Play is the unsung hero of stress management and wellbeing. Intentional and regular practice of playfulness is vital for busy ADHD brains that field many competing interests at a time – from careers and families to household obligations, symptom management, and more. Play, unfortunately, is often pushed to the bottom of the priority list.
The Benefits of Play
Play – engaging in a fun, amusing, entertaining, activity for the joy of it – is an effective way to boost the feel-good hormone dopamine that so many ADHD brains crave. Dopamine reduces stress and brings calm, promotes creativity and cooperation, and even reduces inflammation. Play can also individuals help break out of hyperfocus, which can lead to ADHD burnout if left uninterrupted. Play allows the body and mind to rest, process, and restore its energy to make it through another day.
Fitting in Play
Play isn’t just for children. It’s as important as everything else on your to-do list. But what counts as play? According to Peter Gray, Ph.D., the psychologist and author, play is:
guided by mental rules that leave room for creativity
imaginative
conducted in an alert, active, but relatively non-stressed frame of mind
The possibilities for play, it seems, are endless! All things creative and artistic fit – from playing an instrument and painting to building puzzles and making up games. Still, integrating play through the day can seem impossible with a busy schedule. In her TEDx Talk “Play: The Cure for Burnout,” Acey Holmes, CEO of BoredLess, suggests weaving play into everyday situations and responsibilities to make them interesting or entertaining. Some ideas include the following:
Listen to your favorite music while doing chores or work duties – and perhaps break out in dance while you’re at it.
Institute play breaks in between tasks. One of my clients loves the Paint by Number coloring app to let her mind wander creatively through the day. Setting an alarm may prevent your mind from wandering so far off track that it can’t return.
In the spaces where you get work done, introduce appealing scents and imagery you find fun or inspiring.
Equip your workspace with toys (anything from LEGOs to fidgets) that light up your brain.
Play a harmless prank on family members to get everyone’s laughter going.
Whichever way you integrate play into your life, know that it is a powerful way to manage stress and increase productivity and joy — ADHD or otherwise. Even if things feel overwhelming, try looking for at least one way to play each day. You may be surprised by how easy it is to rediscover play once you pay attention to it.
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References
Quintero, Olga L., et al. “Autoimmune disease and gender: plausible mechanisms for the female predominance of autoimmunity.” Journal of autoimmunity 38.2-3 (2012): J109-J119.
Brauer, K., Scherrer, T., & Proyer, R. T. (2021). Testing the Associations Between Adult Playfulness and Sensation Seeking: A SEM Analysis of Librarians and Police Officers. Frontiers in psychology, 12, 667165. https://doi.org/10.3389/fpsyg.2021.667165
If you grew up in the ‘90s like me, you undoubtedly watched sitcoms featuring the Dumb Dad. From Homer Simpson and Ray Romano to Tim “The Tool Man” Taylor, the Dumb Dad trope was as much a part of our generation as were chunky heels and butterfly clips.
On the flip side, mothers were portrayed as multitasking heroes who kept their families and homes from falling apart. Sure, these are stereotypes, but they’re mostly grounded in real-life expectations. Women are supposed to be the tidy, organized, and dependable ones. When you need help with homework, Mom’s the first one you ask. When you can’t find something, Mom knows where it is. When you need a special cake for your birthday, Mom can make it just right.
For a woman like me who struggles with ADHD, these expectations can be painful. Daddy is the one who keeps things running around here. He’s the organized and calm one. I do a lot. But if it weren’t for him, we’d have ice cream melting in the refrigerator.
I’m fairly traditional. I worked from home with my kids for years by choice. I wanted to cook their meals from scratch, but I almost always left out a crucial ingredient. I was there every time they pulled out a new board game, but I had a hard time sitting down and reading the instructions. I took them to fun places, but it was never a stress-free event. This mama forgot water bottles, diapers, wet wipes, and validation tickets. At some point, I realized I was the Dumb Dad.
For a long time, guilt and feelings of inadequacy plagued me. Not anymore. I’m so grateful to have a husband who grounds me. And with his support, I’m learning self-love.
The Dumb Dad may be bumbling, but he’s also adored. The kids never hold his cluelessness against him because his benevolence is clear. As my kids get older, they’re learning that their mom struggles with some things. And they know that it’s perfectly okay.
I’ve stopped trying to follow recipes or fix remotes. I’m focusing on the things I do well. I’m showing my daughter with ADHD all the tips I’ve learned to make life easier. I’m teaching her about civics and history, where I thrive. I’m hyperfocusing when my children need it, whether they’ve got a mysterious rash or someone needs to convince the city to put crossing guards at the school. I’m dancing and singing to all the kids’ songs because I’m a goofball like them and I know all the words.
I’m not the most organized mom, but I love my children more than anything on this earth. And they know it.
Gender Stereotypes and ADHD: Next Steps
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The following is a personal essay reflecting the opinions of the author.
It began with an Adderall shortage in 2022. Today, prescriptions for many stimulant medications used as the first-line treatment of ADHD are consistently and frustratingly difficult to fill. So it’s unsurprising that ADHD features prominently in the majority of public comments submitted to the Federal Trade Commission (FTC) by stakeholders impacted by long-term medication shortages involved in the treatment of many conditions, including cancer. ADHD patients demand attention on their suffering.
But, by inviting public testimony on the stimulant shortage and pharmaceutical practices, I believe the FTC is only trying to find cover for the Drug Enforcement Administration (DEA). The DEA is the only governmental agency that sets production and distribution quotas for every drug company manufacturing controlled medication. The DEA decides how much of each medication can be released to pharmacies in any given month. Therefore, this problem traces its roots and long tendrils back to the DEA alone. No other agency has the authority to create and prolong it.
The DEA meets with every company that markets a controlled substance each March and April to determine how much of that company’s product can be released each month in the following calendar year. This process tries to predict in March of 2024 how much medication will be needed 21 months later in December of 2025. It is a crude and inadequate system that the DEA is too inflexible to relinquish.
For as long as the United States government has wrestled with combatting the distribution and use of illicit drugs, the DEA has used only one tactic — restricting the amount of drugs available to be sold legally. Now, the DEA is using the same playbook for ADHD stimulants.
Roots of the Adderall Shortage
Two years ago, the DEA decided that ADHD stimulants were being diverted and abused on a large scale, though there was virtually no evidence to support this belief. Studies have shown that a number of people (statistics vary) try stimulants but do not continue to take them without a prescription. About 90% of the diverted immediate-release stimulants are used by a narrow demographic: white male college students who use the drugs so they can stay awake. The medications are not being abused by people with ADHD, many of whom consider the drugs a lifeline for daily functioning.
The DEA’s skepticism also came on the heels of increased rates of ADHD diagnosis and as a response to online providers who were sloppy about prescribing ADHD stimulants during the pandemic. The online clinics, however, never accounted for more than 1% of all prescriptions issued. And that problem was solved more than two years ago.
The DEA also observed that the number of people taking ADHD medications had been growing by 10% a year for 15 years. The growth rose largely from adults being diagnosed in later life. The relative number of children and adolescents taking stimulants has not changed in 20 years.
The DEA’s apparent logic behind its sweeping decisions was that these adults were abusing prescription stimulants, disregarding the well-documented evidence that ADHD persists after childhood. The rate of diagnosis and medication treatment is rising faster in every European country as well. In the last year for which I had access to the drug company marketing studies (2014), the average age of diagnosis of ADHD was 31.
The DEA does not bother with facts. Its answer to this increased level of prescriptions: Decrease the amount of drug available regardless of consequences. Even when it became abundantly clear that placing quotas on drug companies had been a disastrous decision, the DEA did not reverse course. Even if the DEA decided in April to raise the allotments of drugs released to pharmacies, its current flawed and inflexible distribution mechanism would not allow for an increase until January 2025.
I strongly suspect that the FTC is looking for an agency other than the DEA to blame. First, it said the drug companies were not making enough medication. But the drug companies were making and distributing as much as the DEA allowed them to. The idea that the drug companies were forgoing billions of dollars of profit was always unbelievable. Then the blame was laid on raw material shortages, but after two years, that explanation became hard to believe as well.
Then the FTC, FDA, and DEA blamed the telemedicine-only clinics that sprang up during the pandemic. However, the bad actors in this area have all closed down. Still, there has been no improvement in the shortage.
The time has long since passed for the DEA to admit its fault and fix its broken quota system. There has already been too much needless suffering by innocent people who did nothing to cause the DEA’s restrictions.
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As an AuDHD woman (autistic with ADHD) who was diagnosed later in life, I know what it’s like to be discriminated against and exploited, especially in the workplace, for my differences. It was those demeaning experiences that inspired me to pursue a Ph.D. to better understand invisible disabilities in professional settings, with the goal of helping organizations celebrate neurodivergent individuals of all abilities.
Earning my doctoral degree was no easy feat. From navigating social interactions and managing sensory sensitivities to coping with a learning disability, every step felt like a battle against the odds. I came face-to-face many times with imposter syndrome, intrusive thoughts, and task paralysis.
But with unwavering support from mentors and peers – along with my own inner strength and a desire to make a change – this journey ultimately become one of triumph, resilience, and unrelenting advocacy.
During my Ph.D. research, I became acutely aware of the lack of understanding and support for individuals with invisible disabilities in the workplace and its consequences. Too often, stigma and stereotypes prevent talented individuals from reaching their full potential, leaving them feeling marginalized and misunderstood instead.
Determined to address this issue, I developed a tool for employers called the Workplace Invisible Disability Experience (WIDE) survey. This survey aims to assess the experiences of employees with invisible disabilities in the workplace by shedding light on the challenges they face and identifying areas for improvement. By collecting data and raising awareness, the WIDE survey empowers organizations to recognize and address the barriers that prevent a thriving and inclusive environment.
Advocacy’s Many Forms
Advocacy is not just about raising awareness; it’s also about action. That’s why I took the initiative to establish a disability ERG (Employee Resource Group) in my workplace. This group serves as a platform for disabled employees to come together, share their experiences, and advocate for positive change. Through awareness campaigns, training sessions, and policy initiatives, our ERG works to create more inclusive and accommodating workplaces for all.
Education is another crucial aspect of advocacy, which is why I am committed to continuing to educate and inform others about invisible disabilities. Through speaking engagements, workshops, and training sessions, I aim to dispel myths, challenge stereotypes, and promote a culture of acceptance and understanding.
I am most excited to be a speaker at AutisticaPalooza, a multi-day conference that delves into a diverse range of topics by and for autistic women. By sharing my own experiences and insights, I hope to inspire others to embrace neurodiversity and work toward a more inclusive future.
A Transformative Journey
Completing my Ph.D. was just the beginning of my transformative journey of self-discovery, resilience, and empowerment. As I continue to advocate for change, I am driven by a vision of a world where individuals with invisible disabilities are valued, respected, and empowered to reach their full potential. I am confident that together, we can create a more inclusive and equitable world for all.
Autism Advocacy: Next Steps
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For more than 10 years, I ran trail ultramarathons of 35 to 100 miles. I was decent at it, and I loved running those distances. But I’ll tell it straight: Long runs are hard, even if you’re trained for them.
Distance runners anticipate difficulties and know to support themselves in any way possible to get to the finish line. It’s a given – they don’t think twice about it and don’t get hung up on it, either.
In our daily lives, especially as folks with ADHD, we fall into the trap of thinking we don’t need help, or that we’re wimpy if we accept help or create supportive structures for ourselves. Others don’t need this, we think.
Here’s that flawed logic applied to running: Why does the newbie runner need to stop and rest every half mile? The ultrarunner can go many miles before needing to stop. Therefore, the newbie must be a wimp, or worse, incapable.
A non-runner might assume this of a newbie, but ultrarunners know this couldn’t be farther from the truth. An early runner has needs, just as a later-stage runner does. Needs are needs.
Once five miles becomes easy-peasy for the early runner, they realize they only arrived at that point because they gave themselves what they needed to be someone who can run five miles. With that experience, they’ll readily tell the next newbie runner to make sure to stop and rest the legs and heart every half mile. It’s the only way to get to five miles.
Needs are Needs: When Ultrarunning Meets Real Life
This logic – of supporting our needs to become who we want to be – applies to anything and everything. If we accept a tutor to help us, then eventually we’ll be someone who got through a class instead of one who didn’t. If we fully show up to therapy or coaching, then we eventually become someone who tackles the challenges in front of us instead of skirting them. If we externalize the content of our brains with systems, we become someone who forgets less rather than someone who continues to forget.
Guess who all these early-stage self-supporters become? People who make inroads into becoming the kind of person who has wins, and those wins beget more wins. The more support, the more wins.
I got to the point in my abilities as a runner that I would have said yes, without a second thought, if you asked me to run a 50-miler the following weekend.
When you read the prior sentence, did you picture me as someone who was so trained that I needed a lot less than an early-stage runner? I’ll let you in on a secret: I was a running diva. I had far more available at hand than an early-stage runner could imagine was possible. The more experienced I got, the more I learned how much support was out there to take for myself — and I took it.
I say this all the time to people: Do you think successful people have more support or less? They have far more, and it’s because they’re more likely to ask for it and give it to themselves.
Why would it be any different for us when the road to success means we’ll need to support our ADHD and account for our needs?
Graduating from school, nabbing a promotion at work, becoming an accomplished person, becoming a person who has practiced options for staying calm in stressful situations — these are our long-distance runs.
The only way to become a champion — in anything — is to give ourselves what we need to push through. As you run your own race, take any and all support without question, without apology. That’s a champion mindset.
ADHD Life Lessons: Next Steps
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Making friends during adolescence is akin to navigating a labyrinth filled with twists, turns — and the potential for profound connections. For individuals with autism spectrum disorder (ASD), the journey toward friendship often presents its own set of unique challenges and opportunities. Individuals with ASD possess intelligence, compassion, and a propensity to be misunderstood, often leading to experiences of bullying and social isolation. It’s no wonder that depression rates in the autistic community are higher compared to those in neurotypical groups. For me, this reality underscores the importance of genuine friendships — even just one good friend is life-changing.
In 2014, I experienced a heartbreaking loss when my dear friend, Erin, essentially a sister to me, tragically took her own life at age 17. Erin was a remarkable individual filled with spunk, love, and empathy. Despite her supportive family, try-anything attitude, and impressive musical and culinary talents (her pasta dishes were truly legendary!), Erin struggled with social challenges and making friends. She was often excluded from weekend plans and parties, and she lacked a peer confidante to share her joys and passions. The complexities of social interaction, so effortless to neurotypical individuals, were often a puzzle for Erin — a reality she lived daily and felt deeply.
Making Friends with Autism Spectrum Disorder
Out of the tragedy of her death emerged Erin’s Hope for Friends, a non-profit organization dedicated to fostering friendships among individuals with ASD. At Erin’s Hope for Friends, we believe in the profound impact of genuine connections. True friends accept you for who you are, quirks and all, providing a sanctuary free from judgment. Finding friends who embrace each individual’s differences can be transformative, instilling a sense of belonging and confidence.
Erin’s Hope for Friends offers dynamic social programs known as e’s Clubs virtually and in Atlanta, Georgia, and Lexington, Kentucky. These clubs provide a welcoming, safe space for autistic teens and young adults (ages 12 to 24) to connect and engage in various activities tailored to their interests. From Foosball to karaoke to crafts to video games, e’s Clubs offer diverse activities to foster interaction and camaraderie. If you visit a club, it only takes a very short period to witness the joy they create. Currently serving more than 500 members annually, our clubs continue to grow and thrive.
The potential for Erin’s Hope for Friends and e’s Clubs — and other groups like it — is limitless. By expanding our reach nationwide, we aim to significantly impact the autistic community by challenging stereotypes, promoting neurodiversity acceptance, and ultimately creating a space for our members to make life-changing connections.
If you’re passionate about supporting individuals with autism in their quest for friendship and acceptance, I encourage you to check out Erin’s Hope for Friends or another similar organization. Together, we can celebrate abilities, challenge societal norms, and empower individuals to navigate the landscape of friendship with confidence and joy. After all, it just takes one good friend to change the course of a life.
Autism in the Workplace: Next Steps
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It was the first time the card table was used for its stated purpose.
In our excitement playing cards, we got too noisy and woke up the toddler. There was laughter and arguing. There was winning and losing.
I’d like to say my son, Ocean, was a gracious winner. I’d also like to say that I’m never a sore loser. Regardless, I was elated that we were playing – win or lose. I never thought my kid would land on card games as a special interest. And I know it won’t last, so I’m savoring these precious moments with extra gratitude.
Special Interests: My Son’s Rotating Fascinations
Ocean has autism and ADHD. Rather than sticking to one deep and abiding interest or bouncing around several interests at once (like me), he cycles through a different obsession every few months. There are some that repeat, like soccer, BEYBLADES, and various video games. I’m always happy when Pokémon comes up in the rotation.
My husband and I have always joined him in his interests, even when (as a baby) he just wanted to stare at the spinning ceiling fan. I’ll admit I didn’t enjoy spinning wheels on baby strollers when that was his fixation, and his interest in other peoples’ soccer balls didn’t make us popular at the playground. (On the other hand, soccer balls do have really cool designs, especially the Jabulani and Brazuca. Do you know how hard it is to find an original Jabulani? Can you guess how many hours I spent bidding on eBay?) While I didn’t love subway trips to a busy intersection to watch the pedestrian traffic light count down, he’s now traveling alone on public transportation – something I never imagined then.
When my son finds a new special interest, it feels a bit like opening a Christmas gift. I have no idea what it will be, but I know it will surprise me… and that it will get old eventually.
I’ve observed the pattern. He learns all the planets and moves on to galaxies. He maps the states, then the world… But his fixation doesn’t hold; eventually, he gets restless. He spends a few weeks absentmindedly dabbling until something grabs his attention again. I have no influence on his infatuations, or how long he will stay interested in each one. I’ve tried. It backfires. I don’t think he has much say in what grabs him either.
The one time I successfully held the line was when hot peppers became his interest. When his own pediatrician told us that eating too many of them raw could cause internal damage, my own gut wrenched and I felt like the worst parent ever. Nope. No more. I told him, “You can talk about Scoville heat units, you can draw and categorize and research peppers to your heart’s delight, but no more raw spicy pepper eating challenges under my roof!” I value autonomy, but I value his health more. It wasn’t easy, but we moved on, with his stomach lining intact.
Was Celebrating My Son’s Special Interests Wrong?
Ocean was first flagged for early intervention at 13 months. He wasn’t crawling on all fours or showing any signs of walking.
It would be a while before I put all the pieces together: developmental delays, social differences, special interests, sensory avoidance, and difficulty regulating emotions. Still, we hadn’t considered autism. I even brushed off an evaluator who casually mentioned “red flags for autism” when Ocean lined up a set of toy cars instead of playing with them as expected.
Then he went to preschool, where was expected to do things that were not his absolute favorite. The stimulation was a lot for him. He was having multiple meltdowns a day and struggled mightily with transitions. Even with the support of a 1-to-1 special education teacher, he barely endured the year.
At a new special-education school, his teacher asked for reward ideas that could motivate him. When I told her how much he liked letters and numbers, she was dismissive. “But that’s just stimming,” she said. I was speechless.
My confidence eroded. I started to think that all our celebrating of Ocean’s fascinations had been wrong. I wondered if I should have steered him away from the things that gave him comfort and joy. But I couldn’t. I loved to see the spark in him when he engaged with his true loves.
That year was damaging for both of us, and with perspective I am glad to have learned this lesson: Just because someone has a degree, doesn’t mean they are an expert – and they certainly aren’t an expert in your child.
Celebrating My Son’s Special Interests – and Strengths
We moved on to a more enlightened and neurodiversity-affirming elementary school, and my education in celebrating neurodiversity began. Those teachers and therapists brought Ocean’s interests into everything. They encouraged his strengths and nudged him along in his challenges. They partnered with us parents, and it felt like almost every professional truly cared about my son. He thrived.
Still, being neurodivergent in an ableist world is hard, and we leaned on supports as we overcame one struggle after another.
He’s moving on to high school next year, and I want to share a reflection with parents of younger neurodivergent kids: The problems fade with time, especially when you focus on encouraging their strengths. The glimmers of joy are what I recall, like snapshots.
When Ocean wasn’t meeting developmental milestones and was having multiple meltdowns a day, I never could have imagined this scene: my siblings, nieces, parents, all playing a card game that Ocean had organized and taught them, and all having a blast!
I can’t think of anyone with whom I’d rather stare at the fan, draw soccer balls, line up numbers, or play cards.
Special Interests, Autism, and ADHD: Next Steps
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I have always had a strong connection and pull to music, gaining inspiration from trailblazing female artists like Stevie Nicks and Joni Mitchell. But my relationship with music reached another level when I – during a moral burnout episode – stumbled upon a different kind of sound that changed my understanding of my AuDHD brain.
In my field of work, I see injustices often. My hyper-empathy and strong sense of justice drew me to this field, an area that gave me just the right amount of dopamine to help me manage well enough for many years – until things became really difficult and the stress and sadness mounted. I knew that my neurodivergent brain was making everything feel much more intense, but I wasn’t sure how to pull it all back.
One afternoon at home, burnt out, I knew I absolutely needed to clean my home despite a distinct lack of energy. I thought music would help, but this time, rather than put on Stevie Nicks, I selected a playlist at random and tried to power on. After a short time, I found myself dancing to the post punk rhythms of Siouxsie and the Banshees. My energy levels were up, and I suddenly gained the ability to do all the mundane demands I hadn’t been able to tackle for weeks.
Stumbling Into Punk Rock: A New Special Interest
I fell down a rabbit hole searching for more music that I thought might have the same effect. Cue my discovery of Riot Grrrl, grunge bands created by women, and feminist hardcore punk. In an instant, my world (and ears) became full of early ’90s bands like Babes in Toyland and Bikini Kill to more recent groups like War on Women, Lambrini Girls, and others with names too explicit to share.
Bands made up of women who fight for their voices to be heard, stay true to themselves, and don’t seem to care if they’re disliked? I had entered in to special-interest territory. I became absorbed in learning about the music, the women, and the culture they were promoting. At a time when I felt isolated and insecure and like I was losing a big part of my identity through my troubles at work, this music brought me joy and validation. It filled me with energy that I hadn’t felt for a long time and listening to it became the best and most important part of my day.
Aside from the physical release of endless dancing, I found that the louder the music and vocals, the happier and calmer I felt. Any stress I was feeling reduced, and overwhelming thoughts about my inability to do something turned into figuring out how I could.
I decided to experiment with listening to something much louder. Inspired by the death and thrash metal gigs I attended in my early 20s, I found myself – now more than 10 years later – on my way, alone, to see a few hardcore punk bands at a DIY venue 50 miles away. I’d never been to a gig by myself, let alone one like this, and it gave me a buzz that ADHD just loves to pull me toward.
The evening of the gig, as I stood in the middle of the crowd and listened to the thrashing music, I experienced something I’d never experienced before: a quiet mind with no thoughts in my head. Peace. My mind was blown. Literally.
The Soothing Sounds of Hardcore Punk
I spent the next few months tracking the effects of this music on my feelings and behaviors and was amazed by the results. I found that I didn’t need as much sleep and was able to be active late into the night. I wasn’t as drawn to sugar and carbs. Overstimulation after a long day in the office was easier to tolerate, and moments of excruciating under-stimulation were few and far between. My ability to tolerate perceived rejection and criticism grew significantly. This music, it was clear, was making everything so enjoyable.
This was not a life I was used to. It was something I had only experienced in short bursts. But here was punk music, my new special interest, giving me all the dopamine I needed to thrive. It was helping me behave in ways that were right for me, rather than being influenced by my barriers and my fears.
How do I use my special interest now to get the results I need? When I need a quick surge of chemicals to get me moving after waking up, Babes in Toyland’s Bluebell works every time. When I need to sleep, I’ll blast my thoughts away with Petrol Girls. When I’m feeling anxious or fearful at work and need to be brave, Double Dare Ya by Bikini Kill transforms my attitude and reminds me of my values. For those moments when I desperately need inner calm, I find it – in a raging hardcore gig.
AuDHD and Music: Next Steps
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Sometimes, an ADHD diagnosis can bring more confusion than clarity. As a parent, you may think, “Should I share the diagnosis with other adults in the family and in my child’s life? How do I know who to trust?”
You may fear possible judgments and others’ assumptions about your child or yourself. You may feel anxious, ashamed, or uncertain of who to tell or where to go for support. You may wonder if sharing the ADHD diagnosis will make your child feel badly about themselves. Or maybe it’s the opposite — you wonder if choosing to keep quiet will make your child feel like something is wrong with them.
ADHD Diagnosis: Secrecy vs. Privacy
Let’s start untangling this web of uncertainty by differentiating secrecy and privacy.
Secrecy is an intentional act of restraining or hiding information, typically because it is believed that the information is problematic and will have negative consequences out in the open. Secrecy is associated with shame. While privacy is also intentional, it is associated with empowerment, not shame. Privacy is a choice and a right. It connotes respect in that it allows one to know themselves, to have information about who they are, and then to decide with whom to share that information. For this reason, you want to disclose and discuss ADHD within the framework of your child and family’s right to privacy, while rejecting the idea of secrecy or shame.
You should never keep your child’s ADHD from them. How you discuss the condition with your child will depend on their age, comprehension skills, and other factors, but the point is to speak openly about their unique brain and why they have certain challenges.
It gets trickier when deciding who to tell outside of immediate family and whether you or your child gets to make that decision. If your child is too young to consent to their diagnosis being shared, my suggestion is to think about two of Rumi’s three gates of speech before you speak: Is it necessary? Is it kind?
Would sharing the diagnosis and explaining your child’s behaviors or needs help the person better understand your child?
Would sharing the diagnosis help others be more successful in their interactions or relationship with your child?
Would sharing the diagnosis open possibilities for more support without harming your relationship with your child now or in the future?
If it is necessary to share this information, how can you convey your child’s struggles with kindness and respect? Can you include your child or teen in any way in this communication?
Prior to sharing your child’s diagnosis with someone, consider the person’s character and previous behaviors. Have you witnessed them be judgmental toward others? Do they appear to use shame as a tool or a weapon? Do they gossip frequently? Do they show an unwillingness to learn or revise their thinking in light of new information? If it’s yes to all, move on; you won’t find support and acceptance from them.
If you decide to share your child’s diagnosis, you should still respect your child’s privacy by directly asking the individual for discretion. Share whether you have received consent from your child or if this disclosure is your own decision. Engage in private, respectful conversation in appropriate places, not at the bus stop and other public places. Speak about ADHD in a neurodiversity-affirming manner.
Online support groups can be great places to find community, acceptance, and like-minded people. Be cautious about sharing your child’s diagnosis or struggles in ways that can make them easily identified.
As your child grows older, ask them to consider the same questions and points above to help them decide who to talk to about their ADHD. Of course, if your child decides that they do not want you to share their diagnosis with someone, you must also respect your child’s right to privacy, even if you disagree with their reasoning.
Explaining ADHD to Others: Next Steps
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As a psychotherapist, an ADHD coach, and someone who lives with ADHD, I understand fully how the shame, stress, and anxiety of our symptoms and challenges – from procrastination and forgetfulness to time blindness and impulsivity – cause many of us to develop defense mechanisms. We seek to protect ourselves, especially when ADHD causes us to be consistently inconsistent and disappoint the people in our lives, by developing coping strategies that sometimes cause us more harm than good.
The following four defense mechanisms commonly develop among individuals with ADHD:
Blaming
Blaming as a defense mechanism looks like making others responsible for the occurrence of an ADHD symptom and its consequences, as seen in the following examples:
Your child forgets that an assignment is due. The due date was posted and announced, yet they blame the teacher for not being clear enough about the deadline.
You arrive late to an event. You didn’t give yourself enough time to get there, yet you blame traffic or the slow driver in front of you for showing up late.
You forget to pay a bill. You blame your partner for mixing the bill with other papers, even though it was in your court to set a reminder for yourself to pay the bill – and put it on autopay.
Defensiveness
Responding in angry, confrontational ways that deflect from the issue rather than address it marks this defense mechanism. The following are examples of defensiveness:
Your teen arrived late to school and missed their first period class. You try to talk to them about it, but your child tells you to mind your own business or lashes out. Tensions rise.
Your partner mentions that you still haven’t cleaned out the garage like you said you would do for months now. You quickly get angry and deflect. “Well, you haven’t cleaned out your closet in a long time either,” you say. A fight breaks out, and everyone feels miserable.
Minimizing occurs when you respond to complaints or disapproval about your ADHD symptoms by minimizing their effects on yourself or others. For example, you meet a friend half an hour later than you both planned. You notice that your friend is visibly upset, but you downplay your lateness, telling your friend “it’s no big deal.” Your friend gets even more upset, frustrated that you don’t seem to care about them or understand the effect of your actions.
Dishonesty
Not being truthful is a defense mechanism that causes lots of distress for families who are terrified about what it means about their child or partner’s character. But lying or stretching the truth, like other defense mechanisms, often come up in an effort to avoid shame and conflict. It’s also a method to save energy and avoid fatigue. (Living in a neurotypical world, after all, is exhausting.)
How to Break ADHD Defense Mechanisms
Let go of defense mechanisms by humbly owning up to ADHD symptoms as they arise.
Know your strengths and areas of need. When do these defense mechanisms come up the most? What actions, no matter how small, can you take to manage the problem area?
Apologize if you upset someone. As painful as it may feel to own up to an ADHD symptom, an apology shows others that you’re aware of how your actions – even if unintended – affected them. Be genuine in your apology. Say, “I’m sorry I made you wait. I should have gotten in the shower an hour earlier. I will work on that. I will text you ahead of time and let you know if I’m running late.”
Seek to improve, not to perfect. If paying bills on time has always been a tough problem area, then a good goal would be to reduce how many bills are paid late in the next month. Aiming for improvement, not perfection, will take the pressure off and allow you to make more strides.
Perfection doesn’t exist. ADHD symptoms and traits do not make you a bad person. Be kind to yourself and remember that there are many fabulous parts to you. Embrace your gifts and humbly acknowledge the frustrating parts and commit to working on them.
If you are the parent of a child or teen with ADHD, help them adopt the above strategies and heed these tips for parents, families, and partners:
Take an empathetic lens. ADHD is a neurological condition that makes it hard to live up to the expectations of a neurotypical world. It’s why shame and defense mechanisms develop so quickly. Treatments and supports like medication, therapy, and coaching can help your child or spouse better manage symptoms and day-to-day challenges.
Create an accepting environment where it’s safe to talk about ADHD and defense mechanisms. This encourages honesty and problem solving.
Remain calm when bringing up an issue. Do not explode in anger or insult. If your partner left out a piece of wood with rusty nails near your dog’s walking area (as my ADHD husband once did), say, “I noticed you left out a piece of wood with sharp nails outside. That was upsetting and dangerous because it could hurt the dog. Please be more mindful of where you place items.”
Be curious when symptoms go unmanaged. Together, think about how they can be better managed in the future. Look for improvement rather than expecting the issue to never happen again. Your child, for example, may still have moments where they conceal the truth to avoid punishment as a result of an unmanaged ADHD symptom. Your job is to create an environment where you won’t get upset if your child isn’t telling the truth, and work with them to manage the ADHD symptom in question.
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In 2020, my son was born prematurely, weighing a tiny 600 grams, or a little over a pound. He was what they call a micropreemie. I had never seen a premature baby before, but there he was, so tiny he fit in the palm of my hand. Upon his birth, I was suddenly flung into the world of neonatal intensive care.
The trauma of an early birth is incredibly extreme. It’s being thrust onto a high-speed, rickety roller coaster with dangerous ups and downs. My baby was tiny, but he was breathing. Around a sharp turn we went as we were immediately separated after birth. The intensity of the separation was so great, it could have shattered me into a million pieces right there. He was perfectly proportioned – up, up, up – but he needed life support – down, down, down. He was a fighter, but we’d plummet as he’d battle infections. He needed so many blood transfusions. He had a good heart, but some other organs were underdeveloped. His lungs constantly collapsed. There were times when we almost derailed completely, like when he’d turned blue in my hands. Like all the times when his heart almost stopped.
The chaos during his time in the NICU never ceased. But each and every day, I was able to be there for my tiny human because I concentrated so intently on him, a phenomenon that has a name, I learned much later on – hyperfocus – and is part of ADHD.
My Son’s Survival: The Object of My Hyperfocus
So intense was my concentration that I was able to retain a barrage of new medical information, administer medicines and feeds, pump milk, sing to him, read to him, advocate for him, and fight for him even when the prognosis looked dire. One of the doctors in the NICU even asked me if I was in the medical field, too. No, I just know how to concentrate when needed and learn everything possible about a situation. My son’s survival became the object of my hyper focus. There was nothing that could derail me.
Even when he was finally discharged after a long four-month hospital stay, with prongs and adhesives on his little face, I still hyperfocused through this new winding valley. After all, there were many medications to prepare and administer, oxygen concentrators and portable tanks to adapt to, and endless invasive and painful appointments and surgeries. Through it all, I researched every aspect of his diagnoses and care, how to help him heal, and how to prepare him for what was to come.
I was in a daze when I disembarked from the rickety roller coaster of the NICU. Absorbed by my son’s health and all things relating to prematurity, I had tuned out the world around me, even myself.
Used to communicating with nurses, doctors, and others in the NICU, I had to re-learn how to communicate with others who were outside of this world. I learned the hard way (as is my tendency) that not everyone wants to hear about our journey not because they’re disinterested, but because talking about trauma makes others acutely uncomfortable. Hyper focusing on the particulars of my son’s health, it seemed, almost detached me from the pain of this harrowing experience.
The aftermath of months of hyper focus was a rubble of burnout, depression, confusion, unhealthy coping mechanisms, and loss of self-worth. My introduction to motherhood had been as a bystander. I was a nurse and an advocate for my son, but I still had to learn how to be his mother, which brought me so much guilt. I was drowning.
I drew upon all the strategies I could muster from years of therapy. I reached out to others, I asked for help, for company — even just a cup of coffee. Some told me that I was “too much” while others didn’t seem to take me seriously because I seemed fine enough.
If I didn’t do something, I knew I’d be at the bottom of the ocean quickly.
So, once again, I grabbed on to my hyperfocus wire. I researched and researched all things medical trauma and traumatic birth, and I came out on the other end with diagnoses of post-traumatic stress disorder (PTSD), postpartum depression (PPD) and ADHD.
I found a community group that sent volunteers around a few times a week to just sit with me, have a cuppa, and hold the baby while I took a shower. Such simple things gave me the space to breathe and finally steady my feet enough to get the help I needed.
Hyperfocus Saved Me – and My Child
When I’ve hyperfocused previously – before I knew it had a name – it was often a draining experience that, like other aspects of my neurodivergent brain, was hard for me to understand and embrace.
But after my diagnoses, I have a greater understanding of how my brain works, and more grace for myself and what I’ve journeyed through. The ability to hyperfocus, as I now know, can be an incredible strength. I’m thankful that my resilient neurodivergent brain forged a pathway through trauma and saved me and my little human.
Birth Trauma and ADHD: Next Steps
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Before I was diagnosed with ADHD at age 33, my body felt like a mystery, an experience I assume is nearly universal for women with a late diagnosis. Yes, there was forgetfulness, distractibility, “careless” errors, internal restlessness, and emotional dysregulation. Yes, there were incredibly painful menstrual cycles with mood changes so drastic they should have their own amusement park rides named after them. But there were also migraine headaches so severe that they’d often lead me to hide in the bathroom and vomit while working a retail job at age 20.
Despite the unbearable pain and nausea associated with migraines, I attended regular work and school hours. With then-undiagnosed ADHD, untreated migraines, severe mood swings, and an unpredictable body, I completed all of my responsibilities with a smile on my face, masking the feeling of being a walking zombie. Experiencing – or rather, trying to act like I wasn’t experiencing any of it – was likely a big reason why I was diagnosed with depression before I was diagnosed with ADHD.
All Roads Lead Back to Estrogen
After my ADHD diagnosis, I poured myself into research, as I quickly learned I would need to educate myself about ADHD’s unique presentation in women. One finding that struck me was just how much hormonal fluctuations influence ADHD symptoms in women, which complicates an already-complicated picture. The villain causing all of my challenges, it seemed, was low estrogen levels.
It turns out that there’s a strong relationship between estrogen and dopamine, which is one of the main neurotransmitters involved in ADHD. Low estrogen levels mean low dopamine levels. The inverse is true. When we consider that there are predictable drops in estrogen throughout the female lifespan, like right before getting a period or during perimenopause, to name a few, it means there’s a predictable worsening of ADHD symptoms, too. Low estrogen levels seem to hit us hard, which may be why premenstrual mood disorder (PMDD), a severe form of premenstrual syndrome (PMS), disproportionately affects women with ADHD.1
But that’s not all. Low estrogen levels are also known to trigger migraines.2 Could this connection explain why migraines, which are more prevalent in women, co-occur with ADHD about 35% of the time?3 As I tried to put the pieces together, I felt like a detective uncovering the mystery of my life. I finally understood why I felt so out of my body and mind in the midst of a migraine attack. I understood why, on migraine days with yet undiagnosed ADHD, it felt like there was an ineffective replacement version of me steering the ship, and the vessel that was me was constantly on the verge of collapse.
Silent Conditions
As I tried to learn more about the migraines-ADHD connection in women, I learned that, as with ADHD, research on migraines and the scientific attention given to migraines are biased with respect to gender. In Migraine: Inside a World of Invisible Pain(#CommissionsEarned), Maria Konnikova writes that, despite the disease’s prevalence, migraines receive little to no attention in medical schools. Further, Konnikova explains that Sigmund Freud can be thanked for the gender divide in migraine diagnosis. If women are suffering, it must be, quite literally, an unobservable, unexplainable phenomenon in their heads. Like ADHD, migraines are a silent and overlooked condition in women. As with my own ADHD diagnosis journey, I suffered from migraine headaches for years before going to a neurologist to finally get them treated.
In her 1968 essay “In Bed,” Joan Didion writes that the public often views migraines as “imaginary.” I argue that ADHD is often viewed similarly in women. And why wouldn’t this be the case? As long as we mask our pain and our symptoms — a habit I’m still unlearning — ADHD in women will continue to be difficult to detect. As long as the medical community dismisses the relationship between hormonal fluctuations and ADHD, women will go misdiagnosed and improperly treated.
Here’s the truth: Women with ADHD, like women with migraines and other conditions heavily tied to hormonal and dopamine imbalances, are boiling pots with ill-fitting lids that we and the people around us use to avoid being misperceived as untamed shrews. And I’d venture to guess you’re just as tired of acting as I am. Regardless of the condition, we deserve to have all of our symptoms taken seriously.
ADHD in Women: Next Steps
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How often do you show up late to the events and responsibilities of your life? Forty percent of the time? Half? If you can’t say 100% of the time, then I win. I am the Queen of Lateness.
Or I was.
I used to be late for practically everything. And take it from the Queen: Being late stinks. It’s a self-sabotaging act that gave me decades of anguish, hurt, and frustration. I knew the heartache of lateness like I knew the jewels on my crown. I’d have given anything not to wear that crown, to be a commoner who — gasp — gets to appointments a few minutes early.
Following is the story of how I changed my lifelong habit of lateness practically overnight. No, this is not a clickbait story. It’s the sharing of fundamental tools that us late and time-blind folk don’t realize are out there. It’s my “eureka” story.
Step One: Time Yourself
My lateness was “cured” in 2007 at the start of the recession. My job as a tech recruiter was on shaky ground, so I pivoted and started a cleaning and residential organizing company. My sweet cousin recommended my services to her friends, who hired me. With my company and reputation now connected to my friend and family circle, I had to avoid failure at all costs. Lateness threatened it all, which meant I had to find a solution.
How was the Queen of Lateness supposed to undo a lifelong habit? I started with the only thing I could think of — measuring time itself. Rather than assume how long it took me to do something, I actually tracked myself. If you’ve never done this, I can tell you the results will shock you. It shocked me to learn that grabbing coffee, putting on my jacket, walking to the car, setting up my GPS, and backing out of my driveway took 10 minutes, not zero minutes, which is the time I always allotted.
This is what got me to realize why time was such a mystery to me and other folks with ADHD. Though the clock is always ticking, we don’t often account for the little, almost automatic tasks — picking out an outfit, looking over notes before a meeting, making a quick lunch – that undoubtedly use up time. Ten minutes to get out of the house may sound like small peanuts, but when you add up all the other unaccounted-for tasks through your day, that time significantly adds up.
Time yourself and you’ll see that it takes longer than “half an hour” to go from waking up to getting out the door. Google Maps can give you a good estimate of how long it takes to get from Point A to Point B, but it can’t tell you how long it takes to park, pay the meter, walk to your destination, and get inside the building. Trust me on that one.
Step Two: Accept the Numbers
This discovery, which had been hiding in plain sight all this time, shattered my world of lateness and gave me the key to a world where punctuality was possible.
But there was one last door to unlock before I truly internalized punctuality. Though I now had proof of how long tasks really took, it somehow wasn’t enough to change my ways. I had to become willing to drop my prior assumptions and adjust to reality. I had to accept that most things will take longer than I think (or hope). I had to go from an expert bargainer with time to one who submits to it.
At first, I protested when my time estimations, freshly calibrated, told me it would take two hours to do something I assumed I could do in one hour. But that skepticism was replaced with joy when I did what time told me to – and I was early. I became the newly crowned Queen of Punctuality. Guess what this did for my reputation and my serenity? Guess what it did for my self-concept?
I’d love for you to see what this new life feels like. When you do, you will bow to me and thank me until the end of time, which is further away than you might think.
Be on Time: Next Steps
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Most neurotypical people don’t fully understand or recognize ADHD struggles — and why would they? It’s hard for people with ADHD to describe their experiences because they are so complex and all-encompassing. There’s also a false familiarity (“Everyone’s a bit ADHD!”), so neurotypical people often assume that they know what we’re describing when they have only a vague or watered-down idea.
The truth is that ADHD is genuinely debilitating at times. For example, I’ve spent all day writing this, but it was originally meant to be a 10-minute edit.
There are days when I struggle with ADHD impulsivity in ways that seemingly mess up my life, even when I’m being careful and working on managing my impulses. I take responsibility for my actions, but I’ve also beaten myself up for years over past mistakes. These blips and slips do not represent who I am, my skills, or my true character.
Neurotypical people tend to notice our mistakes first and, to a lesser degree, our ‘surprising’ success stories. What they don’t see are the mistakes and blips we stop ourselves from making. Most of our personal progress in managing our ADHD symptoms is invisible to others, but that doesn’t mean we should ignore or discount it. Even small steps in the right direction deserve recognition.
For example, I have a habit of saying things that come out the wrong way when I’m nervous. I’ll see the other person’s eyebrow go up, assume the worst, panic, and try to dig my way out. This has — and never will — work, especially at work.
To solve this, I stop, close my eyes, open them again, make eye contact, and say, “Sorry, that came out wrong, and now I feel a bit silly.” Then I smile, which is a positive cue, and ask a related question to regain the flow of the conversation.
Most people would shrug off this interaction, but when it happens, I know I’ve made progress. I try, in those moments, to recognize that I’m spending time and effort addressing ADHD traits that matter.
Impulsive mistakes don’t define me; neither do first impressions and strangers’ opinions. Over time, I’ve learned to recognize and understand the difference between a royal screw-up that will have a long-term effect on my life and things that are just normal human errors or behaviors that temporarily irked someone.
Think about your past dramas. Do you still talk to the people whose opinions kept you up at night for months? Do you even remember what you actually said? Was it really that important to you or to them?
Chances are that awkward, little mortifying moment was the funniest part of the person’s otherwise boring day. It probably made you quite endearing to them, but you’re assuming the worst because a lifetime of criticism has exacerbated your RSD and accentuated your sensitivity.
Instead, I’d encourage you to embrace and try to enjoy your silly ADHD moments for what they are. You are not the first person to giggle at a funeral or accidentally interrupt an exciting conversation because you want in. Being a bit embarrassed is quite cute, and it’s okay to be nervous and feel silly. Everyone does it, and everyone puts ‘their foot in their mouth.’ If anything, you’ve probably replaced all the stress and tension in the atmosphere, and with some humanity and joy, and that is an invisible victory unto itself.
Embracing ADHD Impulsivity: Next Steps
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We’ve all seen it. The student who inadvertently cuts off their friend mid-sentence because they have something they really, really want to say. The student who is excited and enthusiastic about today’s lesson and can’t help but blurt out responses.
With patience and a few tried-and-true strategies, you can help your student harness their enthusiasm and energy in the classroom while minimizing blurting. Use these ideas to spark your next brilliant behavior plan or classroom-management strategy.
1. Try planned ignoring. During a classroom activity, acknowledge students who raise their hands and wait to be called on. (Be sure to repeat this expectation prior to and during the lesson.) When a student who was previously blurting is now raising their hand, call on that student right away, and praise their enthusiastic efforts to contribute while following classroom expectations.
2. Three nods and a deep breath. For students who struggle with waiting their turn to contribute to a conversation (especially when it’s an exciting one that relates to their interests), encourage them to work and refine their patience muscles with a quick exercise: When the urge to blurt comes up before a friend has finished their statement, slowly and slightly nod three times and then take a deep breath before jumping in. Even if the student does end up blurting, it’s the practice of mindfully waiting that counts. This exercise also teaches students to be active listeners.
3. Use self-monitoring tools. Sometimes, students are unaware that they are blurting and how often they engage in the behavior. Self-monitoring tools can raise their awareness (without causing shame) and help control its frequency. My favorite way to use self-monitoring in the classroom is for both student and teacher to track the student’s blurt count for a lesson/period and compare results.
If the blurt tally is the same, then the student gets to pick from the big prize box for recognizing the number of times they blurted. (If the tally is off, you should reward the student anyway for making progress, perhaps by allowing them to pick a smaller prize.)
Over time, once the student’s baseline number of blurts is established, you can set clear goals around limiting those interruptions. If five is the average for a lesson, then aim for the student to blurt no more than three times a lesson. Praise and reward the student, perhaps with additional time for recess for the whole class.
4. Do an environmental check. Thinking critically about the environment in which our students learn is essential to maximize their learning and make sure everyone is on the same page with respect to the classroom rules.
Review classroom expectations frequently with your students. Make sure that the rules are clear and easy to understand, and write them on the board or keep them on a poster hanging up for all to see. Ensure that students understand when it is okay to talk softly to friends in their desk pod and when it’s time to be absolutely quiet, like during tests.
Consider seating. Put a student who blurts near your desk or away from other students who also blurt. Consider creating a designated space in your classroom that students can go to if they need to self-regulate to control blurting and other impulsive behaviors.
Don’t overlook the importance of a clutter-free space. Where is my notebook? Pencil? Last week’s homework assignment? A cleaner environment can reduce these questions, which may come out as blurting. During transition times, have your students take a few minutes to do individualized environmental check to keep organized.
Check noise levels. Soft music may calm some students, which helps with impulsivity, while others need absolute silence to avoid being “activated.” Think of what works for your students and consider using noise cancelling headphones for students who need quiet.
How to Stop Blurting: Next Steps
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When I was born in 1933, neurodivergence (along with jet aircraft, the atom bomb, and plastic bags) had yet to be. If a child’s behavior did not comply with the norms of the time, as was the case for me, it resulted in punishment, not psychoanalysis. And so I grew up thinking I was naughty, talkative, lazy, untidy, and slow. I prayed to God every night to make me “good.”
A year ago, when I was 89, my psychiatrist said to me after an evaluation, “You are definitely ADHD.” In true neurodivergent style, I blurted out, “At last — I know I’m dotty.”
I sought an evaluation after I learned, years prior, that ADHD could be inherited. My son had been sent to the school psychiatrist at the age of 7 and diagnosed as hyperactive (the term ADHD did not yet exist). Now my granddaughter has been diagnosed at the same age. Could they have inherited the condition from me? Neither my husband nor my granddaughter’s mother were anything other than neurotypical. Could I be the ADHD source?
I thought of my own parents. Mama – stable, competent, organized; always reliable and down-to-earth. Papa – creative; always trying something new. I remember him continually cracking his knuckles as he sat reading. I was his mental counterpart. Mama was sometimes embarrassed by our antics.
The more I read about ADHD, the more certain I became of my own neurodivergence.
In the year since my diagnosis, I have been mentally reliving my life, identifying all the events that pointed to neurodivergence; and I found many. Fortunately, I was interested in most of my school subjects, and passed college matriculation exams with flying colors.
I tolerated arithmetic (although I made basic errors through lack of concentration) and found geometry interesting, but never understood the meaning of algebra. None was more astonished than my math teacher when I passed it. I cherish one report card, on which she wrote, “Anne’s brain has gone to seed.”
Looking back at my employment record, I can now understand why there were some jobs that I enjoyed and excelled at, and some that bored me witless and resulted in real problems. Anything that presented challenge, variety, and interaction with other people was my forte. I was in my element as a police officer, and was sorry to leave when circumstances took me to another country. I finally found my calling in the fields of personnel and training. I looked forward to Mondays, and worked long hours, achieving five promotions in 20 years.
It was only boring, repetitive work that caused problems. I have worked at various times as a telephonist, a copy typist, and a cashier, and I can relate several unhappy episodes in my life to the lack of mental stimulation in these jobs.
My interests and hobbies have been varied, with many that I have dived into enthusiastically, but eventually dropped. These include sports (I played squash and softball, and managed my son’s little league baseball team), performance (singing, speaking, and amateur acting), sailing, pottery, driving a classic car, and embroidery.
Fourteen years ago, I was widowed. For the first time in my life I was responsible to nobody and responsible for nobody. I thought of the things I like doing, and the ways I wanted to spend the rest of my life. I would continue to be involved in the community affairs of my retirement village and pursue what were now longstanding interests in travel, photography, wildlife, wine, music, and, most of all, writing.
I have had a lifetime’s love of language – words are my favorite toys – and have dabbled in writing the occasional short story, and even one or two verses. Writing not only provides a creative outlet for my lively imagination, but it has the advantage of being an activity I could pursue as my mobility inevitably decreases.
This Is ADHD – at 90
The diagnosis and a growing knowledge about ADHD have changed my life. I no longer feel as though I’m acting a part, nor do I still need to mask my real self. It is easier than it was – though not always possible – to curb my actions. I still blurt out inappropriate comments, but I can now recognize them for what they are and apologize where it is called for.
At 90, I am now physically slow and creaky, but mentally alert. I live on my own and still drive my car. My messy house worries no one, though I manage to keep the living room relatively tidy for visitors. I embrace my neurodivergence, happy with who I am. I revel in my vivid imagination and use it to fuel my creative writing. I play the music I enjoy, singing along with it, although my voice may be cracked. I can no longer dance to the music, but I can sway to its rhythm. Now, if I forget something, or I’m late for an appointment, or I make too many typos, I can always apologize and blame my lapses on old age if I choose.
I have discovered the key to living happily with ADHD, and that is self-knowledge coupled with acceptance. That is why, after my ADHD evaluation, I walked out with a happy smile, and rejected the psychiatrist’s offer of medication. No, not for me. I’m ready to enjoy being who I am.
ADHD Later in Life: Next Steps
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What if dancing, coloring, and painting could be part of the parenting toolkit you use to regulate your child’s big, intense emotions?
For children with ADHD who have challenges with emotional dysregulation – everything from meltdowns to overwhelming feelings – creative expression can serve as an effective outlet for powerful emotions. Through creative expression, children with ADHD can tap into stress relief and mindfulness while building on their interests and talents. Creativity can also be a neurodivergent-affirming way of facilitating healthy expression for children with verbal communication challenges.
Along with other tools to help your child manage emotional dysregulation – like medication, counseling, occupational therapy, and coping skills – try the following creative activities that bring calm.
Make sculptures using clay, Play-Doh, textured slime, and/or craft materials. Tactile activities like these are great for children who seek deep pressure input to the hands and upper body.
Make simple puppets, like sock puppets or ice-pop-stick puppets, and recreate a favorite story.
Color or draw mandalas, an activity that can improve focus and attention in children with ADHD.1 Coloring and freehand drawing are also fantastic activities for practicing fine motor skills.
Make a mixed-media mood board with scrap paper, markers, crayons, pictures, stickers, and other art supplies.
Older children and adolescents can use their phone or tablet’s built-in apps to make movies and sharpen photography skills, among other creative projects. There are plenty of free creative apps, like Canva or Shuffles, for creating fun digital collages.
Emotional Regulation Through Creative Expression: More Tips for Parents and Caregivers
As you explore the right creative outlet(s) for your child, consider their sensory needs and sensitivities along with their current emotional state. You may want to hold off on certain activities that can aggravate your child (like dancing to loud music) if they’re in a dysregulated state.
Support your child’s creative expression with intentional feedback that focuses on their efforts and encourages intrinsic motivation. Instead of saying, “Your drawing is so good,” say, “You spent so much time on this project; I can tell you put lots of intention into it.”
As you help your child develop emotional regulation skills, keep these words in mind from Alysson Goodwin, Ph.D., MBA, OTR/L, an occupational therapist, advocate, and educator: “Dysregulation is simply a resource mismatch. Support for children with ADHD is helping them to develop better ways to communicate what they are feeling in their bodies and with their emotions in an objective, open, and nonjudgmental way.”
Creative Expression for Emotional Regulation: Next Steps
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I apprehensively open my prescription bottle and peer in. I pour its contents into my hand, double and triple checking my count of its contents. Dread washes over me; it’s time to get a medication refill.
The ADHD medication shortage that started in late 2022 – and still with no end in sight – has deeply and profoundly worn me down. I am exhausted. I am frustrated. I struggle immensely due to the extra time and effort I now have to invest to get the medication I need to function. Even though millions of us are affected by this shortage, I’ve felt isolated and hopelessly alone in navigating this overwhelming system that has failed us.
An Executive Function Gauntlet: The Outrageous Absurdity of Refills
I take both a long-acting and short-acting version of my ADHD medication, and have been doing so for a decade. Prior to the shortage, the process I followed to obtain medication was imperfect, but more doable than our current nightmare. I had grown accustomed to the task of getting a new prescription for each of my medications to bring to my pharmacy every month. I knew when I had to make an appointment with my doctor to request the prescriptions, and I diligently showed up to my pharmacy within the three-day refill window, as allowed by law, and was ready to wait the usual 45 minutes for both of my medications to be filled.
With the ongoing medication shortage, I only have about 10 blissful days a month where I’m not dealing with some aspect of refilling my medications. Now it’s not only a question of being within my three-day refill window but also relying on my medication to be in stock.
At every turn, obtaining the medication I need requires executive functioning – the very area that is impaired in ADHD, and for which medication, along with employing strategies and learning skills, improves. My prescriptions have gone from being filled on the same day to being filled on different days and then weeks apart. This means shifting things around to make room for more trips to the pharmacy, more phone calls to disgruntled staff, more things to complicate my day-to-day life, all while undermedicated. (As it turns out, living with impaired executive functioning sure takes a lot of executive functioning.)
More than once, I’ve been scolded by pharmacy staff for making the mistake of calling to request my prescription release one day too early. (As many ADHDers know, staying on top of dates is no easy task.) I was acridly reminded that this is a scheduled drug and that my refill is not due yet. Each time it’s happened, I say, “My apologies, thank you for your help,” silently chastising myself for messing up the dates, loathing that I have to start this process all again the next day.
I also started rationing my medication, skipping doses on weekends to make sure I could at least have medication to do my job. After a few months of this, my frustration gave way to panic when my pharmacy said it had no idea when the next shipment would arrive.
I once contacted 15 different pharmacies over three days, trying to find a location that not only had medication in stock, but that would be willing to take my prescription. Pharmacy after pharmacy told me that their location was no longer accepting new ADHD patients. One pharmacy even had the audacity to laugh at my provider when they tried to call my prescription in. This system, designed to prevent drug abuse, was now forcing me into the role of a literal drug seeker despite being on my exact same dosages for ten years – the irony of which was not lost on me.
One pharmacy was willing to take my prescriptions, but getting there and back would easily take me an hour, and they could only put me on the wait list. Another pharmacy was closer, and while they didn’t have my exact dosage in stock, they told me that they’d be able to fill my prescription if my doctor split my dose between two lower-dose pills. I hesitated, anxious to make the request because my doctor had already submitted and cancelled two sets of my prescriptions that month. I worried that the back-and-forth would flag me as a troublesome patient. Thankfully my doctor was willing to accommodate. Still, I thought to myself that this cannot be the price we pay to function.
Then there’s the work of verbally calling to release my prescriptions, which can take anywhere from three minutes to a very literal two hours on hold, only to be hung up on. I can’t just leave a voicemail to release my prescription – there is no way to confirm they received it without calling in again.
At my doctor’s appointments, on the phone with the pharmacy, and at the pick-up window, I started venting my frustrations in the form of humor. I joked that this system is an executive function gauntlet for people with ADHD – it certainly wasn’t designed with us in mind! Yet these jokes only got an occasional weary smile. Meanwhile, I simmered, knowing this “joke” was my real life.
Trapped in a Solitary, Multi-Year Riptide
I have educated myself on the shortage, reading endless articles about it. I have observed how the different agencies, producers, and regulators involved shift the blame. Yes, it is a complex system, but that does not diminish any one participant’s part in making it better or making it worse. I have written to Congress. I have listened to countless stories of the strife everyday folk endure to get their prescriptions.
Every story I hear makes me feel like each individual with ADHD is on their own little island. We’re able to send along messages in a bottle, but we’re unable to collectively make those in power recognize our stories and our pain. I am sick of feeling trapped in this riptide all by myself, subject to forces that I cannot control, powerless to take care of my own physical and mental health. I am saddened that there doesn’t seem to be a way for the 8.7 million of us with adult ADHD (and parents of children with ADHD) to collectively advocate or have a say in this process. We deserve a seat at the table.
A Seat at the Table: How We Can Make Our Voices Heard
The ADHD medication shortage cannot go on. It has caused far too much damage and pain for those of us who simply want to live and work and achieve what we are capable of by limiting the burden of this neurodevelopmental disorder.
I have done all that I can on my part – following all of the expert advice during this shortage – to independently manage my health. I am working toward medical school, and I have thought long and hard about what I’d do if I could magically fix this system. Perhaps new monthly prescriptions should only be required in the first year that a newly diagnosed patient is trying different ADHD medications and dosages. From there, documentation attesting to ADHD and the continued need for medication can be submitted to the DEA, insurance companies, and any relevant regulatory board in order for a patient to be granted the privilege to have their medication treated like any other normal, regularly prescribed medication.
Pharmacies would be able to better predict their orders of stimulant medication instead of having to turn people away with valid prescriptions because they’re already overwhelmed with managing this shortage. I do not deny that stimulant medication has potential for abuse, and a regulatory system is appropriate for this class of medications. But the bottom line is this: There must be a way for diagnosed ADHD patients who have a history of established care to be able to reliably obtain their medications.
But work must be done on all fronts. Individually, we are isolated. Yet we have power in our multitudes and in our stories. It’s time to start to #ADDUsUp. We can all be #ADHDvocatesForChange.
Share your stories of and frustrations with navigating the ongoing shortage, plus ideas for how to make the world better for neurodivergent individuals on social media using the above hashtags.
As you share your story, tag celebrities with ADHD and ADHD organizations/platforms and demand that they unabashedly call out the shortages and seek not just answers, but change.
Write to your U.S. representatives, the DEA, and the FDA, who must understand the real-life consequences of drug shortages and current policies for the millions of us who live with ADHD. Untreated or poorly treated ADHD wrecks lives, and medication is an important tool upon which we rely for our health and wellbeing. Highlight how policy at the governmental, regulatory, and healthcare system-level (including procedures at insurance companies and manufacturers/distributors of medications) directly impacts the care and wellbeing of ADHD patients.
Together we can elevate our voices, share our experiences, and demand more of our institutions and those in power. If we, a bunch of executive functioning-challenged ADHDers can get organized and start a movement, then those with power have no excuse for ignoring breaks in this system. It’s time for them to do their part, too.
ADHD Medication Shortage: Next Steps
Elizabeth (Elle) Sharrard is an aspiring medical student and a proud #ADHDvocate who hopes to empower people to use their voices to improve the world for all. Elle’s blog post inspired the creation of ADDitude’s call-to-action scripts for contacting representatives about the ongoing ADHD drug shortage.
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Twelve years ago, I embarked on a transformative psychedelics journey that opened my eyes to my true self. I did not know then that this trip into my subconscious would completely change my perception of the world, make my then-undiagnosed ADHD more manageable, and lead me to help others experience similar life-changing revelations.
On that fateful day, my psychedelic guide gave me magic mushrooms and said, “Look at the forest one last time; you will never see it the same way again.”
To say he was right would be an understatement.
I arrived with a simple intention: to get to know myself better. What emerged were aspects of myself that I never knew existed. The psychedelic experience revealed the roots of my depression and provided insight about how to regulate my emotions — a godsend for me as I struggled with intense mood swings and disorders. Whereas therapy had failed, this journey transformed me entirely.
To be clear, it was not a magical solution that solved all my problems overnight. But my psychedelic journey gave me a vision of the destination to drive toward. It filled me with an intrinsic motivation to change the patterns that were keeping me stuck.
Fast-forward 12 years, following numerous psychedelic experiences combined with therapy: I have achieved a state of emotional stability. Severe mood swings and depression are a distant memory.
I was diagnosed with ADHD last year, and I consider this revelation the last missing piece of my puzzle. Today, I find it easy to love myself for who I am. I have developed new ways to live and embrace my ADHD brain without using medication.
Helping Others Follow the White Rabbit
In 2016, I decided that I wanted to help others by becoming a psychedelic-assisted therapy facilitator. At the time, psychedelic facilitator training programs didn’t exist, so I pursued extensive training in various modalities. I trained in inner child work and trauma integration therapy. I attended workshops and seminars conducted by experts in the field of psychedelic-assisted therapy.
Since then, I have co-founded a psychedelic-assisted therapy company and guided hundreds of people through psilocybin journeys in the Netherlands, where this work is legal. The changes I have witnessed in people, especially those with ADHD and neurodiversity, have been nothing short of astounding.
Most of the people undergoing this form of therapy experience significant changes in their lives, overcome addictions and depression, transform their self-doubt, and reduce their rejection sensitivity.
It is important to say that this therapy is not for everyone, nor is it a one-size-fits-all solution. Individuals who are prone to psychosis, diagnosed with schizophrenia or bipolar disorder, or who have a family history of these conditions should abstain from this therapy.
That said, it helped me to redefine my life, and I hope it can benefit others like me.
Psychedelic Assisted Therapy: Next Steps
Alice Smeets is a neurodivergent psilocybin-assisted therapy facilitator and co-founder of A Whole New High, which offers guided, private psilocybin therapy sessions and group retreats in the Netherlands.
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White rice, white bread, ground beef, chicken fingers, French fries, and pepperoni pizza — for most of my life — and with very few exceptions — these were the only foods I ate.
From a young age, trying any food outside of this short list was a struggle like no other. I’d chew the food and try to pass it, but my throat would close, and I would gag and choke. No matter how hard I tried to swallow, I just couldn’t.
Of course, everyone thought that I was simply a picky eater. My mom learned early on that there was nothing she could do to get me to eat different foods. Unlike other parents with picky eaters, she couldn’t bribe me, give me trouble, or make me sit there until I was done with my plate. None of it worked on me, so she eventually came to terms with my limited diet, where most of the foods I ate were of the same flavor and color.
Over time, a few other foods did make it into my diet, so long as those foods were of the right brand and prepared a certain way. Fruits and vegetables definitely did not make the cut. And another thing: If foods on my plate touched, I considered my meal ruined.
If I did muster the courage to try a new food and manage to swallow it, I usually ended up getting sick. Eventually, trying new foods was no longer an option.
I struggled with my health growing up, whether it was stomach problems or a cold that would stick around for months and require trips to the emergency room. But my doctor’s visits often ended with me being told that I was a “medical mystery” because all my numbers, even my weight, were good. Though I ate few foods, the fact that my diet comprised mostly calorie-dense carbs meant that I never had any difficulties with putting on weight. If anything, I was always on the heavier side. No one could figure out what was wrong with me, and never did we think that my eating had caused all of these issues. The doctor never asked, and we never brought it up.
It wasn’t until I started Googling “how to fix my picky eating” that I learned about avoidant restrictive food intake disorder (ARFID). The more I learned, the more my eating habits and entire life made sense.
Finally! I knew this went beyond picky eating. Now all I needed to do now was learn how to manage it, right? Or so I thought. Knowing a reason, unfortunately, didn’t make it any more possible for me to try foods.
ARFID in Adults: Diagnosis and Recovery
Years after I learned about ARFID, and now in my late 20s, I checked myself into an eating disorder clinic, where I finally received a professional diagnosis. For the first time, a doctor fully examined me and determined that I’ve been severely malnourished my entire life, no matter what “the numbers” might have said. It made complete sense. I mean, I went over 25 years without consuming a vegetable.
Thus began my ARFID recovery, a journey that gave me the opportunity to travel to England to receive treatment and, later, film a documentary to create awareness around this poorly understood eating disorder, especially in adults.
In my ongoing recovery and research, I learned about a therapist who specializes in ARFID. Given his phenomenal success rate with his clients, I figured that if anyone could help me, it would be him.
Before my session, I went to the grocery store to look at a handful of foods I’d never even think of trying. It was hard, and it was scary. I had a panic attack after picking up a kiwi because the thought of consuming it was so unsettling.
A few short hours later, it was time to head to the clinic.
After I settled into a big, comfy chair and wrapped myself up in a blanket, the therapist and I started talking. To this day, I can’t fully explain or understand what he did. It felt like he spoke to my inner child who had been grasping onto a massive ball of anxiety all this time. He somehow convinced that part of me to let go.
After our talk, I walked over to a table full of foods that I’ve never tried before, or that I had eliminated from my diet, knowing that the next step was to try them. It was different this time. The table full of unknown foods no longer filled me with anxiety. In the next 24 hours, I tried more food than I had in the preceding 28 years.
One Bite at a Time
It’s been nearly four years since I’ve been in active ARFID recovery, an experience that has been harder than I imagined. By now, I expected to be eating plates full of colorful foods and enjoying a wider variety of foods, but I’m not.
It’s hard to think about where I thought I would be by now and realize that I am not even close. But when I feel discouraged, I think back to where I started. My foods can touch, I’ve added multiple foods to my diet, and I am able to swallow when trying something new. As long as I keep trying new foods, I’m better — and moving forward.
ARFID in Adults: Next Steps
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