Tag: behavior disorders

The benefits of ‘body doubling’ when you have ADHD, according to experts | CNN

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Once a week, ADHD coach Robin Nordmeyer joins a Zoom meeting with other coaches while she writes blogs, does administrative tasks or works on content for presentations she has been putting off.

Nordmeyer, who has ADHD, isn’t necessarily using the meeting to collaborate with others — she just needs their presence as a motivator to help her get things done.

“I run a business, and I have to balance lots of different areas of the business,” said Nordmeyer, cofounder and managing director of the Center for Living Well with ADHD-Minnesota, an ADHD coaching group near Minneapolis serving all ages.

“Some of those things come very easy — like, they’re in my wheelhouse, they energize me, I can’t wait to get to them,” Nordmeyer said. “And some of those things are a little more tedious, or I have some resistance around them.”

What Nordmeyer does to get through those tougher tasks is sometimes known as “body doubling,” a productivity and self-help strategy that involves working with another person around to help improve motivation and focus. It has been popular for some time among people with ADHD — attention-deficit/hyperactivity disorder — especially during the pandemic.

“The idea is that the presence of another is essentially a gentle reminder to stay on task,” said Billy Roberts, clinical director of Focused Mind ADHD Counseling in Columbus, Ohio. “For folks (with) ADHD whose minds tend to wander and get off task, the body double somehow works as an external motivator to stay on task.”

Body doubling isn’t just for people with ADHD, but like many “coping strategies, something that can be helpful for anybody is more central and important for folks with ADHD,” said J. Russell Ramsay, professor of clinical psychiatry at the University of Pennsylvania’s Perelman School of Medicine and codirector of the university’s ADHD Treatment and Research Program.

A neurodevelopmental disorder commonly diagnosed in childhood but lasting into adulthood, ADHD stems from underdeveloped or impaired executive function and self-regulation skills, according to Harvard University’s Center on the Developing Child. Those skills help us to plan, focus attention, remember instructions and multitask. Symptoms of ADHD include inattention, hyperactivity and impulsivity — so people with this disorder might have trouble concentrating, staying organized, managing their time or controlling their impulses, which can affect both their work and personal lives, Roberts said.

If people with ADHD have no intrinsic interest in a task, Roberts said, they typically struggle with a lack of internal motivation to complete it or even to get started. Body doubling provides that motivation, experts said.

“It also draws on our social selves,” Ramsay said. “A lot of people with ADHD will say, ‘I have a hard time getting started on this if I’m doing it for myself, but if I know somebody else is relying on me, if somebody else is waiting outside for me to show up to go for our walk, I’m more likely to go and be there because I don’t want to let them down.’”

There doesn’t appear to be extensive research on body doubling for productivity, according to Roberts and other experts. “But I do know that the idea of externalizing motivation is a long-standing, evidence-based mechanism for managing ADHD,” Roberts said.

In theory, the method is pretty straightforward, but there a few factors to keep in mind to make the most of it.

Body doubling can help with pretty much any task you’re having a hard time getting done — whether that’s work, chores, exercise, schoolwork or paperwork. The other person doesn’t have to be doing the same thing as you, unless the activity you need body doubling for — such as exercising — requires that assistance.

Be choosy about whom you ask to be your body double. The person should be as committed to you completing your work as you are, Roberts said — not distracting you with conversation or anything else. Choose someone who usually makes you feel comfortable and safe, and who can encourage you when necessary.

“It’s important to keep a body double session focused on its purpose,” Nordmeyer said. If conversations do come up, table them for later, perhaps during a break or dinner.

Asking someone to be your body double might feel awkward, but Roberts said the best approach is often a straightforward one. You could say, “It’s something I heard can help with productivity. Would you mind just being around me while I work on this? Maybe you have something you could work on, too.”

You could also barter with them, in a sense, by making an offer such as, “You help me organize my garage on Saturday; I’ll help you organize your home office on Sunday,” Ramsay said.

Those small first steps of seeking a partner and setting up the session get you started and keep you going, he added.

Scheduling regular body doubling sessions is one option, Nordmeyer said, or just ask whenever the need arises. How transparent you are about why you need a body double is up to you, as is whether you have more than one body double.

“It depends on the individual,” Roberts said. “If it turns into a distraction more than mindfulness, accountability or behavioral support, then you just want to rework things. You can kind of tinker with things until you find what works.”

If you don’t have a friend or colleague to be your body double, you aren’t out of luck.

Some TikTok users, such as Allie K. Campbell, regularly go live while they’re working so others can use them as a virtual body double. There are also body doubling or coworking platforms or apps such as Flown, Focusmate or Flow Club.

In virtual sessions, “most body doubles ask you to share your camera, and a lot of people are real nervous about being visible,” Nordmeyer said. “The purpose of that is to make sure you’re still in your chair working. … But there might be other ways you can create that accountability through a chat feature.”

The benefits of body doubling are likely why some people like working on things in coffee shops, libraries or coworking spaces — which can be sources of passive body doubling if you don’t have someone to ask, Roberts said.

“Some people work better with community support and just the awareness of other people around them,” he added. “You saw that a lot with the pandemic, like people learning more about the kinds of structure they needed.

“We all think and work differently, and there’s nothing wrong with that,” Roberts said.

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May 28, 2023
ADHD medication abuse in schools is a ‘wake-up call’ | CNN

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At some middle and high schools in the United States, 1 in 4 teens report they’ve abused prescription stimulants for attention deficit hyperactivity disorder during the year prior, a new study found.

“This is the first national study to look at the nonmedical use of prescription stimulants by students in middle and high school, and we found a tremendous, wide range of misuse,” said lead author Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan in Ann Arbor.

“In some schools there was little to no misuse of stimulants, while in other schools more than 25% of students had used stimulants in nonmedical ways,” said McCabe, who is also a professor of nursing at the University of Michigan School of Nursing. “This study is a major wake-up call.”

Nonmedical uses of stimulants can include taking more than a normal dose to get high, or taking the medication with alcohol or other drugs to boost a high, prior studies have found.

Students also overuse medications or “use a pill that someone gave them due to a sense of stress around academics — they are trying to stay up late and study or finish papers,” said pediatrician Dr. Deepa Camenga, associate director of pediatric programs at the Yale Program in Addiction Medicine in New Haven, Connecticut.

“We know this is happening in colleges. A major takeaway of the new study is that misuse and sharing of stimulant prescription medications is happening in middle and high schools, not just college,” said Camenga, who was not involved with the study.

Published Tuesday in the journal JAMA Network Open, the study analyzed data collected between 2005 and 2020 by Monitoring the Future, a federal survey that has measured drug and alcohol use among secondary school students nationwide each year since 1975.

In the data set used for this study, questionnaires were given to more than 230,000 teens in eighth, 10th and 12th grades in a nationally representative sample of 3,284 secondary schools.

Schools with the highest rates of teens using prescribed ADHD medications were about 36% more likely to have students misusing prescription stimulants during the past year, the study found. Schools with few to no students currently using such treatments had much less of an issue, but it didn’t disappear, McCabe said.

“We know that the two biggest sources are leftover medications, perhaps from family members such as siblings, and asking peers, who may attend other schools,” he said.

Schools in the suburbs in all regions of the United States except the Northeast had higher rates of teen misuse of ADHD medications, as did schools where typically one or more parent had a college degree, according to the study.

Schools with more White students and those who had medium levels of student binge drinking were also more likely to see teen abuse of stimulants.

On an individual level, students who said they had used marijuana in the past 30 days were four times as likely to abuse ADHD medications than teens who did not use weed, according to the analysis.

In addition, adolescents who said they used ADHD medications currently or in the past were about 2.5% more likely to have misused the stimulants when compared with peers who had never used stimulants, the study found.

“But these findings were not being driven solely by teens with ADHD misusing their medications,” McCabe said. “We still found a significant association, even when we excluded students who were never prescribed ADHD therapy.”

Data collection for the study was through 2020. Since then, new statistics show prescriptions for stimulants surged 10% during 2021 across most age groups. At the same time, there has been a nationwide shortage of Adderall, one of the most popular ADHD drugs, leaving many patients unable to fill or refill their prescriptions.

The stakes are high: Taking stimulant medications improperly over time can result in stimulant use disorder, which can lead to anxiety, depression, psychosis and seizures, experts say.

If overused or combined with alcohol or other drugs, there can be sudden health consequences. Side effects can include “paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in large doses or in ways other than swallowing a pill,” according to the Substance Abuse and Mental Health Services Administration.

Research has also shown people who misuse ADHD medications are highly likely to have multiple substance use disorders.

Abuse of stimulant drugs has grown over the past two decades, experts say, as more adolescents are diagnosed and prescribed those medications — studies have shown 1 in every 9 high school seniors report taking stimulant therapy for ADHD, McCabe said.

For children with ADHD who use their medications appropriately, stimulants can be effective treatment. They are “protective for the health of a child,” Camenga said. “Those adolescents diagnosed and treated correctly and monitored do very well — they have a lower risk of new mental health problems or new substance use disorders.”

The solution to the problem of stimulant misuse among middle and high school teens isn’t to limit use of the medications for the children who really need them, McCabe stressed.

“Instead, we need to look very long and hard at school strategies that are more or less effective in curbing stimulant medication misuse,” he said. “Parents can make sure the schools their kids attend have safe storage for medication and strict dispensing policies. And ask about prevalence of misuse — that data is available for every school.”

Families can also help by talking to their children about how to handle peers who approach them wanting a pill or two to party or pull an all-night study session, he added.

“You’d be surprised how many kids do not know what to say,” McCabe said. “Parents can role-play with their kids to give them options on what to say so they are ready when it happens.”

Parents and guardians should always store controlled medications in a lockbox, and should not be afraid to count pills and stay on top of early refills, he added.

“Finally, if parents suspect any type of misuse, they should contact their child’s prescriber right away,” McCabe said. “That child should be screened and assessed immediately.”

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April 18, 2023
Covenant School shooter was under care for emotional disorder and hid guns at home, police say | CNN

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Editor’s Note: This story contains graphic descriptions of violence.

CNN
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The 28-year-old who killed three children and three adults at a private Christian school in Nashville was under care for an emotional disorder and had legally bought seven firearms that were hidden at home, Metro Nashville Police Chief John Drake said Tuesday.

The parents of the shooter, Audrey Hale, spoke to police and said they knew Hale had bought and sold one weapon and believed that was the extent of it.

“The parents felt (Hale) should not own weapons,” the chief said.

On Monday morning, Hale left home with a red bag, and the parents asked what was inside but were dismissed, Drake said.

Three of the weapons were used in the attack Monday. Police also said Tuesday they did not know a motive.

The shooter targeted the school and church in the attack but did not specifically target any of the six people killed, police spokesman Don Aaron said. He also said Hale’s writings mentioned a mall near the school as another possible target.

Live updates: Nashville Covenant School shooting

The news conference came a day after Hale, a former student at the Covenant School, stormed into the elementary school and killed six people before being fatally shot by responding police officers.

The attack was the 19th shooting at an American school or university in 2023 in which at least one person was wounded, according to a CNN tally, and the deadliest since the May attack in Uvalde, Texas, left 21 dead. There have been 42 K-12 school shootings since Uvalde.

The victims included three 9-year-old students: Evelyn Dieckhaus, William Kinney and Hallie Scruggs, the daughter of lead church pastor Chad Scruggs. Also killed were Cynthia Peak, 61, believed to be a substitute teacher; Katherine Koonce, the 60-year-old head of the school; and Mike Hill, a 61-year-old custodian, police said.

Earlier Tuesday, police released body-camera footage from the two officers who rushed into the Covenant School on Monday and fatally shot the mass shooter.

The footage is from the body-worn cameras of officers Rex Engelbert and Michael Collazo, who police said fatally shot the attacker on Monday at 10:27 a.m. The videos show a group of five officers entered the school amid wailing fire alarms and immediately went into several rooms to look for the suspect.

They heard gunfire on the second floor and so hustled up the stairs as the bangs grew louder, the video shows. The officers approached the sound of gunfire and Engelbert, armed with an assault-style rifle, rounded a corner and fired multiple times at a person near a large window, who dropped to the ground, the video shows.

Collazo then pushed forward and appeared to shoot the person on the ground four times with a handgun, yelling “Stop moving!” The officers finally approached the person, moved a gun away and then radioed “Suspect down! Suspect down!”

The video adds further insight into the timeline of the shooting and the police response. The first 911 call about the shooting came in at 10:13 a.m., and the shooter was killed 14 minutes later, according to police. The bodycam footage of Engelbert entering the school and shooting the attacker lasts about three to four minutes.

The Covenant school is a private Christian school educating about 200 students from Pre-K through 6th grade. The school is a ministry of Covenant Presbyterian Church, its website states.

Nashville Mayor John Cooper told CNN the swift police response prevented further disaster.

“It could have been worse without this great response,” the mayor of the police response. “This was very planned and numerous sites were investigated.”

The police chief similarly praised the response as swift.

“I was hoping this day would never ever come here in the city. But we will never wait to make entry and to go in and to stop a threat especially when it deals with our children,” Drake said in a Monday news conference.

Police said the shooting was targeted, closely planned and outlined in documents from the shooter.

Hale left writings pertaining to the shooting and had scouted a second possible attack location in Nashville, “but because of a threat assessment by the suspect – there’s too much security – decided not to,” Drake said on Monday.

The shooter left behind “drawn out” maps of the school detailing “how this was all going to take place,” he added.

The writings revealed the attack at the Christian school “was calculated and planned,” police said. The shooter was “someone that had multiple rounds of ammunition, prepared for confrontation with law enforcement, prepared to do more harm than was actually done,” Drake said.

Three weapons – an AR-15, a Kel-Tec SUB 2000, and a handgun – were found at the school, he said. A search warrant executed at Hale’s home led to the seizure of a sawed-off shotgun, a second shotgun and other evidence, according to police.

“They found a lot of documents. This was clearly planned,” Mayor Cooper said. “There was a lot of ammunition. There were guns.”

Police have referred to Hale as a “female shooter,” and at an evening news conference added Hale was transgender. Hale used male pronouns on a social media profile, a spokesperson told CNN when asked to clarify.

Hale graduated from Nossi College of Art & Design in Nashville last year, the president of the school confirmed to CNN. Hale worked as a freelance graphic designer and a part-time grocery shopper, a LinkedIn profile says.

Former teammate of Nashville school shooter got unusual Instagram messages before rampage

Information from police and from the shooter’s childhood friend helped illuminate a timeline of the deadly attack.

Just before 10 a.m. Monday, the shooter sent an ominous message to a childhood friend, the friend told CNN on Tuesday. In an Instagram message to Averianna Patton, a Nashville radio host, just before 10 a.m. Monday, the shooter said “I’m planning to die today” and that it would be on the news.

“One day this will make more sense,” Hale wrote. “I’ve left more than enough evidence behind. But something bad is about to happen.”

Patton told CNN’s Don Lemon she was the shooter’s childhood basketball teammate and “knew her well when we were kids” but hadn’t spoken in years and is unsure why she received the message. Disturbed by its content, she called a suicide prevention line and the Nashville Davidson County Sheriff’s Office at 10:13 a.m.

At that very minute, police in Nashville also got a 911 call of an active shooter inside Covenant School and rushed there.

Armed with three firearms, the shooter got into the school by firing through glass doors and climbing through to get inside, surveillance video released by Metro Nashville Police shows. Pointing an assault-style weapon, the shooter walked through the school’s hallways, the video shows.

As the first five officers arrived, they heard gunfire from the second floor. The shooter was “firing through a window at arriving police cars,” police said in the news release.

Police went upstairs, where two officers opened fire, killing the shooter at 10:27 a.m., police spokesperson Don Aaron said.

After the shooter was dead, children were evacuated from the school and taken in buses to be reunited with their families. They held hands and walked in a line out of the school, where community members embraced, video showed.

“This school prepared for this with active shooter training for a reason,” Nashville Metropolitan Councilman Russ Pulley told CNN. “We don’t like to think that this is ever going to happen to us. But experience has taught us that we need to be prepared because in this day and time it is the reality of where we are.”

Patton, meanwhile, had “called Nashville’s non-emergency line at 10:14 a.m. and was on hold for nearly seven minutes before speaking with someone who said that they would send an officer to my home,” she told CNN affiliate WTVF. An officer did not come to her home until about 3:30 p.m., she said.

Two Covenant School employees are among the victims of Monday’s mass shooting, according to the school.

Katherine Koonce was identified as the head of the school, its website says. She attended Vanderbilt University and Trevecca Nazarene University in Nashville and got her master’s degree from Georgia State University.

Sissy Goff, one of Koonce’s friends, went to the reunification center after the shooting and suspected something was wrong when she didn’t see Koonce there.

“Knowing her, she’s so kind and strong and such a voice of reason and just security for people that she would have been there in front handling everything, so I had a feeling,” Goff said.

She said Koonce was a calming influence and even got a dog named “Covie” who greeted students before and after school.

“Parents are so anxious, kids are so anxious, and Katherine had such a centering voice for people,” Goff said.

Mike Hill was identified in the staff section of the Covenant Presbyterian Church’s website as facilities/kitchen staff. Hill, 61, was a custodian at the school, per police. A friend confirmed his image to CNN.

Cynthia Peak, 61, was believed to be a substitute teacher, police said Monday.

The family of Evelyn Dieckhaus, one of the 9-year-old victims, provided a statement to CNN affiliate KMOV.

“Our hearts are completely broken. We cannot believe this has happened. Evelyn was a shining light in this world. We appreciate all the love and support but ask for space as we grieve,” the family said.

The Covenant School issued a statement Monday night grieving the shooting.

“Our community is heartbroken. We are grieving tremendous loss and are in shock coming out of the terror that shattered our school and church. We are focused on loving our students, our families, our faculty and staff and beginning the process of healing,” the school said in a statement.

“Law enforcement is conducting its investigation, and while we understand there is a lot of interest and there will be a lot of discussion about and speculation surrounding what happened, we will continue to prioritize the well-being of our community.

“We appreciate the outpouring of support we have received, and we are tremendously grateful to the first responders who acted quickly to protect our students, faculty and staff. We ask for privacy as our community grapples with this terrible tragedy – for our students, parents, faculty and staff,” the statement said.

Cooper, the Nashville mayor, said he is “overwhelmed at the thought of the loss of these families, of the future lost by these children and their families.”

“The leading cause of kids’ death now is guns and gunfire and that is unacceptable,” Cooper said.

A recent study published in the journal JAMA Pediatrics in December backs that point, finding that homicide is a leading cause of death for children in the United States and the overall rate has increased an average of 4.3% each year for nearly a decade.

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March 28, 2023