave, first to arrive on the site, Joe exhibited motivation. Why? He likes to help people. Doing a job well is cool. He likes to see progress. Joe also loves to work with his hands.

What do you know?

Knowing what makes you tick informs the best plan. Your plans benefit from the understanding of ADHD brain wiring as well. Such information can help you consider your challenges objectively, without judgment. Then you can apply creative strategies that combine self-awareness with ADHD understanding.

Steve shared that he had been successful at maintaining motivation to train for and run a marathon. He had never run one before. With careful preparation and planning, he designed a practice schedule that he kept to. Steve now uses this achievement as a model to learn from and apply to the current book project.

He also understands the power of distraction and the challenge to get started. Even if connected with the goal, Steve automatically categorizes next steps as “required tasks.” They take on the stigma of being uninteresting.

Difficulty carrying out “uninteresting” tasks is typical for individuals with ADHD. A recent study offers a neurological explanation as to why some individuals do not feel satisfied to complete non-interesting activities – less dopamine along the reward pathways. Steve knows he needs to compensate with strategic cues, accountability, or other external reinforcement.

What do you need?

Discovering what you need starts with observation. The best observations are judgment free. Think of your observing eye as if it belongs to an alien who has never been to earth. Don’t assume, just notice.

In addition to observation, knowledge that can feed your understanding of ADHD also informs need. Discover how the brain works. Glean tips from professionals and others with ADHD.

Pulling it all together requires reflection. And with reflection, Steve realized he needs doses of inspiration administered throughout his week. He realizes the need for specificity in his plan – to have very concrete steps laid out and ready for action at the allotted time.

Joe also identified his need for a specific plan to follow each week. He needs to know where and when he will study. He needs understanding and validation for his integrity. It helps to be accountable. And he knows he needs to get out of the apartment and study at the library sometimes.

What can you do now?

Research suggests that the brain registers thought about action the same way it registers the action itself. This means that you can pave the neural way (so to speak) for your intentions. You can think concretely about a task to get your mental juices flowing. And doing this will increase motivation to complete the action.

Inspired by the book “Art of Possibility,” Steve wrote a letter dated end of 2010. He wrote to me about the successful completion of his book. The letter contains details of celebration dinners, contact with a publishing house, and the steps undertaken throughout the year. The process of writing the letter helped Steve connect with what completing the book will be like. It also helped him identify milestones to the completion.

Right now, Steve is more excited about the book project than ever. He receives sporadic emails of entries from various blogs. He has a detailed plan for January, which includes mapping out milestones for the year much like his marathon plan. Steve knows what to do now. And he is doing it.

Joe just finished the fourth semester of mostly A’s. He feels more confident and excited about his direction. He clarified his desire to pursue petroleum engineering and continues to look forward to overseas work experiences as he winds up his last year of college. His parents are proud and marvel at the motivation he exhibits at school and in the home.

Do you know what you want? If not, ask yourself some questions. And if you know what you want, connect with what excites and stimulates you to action. That stimulation will keep you going. And as long as you plan in accordance with what you know about yourself and the challenges you face, you will be able to strategically inject excitement and impetus to carry forward actions that support what you want. Your days, weeks, months, and years of your life will be driven by the kind of energy that connects with the heart of who you are and what you want.

For more information:

Art of Possibilityby Benjamin and Rosamund Zander. A short book about possibility. It claims you can paint your own reality. Possibility exists to the extent you can imagine it.

Drive by Daniel Pink. This book explores the source of motivation from the perspective of economic, social science, and biological research. Pink makes a plea to the business world to act on the knowledge of motivation that exists.

"Exceeding Expectations," by Henry B. Reiff, Paul J. Gerber, Rick Ginsberg. Book reporting research of successful adults with ADHD and/or learning disabilities.

“Finding your Focus Zone” by Lucy Jo Palladino, PhD. This book explores ways to maximize attention and motivation with ADHD.

“Evaluating Dopamine Reward Pathway in ADHD” by Nora D. Volkow, MD; Gene-Jack Wang, MD; Scott H. Kollins, PhD; Tim L. Wigal, PhD; Jeffrey H. Newcorn, MD; Frank Telang, MD; Joanna S. Fowler, PhD; Wei Zhu, PhD; Jean Logan, PhD; Yeming Ma, PhD; Kith Pradhan, MS; Christopher Wong, MS; James M. Swanson, PhD . Abstract of research that concluded, “A reduction in dopamine synaptic markers associated with symptoms of inattention was shown in the dopamine reward pathway of participants with ADHD.”

ADHD Brain discussion offered by John Ratey. Podcast from Brain Science Podcast Forum.

Ose Schwab of Potentia Vita has been coaching adults and college students for over three years. She lives and works in the Boston area. She believes that individuals with ADHD are an untapped treasure that when mined will help our world solve problems and thrive. To follow her blog "Shift Forward", visit