Adult ADHD Strategies: ADD Productivity, Time, Health, Organization

“Stop Chasing Others’ Approval: On Twice Exceptionality and Living Life for Me”

Nathaly Pesantez — Thu, 11 May 2023 09:34:46 +0000

“You’re going to do great things!”
“You have so much potential!”
“You’re so talented. I see great things in your future!”

So many people in my life have directed various versions of these well-meaning yet anxiety-inducing, expectation-laden comments to me during every phase of my academic career. As a gifted child, I felt as though I could succeed and, at the same time, as if I had to… or I would be letting everyone down.This black-and-white way of thinking did get me to check off a list of great accomplishments:

first in my family to graduate college, go on to complete a masters, and start a doctoral program
a successful career
financially independent since age 18

But hidden in these accomplishments are the many, many struggles and failures I encountered along the way:

flunking out my freshman year of college
being asked to resign from a job for an error in judgment I made
flunking out of my Ph.D. program due to being unable to complete assignments
piling on credit card debt

I eventually learned that my setbacks — so confusing and contrary to my successes — were actually due to undiagnosed and unmanaged ADHD. I was twice exceptional (or 2e) all this time, and I had no idea.

[Read: I Grew Up Gifted and Autistic — and Suffered the Burnout of Twice Exceptionality]

My undergraduate transcript is a wonderful example of my interest-based nervous system. I had As and Bs in classes within my major, but failed yoga (which likely had to do with my impulsive, oppositional streak).

Perspective Shift: From Never Enough to Good Enough

At the age of 29, I came to the realization that my life is my own, and while the approval of others is nice, I would never feel content if I continued to chase it. I made the conscious decision to let go of “greatness” as defined by others and to start experiencing life as it came to me.

Letting go of greatness freed me up to be content with where I am currently, instead of always trying to do more or be better. I still have personal and professional goals, but these goals are now based on my values rather than the values of other people.

My shift from “not good enough” to “good enough” has changed my self-view from lazy, unmotivated, and stubborn to efficient, understanding, and passionate.

[Read: “Twice Exceptional Is a Cruel Double-Edged Sword”]

Now I am:

enrolled in a doctoral program to advance MY learning and knowledge
in a job I can see myself in long-term, with opportunities to advance or switch it up, if I choose
writing this blog from a house that I own after paying down my debt

I don’t believe any of this would’ve been possible if I hadn’t made the choice to live life for me, instead of an image I could never realistically attain. I’ve found a specialty I love and a life that finally feels sustainable.

How to Live for Yourself

If you are 2e like me, or if you see yourself in my story, start living life for you with these steps:

Clearly identify your current values. Your personal values will come to define and frame everything else you do in life.
Set at least one goal for each value. They can be as broad or as specific as you like. For example, if you value family, how will you commit to spending more time with them?
Let go of the constant pursuit of greatness. If you are always thinking of where you could or should be, it only robs you of the ability to appreciate who and where you are now.
Foster self-compassion. You are a multi-faceted person. Your worth is not directly measured by your productivity or your achievements.

2e and How to Live for Yourself: Next Steps

Read: “My Gifted Teen Has ADHD — and So. Much. Frustration.”
Read: “Where Is the Help for Gifted Kids with ADHD?”
Read: How Unhealthy Expectations Feed Frustration

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Live Webinar on July 19: Your Organized Home: Functional Organization for Your Life Phase Right Now

Carly Broadway — Tue, 09 May 2023 23:01:55 +0000

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

Not available July 19? Don’t worry. Register now and we’ll send you the replay link to watch at your convenience.

What does a functionally organized home look like? For families with working parents and school-age children, it’s most essential (and difficult) to organize rooms and backpacks. For remote workers, organizing the home office is essential for your day-to-day work life. What doesn’t work: Closets filled with children’s sports equipment, school supplies, and decades-old clothing if you’re an empty nester or older adult with ADHD.

Embracing the season of life you’re in right now is one of the most creative and freeing things you can do to make your home optimally functional. In this webinar, you will:

Gain a better understanding of how to organize your space for each phase of life
Learn how to set realistic expectations so that everyone in the household can contribute to organizing spaces
Hear practical, easy-to-implement ideas for quick and functional changes in your kitchen
Learn how to make a plan for refreshing your bedroom spaces for each family member
Understand how to carve out a defined workspace for each family member, even if you do not have a home office or spare bedroom

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:

Lisa Woodruff, founder & CEO of Organize 365®, believes that organization is a learnable skill. She is the author of The Mindset of Organization: Take Back Your House One Phase at a Time and How ADHD Affects Home Organization. (#CommissionsEarned) Lisa has helped thousands of women reclaim their homes and finally get organized with her focus on functional organizing, encouragement, and humor her through her weekly podcasts, Organize 365.

#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.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

Closed captions available.

Solve My Problem: I Can’t Make Myself Exercise!

Nicole Kear — Tue, 09 May 2023 09:14:43 +0000

ADHD brains benefit from exercise — but they also struggle with follow-through and lack of motivation. Which is why, for most of us, having the best intentions to exercise doesn’t always translate into actually breaking a sweat.

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

How Parental Alienation Harms ADHD Families

Melanie Wachsman — Mon, 08 May 2023 09:01:30 +0000

When Nadine Vogel* got divorced, she rented a four-bedroom house so each of her children, ages 14, 16, and 18, could have their own room when they came to visit as her custody agreement dictated — one night a week and on alternating weekends. Except her children rarely came. And when they did, they were often angry and suspicious, repeating their father’s accusations about Vogel. That she was crazy. That her efforts to seek treatment for their ADHD — all three kids had been diagnosed with the condition — proved she over-medicated them. That she was trying to cut off the kids from their dad. That she was not to be trusted.

“In his senior year, my son started drinking, doing drugs, and not going to school,” says Vogel, who lives near Washington, D.C. “They didn’t let him graduate. My kids were all suffering.”

What Is Parental Alienation?

What Vogel and her kids experienced is called parental alienation, a form of emotional abuse so profound its effects on children can last a lifetime. Parental alienation happens when a child aligns with one parent and rejects the other, without justification, due to manipulation by the favored parent. This typically occurs during high-conflict divorces. Methods of manipulation include badmouthing the targeted parent, limiting contact, and interfering with communication.

”We Don’t Talk About It”

A study, published recently in The Children and Youth Services Review found that more than 3.8 million children were affected by parental alienation.¹ These numbers, as devastating as they are, may not reflect the full scope of the problem because “it’s shameful and heartbreaking, so we don’t talk about it,” says Danielle Silverman,* a New York City mother who has been alienated from her three kids, ages 22, 23, and 28, for several years. “It reflects on you, even if you know you did nothing to deserve it.”

Amy J.L. Baker, Ph.D., co-author of Surviving Parental Alienation: A Journey of Hope and Healing (#CommissionsEarned), emphasizes that catching alienating behaviors early, when it’s easier to treat children effectively, is critical. “A mildly alienated child comes back after spending time with the other parent; they may be a little suspicious, cold, wary, but that distrust only lasts an hour. It might take a full week for a moderately alienated child to warm up. Severely alienated children are shut down the whole time they’re with the targeted parent — or they don’t come [to see them] at all,” she says.

[Click to Download: 13-Step Guide to Raising a Child with ADHD]

It’s important to note that, to establish whether a child is being alienated, experts must determine that the targeted parent has not committed abuse or neglect, as the other parent may have alleged.

“Your Dad’s in a Cult”

Crystal Shivers was five when her mother told her that her father was in a cult that killed people. She said it wasn’t safe for Crystal to talk to him or any of his family. This story wasn’t true. “I remember being so sad,” says Shivers, who reunited with her father as an adult. “I missed out on relationships with my cousins, aunts, uncles, extended family, grandparents. It was a huge and heavy burden to carry.”

Joshua Coleman, Ph.D., author of The Rules of Estrangement: Why Adult Children Cut Ties and How to Heal the Conflict (#CommissionsEarned), and senior fellow with the Council on Contemporary Families, says children in alienation situations often suffer from depression and anxiety and have difficulty trusting themselves and others. They also suffer from guilt, low self-esteem, impulse control, and academic challenges. The emotional abuse is usually invisible to teachers, social workers, and even family court judges involved in custody hearings, according to a report by the National Center for State Courts.²

“Your child is out to sea. They’re being pushed underwater,” Coleman says. “You have to be the lighthouse on the shore that’s always on.”

[Self-Test: Does My Child Have Generalized Anxiety Disorder?]

Parental Alienation: Warning Signs

Examples of parental alienation behaviors include:

telling a child that their targeted parent does not love them
saying, or implying, that the targeted parent is dangerous
asking a child to spy on the targeted parent or keep secrets from them
withholding medical, academic, and other important information about the child from the targeted parent

When You’re the Target of Parental Alienation

Look at your own behavior: Is there anything you can change about how you’re relating to the co-parent to avoid triggering them?
Don’t argue with your child about the lies being leveled against you. Do everything you can to make your time together pleasant.
Document every instance of alienating behavior in the event you need to hire a family lawyer, preferably one knowledgeable about parental alienation.
Learn about coping strategies from organizations such as the Parental Alienation Study Group and the National Coalition Against Parental Alienation.

Parental Alienation: Next Steps

Read: When Parents Disagree About ADHD Medications
Q&A: “How Do I Manage Inconsistent Routines and Discipline in a Shared Custody Situation?”
Free Download: Take Charge of Your Child’s Medication

*Vogel and Silverman asked that their names be changed.

Nicole Kear is Consumer Health Editor at ADDitude.

Sources

¹Harman, J. J., Leder-Elder, S., & Biringen, Z. (2019). Prevalence of Adults who are the Targets of Parental Alienating Behaviors and Their Impact: Results from Three National Polls. Child & Youth Services Review. 106, 1-13. https://doi.org/10.1016/j.childyouth.2019.104471

² Lewis, Ken. (2020) Parental Alienation Can Be Emotional Child Abuse. NCSC Trends in State Courts https:www.ncsc.org/__data/assets/pdf_file/0014/42152/parental_alienation_Lewis.pdf

“My Self-Esteem Was Garbage:” How ADHD Impacts Relationships

Anni Layne Rodgers — Sun, 07 May 2023 09:22:32 +0000

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

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

Decision 5: How can I improve treatment outcomes for patients with ADHD and comorbid diagnoses?

Hope @ ADDitude — Fri, 05 May 2023 17:28:42 +0000

COMPLEX TREATMENT: How should clinicians approach treatment for patients with ADHD and comorbid conditions?

A: As clinicians, we must expect that adults with ADHD will come to us with complex presentations… | Keep reading on ADDitude »

PEDIATRIC COMORBIDITIES: How should clinicians adjust pharmacological treatment for children with ADHD and comorbidities?

A: Though stimulant medication, paired with behavioral therapy, is the first-line treatment for ADHD in children, contraindications and side effects may limit their use. For example, depression and anxiety can worsen… | Keep reading on ADDitude »

ADHD + DEPRESSION: What is the recommended approach for treating ADHD with depression?

A: Options for patients include an array of psychological and psychopharmacological treatments, along with newer, cutting-edge approaches… | Keep reading on ADDitude »

ADHD + EATING DISORDERS: How should clinicians adjust treatment approaches for patients with ADHD and comorbid eating disorders?

A: Treat both ADHD and the eating disorder together and don’t discount the relevance of ADHD symptoms in driving the eating disorder. ADHD has to be treated in order to unlock effective ED treatment… | Keep reading on ADDitude »

ADHD + EFD: How is executive dysfunction related to ADHD, and how should it be treated?

A: The FDA does not allow prescriptions for stimulants to be phoned into a pharmacy or refills to be added to prescriptions — and this adds to the burden of treating patients who take them… | Keep reading on Medscape »

RELATED RESOURCES

Substance Use Disorder and ADHD: Safe, Effective Treatment Options

Expert Webinar with Timothy Wilens, M.D. | Listen now on ADDitude »

Current Guidelines for Treatment and Behavioral Interventions for Tourette Syndrome and Tic Disorders

Expert Webinar with John Piacentini, Ph.D., ABPP | Listen now on ADDitude »

7-Week Guide to Treating ADHD, from Medscape x MDedge x ADDitude:

DECISION 1: What should I consider to develop a comprehensive ADHD treatment plan?
DECISION 2: What medications and other approaches should I turn to as first-line treatments for ADHD?
DECISION 3: How can I decide which ADHD medication to prescribe first?
DECISION 4: What challenges and side effects should I anticipate from ADHD medications, and how should I address them?
> DECISION 5: How can I improve treatment outcomes for patients with ADHD and comorbid diagnoses?
DECISION 6: What dietary, behavioral, or other complementary interventions should I recommend to patients with ADHD?
DECISION 7: How should I follow up with patients with ADHD, and what should we discuss during these checkups?

The Dope on Dopamine Fasting: Expert Answers to Your Digital Detox Questions

Carole Fleck — Fri, 05 May 2023 09:51:28 +0000

What Is Dopamine Fasting?

“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.

Live Webinar on June 22: ADHD and Sex: Building Focus and Attention for Intimacy

Carly Broadway — Wed, 03 May 2023 18:07:23 +0000

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

Not available June 22? Don’t worry. Register now and we’ll send you the replay link to watch at your convenience.

Partners in healthy, enduring romantic relationships typically experience sexual satisfaction as part of their strong connection. But as many couples living with ADHD know all too well, forgetfulness, procrastination, and other traits associated with ADHD can take a toll on relationships and on sex.

Sex therapist Ari Tuckman conducted a survey of 3,000 people with ADHD and their non-ADHD partners about their sex lives. He asked about levels of satisfaction, frequency, infidelity, and much more. Among his findings: people with ADHD feel things more intensely and experience more sexual eagerness than do their non-ADHD partners. Bridging these differences, and other flashpoints, can strengthen a relationship.

In this webinar, you will learn:

How ADHD can affect your sex life and relationship
Strategies to make time for intimacy and why this is important
Why sensitivity can make intimacy challenging for the non-ADHD partner
Approaches to help couples build trust for each other
How treatment for ADHD improves intimacy

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

Meet the Expert Speakers:

Ari Tuckman, Psy.D., MBA, is a psychologist, sex therapist, and author of four books, including, ADHD After Dark: Better Sex Life, Better Relationship; Understand Your Brain, Get More Done; More Attention, Less Deficit; and Integrative Treatment for Adult ADHD. (#CommissionsEarned) His podcast, More Attention, Less Deficit, has more than 100 episodes and almost 3 million downloads. He has a private practice in West Chester, Pennsylvania, and is co-chair of the CHADD conference committee.

Stephanie Sarkis Ph.D., is a psychotherapist and author of numerous books, including Gaslighting: Recognize Manipulative and Emotionally Abusive People and Break Free and Healing from Toxic Relationships. (#CommissionsEarned) She is a licensed and board-certified mental health counselor, and a Florida Supreme Court-certified family and civil mediator based in Tampa. She is the host of the Talking Brains podcast. You can reach Stephanie at stephaniesarkis.com.

Closed captions available.

ADHD and the Midlife Crisis Crisis

Anni Layne Rodgers — Wed, 03 May 2023 13:18:59 +0000

The film industry has dedicated a whole genre to it. From Lost in Translation and Sideways to American Beauty and Thelma and Louise, it has captivated our cultural psyche since Dudley Moore chased Bo Derek to a remote beach in Mexico. I’m talking, of course, about the midlife crisis — that emotional and psychological inflection point encountered between ages 40 and 60, when the undeniable truth of our mortality smacks headlong into our unrealized dreams and ambitions.

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:

Impulsivity

“I made a lot of impulsive decisions that weren’t thought through,” wrote a 43-year-old man in the UK. “I cheated on my long-term partner, split up with her, had multiple short-term relationships, sold my house, and invested all my money into a new business without adequate planning that ultimately wasn’t successful and got into a lot of financial debt.”

[Take This Self-Test: ADHD Symptoms in Women]

Emotional Dysregulation and RSD

“I had been driving in the rain my whole life,” wrote a 51-year-old Minnesotan who divorced her emotionally abusive husband. “When midlife hit, I was suddenly navigating rush hour with tornado warnings, hail, and zero visibility. I could no longer manage… To say that my ADHD symptoms of RSD, depression, anxiety, working memory, and overwhelm affected me is an understatement.”

Restlessness and Boredom

“I had created a comfortable life for myself by achieving all of my major goals, but then became extremely restless, feeling like the rest of my life would just be spent maintaining my current success,” wrote a 43-year-old male with ADHD who quit his job, ended a long-term relationship, moved, and “essentially started over.” “There wasn’t enough to look forward to, not enough variety or excitement to be had. The novelty of my previous successes had long worn off.”

Anxiety

“Lately, I want to quit my current job of 27 years, move out of my home of 22 years to another state, and make other life changes like opening my own business,” wrote one 53-year-old woman in Illinois. “I feel this is a result of many things, but namely my ADHD disorganization and emotional dysregulation have heightened my anxiety to a whole new level.”

Risk-Taking

“I quit my job, abandoned a lot of responsibilities, and neglected friendships,” wrote one 44-year-old mother in Pennsylvania. “Eventually, I got sober in AA and realized during that first year of sobriety that I have had ADHD since childhood.”

Overwhelm

“Life feels like it doesn’t work,” wrote a 51-year-old mother in Vancouver, Canada. “How I organize my time, my life, everything is impacted by ADHD. Challenges with self-care and health issues brought on by decades of untreated ADHD make it exceptionally hard to get into a routine that works and is consistent. Life feels harder than ever with perimenopause, teens with ADHD, and my own mother with failing health and untreated worsening ADHD.”

Bravery

“It wasn’t a crisis so much as I reached my limit,” said a 57-year-old woman who escaped an abusive marriage, moved, found new work, filed for bankruptcy, and continues to fight. “I sought counseling and learned that I wasn’t a terrible person; I was in an abusive marriage with a covert passive-aggressive narcissist. I stopped second-guessing myself, feeling shame and self-blame, and not trusting what I saw or valuing how I felt.”

Tenacity

“I’m not sure ‘crisis’ is the right word here,” wrote one 56-year-old Californian who divorced her husband. “I believe it took me until I was 29 to gain the confidence in myself to make the change. And it made my life so much bigger. I would call it midlife bravery. I was never in crisis.”

Regret and Shame

“I had massive burnout due to not being diagnosed earlier and thinking I was a useless waste of space, even though I was taking care of my chronically ill wife and two kids and holding down a full-time job,” said a 44-year-old man with combined-type ADHD in the UK. “I could never relax or rest because, as soon as I stopped, I just wanted to get high or drink as it felt like the only way to calm my mind. I became a shell of my former self.”

Midlife Crisis: Next Steps

Read: ADHD Symptoms in Men Manifest Differently
Download: Free Guide to Hormones and ADHD in Women
Read: Realistic Solutions for Managing Life, Time, & Emotions with Adult ADHD
Watch: “ADHD in Women – How to Unlock Your Potential After a Midlife Diagnosis”

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

“We Are All Running from Something:” Marathoner Molly Seidel On ADHD & Self-Care

Anni Layne Rodgers — Tue, 02 May 2023 20:04:02 +0000

“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

“Drowning on the Inside:” Misunderstood Symptoms of ADHD in Women

Nicole Kear — Sun, 30 Apr 2023 09:24:33 +0000

A little boy bouncing off the walls of his classroom, blurting out and squirming incessantly. This is the image of ADHD burned in our popular culture — and in the minds of too many medical professionals. But for the majority of people with ADHD, particularly women, this representation does not match their experience. More troublesome than distractibility and external hyperactivity, you tell us, are ADHD overwhelm, volatile emotions, shame, racing thoughts and mental fatigue, rejection sensitivity, and social struggles. These symptoms, while common, are often overlooked and misunderstood.

So, we asked the women who read ADDitude to share their misunderstood symptoms, and to answer the question: What do you wish the world knew about ADHD? Read their answers below — and share your own thoughts in the comments section above.

“I just don’t feel believed, especially about how much my hormones and menstrual cycle deeply impact all of my symptoms. When I try to explain that my ADHD symptoms are more severe during the second half of the month, I’ve been told by more than one doctor that they’ve ‘never heard of anything like that.’” —Maria, Colorado

“Neurotypicals need to know that hyperactivity in women doesn’t present as the stereotypical ADHD little boy who fidgets and runs in circles. Our hyperactivity is invisible: it’s in our heads. My ADHD mind is like a L.A. highway with high-speed cars zooming here, there, and everywhere.” —Michelle, Mississippi

“I think the most misunderstood symptom of ADHD is emotional dysregulation. And particularly for women I think this piece gets either downplayed or used to justify mood disorder diagnoses that aren’t accurate.” —Em, New York

[Read: DESR – Why Deficient Emotional Self-Regulation is Central to ADHD]

“I wish health care professionals knew we struggle with many more medical issues than the general population.” —Elizabeth, New Hampshire

“I wish that women with ADHD were better represented in scientific studies and the media. The common assumption of what ADHD looks like is very outdated and stereotypical. And it’s still embedded within our education and health systems, leading to under and misdiagnosis of women with ADHD.” —An ADDitude reader

“I wish the world knew how severely inattentiveness can affect someone’s life. For me, it meant the difference between having and not having a successful career. For a lot of women, it means they are forced to be financially dependent on a spouse and prone to suffering from the ADHD tax.” —An ADDitude reader

[Read: What Is Inattentive ADHD? ADD Symptoms, Causes, Treatment]

“You can be academically gifted and have ADHD. My psychiatrist told me that I was ‘too smart to have ADHD.’” —Anna

“Undiagnosed ADHD in girls and women will lead to dangerous behaviors including substance abuse and suicidality. There is so much shame that comes from not being typical. I personally struggled with substance use disorder due to undiagnosed ADHD and even after my diagnosis at 40, I felt I could never live up to being a ‘good’ wife and ‘good’ mother.” —Beth, Colorado

“Some of us don’t look like we struggle, because we are working overtime not to disappoint, but this extra effort takes its toll on our physical and mental health and is often unsustainable. If we are asking for help, it’s because we can see the wall we are heading for at high speed and know the impact will be catastrophic.” —Sarah

“The most misunderstood ‘symptom’ to me is invisible to others and it is the deep shame I feel.” —Aimee, Maryland

“The difficulty, anxiety and misunderstanding that come from rejection sensitivity dysphoria. I find it really challenging across all areas of my life. It causes me great difficulty in my workplace, as I find it really difficult to take on constructive feedback even though rationally, I know it’s not a biggie.” —Madeline

“I wish the world understood that I don’t always read the underlying social cues around me and it makes navigating social situations difficult.” —Sara, New Hampshire

“We need medication on weekends too, not just 9-5, Monday through Friday, for work. Juggling tasks and responsibilities doesn’t stop when we clock out, especially for those of us with children.” —Lynette

“In conversation, if a thought comes into my head that is relevant, I have to say it then and there, otherwise the constant bombardment of thoughts means if I wait, it’s gone or forgotten. I don’t mean to be rude, I just want to join in and be accepted.” —An ADDitude reader

Misunderstood Symptoms of ADHD in Women: Next Steps

Read: ADHD is Different in Women
Download: Free Guide to Hormones and ADHD in Women
Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, and Treated Inadequately

“My Doom Piles Screamed ‘Undiagnosed ADHD’”

Nathaly Pesantez — Fri, 28 Apr 2023 09:38:50 +0000

What’s in your doom pile?

I first learned about doom piles from a client during one of our therapy sessions. She told me she was recently diagnosed with ADHD, and she described all the signs and symptoms that led to her diagnosis. That’s when she said two words that changed my life: doom pile.

The doom in ‘doom pile’ is actually an acronym. It stands for “Didn’t Organize, Only Moved” – an experience many people with ADHD can apparently relate to when they try to organize their spaces, whether physical or virtual. Instead of sorting things in their rightful places, they end up stacking them along with other random, unsorted things to be organized later – or never. That’s how people end up with doom piles, doom boxes, doom bags, doom folders and drives, doom rooms and closets, and other kinds of doom arrangements.

As my client described doom piles as a messy consequence of her ADHD (especially undiagnosed ADHD), I immediately thought of the mountains of paperwork on my desk. Though I loved my career as a therapist, some parts of my work made me feel anxious all the time. It seemed like my work life was ruled by unopened emails, unchecked voicemails, and piles of incomplete case notes.

Doom Piles, ADHD, and Me

Though I was hesitant to do so, I continued to explore doom piles from a personal lens. Piles, boxes, and bags full of “stuff” seemed to define all parts of my life even outside of work. Combined, my home, office, and car were one massive junk drawer of unused worksheets, clothes, receipts, books, and other miscellaneous items. Nothing had a home, and whenever I tried to tackle the piles, avoidance and procrastination reigned supreme.

Diving deeper, I realized that doom piles have always been a part of my existence. Whether it was a messy closet behind a closed door or a school locker full of crumpled-up papers, doom piles were always there. I also thought about how disorganized, restless, and anxious I felt most of the time, even as a child, and how I believed I was lazy and prone to chaos.

[Get This Free Download: 22 Clutter-Busting Strategies for Adults with ADHD]

Could it be that my own doom piles pointed to ADHD?

After that single session, I began to connect the dots and make more sense of my experiences from childhood to the present. Eventually, I pursued an evaluation, and I was diagnosed with ADHD.

The diagnosis afforded me a huge sense of relief. It explained so many of my frustrations and challenges beyond my doom piles — from my troubles in school to how I’d beaten myself up for being unable to complete menial tasks. Many of the negative beliefs I held about myself, including my overwhelming sense of being a failure, were directly tied to my life with undiagnosed ADHD. After years of thinking I was making up excuses for myself, I was finally given a reason to show myself self-compassion.

Making the Doom Piles Smaller

My journey toward structure and organization didn’t start with my diagnosis, but it definitely took an interesting turn in that moment. I knew that ADHD medication wouldn’t be a fix-all solution for my doom piles, but it was certainly a game changer. I felt like I could finally focus on one task at a time.

Then came taking a hard look at the organizing systems (or lack thereof) I had both at work and at home. Each week, I would schedule a few hours to read about ADHD, planning, and organizing. I looked into how others with ADHD tackle their own doom piles, but the most valuable thing I learned is that there is no one-size-fits-all approach. What worked for someone else with ADHD may not work for me.

[Read: Attack of the Paper Stacks! How to Defeat Masses of Mess]

As I sorted through the doom pile in the trunk of my car, I grappled with the surprising difficulty of parting with items that had followed me for years. Still, I knew it was necessary. Organizing the smaller things gave me a sense of accomplishment that kept my motivation high.

Another big learning curve for me was learning how to prioritize while cleaning. I’d sometimes try to convince myself that another, non-doom task was equally important, only to realize this was just a form of avoidance creeping in.

My home, office, and car are still not immaculately organized. I don’t think I’ll ever be the type of person who can effortlessly keep tidy. But I have come a long way since that therapy session. Slowly but surely, I have cut down on my doom piles and have set up organizing systems that work for me. My doom piles no longer fill me with so much doom and gloom.

Doom Piling and ADHD: Next Steps

Find: Professional Organizers Who Understand ADHD
Free Download: 73 ADHD-Friendly Ways to Organize Your Life Now
Q: “How Do I Get Rid of My Sentimental Clutter?”
Read: Filing Cabinets Don’t Work for ADHD Minds — Help for Paper Pilers

Treating for Two: ADHD Meds in Pregnancy

Nicole Kear — Fri, 28 Apr 2023 09:07:31 +0000

ADHD symptoms can impair work and home life so severely that women are increasingly electing to continue taking their medications during pregnancy. In perinatal psychiatry, clinicians meet with women and their families as they plan for pregnancy and review the risks associated with continuing and discontinuing their ADHD treatment throughout pregnancy.

Stimulants During Pregnancy: Insights from Research

Many of the largest studies on the reproductive safety of stimulant medications are reassuring, finding no increased risks for adverse outcomes like congenital malformations, perinatal death, and obstetric complications. More recent studies have suggested a potential association between the use of methylphenidate and cardiac malformations, particularly ventral septal defects (a hole in the heart). Though the risks are low, and confounding variables exist, the patient and her obstetrician could consider doing a fetal echocardiogram, a procedure that provides additional data on the baby’s heart development, if she chooses to continue her methylphenidate throughout pregnancy.Other women decide to stop using stimulant medications during pregnancy due to a lack of data about long-term neurodevelopmental outcomes for children. These women would do well to consider nonpharmacologic treatment for ADHD, including cognitive behavioral therapy, a reduced workload, stress-mitigating strategies, and coaching and support groups.

[Download: Navigating Natural ADHD Treatment Options]

A small study showed that women who discontinued stimulant treatment during pregnancy, but who didn’t stop taking their antidepressant medication, experienced a clinically significant increase in depression. They also were more likely to experience conflict within their family, rate parenting as more difficult, and report feeling more isolated.

Conversely, many perinatal women (the time before and after the birth of a child) have reported significant benefits from taking their ADHD stimulant medication, including feeling more “together,” centered, and generally competent. This, in turn, can have a positive impact on functioning and parenting. One change in ADHD treatment can potentially lead to psychiatric symptoms, which doctors seek to avoid during the transition to motherhood.

ADHD Treatment Considerations

The new demands of caring for their babies during a time of changing hormone levels, infant feedings, and sleep disruption are exceedingly difficult for some women. Being an effective mother requires the ability to get and stay focused, modulate attention, control impulsivity, and utilize executive function skills. Women with ADHD struggle in these domains, yet this population and the course of their condition during pregnancy and the postpartum period have received little attention and systematic study.[Read: Women, Hormones, and ADHD]

Women of reproductive age with ADHD would benefit from working with a psychiatrist and/or medical team to understand the impact of hormones on ADHD throughout the lifespan, and the interplay with medication. For example, stimulants may be less effective during the second half of the menstrual cycle, and hormone replacement therapy can improve ADHD symptoms in postmenopausal women.

Working with an integrated, informed, and supportive health care team can lead to better outcomes for women.

ADHD Treatment in Pregnancy: Next Steps

Read: Motherhood with ADHD
Download: Free Guide to Hormones & ADHD in Women
Download: Free Parenting Guide for Moms & Dads with ADHD
Read: Why ADHD in Women is Routinely Dismissed, Misdiagnosed, and Treated Inadequately

Allison S. Baker, M.D., is a child and perinatal psychiatrist at Massachusetts General Hospital.

Help! My ADHD Spouse Finds Relationship Drama Stimulating

Melanie Wachsman — Thu, 27 Apr 2023 09:34:03 +0000

Relationship Problem: Couple Fighting

Q: “My spouse and I fight a lot. He provokes conflict, whether he’s aware of it or not. It’s like he needs the stimulation of an adrenaline rush. How can I break this pattern?”

Here are some approaches you might take based on the underlying motivation for his conflict-seeking behavior.

He finds conflict stimulating. If the fights are purely about stimulation, then your approach should be two-fold. First, don’t engage by being sucked into an argument. Practice emotional stability work such as meditation, journaling, exercise, mindfulness, or anything that enables you to stay calm in the moment. Respond to him by saying, “I can see that you’re upset.” You might want to tell him in advance that you don’t wish to join in these conflicts but would be happy to address any relationship problems you have when he is calm.

[Free Resource: Emotional Regulation & Anger Management Scripts]

Second, it would serve him well to replace the conflict with another form of stimulation, such as exercise, or taking up a new sport or hobby. Of course, he would need to first agree that the conflict between you is not desirable. The less you feed the conflict stimulation, the more likely he is to go in a better direction.

He is stressed out. Stress and ADHD are a combustible pair, and many people lash out when under pressure. In this case, stay clear if the stress cannot be avoided (for example, he’s late for a plane and very agitated) or seek ways to reduce household stress, if there isn’t a specific trigger.

You’ve become the “enemy” in your relationship. Your partner might be picking fights with you because a storyline has developed in his head that you are doing things to him that he doesn’t like. Common examples: You’re too controlling, or your behavior triggers feelings of shame. He generally feels unloved and even disliked, so he lashes out in anger. If this is the situation, you need professional couples counseling.

— Melissa Orlov is a marriage consultant who specializes in helping ADHD-affected couples balance their relationships.

Relationship Problem: Toxic Love

Q: “We’re worried about our young adult daughter’s relationship. Her boyfriend seems manipulative and controlling. She has ADHD and hasn’t had a lot of romantic experiences. What should we do?”

Since your daughter is an adult, the best (and only) thing you can do is express your concerns and offer your support. Pushing or encouraging her to leave her partner may strengthen their bond, and he may use this to further alienate your daughter from friends and family.

[Free Resource: Manage ADHD’s Impact on Your Relationship]

If or when your daughter does leave the toxic relationship, offer support without judgment. Refrain from criticizing her former partner. Remember that a person in an abusive relationship will return three times, on average, before they leave for good. Be prepared for the possibility that she’ll return to the relationship and decide in advance how you will respond if she does.

— Stephanie Sarkis, Ph.D., is a clinical specialist in child and adolescent counseling.

Relationship Problems with ADHD: Next Steps

Learn: How to Respond to Gaslighting — in Your Relationship and in Yourself
Free Download: Get A Grip On Tough Emotions
Watch: “Gaslighting, Love Bombing & Beyond – How to Recognize (and End) Toxic Relationships with ADHD”
Read: How to Fix a Relationship: 9 Solutions from ADHD Couples

I Fired My Therapist. It Was an AI Chatbot.

Nathaly Pesantez — Tue, 25 Apr 2023 09:46:23 +0000

My therapy sessions typically begin with a big smile. “Hi, Eliza!” Stephanie says. “It’s so good to see you!” She usually mentions something fun and asks, “So how’d [that thing I was excited about] go?” Maybe it’s a secret therapist trick, but even via a telehealth portal, her care feels genuine — her smile reaches her eyes; she nods along.

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