What I learned from How to ADHD
Author: Jessica McCabe
Ableism
For neurodivergent individuals, striving to be 'neurotypical' not a realistic goal; instead, functioning effectively often involves embracing behaviors that diverge from neurotypical norms. Society is heavily influenced by ableism, leading some neurodivergent individuals to feel they aren't 'disabled' enough to claim that identity or the accommodations that accompany it.
Internalized ableism may mislead neurodivergent people into believing they can manage without necessary support. Further, internalized ableism can result in accepting negative labels imposed by others when unable to meet societal expectations. For example, someone might be labeled as "irresponsible" due to executive functioning challenges that impact task completion . Having a formal diagnosis can provide validation and insight, helping individuals recognize that many of their challenges are not personal shortcomings but rather invisible barriers related to their neurodivergent identity.
For instance, difficulty remembering to complete a task may indicate a working memory or recall issue, which is often experienced by individuals diagnosed with ADHD. Additional challenges include making careless errors, forgetting appointments, or experiencing a lack motivation.
These are shared experiences of ADHD and are not personal failings.
I wanted to share some of the things I learned from How to ADHD by Jessica McCabe. I recommend that you read this book if you (1) have ADHD, (2) love someone with ADHD, or (3) want to learn more about ADHD. Your take-a-ways may be very different from mine. Below is my summary, written in my own style :)
It's important to recognize that many behaviors typical of a neurodivergent experience are frequently suppressed, or masked. These behaviors may include the need to stim or move, which are often deemed socially inappropriate in school or work settings. In efforts to fit in, the person might try to remain still, make eye contact, and attend. However, this masking can lead to dysregulation, meltdowns, zoning out, or engaging in activities such as doom-scrolling on social media as a way to recharge.
Managing ADHD Challenges
First, it is not helpful to pretend that ADHD does not exist. Pretending that one does not experience challenges associated with having ADHD or other neurodevelopmental conditions does not make the challenges go away. Be honest with yourself and those around you about your struggles, and accept that accommodations can be beneficial
Second, it can be helpful to connect with others who experience similar challenges. Understanding that you are not alone in your struggles can be very validating – and you can swap helpful strategies as well!
Third, FOCUS – Figure Out the Cause and Use a Strategy – if you are struggling, ask yourself what gets in your way and use a strategy to help combat it
Strategies include:
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Add reminders in your line of sight when you need to do something AND remove things you don’t want to do (or that will distract you) from your line of sight
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Think through the order you want to do the task in to help you stay on track (this can include making a list, looking at your calendar, etc.)
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If you are easily distracted – fight it with other distraction. Keep parts of your brain or body busy so they don’t seek stimulation - put on an old tv show as background noise, keep your hands busy by using a fidget, etc.
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Keep a “to do list” and a “not to do list” that you can reference to make sure you are doing the things you want to get done that day and are not flipping over to things on your “not to do list”
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If a thought pops up to remind you to do something – don’t switch gears, write it down on a Post-it Note to complete later
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If you are doing something that might be dangerous if you forget about it (like cooking) or time sensitive (like switching over the laundry), put a bracelet on your wrist. Once you notice it, you will remember to check the thing
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If you are doing an activity that you may hyperfocus on, set a stop time for yourself. That could be an alarm or putting on a movie that lasts about as long as you want to do the thing to help you keep track of time
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When you need to take a break from a task and you worry about not being able to pick it back up, end with a sentence or two to describe what you were going to do next if you had more time
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If there is nothing that you “have to do” allow yourself to be distracted. Your brain is designed to make connections, think, wander, and do all the things to be creative and think outside the box. This is self-care and can be incredibly meaningful to neurodivergent brains
When we say executive function challenges, what do we mean?
Executive functions are a set of cognitive abilities that come from the prefrontal cortex – the last part of your brain to fully develop. These abilities help us make plans, emotionally regulate, prioritize activities, and sustain effort towards a goal.
Research suggests that the development of executive functions in people with ADHD are behind by 30%. This means that a 10-year-old may only have the executive functioning ability of a 7-year-old.
Some executive functions that are different in people with ADHD include:
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Response inhibition - the ability to suppress activities that may interfere with the completion of other activities – this is a common challenge for people with ADHD
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Working memory - the ability to hold information in our minds and manipulate it for use. For example, holding 20 + 12 +12 in your brain and then solving for the answer – having difficulty holding information and manipulating it in your mind is a common challenge for people with ADHD
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Set shifting - the ability to switch between tasks that may have different demands (for example, switching between talking to quietly listening during conversations. Challenges with set shifting can be challenging for people with ADHD (which may be why it is common for ADHDers to interrupt people who are talking to them when they are ‘supposed to be in listening mode’ – they are still in the talking set.
Research suggests that people with ADHD experience challenges with encoding information. Encoding involves comparing what we just heard or read with information we already know and then we store it away. This involves using working memory, which is impacted in ADHD.
What can one do?
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ADHDers may need more time to plan, process, and shift sets when doing the thing
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Try to work on one thing at a time
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Use auditory or visual cues for reference to help keep working memory slots free
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Give away areas of responsibilities to others (also called delegation) – for example, you can take responsibility for cooking if your partner/roommate/parent takes over the responsibility for clearing up following meals
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Simplify your systems as best you can - this means you don’t need an elaborate online planner to track your activities (unless this works for you) – you can simplify with a handheld day planner where you keep personal and professional tasks
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If you take stimulants, save your toughest/most demanding work for when your stimulants are at their peak effectiveness
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Practice saying no - you don’t have to volunteer or agree to everything (this may be challenging for those of us who are people pleasers). Saying yes is an easy way to get taken advantage of and to burnout
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On days when you can’t do all the things or just want a break from all the things, just do the ‘have to dos’ like eating and feeding your kids/pets/plants
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Find work-a-rounds. For example, if you often leave the house with your slippers on and have to go back to get your shoes, leave a pair of shoes in your car
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If you don’t know where to start – start with sleep hygiene. Adequate sleep will impact/improve many areas of your life. Setting up a simple bedtime routine and sticking with it is a great intervention. Within in, consider your sensory needs (how are the bed sheets? How do you feel about brushing your teeth? Can you do that earlier if it bugs you? Maybe cut the tags off your PJs) – it may take some time to take off but once your brain learns “oh this is the time we sleep” it can be magical
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For sleep, you can consider purchasing dimming lights that dim throughout the day to alert your brain to produce melatonin, or you can use store bough melatonin to assist with sleep onset
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When you find a strategy that works – keep using it. It is easy to think, in times that are going well, that you don’t need the strategy anymore. But one of the reasons things are going well is because of the strategy.
Invisible Tax
Many people with neurodevelopmental conditions, such as ADHD or autism, often have extra expenses that incur due to their diagnosis. For example, to apply for programs (such as AISH or CRA Disability Tax), people must pay a medical professional to complete forms. This can also include late fees (forget to return things), forgetting to cancel subscriptions you no longer need, replacing lost things, higher costs for last minute bookings, and so on.
Time Blindness
Time blindness is real – many people with ADHD experience that things are due either “now” or “not now” and often struggle with the signal that things are “coming soon.” This can also impact the planning for things: often forgetting to build in time for things that may wrong, for biological breaks (bathroom, eating), for transitioning between parts of a task or between tasks, or thinking (before doing) time. Important to consider when prepping for an activity or task includes considering the impacts of ADHD. Basically, the task is probably going to take 2-3x longer than you think it will.
Below are some reasons why this if often true:
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Working memory – you may forget some things needed to complete a task (like grabbing all the materials beforehand) and you will need extra time to go out and come back, sometimes many times. The set up is probably going to take longer than you think
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Organizing – time is needed to work with your neurodivergent brain –unhelpful thoughts may appear (e.g., I wonder if the new Bob’s Burgers episode is out? Should I check), or too many paths you could follow may come to mind. Adding time to accommodate ADHD thinking is helpful!
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So is planning backwards (what is the product?) Work backward to find the steps and estimate the time needed to complete each step instead of the overall project
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Attention regulation – you will likely get distracted by something. An email sound, a text message, a thought, someone coming into the room; side-questing is a common experience and adding time for this can also be helpful
Lacking Motivation
Motivation is just one part of getting stuff done. Other things may be at play that impact getting started
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A skill gap – do you know or remember how to do the thing. If you aren’t sure how to begin or what steps are needed, it can impact starting
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Lack of resources – do you have all the things you need to get started? This includes supplies, but also time and energy
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Perfectionism – sometimes if you feel like you can’t do it perfectly then there is no point beginning
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Optimistic thinking – believing that you can do it tomorrow without considering if there will be enough resources (again, time and energy)
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Forgetfulness – you may not remember why you even want/have to do the thing
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Realistic goal – is the goal you chose a realistic one? Did you set yourself up for failure due to insufficient skill and resources or forgetfulness (items 1-5)?
What can you do?
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Create a sense of urgency – for example, if you need to clean your house, invite someone over
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Find the right level of challenge – if the task is too easy, it’s too boring to do. If it’s too hard, then there is difficulty starting. Finding the niche of just challenging enough can spark the baby bear phenomenon – it's just right!
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Tie the task to your personal interests - have to do a talk? Add examples/images from your preferred interests.
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Add novelty - go to a café, a library, work with a friend, switch colours between pages. Add fun and novelty to spark interest.
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Do an enjoyable thing first to get you started on doing a task and then do the harder thing after
When considering motivation and stopping a task, see the below example to provide context
Need to fill out a form – get overwhelmed and frustrated
Can 1: avoid it and play a video game while feeling terrible cause I could not figure it out; or
Can 2: recognize why – it may be a working memory issue – have the instructions besides you or ask someone to read through the instructions and support you as you complete the form
Emotion Regulation
Those with ADHD tend to be more emotionally reactive and emotions tend to last longer compared to neurotypical peers. Emotional challenges are not included in the diagnostic criteria for ADHD and are often why people with ADHD may be diagnosed instead with depression or anxiety.
Unfortunately, suppressing your emotions does not make them go away – they will pop up, often at times when you don’t want them too (like at work!). When an emotion pops up and you are in a place to experience it (at home, for example), label it and ask yourself why you are feeling that emotion?
Socioeconomic Factors
Socioeconomic factors play a role in ADHD diagnosis and treatment.
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Culture – Some cultures are more accepting of mental health challenges; Some cultures are more adaptive for those with ADHD, for example, with less strict rules around time
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Socialization – many people with ADHD feel out of step with societal expectations and are often gender non-conforming
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Ethnicity/Race - access to diagnosis differs by ethnicity; some research suggests that as adults, Black Americans are 77% less likely to be diagnosed than White Americans, but Black children are 24% more likely to be diagnosed than White children and Asian children are least likely to be diagnosed and receive treatment (research from USA).
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Access to care – there can be medication shortages, those with lower incomes may not be able to afford medications, and stimulants are illegal in some countries, such as Russia
Just DO the Thing
There are reasons why people with ADHD cannot “just do the thing.” Cognitive ability is actually many cognitive abilities. For example, many tasks require using a combination of different cognitive abilities and many of these abilities are affected in ADHD.
Cooking supper means organizing the ingredients and then set shift between looking at a recipe and cooking the food. It is also important to recognize that demands placed on a person can impact their ability to use their cognitive abilities – there will be some days where they can do the thing and other days where they cannot.