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We asked ADDitude’s innovative readers what tricks they have up their sleeve to avoid the powerful pull of the couch and embrace exercise. Here’s what they said:

“I purchased a treadmill and put it in front of the TV. If I want to watch TV, I have to walk on the treadmill for at least 15 minutes.”

“I signed up for a workout class with a friend.”

“Finding someone local to go on a walk with can be a game changer, especially if you explain that you need support getting out of the house). Having the other person to help me “task initiate” is brilliant.”

[Read:Take It Outside! How to Treat ADHD with Exercise]

“When I put a load of laundry in, I do a yoga or walking video until the washing machine buzzer goes off. I get in exercise and feel productive.”

“I just got a VR (virtual reality) headset and am super into one of the fitness games in it. I don’t even realize I’m working out.”

“I tricked myself into liking the gym by getting a “black card” which gets me access to a hydro massage chair! I work out, I get a massage.” 

“My creative solution: accountability and competition. I don’t want to exercise, but I do want to keep my promise to play tennis with my friend (and I also want to destroy him).”

[Watch: “How to Leverage Sports Psychology to Benefit ADHD Brains”]

“Committing to just the warm-up portion of a video exercise helps. I usually feel like doing the rest once I’ve warmed up.”

“I have finally, after years of wanting to, got into doing yoga regularly —every single weekday morning. I’ve identified the barriers, and tried to address them. Number one is:  I have to work out straight away, as if I do anything else, my meds kick in and I’ll get focused on it too much.”

“Sign up for an intramural sports team. That way, you have people counting on you to show up to practice and for games.”

Workout Motivation with ADHD: Next Steps

• Read: 6 ADD-Friendly Tips for Starting and Maintaining an Exercise Program
• Download: Free Guide to Health & Fitness — Lifestyle Changes for Adults with ADHD
• Read: Exercise and the ADHD Brain -— The Neuroscience of Movement

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As a teen, Taylor* struggled to develop intimate social relationships with her peers. She felt compelled to drink in nearly any social setting — including on dates and around boys. In high school and college, she never ‘hooked up’ with a man without being under the influence. At age 29 — after years of low self-esteem and criticism — Beth finally had her first healthy romantic relationship.

“I dated loser after loser, unavailable men, dangerous men,” Taylor, a woman with ADHD, told ADDitude. “I never had a ‘real’ relationship until I met my future husband at age 29. We didn’t marry until I was 33.”

Taylor was the last of her siblings, and of her small friend group, to get married.

“People always told me that I wouldn’t find a husband, that no man would ever love me, etc. My self-esteem was garbage, and it was reflected in all of my dating decisions.”

Low self-esteem and lagging social skills are common for children with ADHD. With the proper treatment plan, teens can go on to have healthy and successful relationships. But for women and girls — who often go undiagnosed or misdiagnosed ^{1, 2} — the impact of untreated ADHD cannot be understated.

[Download: Hormones & Symptoms of ADHD in Women]

We asked ADDitude readers: “How has ADHD influenced your decisions about dating, marriage, and other relationships?” Answer this questions yourself in the Comments section, above.

How Does ADHD Affect Relationship Decisions?

“Before I was diagnosed, I was easily manipulated by a narcissist who didn’t need to try hard to make me fall into patterns of masking. By the time we divorced, I had masked so much and for so long that I didn’t even know who I was anymore. My ADHD influenced me by thinking I could publicly prove my worth if I married again. That was an even bigger disaster… I have remarried — yes, for a third time — but since being diagnosed, I understand myself, my needs, and my worth to a level that allowed me the confidence to talk with my current husband calmly and openly about my struggles. It’s not paradise all the time, but it is healthy and supportive.” — Brianna, Iowa

“I have been impulsive with all of my relationships prior to being medicated. I either move in quickly, get married quickly, or have children quickly without paying attention to the red flags.” — Courtney, New York

“Absolutely; [there was] lots of risk-taking in [my] late teens and early 20s. Lots of impulsive sex, forgotten contraception, zoning out, and not interpreting male behavior correctly. I put undeserving men on pedestals because of my own lack of self-worth, a lifetime of negative self-talk, and what I didn’t know were ADHD symptoms.” — An ADDitude reader

[Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, & Treated Inadequately]

“Though I did not realize it when I was younger, I see now that my ADHD had a huge influence on my relationships — both romantic and platonic. If I was around someone frequently in school or work, I found it much easier to keep up with those relationships. Once a situation changed and required any level of effort on my part to keep up with the relationship, it would begin to fade. I still find it extremely difficult to initiate phone calls, texts, and get-togethers. With my spouse, I forget to call or text during the day. It’s like out of sight, out of mind.” — Gina, Florida

“It makes my marriage much harder because my spouse doesn’t understand (he says he tries) why my ADHD brain works the way it does. I have realized that maybe being married isn’t for me, but I am not confident enough to do anything about it.” — An ADDitude reader

“Over the years, I’ve learned that the level of stress and shame in my life is directly proportional to the efforts I make to have relationships of any kind. So, I don’t. Isolation isn’t ideal, but it’s easier and less stressful than trying to maintain friendships or romantic relationships.” — An ADDitude reader

“Since I got my diagnosis, my relationships with many people have changed — mostly because of their prejudices against ADHD. But my relationship with my fiancé and our daughter has greatly improved because we now know why I am the way I am. It helps to avoid lots of conflicts that would have evolved to arguments before my diagnosis.” — An ADDitude reader

“My ADHD played a significant part in my decision to stop dating and spend more time alone. I like and understand myself! I don’t have to apologize for my clutter. And I’m fortunate, after one marriage, to have produced a wonderful young adult son with whom I share this complex and creative brain condition.” — Kathy, California

“Unknowingly, yes. Neither one of us was diagnosed at the time, but I remember breaking off an engagement with a very smart, nice young man because we both seemed to have difficulties with follow-through on household (and other) tasks. I knew our budget would be very tight, and I had trouble with maintaining a strict budget. I knew just these two issues were more than enough to cause us serious problems.” — Victoria

[ADDitude Directory: Find an ADHD Coach]

“My daughter is always educating others on the limitations and difficulties of living with ADHD. She works hard every day to keep her coping skills at above-normal levels. She does not want to date or marry another person with ADHD as she feels daily life would be difficult, especially when she becomes a parent.” — Barbara, Georgia

“I was diagnosed when I was already in a relationship with my current partner. My partner also has ADHD and is part of the reason why I was finally diagnosed. I think if anything happens in the future and we are no longer together, I would look for a partner who is supportive of my ADHD.” — An ADDitude reader

“My relationship is just ending after 19 years largely because of ADHD, I believe. She is never able to just laugh over things that go wrong, whether because of my ADHD or our sons. I grew up in a family that always said, ‘Don’t sweat the small stuff,’ and some of our funniest memories are of things that went awry. I am in no hurry to look for another serious relationship in my lifetime. I’ll stick with my friends who love me as I am.” — Janice, California

“Marriage has become a struggle; we believe all four of us have ADHD. No one is good at follow-ups on low-interest items. We have sought outside advice on how to distribute tasks, partner better, and learn coping skills.” — An ADDitude reader

“It is difficult to form relationships when you are always talking. Learning to listen has been difficult.” — Lisa, North Carolina

“Sometimes I have to limit my time with friends or family members who try to change my bad habits. It’s overwhelming.” — Donna, Georgia

“My spouse and my daughter have ADHD. I realized that I need to preserve energy and have to say ‘no’ to things I would like to say ‘yes’ to in order to preserve my well-being.” — An ADDitude reader

*Name has been changed to protect anonymity.

Women with ADHD & Dating: Next Steps

• Download: Manage ADHD’s Impact on Your Relationship
• Read: From Love Bombing to Boredom
• Read: The Rules of Dating (and Breaking Up) with ADHD

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ 1 Kessler R.C., Adler L., Barkley R., et al. (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry, 163(4):716-723. https://doi.org/10.1176/ajp.2006.163.4.716

²  Slobodin, O., & Davidovitch, M. (2019). Gender differences in objective and subjective measures of ADHD among clinic-referred children. Frontiers in Human Neuroscience, 13, 441. https://doi.org/10.3389/fnhum.2019.00441

“Dopamine fasting” is a buzzy term for the practice of temporarily abstaining from stimulation — via smartphones, social media, video games, and other platforms that deliver reliable dopamine hits — to feel more pleasure later. Here, psychologist Wes Crenshaw, Ph.D., weighs in on the Silicon Valley and TikTok trend that is gaining momentum, particularly among people in their 20s who have ADHD.

Q: People say they go on a dopamine fast or digital detox to “reset their dopamine levels” so that they will feel heightened pleasure when they return to their screens and other forms of stimulation. Does this work?

Our minds are so habituated to a heightened level of engagement from near-constant phone or computer interaction that taking a pause seems wise. But when it comes to video games, TikTok, and other high-dopamine-hit engagements, doing a “fast” isn’t the way to go because you’re not really changing anything about your brain. It’s better to moderate your device usage to have an effect that’s less negative than stopping cold.

[Read: “My Phone Was My Drug”]

Q: Can a digital detox help your brain overcome addictions to compulsive behaviors like checking social media and high levels of stimulus delivered via texts and alerts?

The idea of using abstinence to address addiction is not supported by research. And it’s not a practical solution for behaviors integral to functioning in the modern world, such as using social media and texting. These tools, when used in moderation, are a regular part of modern life. But when these devices draw you away from more necessary activities, or impair your ability to do daily tasks, they become destructive.

I have college-age clients who put their phones in timed lock boxes for, say, three hours during their study time. Once the box is locked, there’s no opening it without a sledgehammer. This technique is referred to as “precommitment,” and in my experience, it is much more effective than other phone apps.

Q: Can individuals exert control over their dopamine levels or is sensitivity to stimulation just baked into your DNA?

[Read: “I Need a Digital Detox. How Do I Break a Social-Media Habit?”]

The timed lock box is a good example of exerting control, except you’re not really controlling your dopamine; you’re moderating your behavior. That’s about the best anyone can do. Another kind of moderation is setting an alarm to signal when it’s time to exit a game or social media, or shutting down the Internet at 10pm to avoid interrupting sleep with multiple dopamine hits.

Q: Are there risks associated with dopamine fasting? Should people be trying it?

I think the risk is that you constantly feel uncomfortable. Unfortunately, feeling uncomfortable is exactly what a lot of people are trying to escape with so-called addictions. They want things that are easy, fun, and stimulating to their brains instead of the tedium of getting business done.

Dopamine Fasting and ADHD: Next Steps

• Read: Wasting Time on Social Media? 6 Ways to Stop ADHD Brains from Doom Scrolling
• Read: Hooked on Social Media? How to Break the Habit
• Read: My ADD Sabotages My Social Skills Online

Carole Fleck is Editor-in-Chief of ADDitude.

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The concept of the midlife crisis began a century ago with Sigmund Freud and Carl Jung, who argued that greater self-awareness and self-actualization in midlife leads to a fear of impending death. Critics challenge whether mortality-related anxiety is actually to blame for the drastic life changes so commonly associated with midlife crisis: divorce, job loss, and convertible acquisition.

Research suggests that 10% to 20% of adults will experience a midlife crisis.¹ Among adults with ADHD, that number is considerably higher: 59% of men aged 40 and older, and 51% of women aged 40 and older said they have experienced a “period of emotional turmoil in middle age frequently characterized by a strong desire for change,” according to a recent ADDitude survey of 1,829 adults with ADHD.

The 690 women and 228 men who responded in the affirmative shared stories of career upheaval, infidelity, divorce, money problems, substance abuse, and burnout. For some, the change was more like a “midlife catharsis” that was long overdue; for others, it was traumatic.

“I divorced my narcissistic ex, started graduate school to become an educator, met the best man I’ve ever known, fell in love (for real this time), and earned two black belts during about an 18-month span of time,” wrote one 49-year-old mother in Washington.

[Take This Self-Test: Do I Have ADHD?]

“I didn’t feel I was able to function in the world,” wrote a 49-year-old male who rated his ADHD symptoms as “life-altering” in his 40s. “I left a seven-year relationship with my partner and stepdaughter, quit my job with no other job to go to, and went to live at a Buddhist monastery.”

These may seem like extreme examples, but the root causes of these crises — namely, ADHD traits like impulsivity, emotional dysregulation, and restlessness — form a ribbon snaking through many of the ADDitude survey respondents’ answers. Indeed, 81% of men and 71% of women who said they have experienced a midlife crisis attributed it to ADHD symptoms and attributes.

“I believe my midlife crisis was a perfect storm of life-stage dissatisfaction, perimenopause, a poor relationship, and the upsurge of previously well-masked ADHD symptoms due to stress, hormonal deficiency, and increased emotional dysregulation (oh, and lockdown!),” wrote a 53-year-old mother who quit her job and divorced her husband of 28 years. “I experienced a peak in my impulsivity, libido, mood changes, and interests in new and varied topics, which I pursued in ways that my husband saw as distractions from the marriage. I needed new stimulation and to get out of old situations that were no longer serving me.”

Here are more stories of ADHD’s impact at midlife, from ADDitude readers reflecting on their experiences:

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Source

¹Lachman, Margie E. (2003). Development in Midlife. Annual Review of Psychology. Vol. 55:305-331. https://doi.org/10.1146/annurev.psych.55.090902.141521

“I see a lot of women who probably have undiagnosed ADHD in this sport because we all gravitate toward this… and find that the repetition and structure of running works,” said Olympic marathon medalist Molly Seidel during her recent conversation with WebMD about barriers to mental health care for women. “A lot of people in elite sports, I think, do have something going on… Yeah, we’re all running from something.” (Seidel may be on to something, as some research suggests that ADHD may actually be more common in elite athletes than it is in the general population.)

For Seidel, that something is a late-life diagnosis of ADHD, along with comorbid obsessive compulsive disorder and eating disorders.

“This Is Never Going to Get Easier. And That’s OK.”

It took Seidel years, and a lot of work, to figure out how to manage her conditions, and to find the self-care systems and strategies that are most beneficial for her. She likens this work to her training as a runner, and emphasizes that both are ongoing.

“I think a lot of people assume that I’m a lot more naturally talented than I actually am at this sport. I’m really not,” she said, emphasizing that her success is a product of hard work and dedication. “It’s that consistent, day-to-day work that has translated exactly into my mental health, my realizing that it’s OK that I’m going to have to work at this every day… I also have to wake up every day and brush my teeth, and I’m not expecting that if I brush my teeth enough, I’m never going to have to do it again.”

Seidel’s sharp understanding of herself and what she needs to be at her best every day echoes the advice of Dawn Brown, M.D., a sports psychologist and ADHD specialist who recently hosted the ADDitude webinar, “How to Leverage Sports Psychology to Benefit ADHD Brains:”

“We should adapt to how our brain, our minds are created, meaning we have to find accommodations and strategies that are in line with how our ADHD brains respond to performance and productivity,” Brown said.

Though Seidel has developed effective methods for managing her mental health conditions, she says their impact on her life is far from static. “There are times where these things are very manageable for me,” she shares. “And there are other times when it takes over my entire life.”

Mindfulness and Other Self-Care Strategies

Mindfulness is the lynchpin of Seidel’s daily routine. “I operate on a very high-strung, very over-stimulated level, and I struggle with coming down,” she said. “Being able to decompress, come down from that, [by using] various breathing and calming techniques has been absolutely vital for me. That is something that I have to do every day, multiple times a day.”

Mindfulness, she said, “is about really focusing on lowering the temperature in the system and lowering the breath rate…so that I can come back to almost like a baseline level.”

Mindfulness, like other relaxation techniques, is part of optimal mental performance conditioning — “what great athletes practice,” according to Dr. Brown.

Recovery and Structure Outside the Track

What happens outside her running shoes is just as important for Seidel’s overall mental health and performance, she said.

“I need to have stuff outside that I’m working on,” she said. “Being able to have some sort of structured time and structured assignments is really mentally healthy for me.” Seidel is pursuing an MBA through DeVry University’s Keller School of Management. “It’s nice having something else outside of running to focus on.”

Another important self-care lesson Seidel has learned as a professional athlete: Healing — both physical and mental — is not a luxury, but a necessity. “Recovery is a huge part of my job,” she says. “And I’ve found that it is just enormously helpful for what I do, and for being able to manage not only just life, but a higher level of training.”

Athletes and Self-Care with ADHD: Next Steps

• Read & Watch: “Maybe I’m Not Just Thoroughly Messed Up:” Olympian Molly Seidel On Her Late ADHD Diagnosis
• Read & Watch: “Athletes are Real People with Real Mental Health Issues”
• Webinar: How to Leverage Sports Psychology to Benefit ADHD Brains
• Read: Olympians, Professional Athletes, and Sports Legends with ADHD

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

I have another therapist whom I see on my phone, too. But unlike Stephanie, this therapist starts a session by asking if I would like to “get help with a problem,” “work on my goal” (which has been decided for me), or “track and journal.” Also unlike Stephanie, this therapist is available 24/7 — but doesn’t remember my big parties, my book launches, my successes, or my failures.

This therapist is named Woebot, and it’s a therapeutic chatbot powered by artificial intelligence (AI).

A free app available for both Apple and Android devices, Woebot serves “tens of thousands” of users daily, said its founder and president, psychologist Allison Darcy, in The New York Times in 2021. Based on principles of cognitive behavioral therapy (CBT) and “natural language processing,” Woebot engages users in text-based conversations, and is designed to help people cope with stress, anxiety, and depression in a growing field of mental health tools.

Woebot tells me during our chats that it can also help with my anger, procrastination, and guilt — common issues for people living with attention deficit hyperactivity disorder (ADHD). It sounds useful: America is plagued by a therapist shortage and long wait times for care. The high cost of therapy can also be a barrier. If you can’t find a therapist and you need one fast, a free chatbot built on sound CBT-based science sounds tempting.

My advice: Resist.

[Read: The Top 6 Mental Health Apps, According to ADDitude Readers]

WoeBot Woes

Woebot assumes neurotypicality. It expects that all brains can be retrained to cope with negative emotions using the same therapeutic model. But ADHD brains process information and emotions differently.

For example, Woebot doesn’t understand that people with ADHD have big, all-consuming emotions. When I told it I was mad, Woebot told me to “imagine my emotions had a voice.” Wait, what? I was in total rage mode when it asked me to write down three of my angry thoughts. So I did, albeit poorly. It then asked me to identify my “cognitive distortions” — i.e., thought patterns that aren’t based on facts.

But when I’m mad, I am too flooded with hot emotion to stop and look for cognitive distortions. Something is wrong; I need to calm down, but the opposite is now happening.

Woebot also claimed it could help with procrastination. But it offered such a complicated mathematical equation about the merits of doing something now or later that I couldn’t (and still can’t) understand. Maybe it could assist in a pinch — if I remembered it existed. But Woebot did not intervene when I began tumbling through TikTok rather than washing dishes.

[Read: The Emotional Resilience Playbook for People with Big Emotions]

Woebot was no match for my negative self-talk, either. When I told it I felt sad because I don’t have any friends — social issues are a common problem in women with ADHD — it launched an ineffective CBT round-and-round that had me fill in blanks and flag “unhelpful” thoughts. Eventually, I avoided my negative thoughts by watching TV instead. (Avoidance is not an acceptable tactic for coping with negative thoughts, of which I had several regarding Woebot.)

We Need More Than AI Chatbot Therapy

At least Woebot comes with safeguards: Certain words trigger suggestions for immediate clinical intervention. During one conversation, Woebot told me, “I can’t comment on the content of your thoughts, just the process. If you’re looking for guidance around content, this might best be done with a human.” I still don’t know what triggered that response, so how would someone in serious trouble understand it, and how could it help those people using Woebot in place of that therapist with availability in October?

No matter how poor my efforts or how ineffective our sessions, Woebot always told me that making an effort was the important part. Unfortunately, mental illness doesn’t get bonus points for effort. We need effective help to improve our lives. And that means a human therapist, not a bot.

AI Chatbot Therapy and ADHD: Next Steps

• Find: Psychologists and Therapists Who Understand ADHD
• Free Download: Emotional Regulation & Anger Management Scripts
• Read: “How Therapy Helped Me”
• Read: How Cognitive Restructuring Reframes Failure and Erases ADHD Self-Doubt

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

As if having an ADHD nervous system were not hard enough, research now shows that having the disorder nearly doubles the risk of heart disease, regardless of a person’s age, gender, or ADHD medication use.

In a study of 5 million adolescents and adults from Sweden, researchers found that having any mental health condition increased the risk for all cardiovascular conditions — and that risk more than doubled for those with ADHD and one or more co-existing conditions. Surprisingly, the greatest risk was in young adults and not in the elderly. While the cause is not yet known (a genetic predisposition is likely), we can now see that the risk is broad and substantial.

How Comorbidities Complicate Heart Health

The incidence of heart disease was 1.8 times higher among people with ADHD than it was in the general population, with cardiac arrest and strokes posing the greatest risk. If a person has ADHD and a co-existing mental health condition, the risk of heart disease more than doubles. For those with substance use disorder, the risk increases 2.53-fold; eating disorder increases the risk 2.75-fold; conduct disorder boosts it 2.79-fold.

The study also confirmed previous findings that men faced higher risk than did women throughout the lifespan.

[Read: ADHD Medication Not Associated with Cardiovascular Risk at Any Age]

Many people want to ignore or deny the seriousness, and even the existence, of ADHD to justify not treating their own and/or their child’s ADHD. The Swedish study should raise awareness and a sense of urgency about the necessity of making good lifestyle choices, such as quitting smoking and substance use, eating healthy, and exercising, all of which have been shown to protect against many illnesses.

Treating ADHD Decreases Your Risk

It is important to emphasize that medication treatment of ADHD and other mental health conditions effectively decreased the risk of heart disease in many cases. The research also emphasized that ADHD and other mental health conditions, such as depression and anxiety, should be aggressively treated with medication to protect against the well-known risks posed by the conditions.

6 Ways to Improve Your Heart Health

Mitigate the risk for heart disease by doing the following:

• Establish ongoing care with a clinician who can guide you toward a more balanced lifestyle.
• Get a baseline cardiac workup, especially if you’re a young male adult.
• Ask relatives about heart disease in the family. Most of the risk of heart disease is genetic. This can help you to assess your individual risk.
• Exercise regularly.
• If necessary, lose weight on a healthy, balanced diet.
• Use a pill box to assist you in taking all of your medications consistently.

[Read: The Dopamine Deficiency That’s Sabotaging Your Diet]

This new information confirms much of what we already know: People with ADHD and other mental health conditions can lead healthy and fulfilling lives when they protect their health and wellbeing.

Heart Health and ADHD: Next Steps

• Read: Exercise and the ADHD Brain – the Neuroscience of Movement
• Download: The ADHD Healthy Habits Handbook
• Read: The Best Nutrition & Diet Apps for ADHD Brains
• Download: Free Guide to Healthy Lifestyle Changes for Adults with ADHD

William W. Dodson, M.D., LF-APA, is a board-certified adult psychiatrist and one of the first practitioners to specialize in treating adults with ADHD.

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As a 62-year-old man with ADHD, I can get emotional quickly and often about relatively insignificant things. I can be immature and irresponsible. For years, I have felt embarrassment and shame about the lack of progress in my career. I also have learned that these characteristics, among others, are more pronounced in many men with ADHD than they are in their female and neurotypical counterparts.

Much has been written, deservedly, about the unique challenges facing women with ADHD. But, arguably, not as much has been written about how men experience ADHD differently. Sure, most of us know that hyperactive boys are more likely to be diagnosed than are inattentive girls. However, the people in our lives really need to understand the differences men with ADHD experience.

Here are examples of how I think ADHD manifests differently in the sexes.

Common ADHD Symptoms in Men

Delayed emotional development. Research has shown that males mature more slowly than do females, and this seems especially true for men with ADHD.

Being quick to anger. While girls tend to internalize emotions, boys are more likely to externalize theirs. It stands to reason, then, that boys with ADHD have higher rates of oppositional defiant disorder (being argumentative, uncooperative, and sometimes hostile). In adulthood, men with ADHD are more prone to emotional outbursts fueled by anger at real or perceived slights.

Resistance to pursuing a diagnosis. In my many years of ADHD coaching, I’ve encountered countless women who struggle with their husband’s or young adult son’s resistance to seek or accept an ADHD diagnosis because they fear the “stigma” of the disorder, and, in their male minds, it’s admitting to “weakness.” Unsurprisingly, most of my female social media followers are the ones who most actively pursue understanding ADHD on behalf of their husbands, their kids, and themselves.

[Take This Test: Could You Have Adult ADHD?]

Lackluster career advancement. This issue for men arises, in part, from the social construct that still expects men to be the head of the household, the main breadwinner. When a man with ADHD is unable to perform optimally in or successfully retain his job (as was the case for me for many years), the shame and guilt can be devastating.

Think about how often new social interactions begin with, “So, what do you do for a living?” In other words, what is your value? And when you’re not proud of what you do, or how well you’re doing it, you feel shame and embarrassment.

How Men Can Manage ADHD Symptoms

Men with ADHD need a safe place to share their struggles, like a support group with people who share similar challenges. Feeling heard, and learning new ideas for how to cope, can be very comforting.

Mindfulness training and exercise can help with mood stabilization and rein in emotions. I also recommend working with your partner, and perhaps a therapist, on communication strategies to control outbursts before they happen.

[Take the ADHD in Men Survey]

I’ve found that understanding common ADHD symptoms in men and working on managing them has helped me become more effective in my life as an adult with ADHD.

ADHD Symptoms in Men: Next Steps

• Read: Men with ADHD Are Asking, “Why Am I So Angry?”
• Blog: “I’m a Better Father, Now a Better Person”
• Download: Emotional Regulation & Anger Management Scripts

Alan P. Brown is an ADHD coach and host of CrusherTV. His free eBook, 5 Things You’re Doing Every Day That Make Your ADHD Worse, is available at www.ADDCrusher.com.

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Recently diagnosed with ADHD (at 38 years old), I have been looking back over my life and taking stock. Today, I see everything through a different lens. I understand now that beyond the pain of others saying that they couldn’t stand me – a pain ignited by rejection sensitive dysphoria (RSD) — I couldn’t stand myself most of the time (and still can’t). Being in my head is like being in a broken computer game from the ’80s: streams of neon lights ricocheting off the walls of my neurodivergent brain, patterns of half-finished coding, and working in overdrive just for a glimmer of nonsensical light to break.

To Those Who Will Never Cancel Me

When I told a close friend about my diagnosis, we both chuckled. It was not a surprise to either of us. She said she was drawn to people with ADHD and that they “drove her crazy,” but she still loves them so. She, like the few others who have stuck with me through the years, display unusual amounts of grace and compassion. They see deeper than the outrageous things I sometimes say or do. They know how my social anxiety shows up during the functions they invite me to, and that I forget so many things they tell me.

My husband is one of those people with limitless grace. He has withstood my RSD and the emotional dysregulation that floods my brain. He has also withstood my OCD, anxiety, depression, and hypervigilance. When others have thrown me away, he’s scooped me up off the floor and wiped my tears or given me space to rage through the pain. He truly sees me.

But I see him, too. He also has ADHD, though we have different symptoms. Sometimes we laugh about how we found each other in this life and how we are forever grateful that we did. Even though our ADHD symptoms often collide and our communication can get tangled up like old telephone wires damaged by storms, we are united in love and dedication. We help each other navigate this strange neurological land. And after becoming parents, we want to do everything in our power to show our children that there is nothing wrong with the way we were made.

[Read: “I Can’t Handle Rejection. Will I Ever Change?”]

Surviving Rejection, Cancelation, and ADHD Stigma

After my diagnosis, I came to understand that some people will always be committed to misunderstanding me. They view their assumptions about me as absolute truth. I have chosen to cut off contact when this is the case. Despite the sting of rejection, I try not to go around defending myself too much or justifying to others why I am the way I am. I’m learning, slowly, to stop apologizing.

I’m learning how to be kinder to myself. I try not to beat myself up when I fail in the workplace, when I start another project that will go unfinished, when I unintentionally offend someone, when I forget important things, and when I make so many other mistakes. I remind myself that there is a real and neurological reason behind this. I give myself the grace and understanding others cannot.

When I am overwhelmed by how the simple aspects of life are so much harder for people like me, I remind myself how far I’ve come. I remind myself that having a husband who loves me for me and a few close friends who I can truly be myself with is more than enough.

When I wonder again why I had to be born this way, I pause, take a breath, and remind myself that it’s not my fault or anyone else’s — because there isn’t anything wrong with me. Some people will simply choose not to see that there is so much gold to be found in people like me.

[Read: Coping With the Stigma of ADHD]

When I’m told I’m either too much or not enough, I remember that I am not perfect, but good enough. That I am brave. That I am tender. That I am creative. That I am not a problem to be solved. That I’ve been canceled before, and I’ll probably be canceled again. But I can take it.

Cancel Culture, RSD, and ADHD: Next Steps

• Free Download: Understanding Rejection Sensitive Dysphoria
• Q&A: My Fear of Rejection Keeps Me Socially Isolated
• Read: How to Break the Habit of Internalized Criticism

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Register to reserve your spot for this free webinar and webinar replay ►

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ADHD impacts the genders differently and in significant ways.

Men with ADHD and emotional dysregulation may be quick to anger and prone to outbursts at real or perceived slights. They may also be less likely to advance in their careers than neurotypical men. As a result, these men with ADHD may feel shame and embarrassment. Understanding these unique challenges, and the solutions that address them, is important for any partner, colleague, or caregiver to understand.

In this webinar, you will learn about:

• The ways in which ADHD is experienced differently by men, affecting their personal and professional relationships
• The problems with working memory, anger, and emotions — including feelings of shame and guilt — common in men with ADHD
• Evidence-based, practical solutions designed to address these challenges
• The ways in which men and their partners can better navigate these differences

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meet the Expert Speaker:

Alan P. Brown is an ADHD/productivity coach and host of CrusherTV (www.CrusherTV.com), the award-winning video series designed for ADHD teens and adults. Undiagnosed for decades, Alan experienced underachievement, failed relationships, substance abuse, and worse due to his untreated ADHD. Once diagnosed, he found it difficult to learn coping strategies from books, so he developed his own evidence-based “brain hack” strategies while building a successful advertising career and several start-ups. A featured presenter at ADHD conferences in the U.S. and abroad, and a TEDx speaker, he is the #1 best-selling author of Zen and the Art of Productivity. (#CommissionsEarned) Get Alan’s free eBook, 5 Things You’re Doing Every Day that Make Your ADHD Worse at www.ADDCrusher.com.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

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April 17, 2023

High-intensity physical activity greatly improves mental health symptoms in adults across clinical conditions, according to a meta-analysis recently published in the British Journal of Sports Medicine. Vigorous and short-duration exercises were found to be most effective in improving mild-to-moderate symptoms of depression and anxiety, compared to usual care.¹

Higher-intensity workouts were found to be most effective at improving symptoms of depression and anxiety — the comorbid conditions that most commonly occur alongside ADHD. Short-term interventions lasting 12 weeks or less were more effective at improving symptoms than were longer-term exercise programs. Outcomes were measured through self-reports or clinical assessments.

Healthy adults, adults with mental health disorders, and adults with chronic diseases were included across 97 systematic reviews. The study found mental-health benefits associated with all modes of physical activity, including strength-based exercises; mixed mode exercises; stretching, yoga, and mind-body modalities; and aerobic exercise.

Exercise, Depression & Anxiety

While positive effects spanned all groups, the clinical effects of different modes of physical activity varied. Researchers found that resistance or strength training had the largest beneficial impact on depressive symptoms.

“Physical activity improves depression through various neuromolecular mechanisms including increased expression of neurotrophic factors, increased availability of serotonin and norepinephrine, regulation of hypothalamic–pituitary–adrenal axis activity and reduced systemic inflammation,” the researchers wrote.

For symptoms of anxiety, mind-body modalities like yoga had the greatest impact.

“Physical activity (PA) on depression and anxiety are due to a combination of various psychological, neurophysiological, and social mechanisms,” the researchers said. “Different modes of PA stimulate different physiological and psychosocial effects, and this was supported by our findings.”

High-intensity exercise has also been associated with improvements in sleep — thought to be closely connected to mental health.² For middle-aged or older adults, the long-term effects of too much sleep (more than 8 hours) or too little (less than 6 hours) can lead to death by various causes, including cardiovascular disease. Exercise can help to negate those mortality risks. In a recent U.K.-based population cohort, adults who exercised often greatly lowered their sleep-duration-related mortality risk. That risk was nearly non-existent when adults went beyond the WHO’s recommendation of 150 minutes of moderate to intense physical activity per week.³

In the current study, the adults who benefited most from physical activity included generally healthy adults; pregnant or postpartum women; adults with depression; and adults with HIV or kidney disease. Participants included adults aged 18 and older.

Exercise and ADHD

Exercise was rated very highly by people with ADHD in ADDitude’s treatment survey conducted in 2017. More than half of the 1,563 adult respondents rated exercise as “extremely” or “very” effective in managing their ADHD symptoms — which may coexist with and become exacerbated by symptoms of mood disorders like depression.

Exercise was one of the top-rated treatment options among adults in the survey, but only 17% said that exercise came at the recommendation of their doctor. Though it received lower patient ratings, medication was more often used to treat symptoms; patients said they believed medication would have more “immediate” and “consistent” effects. Though exercise promises to lessen some of the commonly reported side effects of ADHD medication — like sleep disturbances and irritability — only 37% of ADDitude survey respondents said physical activity was included in their treatment plan.

The current meta-analysis found that “effect size reductions in symptoms of depression (−0.43) and anxiety (−0.42) are comparable to or slightly greater than the effects observed for psychotherapy and pharmacotherapy.”

Limitations & Future Research

The growing body of research on exercise and mental health is promising, but not without its flaws.

Though researchers from the present analysis “applied stringent criteria regarding the design of the component randomized controlled trials to ensure that effects could be confidently attributed to PA,” AMSTAR 2 ratings were a limitation. Of the 97 systematic reviews, 77 received a clinically low score. Those studies were identified as having more than one critical flaw, and three or more non-critical weaknesses.

A meta-analysis published in Nature found many short trial durations, small sample sizes, variable outcome measures, and other potential biases or inconsistencies in studying exercise and cognition.^{4 5} That’s not to say exercise is without cognitive (or social, or physical) benefits, but the research on mental health and exercise requires more validation.

“Organizations committed to public health, such as the World Health Organization or the National Institutes of Health, currently recommend regular exercise as a means to maintain a healthy cognitive state, which based on our findings cannot be affirmed,” they wrote.

The current study acknowledges this, stating: “Patient resistance, the difficulty of prescribing and monitoring PA in clinical settings, as well as the huge volume of largely incommensurable studies, have probably impeded a wider take-up in practice.”

Future research should reflect these limitations and consider ways to integrate conclusive findings into the clinician-patient setting.

Sources

¹Singh, B., Olds, T., Curtis, R., et al. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine. doi: 10.1136/bjsports-2022-106195

²Suni, E., and Dimitriu, A. (2023, March 17). Mental Health and Sleep. The Sleep Foundation. https://www.sleepfoundation.org/mental-health

³Liang, Y. Y., Feng, H., Chen, Y., Jin, X., Xue, H., Zhou, M., Ma, H., Ai, S., Wing, Y., Geng, Q., Zhang, J. (2023). Joint association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: a population-based cohort study using accelerometry. European Journal of Preventive Cardiology, zwad060. https://doi.org/10.1093/eurjpc/zwad060

⁴Pollina, R. (2023, March 28). New research suggests physical exercise has ‘little’ mental benefits. New York Post. https://nypost.com/2023/03/28/new-research-suggests-physical-exercise-has-little-mental-benefits/

⁵Ciria, L.F., Román-Caballero, R., Vadillo, M.A. et al. An umbrella review of randomized control trials on the effects of physical exercise on cognition. Nat Hum Behav (2023). https://doi.org/10.1038/s41562-023-01554-4

I often hear individuals with ADHD say things like, “I want to sleep, but my body won’t let me” or, “It’s difficult to turn off my mind so that I can go to sleep.” Sure, keeping a regular wake schedule, expending energy throughout the day, and avoiding stimulating activities and foods close to bedtime help regulate sleep patterns. But to really prep for a good night’s sleep, it is also vital to send “it’s time to sleep” signals to the brain and body. One of the best ways to do that is through the senses.

Try these simple sensory-based approaches to help your body get the message that it is time to rest.

[Get This Free Download: How to Sleep Better with ADHD — A Guide for Adults]

How to Make Yourself Sleepy: ‘Sense-ible’ Ways to Rest the Body and Mind

Sight

• Block out as much light as possible. Close your door, hang light-blocking curtains over windows, and consider an eye mask if you are still bothered by other sources of light (like the digits on your alarm clock) when trying to sleep. Of course, try your best to avoid screen time in the hour before bedtime.
• If you do need light, consider investing in a dim red night light, which is less stimulating to the eyes.
• As you close your eyes to sleep, visualize yourself drifting off to a calm and peaceful place.

Sound

• Block ambient noise with ear plugs or earmuffs if you’re ultra-sensitive to sounds.
• If you have trouble sleeping when it’s too quiet, try white noise or pink noise machines/apps or a fan that will fill your space with calming neutral sounds.
• If you like to listen to music to fall asleep, choose slow-tempo tunes rather than fast, complex ones.
• While lying down, take long, deep breaths to relax your body. Listen to your breathing, too, to give your mind something on which to focus.

Smell

• Well-known calming scents like lavender and jasmine can help you relax prior to bedtime. Bring these aromas to your bedroom through unlit candles, sprays, diffusers, and/or other methods.
• Is your laundry detergent too strong? Strong scents and additives on bed linens can actually keep the mind alert when it really wants to relax. Consider scent-free detergents and linen sprays.

Taste

• If you brush your teeth immediately before bed, consider an alternative to mint-flavored toothpaste, dental floss, and/or mouthwash, as this strong flavor could encourage alertness.

[Read: Your ADHD Brain Needs More Sleep — How to Get It]

Touch (Thermosensation and Proprioception)

• Proprioception is the sense that allows us to feel our body’s position in space. A supportive mattress can provide the right kind of pressure and sensory input to aid with sleep. Don’t forget about your pillows and linens, too; find fabrics and sleep supports that are soothing in texture and weight.
• A cool (not cold) room is ideal for sleep, so experiment until you find the best temperature that encourages your body to slow down and rest.
• Try a progressive muscle relaxation exercise, a method that has been proven to help reduce stress and relax the body. As you’re lying in bed (on your back), notice your body and its limbs, from head to toe. As you focus on each part, notice the heaviness of your relaxed muscles. Then, squeeze the muscles on that part of the body for a few seconds, and then release tension. Continue working on this relaxing exercise until you’ve reached your feet.

How to Make Yourself Fall Asleep: Next Steps

• Read: ADHD and Sleep Problems — This is Why You’re Always Tired
• Read: How to Break the Exhausting Habit of Revenge Bedtime Procrastination
• Read: This Simple Sleep Formula Calms My Racing ADHD Brain

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

ADHD coaching can be a lot of things to a lot of different people, in large part because no two coaches use the same approach.

But as an ADHD coach myself, I can definitely say that coaching helps individuals overcome the shame that so often accompanies ADHD.

[Read: Life Coach or Therapist — Who Should You See First?]

ADHD coaches help build accountability — a huge step for many people with ADHD who can’t always trust themselves to honor their own promises. (A frequent source of shame.) ADHD coaches bolster accountability by emphasizing what’s going right. They are the outsiders who will hold up a mirror and say, “Look at all the things you’ve accomplished.” They also help you solve problems when somethings isn’t going right.

An ADHD coach will help you understand, for example, what got in the way of the tasks you said you’d complete last week. Maybe you didn’t have enough time, or maybe the task was more overwhelming than you anticipated and it needed to be tackled in smaller chunks.

By helping you understand (and depersonalize) your roadblocks so that you can reach your goals, coaching does a tremendous job of accentuating your strengths, building self-esteem, and reducing chronic ADHD shame.

If you are interested in working with an ADHD coach, use these pointers to guide your search:

[Read: The 7 Most Essential Benefits of ADHD Coaching]

• Find someone who is trained in ADHD and has a life coaching background.
• Talk to multiple coaches before deciding on one whose style you like and who fits your needs.
• Make sure you have time for coaching. Depending on where you are in your life, sometimes adding one more thing — especially if it will burden you financially — may not be the best choice at the right time.
• New coaches are often more affordable than coaches who have many years of experience. Private coaching also tends cost more than coaching groups.
• Coaches are not the same as therapists. Learn more about the differences here to help you decide if therapy might be a better option.

ADHD Coaching to Cope with Shame: Next Steps

• Find: ADHD Coaches via The ADDitude Directory
• Read: ADHD and the Epidemic of Shame
• Read: ADHD Therapy Comparison — CBT vs. ADHD Coaching
• Read: Solid Reasons for Investing in an ADHD Coach
  

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “ADHD Is a Whole-Life, Whole-Body Experience” [Video Replay & Podcast #427] with Linda Roggli, PCC, which was broadcast on October 26, 2022.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Educating others about ADHD can foster greater inclusivity and understanding, but self-acceptance is the key ingredient needed to stop masking and start embracing ADHD. Here, learn how ADDitude readers are working to unmask their ADHD traits; find courage in their comments below.

Being Yourself with ADHD

“Since learning I have ADHD as an adult, I’ve let so much happen. My husband says my symptoms have exploded. I think I’m just not hiding them because of shame as much anymore. We’ll work it out somehow.” — Sara

“My diagnosis helped me finally unmask. It is so liberating. I whip my hair whenever I feel like it, I fidget, I bounce my leg and I think to myself: What was so shameful about it all that I needed to suppress that?” — Katarzyna

“This has been me the last few months while I waited to be evaluated and subsequently diagnosed. It felt good to just do what I needed to do. I spent too much of my life uptight, high strung, and anxious. It’s hard, but I’m enjoying the overall process of figuring out who I am, what I built to cope for so long, and what I can let go of now.” — Jessica

[Download: Need Help Finding Your Passion? Use This ADHD “Brain Blueprint”]

“I’m pretty high up the food chain at a mid-sized tech company, and I share my diagnosis quite openly. I let people know what to expect when ADHD symptoms happen. Now when I randomly bring in a new thought, I excitedly interrupt someone’s train of thought to tell them how cool I think what they’re talking about is, or I forget what I’m saying mid-sentence and need someone to remind me, nobody’s bothered by it. Since I also give them permission to interrupt and bring me back on topic if necessary, nobody has to sit and seethe while I hunt for tangents.” — Chris

“I’m 34 and living authentically as much as possible. I’m better at my job and a lot happier.” — Chriss

“Yes and no. Hear me out. You do what you can to avoid masking… Yes, I’d like to sing out loud at work and have a shake-out dance when I need to move. That’s not considerate of others’ need for peace and quiet in work requiring concentration. So on go the headphones and I sing in my head. I go to the handicapped washroom and have a squiggle break. I’m still upfront about the ADHD and what I need, yet I get cooperation by being considerate, too.” — Anneke

“I’m unmasking for the first time at age 45! It’s scary but so freeing!” — Andreya

[Read: Why Women with ADHD Feel Disempowered — And What We Can Do About It]

“Let it out! We are who we are. There’s no shame in that. [There are] 8 billion humans worldwide, and an army of us ADHDers. We’ve got your back.” — Trev

“It’s actually kind of amazing that I did not realize I had ADHD my whole life, or recognize the habits and things I picked up along the way to help myself. Everyone used to give me such a hard time because I would chew my fingernails so bad that they would bleed, but I couldn’t stop. Now I’m really particular about keeping my fingernails nice and polished so I don’t chew them, but I constantly need something in my hands to fidget with. Otherwise, they’ll go straight to my mouth for stimulation.” — Erika

“I hate having to mask myself most of the time. It’s so liberating when you’re with people who you can be your authentic self around.” — Ben

“I give others, whom I might annoy, permission to remove themselves from my life! No more hiding; no more not being myself!” — LocdSeñorita

“I sat in the window of my favorite café today. Staff were gathered outside at a table between shifts, chatting away. One of them didn’t stay still for long at all. They’ve worked together through COVID and are good mates, so I’m guessing he feels comfortable being himself with them and doesn’t need to suppress. It was so good to see.” — Pamela

“No one should be ashamed of who they are.” — Daniela

Comments were originally published on Instagram and can be found here.

Unmasking ADHD in Adulthood: Next Steps

• Download: 25 Things to Love About ADHD
  
• Read: Why ADHD Masking Is a Form of Self-Sabotage
• Read: Crying, Screaming, and Hiding —All the Ways I Deal with ADHD Shame
  

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.