What does brain imaging tell us about ADHD?

We now are able to look at the brain in ways that show its development and function. Studies have shown that kids with ADHD have smaller brains than kids without ADHD. This does not correlate with the head size your doctor measures in infancy, and head size does not help physicians predict ADHD.

Last week’s post What is ADHD? Why do some develop it? introduced the concept that ADHD is a brain disorder, not a problem with parenting or other common misbeliefs. Today we’ll go more in depth into how brain imaging has shown differences when people have ADHD. Next week we’ll go further into the genetics of it. 

Brain imaging

There are many ways we can image the brain for different reasons. Single-photon emission computer tomography (SPECT), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI) are all being studied to show different aspects of brain function and development.

Some of the studies look at blood flow to various parts of the brain during different tasks to show which parts of the brain are triggered and how that differences among different groups of people. Others look at subtle changes in brain growth.

With vs without ADHD

Brain imaging comparing large groups of kids with ADHD to those without ADHD show significant differences. These are very subtle differences and are still considered investigational. The changes are too subtle to diagnose ADHD in any one person.

There are several areas of the brain that have been shown to be smaller in children with ADHD. At this time the specific areas of delayed growth do not correlate with specific treatments.

ADHD is a brain condition

It is not recommended to do imaging studies to diagnose ADHD, but the fact that large groups of people show differences highlights the fact that ADHD is a real disorder of the brain.

Hopefully as this information is recognized, the stigma of ADHD and other brain disorders will be lost. People will be able to understand that it is a real brain dysfunction.

The case for a clinical diagnosis

Studying brain differences helps us to understand ADHD, but imaging is less useful to any individual for diagnosis. We have a good track record for diagnosing ADHD with standardized questions and a clinical history.

Images capture a moment in time, but they don’t necessarily tell the whole story.

What happens to a brain in different circumstances? It can be very insightful to ask what happens when a child is doing a favorite activity versus when he’s stressed.

Clinical history can cover different situations over time. This cannot be captured in any brain image.

To be useful for diagnosis and management of a medical condition, a test must first:

  • Be reliable: The changes seen are very subtle, and results must be shown to be accessible and identifiable in individuals to be useful for diagnosis. If only a few trained people can identify the subtle differences, it will not be available or helpful to most people. 
  • Show safety: Everything we do in healthcare must be shown to be safe and effective before it’s used. Risks and benefits must be weighed. Risks of imaging must be considered.
  • Show benefit: If a clinical diagnosis can be made, what benefit would be attained by doing an expensive test? If it does not add to the treatment, it should not be done. Since the large majority of people with ADHD can be diagnosed clinically, we should not need to do studies that add risk and cost.

Back to the prefrontal cortex…

In What is ADHD? Why do some develop it? I mentioned that the prefrontal cortex and said that it was especially interesting. Let’s talk more about why.

Brain lobes serve different functions.  Learn more at www.adhdkcteen.com. #adhd #adhdkcteen #development

Studies have shown that the prefrontal cortex develops more slowly in children and teens with ADHD. This means that the areas of the brain that control executive functioning are thinner in children with ADHD versus those without ADHD.

Functional imaging shows that the frontal lobes in children function less during activities involving concentration, memory, decision-making and problem solving.

It’s even more than that. Those with worse outcomes as they mature have fixed thinning (it doesn’t ever normalize) but those who ultimately develop a normal thickness have a better outcome. 

A thinner brain cortex is not a damaged brain. It is an alteration in development.

Other parts of the brain are affected too

Our cerebellum helps us with movement and memory. Children with ADHD show slower growth of cerebellar white matter in early childhood, but faster growth in late childhood. 

The amygdala and hippocampus are also smaller in the brains of people with ADHD. These areas are responsible for emotional processing and impulsivity, problem areas for many with ADHD.

What does all of this mean?

You guessed it: it’s still being studied.

Studies continue to help us learn more about brain structure and function. We also continue to learn about the chemical interactions that happen while our brain is working. 

What all this information means and how we can use it to best manage the troubling symptoms of ADHD is yet to be fully uncovered.

It may be possible one day to predict which children will develop ADHD and change something in the early years to alter that development. But we’re not there yet…

Does a slower development of certain brain areas have an advantage? Maybe the slower development of the cerebellum is why kids with ADHD learn better when they fidget.

These are the things we still need to learn.

We don’t really know the full extent of it yet.

For more:

ADHD Neuroimaging: What’s New?

What is ADHD? Why do some develop it?

ADHD was first recognized as a behavior problem, but now we know it’s a developmental disorder. Don’t worry though. Having a developmental disorder doesn’t make you stupid or damaged. It simply means that brain development is a bit different. We’ll tackle details here.

Typical Brain Development

Our brains have billions of nerve cells called neurons that start developing a few weeks after conception. Within 6 months after conception, there are even more neurons than are found in an adult brain. As we develop, neurons grow and make connections with one another. The number of brain cells decrease as unneeded neurons are pruned away.

Neurotransmitters help to communicate from one neuron to another. For more see adhdkcteen.com. #adhd #whatisadhd #braindevelopment

A network of fibers develops to connect the brain cells in order to interact with other parts of the brain and to perform complex functions. Neurotransmitters help send messages between nerve cells.

We’ll tackle neurotransmitters more in future posts. They’re important!

How long does it take for the brain to fully develop?

We might look pretty mature by our teen years, but our brain is still growing!

The first 3-4 years of life is a time of rapid brain development, but it continues for more than 20 years.

Brains don't stop growing when we do. Learn more at www.adhdkcteen.com. #adhd #adhdkcteen

Prefrontal cortex

The prefrontal cortex is especially interesting. It helps us plan, organize, make decisions, and maintain self control. These are considered executive functions and are often problematic for those with ADHD.

The prefrontal cortex typically doesn’t finish full development until mid-20s. That means our brains are still developing key areas into our early adult years!

For a fun interactive way to see all areas of the brain, visit Brainfacts.org.
For a fun interactive way to see all areas of the brain, visit Brainfacts.org.

How does ADHD develop?

There are many things that affect our brain development that can lead to symptoms of ADHD.

At this point we don’t diagnose the cause of the ADHD since treatment is geared toward addressing the symptoms, but it can be helpful to know that there are many reasons a person develops ADHD.

Genetics

Like many things, brain development is affected by our genetics. Genetics affects how we look, how tall we should grow, our intelligence, and risks of certain health problems – such as cancer or heart disease. Of course our genetics are only the blueprint. Our environment, nutrition, experiences, and much more also affect how we grow and develop.

If one parent has ADHD, a child is more likely to have ADHD. If both parents have ADHD, their child is much more likely to have ADHD.

Genes can affect whether or not we develop ADHD. Learn more at www.adhdkcteen.com. #adhd #adhdkcteen

Prenatal development

While a baby is still in its mother’s womb, it is considered a fetus. This is considered the prenatal time of development.

Many things can affect development during the prenatal time. Drugs and alcohol, illness, and other stressors affecting the mother can affect the baby.

Prematurity (being born before the due date) and being small at birth can increase the risk of developmental disorders, including ADHD.

Our brains develop for months before we're born. Learn more at www.adhdkcteen.com. #adhd #adhdkcteen #development

Illness, injury, toxins and more… oh, my!

The first few years of a child’s life can be complicated by illness, injury, nutritional deficiencies, and toxins. These can all affect brain development.

Even after the critical developmental years, injuries and toxins to the brain can change our brain function. Think of a teen or adult who has had a concussion. Their brain function can be severely altered. They might suffer from mental fogginess, fatigue, irritability, and more after the injury. In fact, sometimes people will be treated with medications commonly used for ADHD temporarily after a concussion. 

What it’s NOT:

ADHD is not due to bad parenting, poor discipline, or bad schools. 

ADHD is not from bad parenting. It is based in our brains and is neurological. For more see adhdkcteen.com. #adhd #whatisadhd #braindevelopment

Yes, those things can worsen a child’s behavior, but they don’t cause ADHD.

What about sugar?

ADHD also isn’t from too much sugar.

Studies have even shown that even when a parent perceives worsening of behavior after sugar, independent observers see no real change. For more on that and how diets affect ADHD, see Special Diets for ADHD.

There are many myths about why ADHD exists - and some even deny its existance. Learn the real cause of ADHD. #adhdkcteen #adhd

Tune in next week for details about how we know that ADHD is a developmental disorder!

2018 International Conference on ADHD recap

I was excited to attend the 2018 International Conference on ADHD with a group of ADHDKC board members. I’ll try to recap some of the best information learned.

We were all able to make connections with people from all over the world who research and treat symptoms associated with ADHD and with those who are in various learning stages about their own ADHD. It was not uncommon throughout the conference to hear that people found their tribe…

#ADHDcon2018 - Tribe talk

Too much information

There were many simultaneous talks during the 4 day conference. I went to many great talks but missed others. I tried to tweet #ADHDcon2018 during the conference, but couldn’t pay attention and tweet at the same time, so missed a lot of points to share.

International connections

I was very fortunate to meet Marylin, a woman from France who is passionate about learning and sharing information about ADHD. She shared with me that ADHD is not commonly recognized in France and she is working to change that. Learn more about her organization at TDAH.

Marilyn recorded several of the sessions and uploaded them to her Facebook page. I’ll share these along with other information below.

Marylin and speakers, Dr. Michelle Frank and Sari Solden.

Translation from Facebook:

If you thought ADHD was reserved for children….
If you thought that: in the same way as intellectual early, (fortunately less and less used) ADHD disappears over time….
If you thought ADHD was a bad education…. too permissive….
If you thought ADHD was a simple motor hyperactivity….
So…. it’s time to learn, to inform you to understand this neurobiological disorder that affects millions of people around the world: Children, adolescents, adults, men and women together.
The symptoms differ, however, the disorder remains the same.
ADHD is an invisible, ill-known, misunderstood handicap, particularly in France, where diagnosis and care have accumulated considerably harmful delays. 10, 15 (rather 20 years to be honest) compared to other countries of the world.
ADHD is not happy with associated disorders (called morbid), dyslexia, dyscaculie, ect… anxiety disorder, disorder disorder with provocation.
Non-diagnosed ADHD may also lead to adolescent-Risk Pipelines: Sexuality, driving, risk-taking, addictions,
(drugs, tobacco, alcohol) unwanted pregnancies, and
D after the latest research: a considerably reduced longevity. Are you ready to open your eyes and ears and change your states d spirits…

Dr. Russel Barkley

Dr. Russel Barkley is a world renowned expert on ADHD and was one of the keynote speakers. He spoke at the Midwest ADHD Conference sponsored by ADHDKC.org last spring, so you might recognize him and his message: untreated (and undertreated) ADHD has risks!

If you want to skip to Dr. Barkley, go to 8 min. To do this, hover over the bottom and click on the Facebook icon. It will bring you to the Facebook video, and you can scroll forward.

Hover over the bottom and click on the Facebook icon to be able to fast forward.

And yes, we were smitten with him being there… he’s that big of a deal!

Unique Challenges Facing Mothers & Daughters with ADHD

Our own Jeremy Didier and her daughter were among a panel of mother/daughter pairs who talked about living with ADHD.

Our own Jeremy Didier and her daughter were among a panel of mother/daughter pairs who talked about living with ADHD.

Self care

I was not in this session, but found a snippet on Twitter:

Importance of self care. Thoughts on shame. Eric Tivers from Susie Sahim. #selfcare

Importance of self care. Thoughts on shame#adhdcon2018 #adhd@EricTivers talk on adulting pic.twitter.com/SeyAFIVXl1— Susie Sahim ➡️ #ADHDCon2018 (@bogusred) November 11, 2018

Jessica McCabe from How to ADHD

I was excited to be able to see How to ADHD's Jessica McCabe as the final keynote speaker.
I was excited to be able to see How to ADHD‘s Jessica McCabe as the final keynote speaker.

For those who don’t know her, she has made a name for herself making videos about ADHD. I’ve been a fan of her videos for several years, so seeing her live was awesome! 

One of her first slides summarized the other three keynote speakers talks. 

LeDerick Horne spoke of growing up with dyslexia and ADHD in a time and place that was not supportive, yet developing into a renowned poet and public speaker. Eduardo Briceno talked about having a growth mindset. Dr. Russell Barkley shared his 40+ years of research data showing that untreated ADHD has too many risks to ignore – they all culminate in a significantly shortened lifespan. 

Marylin also caught this in full on Facebook live. Start at about 14 min in to skip all the conference acknowledgements if you’re not interested in those.

Coach Diane

Coach Diane from Odyssey Learning spoke about various ways to help kids and teens learn executive functioning.

I was really excited to see that Coach Diane, from Odyssey Learning, was speaking at this conference. Since I won’t be able to make her local talk next month, it was fantastic to hear how she uses creative ways to help kids and teens learn executive function skills.

If you can make it to her local talk, please RSVP on SignUpGenius. Her ADHDKC talk will be geared for tweens and teens, but her slides are more for professionals working with people with ADHD.

All of her slides are available from her website, Odyssey Learning.

What did she talk about?

She talked about how we’re wired to learn when we’re interested. Everyone, but especially those with ADHD, struggle to pay attention when they aren’t interested.

Fear, stress, boredom and anxiety of course make learning even harder, and these are common traits found in people with ADHD. When kids with ADHD are bored, they can suffer from agitation. This gets mislabeled as a behavior problem, but it’s a neurological problem!

Making new concepts and information interesting is one successful way to help people learn. She uses cooking, games, magic, and more to help kids learn.

Backwards planning is one strategy that helps kids complete tasks. Knowing where you want to end up, then coming up with all the steps that are required to get there, is backwards planning. She will use cooking to model backwards planning, then help kids learn to generalize the skill to real life examples.

So much more…

There was so much that I have not been able to share. There are API handouts as well as general session handouts available online.

If you are able to make it to the next conference, it should be great!

Learn to Learn

Studies consistently show that people who know how to learn and have grit are more successful than people who are smart but don’t have resilience. That means we all need to learn how to learn and how to be resilient!

Let’s start with the basics and then review a few learning techniques that can help.

People who know how to learn and have grit are more successful than people who are smart but don't have resilience. Learn how to learn to succeed!

Basics

Organize

If you take a few minutes each day to fill out a planner and review what needs to be done, you will save yourself a ton of time overall. And have fewer periods of last minute anxieties!

There are many organization systems out there. Online planners and paper planners each have their pros and cons. The most important thing is that you pick one that works for you. Just search for reviews of planners, and you’ll find many suggestions.

There’s also the Google calendar or iCal – both offer the ability to keep track of things wherever you are! There are also many online apps for organization, most of which offer free versions as well as premium plans.

The most important thing about calendars and planners: put everything in them and use them regularly.

Of course you should put all your assignments in your planner. Also add in your extracurriculars. If you’re making plans with friends, add that in too. Don’t forget to add in time for exercise and sleep. Everything that’s important should be in there!

If you take a few minutes each day to fill out a planner and review what needs to be done, you will save yourself a ton of time overall. And have fewer periods of last minute anxieties! #organize

Don’t put it off!

It’s tempting to put off studying until the last minute, but don’t fall for the temptation.

Some people even say they do best at the last minute because of the adrenaline rush they get from the anxiety of the last minute. But chances are if you really look at it, you do a much better job and feel much better if you pace yourself and do a little each day.

If you finish parts of tasks on time at a healthy pace, you’ll have less time spent worrying about it. This leaves more time to enjoy life. You’ll probably sleep better and be healthier!

Finish parts of tasks on time at a healthy pace. You'll have less time spent worrying about it. This leaves more time to enjoy life. #organization

Sleep

Your brain needs sleep to process and store information. All nighters will keep you from performing at your best. 

Study in the evening, get a good night’s sleep, then review your notes a bit in the morning. This is a recipe for success!

Dogs get it. Your brain needs sleep to process and store information. Get enough sleep to be the best you can be. #sleepmatters

Exercise

There are studies showing that people who exercise right before a test do better than those who cram a little longer. 

Exercise is not only great for your body… it’s also good for your mind!

Exercise is not only great for your body... it's also good for your mind! #exercise

Think positive!

If you get stuck in negativity, you’ll waste a ton of time and energy just being mad or scared. 

It’s easy to fall into the trap. If you start to feel overwhelmed and frustrated that you won’t have enough time to finish a report, you will waste even more time not doing the report. It’s too easy to waste time worrying. 

How do you change your mindset from, “I’ll never finish this,” to “I might have waited a long time to start this, but I’ve always been able to push through and finish it in the past”? See the “Related Posts” section at the bottom of this blog.

Learn to be positive by changing your mindset. It makes a world of difference! #growthmindset #powerofpositivity

Learning techniques

Write it down

Take notes as you study. The process of writing helps people remember. 

Don’t simply re-write exactly what you hear in lecture or read in your textbook. Summarize the thought in your own words. This helps much more!

Writing has been shown to be more effective than typing to help with learning, so unless you can’t write, put the keyboard aside and use a simple pen and paper! (Maybe a pen on the appropriate screen would be okay… I don’t know if that’s been studied.)

Writing has been shown to be more effective than typing to help with learning. Summarize ideas during lectures or while reading and write them down! #studytip

Mnemonics

Memorizing dates, words in a foreign language, and more can be difficult, but associating them with something else can make a big difference. 

I still remember many of the mnemonics I used years ago…. 

Who else learned “Every Good Boy Does Fine” to learn to read music?

You can use images, songs, word associations and rhymes to help remember difficult information. This great video explains how to use several of the techniques.

Sing a tune – one type of mnemonic

Songs and rhymes help us learn. You know how you can remember all the words to your favorite song, right? Words in a song are grouped together more easily in our mind and are easier to remember than non-associated words. 

Songs and rhymes help us learn. Words in a song are grouped together more easily in our mind and are easier to remember than non-associated words. #singtolearn

Pick a familiar tune and put the information you need to learn in it. If you’re not that creative or short on time, search your topic with “music” or “song” and check out the results.

Pick a familiar tune and put the information you need to learn in it. If you're not that creative or short on time, search your topic with "music" or "song" and check out the results. #learntolearn More tips on www.adhdkcteen.com.

Singing is one type of mnemonic memorization. For more types and descriptors, see Try these 9 Types of Mnemonics to Improve Your Memory.

What’s your learning style?

You might have heard that everyone has their own learning style. It’s true. Some people learn from reading things best. Other people are more auditory learners – they learn from listening.

There are 7 basic learning styles. We’ll cover more of those in a future post.

See our related posts:

6 tips to de-stress

We all have stressful things happen, but what can we do about it? Learning to de-stress is possible with these simple tips.

We all have stressful things happen, but what can we do about it? Learning to de-stress is possible. 

1. Exercise

You’ve heard that exercise is good for your health, but you may not realize how great it is for your mind too. Or maybe you do realize it, but you feel so overwhelmed that you don’t think you have time for it.

Bill Phillips

Make the time. This one’s important enough that it should remain a priority when you’re busy.

Plus exercise has been shown to help clear your mind so you can focus and be more efficient at everything else you do. It helps you sleep better at night, which in turn helps you focus better and feel less stressed. 

2. Cut back to limit stress

If you’re overwhelmed, prioritize what is important.

If you have a ton of difficult classes, maybe consider limiting that next semester. Instead of taking all AP or IB classes, pick the one or two that you feel are best for you and then the regular level of class for the other subjects. Take a fun elective that won’t involve as much homework. That can help broaden your skills and still looks good on a college application if you grow from the experience. Remember that colleges want well rounded students, not those who only eat, sleep, and study.

If you have an after school job, volunteer regularly, and are in a sport, maybe that’s just too much to do after your school day. Think about what is important and limit the extras. That doesn’t mean you have to quit your job, but maybe ask to limit hours after school. If you volunteer, limit when you go. Depending on what type of volunteering you’re doing, see if you can arrange things to work with your course load. If you are doing a bunch of little volunteer experiences that aren’t really interesting to you, maybe find something you’re passionate about and spend time with that one thing.

Remember that if you take on too much, you can’t do everything well, so you will not be your best. Mental health is more important than doing it all. Cut back and focus on what’s really important to you getting where you want to be!

As you’re cutting back, be aware of what’s important.

You can’t simply stop doing coursework if you’re a student.

It’s not wise to cut back on the essentials of sleeping and exercise. These should always be entered into your planner so they get done.

You still need time to relax and be around your friends and family. Put that time in your schedule and make it happen. 

I strongly feel that giving to others helps us on many levels, so doing volunteer service is great – but it should mean something to you. Don’t just do something because you feel like you need to do it. Find things you enjoy and help others using that passion.

It’s all about balance.

It's all about balance. You can do anything, but not everything.

3. Eat healthy to decrease stress

We’ve all heard that we should eat healthy. It’s not new news at all that we should try to eat plenty of fruits and vegetables, healthy proteins, and complex carbohydrates. 

Yet many of us fail to eat well for a variety of reasons. I know all the excuses, but we all need to problem solve to find solutions, not just grab another unhealthy snack and keep repeating the same mistake.

If you make a few adjustments each day, you’ll start noticing a difference in how you feel.  Start by choosing water over soda or juice. Try eating a fruit or vegetable with each meal and snack. Pass on the crackers, cookies, and other junk foods. Try a new healthy food if you’re picky. 

If you aren’t hungry mid-day due to medicine, be sure to eat a healthy breakfast. This does not mean cereal. Healthy breakfasts that will last through the day include protein and fiber. 

If money is an issue, talk to people who can help. Start with your school counselor.

Many of us fail to eat well for a variety of reasons. A healthy diet is key to being healthy.

4. Sleep

I can’t stress enough how important sleep is. 

We seem to underestimate the value and see it as time wasted. 

Time management problems all day do not give you the excuse to stay up finishing homework.

You should never stay up to do something you wouldn’t get up early to do. For instance, you would probably not set your alarm to wake up and watch a YouTube video, right? That means you shouldn’t stay up “just a few minutes” later to watch it. Go to sleep. It will be there later.

Sleep is a necessity. Make time for it.

Use all the night features your computer and phone offer.

Make sure your phone will never wake you if a friend tries to call or text in the middle of the night. Just because they’re suffering from insomnia doesn’t mean you need to be awake. Set the night mode. Tell your friends you won’t respond at night so they don’t keep trying. Blame it on your parents or your doctor. They won’t care. (And if your parents are following the standard recommendations, they will take your phone away an hour or two before bedtime…)

The blue light from your screen keeps the melatonin in your brain from rising. You need melatonin to feel tired. That means if you’re using any screen with normal lighting, you won’t feel tired and you’re likely to lay awake even if you go to bed. 

5. Screen time limits

This seems to repeat what I just said, but there’s more. So much more that it’s covered in Screen Time Limits

I covered this in detail, but want to remind you to check out some screen management apps that might help you take control of your phone and computer time.

  • Moment (currently iOs only, but Android version coming)
  • Forest is an interesting app that not only helps you stay on task, but you can earn points that helps to plant a real tree – helping our world
  • Flipped
  • Mute 

I’ll bet you underestimate how much time you spend online. Try the apps mentioned above. Use the knowlege gained about your use to adjust it to an amount that allows you to be productive and have time for the necessities of life.

It’s too risky to have full access to phones and all of their distractions 24/7. You’re fighting against an industry that invests in finding ways to get you hooked and wanting to spend more time on their content. We get dopamine hits each time we play online. Dopamine makes us feel good, so we want more.

It's too risky to have full access to phones and all of their distractions 24/7. You're fighting against an industry that invests in finding ways to get you hooked and wanting to spend more time on their content.

6. Take 5

Take 5-10 minutes each day just for you. It’s not much time, and if you make the time, you’ll find that it pays back!

Set a dedicated time to reflect: What did you accomplish – celebrate the big and the little goals met. Are there things that can be high priority tomorrow. What are you thankful for?

You can go one step further and also make time throughout every day to be mindful. I’m still in the learning stages of this, and experts always talk about practicing mindfulness. We can all practice it daily. Find something that you do every day and link it to stopping to be purposefully mindful. Start a morning routine.

For more mindfulness tips and several free apps to help guide your mindfulness, see my Pinterest Mindfulness board. If you use mindfulness regularly, you will notice less stress. 

Change your perspective: Be Positive!

How often do you get stuck in negative thoughts? It can happen to any of us, but when it does, we stop being productive. Sometimes all it takes is a change in perspective.

Step back

If you are frustrated at how things are going, take a step back. Maybe several steps back. 

Try to look at the issue from another perspective, maybe several other perspectives. 

Changing your perspective can help problem solve. Step back and look at it from other angles. This is a great way to build resilience and be successful. #growthmindset #perspective

Things we can’t change

We can’t change what others say or do. The weather is beyond our control. What’s in the past is already done. 

We can change none of those things. But that doesn’t mean we need to stay stuck in the rut of accepting those things as they are.

Focus on things you can control to help solve problems. Find more positive tips in the post. #perspective #positivethinking

Things we can control

There are a lot of things we can learn to control.

Sometimes it’s as simple as learning to take a few breaths to allow our brain to sort through things before we say something we regret. Collect thoughts and then plan what to say. 

Choose your reaction

If you don’t like what someone’s saying, you can choose to react one way or another. That choice will help determine what that person says in response.

If you show anger, belittle them, or respond in any negative way, the situation will probably spiral downward.

When you take a few big breaths and carefully choose words that help show your perspective without putting theirs down, it can help.

Humor often helps, as long as you don’t belittle others in the joke.

Try it on

An even better response is one that you acknowledge their perspective, step back and try it on.

If their idea or angle might work, even though you initially didn’t like it, then stay open to it.

What can you both agree upon to make their idea work for you? Or to make your idea work for them?

Of course if you are not okay with something because it’s not safe or doesn’t align with your morals, you shouldn’t cower back and accept it.

Have an open dialog and come to an agreement.

Look for what you can control

We certainly can’t make a rainy day sunny, but we can dress for the weather appropriately and make alternative plans if the weather prevents our original plan from happening. 

Stop reliving the past

Changing your perspective can help problem solve. Step back and look at it from other angles. This is a great way to build resilience and be successful. #growthmindset

Too often we dwell in past mistakes.

We can’t change what’s already done, but we can learn from those mistakes.

Don’t miss the opportunity to use experiences to help you grow.

Regrets only cause insecurities and sadness.

Stop regretting things that have happened in your life.

It won’t change the fact that they happened.

What can you do to grow from the experience? How can you make that situation better in the future?

Blame is never productive.

Whether you blame yourself or someone else for something that happened, it doesn’t change what happened.

What can you do to make something good out of the situation? Is there something you can do to prevent something similar from happening again? What needs to be done to set things right?

Changing your perspective can help problem solve. Step back and look at it from other angles. This is a great way to build resilience and be successful. #learnfrommistakes #growthmindset

No regrets

Regretting and pointing fingers both keep us from learning about our mistakes.

Take ownership and accept consequences when appropriate. Then use this as a part of the learning experience, grow, and move on.

Another perspective on mistakes

If you never open yourself up for failure and play it too safe, you’ll never grow. Taking chances is the only way to stretch ourselves to aim higher than we ever felt possible. 

Taking chances is a way to stretch ourselves and grow. #growthmindset #healthyrisks

Take risks 

This does not mean I want you to take unsafe chances. It’s not okay to put your life or someone else’s life in danger.

Racing a motorcycle without a helmet in the rain is just stupid. Vaping is dangerous to your health. Getting drunk can have serious consequences. These are not the type of risks taking I’m talking about.

Take a risk by trying a new sport or audition for a play.

Step outside your comfort zone.

Start a conversation with someone new.

Challenge yourself to learn something you’ve never tried before, like a new language or about a different culture.

These are great opportunities to mess up or feel insecure initially. But they offer a chance to grow and learn.

Take some risk in life by stepping outside your comfort zone to grow! #growthmindset

Get help analyzing

Sometimes we’re so set in our way of thinking that it’s hard to change our perspective.

Ask friends and family for help.

Listen to other’s opinions with an open mind. How does their view of the issue differ from your own? Does this change your opinion at all?

Rewind

Take the time to rewind and rethink a situation that didn’t end well. 

What happened?

At what points (if any) could you have said or done something differently?

How could that have changed the outcome?

Although you can’t change the past, you certainly can use this experience to change how you approach similar situations in the future.

Move forward

After taking the time to reflect and learn, you must move on.

You cannot dwell on any one situation indefinitely.

Learn from your mistake and use that knowlege for life.

Your best teacher is your last mistake. #learnfrommistakes #growthmindset #adhd

My medicine stops working too soon! What can I do?

Teens have long days. The most common medicines they use to manage ADHD symptoms last 8-12 hours. It isn’t surprising that stimulants don’t last long enough, but that doesn’t make it okay. What can you do to get everything done if you medicine doesn’t last long enough?

Sleep.

It goes without saying that we all need sleep to focus. People with ADHD often struggle with sleep, but they need sleep.

If you struggle to sleep, check out How can you get better sleep?

Don't underestimate the power of sleep
Don’t underestimate the power of sleep!

Organize it!

Organization helps us all. If you can stick to a schedule an prioritize things appropriately, you can get a lot more done than you realize.

Taking a little time to make a schedule can save you time in the end so you’re not lost trying to figure out what to do next, especially if you start and stop projects often.

For more on scheduling, see 10 Secrets of Productivity.

What can you do to be the most productive? Our top 10 secrets of productivity are found here! Start with a schedule!

Knock out the hard stuff.

Get the hardest task done first.

Try to get your hardest subject’s homework done in your spare time during school hours or right after school.

We often put off the hard stuff due to procrastination, but that comes back to haunt us later! Get it out of the way and check it off the list!

Reminders.

Set reminders to get back on track. If you get distracted easily, figure out what helps remind you to refocus.

Use post it notes where they will remind you when you need the reminder. 

For example, if you frequently stare out of a window, put a sign there to remind yourself to get back to work.

Turn off notifications.

No one needs an alert to know that they have a new social media message or email.

Yes, notifications and alerts can help you remember to do what you need to do, but only if timed properly. If you set an alert at the time you need to take medicine, that’s great! But random notifications that pop up when you’re in the zone doing something is distracting.

Schedule time to check  whatever will need to be checked, but don’t check them while doing other tasks.

Those notifications are simply too distracting. Turn them off!

Accountability partners.

Would you benefit from studying in a public place, where having people around will keep you from daydreaming?

No one wants to be seen drifting off… 

Or maybe you can simply invite an accountability partner to work with you. Ask a friend to study with you. Be each other’s accountability partner. Keep each other on track. Don’t talk and distract one another.

If your friend isn’t good at this, then have a heart to heart or find another study partner.

What can you do to be the most productive? Our top 10 secrets of productivity are found here! Make the most out of your time with these tips. Would a study buddy help?

Move!

Exercise has been proven time and again to help us focus. Plus it’s just good for our bodies.

If you need a brain break, even a few minutes of walking around can help reset your brain.

Food!

We all have a hard time focusing when our bodies are hungry.

Grab a healthy snack to get recharged.

Healthy is not a sugar snack. Sugar might pop us up temporarily, but then we’ll crash later.

Think of snacks as mini meals. Eat something with protein and either a fruit or vegetable.

Good snacks are apples with peanut butter, carrots or cucumber with hummus, grapes and cheese, strawberries and yogurt.

Change your medicine 

If your medicine doesn’t last long enough and all of the above still doesn’t help you focus for the duration of your day, talk to your doctor.

Sometimes increasing the dose of your long acting stimulant can increase the time that it remains above your treatment threshold. This may or may not be tolerated, since a higher dose may increase the side effects. 

Some people will add a short acting stimulant in the afternoon. For instance, if you take a long acting methylphenidate in the morning, you could add a short acting methylphenidate in the afternoon. If you take a long acting amphetamine in the morning, you could add a short acting amphetamine in the afternoon. 

Other people benefit from adding a different type of medication, such as guanfacine or clonidine to their daily routine. These medicines can last longer and have a different side effect profile from the stimulants, so if the addition of a short acting stimulant isn’t tolerated or desired, it can be another option. 

Another long acting medication is atomoxetine. It also works differently than the stimulants do, so is an option for some people.

For more on ADHD Medications, see ADHD Medications: Types and Side Effects. 

Screen Time Limits

We all waste time on our screens. Companies pay to find ways to encourage people to use their sites. They use psychology to make you want to spend more time online. People with ADHD are at risk due to their executive management issues with time management, impulsivity, and more. Screen addiction isn’t an accepted diagnosis yet in the US, but excessive screen use certainly is a problem for many people. Learning to set personal screen time limits is one way we can make a positive impact on our own lives.

How much time do you spend?

See where you spend your time.

Do you check messages and notifications before you even get out of bed? Does that help or hinder you getting started in your day?

My guess is you could use that time for a much better purpose.

Mindfulness is a great way to start your day. Just getting out of bed and getting ready for your day will keep your parent off your back – which in itself is a better start to the day!

If you spend 3 hours a day doing mindless stuff online checking social sites, playing games, and watching videos, that’s 3 hours a day you could be productive. Limit it to a reasonable amount of time and then stop.

Take back your time!

Tracking and limiting time on your phone

Find an app that can help you track your time online. Many will work across several social site platforms as well as general browsers.

Some will allow you to set a daily reminder for a custom interval that pops up an alert when you’ve spent your chosen limit in the app for that day. It won’t lock you out, but sometimes we all need a gentle reminder to get back to real life.

Go to your app store and search “time on phone tracker” or “phone addiction” or check out these popular apps:

  • Moment (currently iOs only, but Android version coming)
  • Forest is an interesting app that not only helps you stay on task, but you can earn points that helps to plant a real tree – helping our world
  • Flipped
  • Mute 

I already have parents, why do I need this?

I know some of you will think this is too much like when parents set limits, but for many with ADHD, it is too risky to have full access to phones and all of their distractions.

Websites, gaming sites, advertisers, and more pay people to look into the psychology of what makes people want to play and participate.

We get a dopamine hit each time we play. We need to fight the urges that they’re trying to create.

In short, we need to stay in control of ourselves. You don’t want anyone or anything controlling your brain, right?

Bonus: If you show your parents that you are responsible in this (and all things) they tend to give you more freedom. It’s all part of growing up and showing maturity!

We are all at risk of wasting time online.  Learning to set personal screen time limits is one way we can make a positive impact on our own lives.

Schedule time 

Schedule time to check your messages.

It’s important to know what’s going on, but you don’t need to check every few minutes. People can wait.

Trust me, it was much better years ago when people didn’t have instant access to everyone and everything. People had less stress. Return to that mindset. There’s a time and a place for everything. Focus on what you’re doing at the moment, whether that’s talking with a real live person, paying attention to your teacher, working or studying. Especially if you’re driving. Messages can wait!

Ask your friends and parents to join you in this. You can set times to check in, then do other things at other times. If they know you limit your time checking messages, they won’t get as anxious when you don’t reply in 2.4 seconds… It’s that need for instant gratification and response that is a huge driver of anxiety in some people. Let it go…

Trust me.

Turn off notifications

If you get into the zone writing a paper and a notification box pops up, you’ve lost the zone.

You waste time responding to the message and your focus is gone.

You’ll have to get back into the paper writing mindset, which wastes your time and energy.

Use the online time management apps listed above to help with this. 

For more information:

How Teens and Parents Navigate Screen Time and Device Distractions

Screen Addiction Among Teens: Is There Such A Thing? 

SPIN Cycle

Dr. Ed Hallowell is a well known expert on ADHD. He often talks of the SPIN Cycle and how people must learn to harness energy from their ADHD to learn to thrive. It’s natural in all aspects of life though to have periods where we excel followed by times that seem stagnant or even time where things worsen. 

Positive aspects of ADHD

When ADHD is well managed, we can learn to improve upon our skills. We can work on our organizational skills. Our time management can improve. Sitting down and staying on task is possible. We feel more successes than failures.

I’ve written before about all the reasons we should appreciate ADHD, including creativity and extra energy. The problem is getting to the point where we can recognize the benefits of the ADHD mind – the negatives easily get in the way. 

Waterfalls and ADHD

Dr. Hallowell compares ADHD to a waterfall in his blog on the SPIN Cycle. 

Dr. Hallowell compares ADHD to waterfalls - both are powerful but must be managed.

He goes on to say,  “This waterfall is an insurmountable obstacle if your goal is to paddle.  But, if you will change your plan, I can show you how you can turn this waterfall into something wonderful.  This waterfall can generate enough energy to light up millions of homes.  People will pay you for all that electricity.  You just need to throw away your paddle and build a hydroelectric plant.”

What’s the SPIN Cycle?

During the spin cycle we get stuck in a period where we seem to stop progressing in our self improvement. Sometimes we even seem to slip back into old habits. The negativity weighs us down and can make us want to stop trying.

Dr. Halloway coined the SPIN Cycle. It's natural to have periods of excel followed by times that seem stagnant or even time where things worsen. Learn more.

Shame

It’s not uncommon for people with ADHD to feel ashamed due to their inabilities to sit still, stay quiet, turn in assignments on time, and the myriad consequences of the executive functioning struggles they have. This can lead to Rejection Sensitivity, anxiety, and depression.

Until we learn to love ourselves and look at ourselves in a positive light, it is impossible to function well. Negative self talk keeps us from being productive. It inhibits our sleep. We start to give up. 

We all tend to be our harshest critic. Learn to look at yourself as you would look at a close friend. You’re probably able to accept that a friend forgot to reply to a text or showed up late. Don’t beat yourself up over the same issues. While it’s not good to do those things, you can use failures to learn instead of to fall into the trap of negative self talk.

Focus on the positives in your life, not the negatives. Look at everything you have accomplished. Write accomplishments down as they happen so you can easily review the list to give yourself a boost when you’re feeling down! Don’t wait to solve the world hunger problem to consider something an accomplishment. It can be the little mundane things that we need to do every day but struggle to do.

Is it hard to remember to feed your pet without your mother reminding you? Today you remembered. Write that down!

A great way to block the shame is to focus on gratitude.

Each day take a moment to think about why you’re thankful. This can be things you’ve accomplished as well as people and things in your life you appreciate. It’s also a great time to set goals for the next day. Don’t forget to include doing things for others. There’s no better way to feel better about yourself than to help others!

Pessimism and Negativity

It’s easy to fall into pessimism and negativity, as discussed above. Sometimes we feel like nothing will work out, so why bother even trying. 

We can’t control what other people say or do. The weather is beyond our control. A classmate might say something really hurtful. Natural disasters happen. All of these things can bring us down. Or we can change the way we think about them.

We can learn from things that go on around us. If we don’t like the way we feel when people say certain things, we can learn to not say those types of things and hurt others. We can practice responses to say or how to leave the situation when people say things that cause us to hurt or feel angry.

Maya Angelou

You might know someone who simply gives up. They stop trying to do homework because they get so frustrated that they make silly mistakes or they don’t understand the assignment. Maybe they can do the work but they always forget to turn it in. Why even bother doing it in the first place if you don’t get full credit, right? 

That’s negative thinking. The glass is half empty. With this type of thinking, it’s less likely that you’ll get anything done. 

Focus on the positives and stop the negativity. Learn to control what you think. To learn more about this, read How to Get a Growth Mindset

Focus on things you can control to help solve problems. Find more positive tips in the post.

Isolation

Dr. Hallowell writes,  ” Isolation is often the by-product of shame, pessimism, and negativity.  It intensifies the shame and negativity, and can lead to depression, toxic anxiety, drug and alcohol abuse, and generally poor performance in all aspects of life.”

It can feel easier to simply avoid being around people if you worry about what people will think of you. While it might seem to decrease your stress if you avoid a stressful situation, it can lead to new worries that you have no friends. It also leads to a weak support system, so when you need a friend to lean upon, they aren’t around. 

It might take working with a friend to draw you out and into situations. Some people need to work with a therapist to learn how to socially interact.

Jessica from How to ADHD has some great social skills tips in this video:

No Creative, Productive Outlet

When we’re stuck in a negative mindset, we lose our creativity. Productivity goes out the window. That leads us to more frustration and dispair. 

We need to get out of the rut and do something productive to regain some self esteem and feel good. 

Try to make tasks fun. Think of Mary Poppins… she helped Jane and Michael clean the nursery by making it into a game. Granted, she used a little magic, but you can sing a tune or find another way to make chores fun.

I sometimes listen to an audiobook while I clean. It makes the task more fun while I listen to a book I enjoy. You could get more creative and pretend you’re in a movie and act out what the character would be doing. If nothing else, focus on a positive aspect of whatever chore you must do as you do it.

How to stop the SPIN Cycle

When you get stuck in the SPIN Cycle, you can find a way out by simply playing. Have fun. Clear your mind of the negative thoughts. Be around positive people. Do something nice for someone else. Think positive thoughts. 

Learn a few tips from Mary Poppins…

Catastrophizing: When the sky is falling…

It’s not uncommon for us to automatically think the worst when something unexpected or negative happens. If you think life is one catastrophe after another — the end of the world — you can learn to change your perspective and move on. When you think every little setback is a huge hurdle, it’s called catastrophizing. It’s possible to stop catasstrophizing by taking a step back and finding solutions. It isn’t easy, but you can learn to change your perspective.

Making mountains out of molehills

This is a common phrase, which just highlights how often people feel like whatever problem they’re having is the biggest problem of all. The good news is we can learn to handle this strong anxiety.

For example, if you don’t feel ready for a test, it’s easy to think you’ll bomb it. If you do bad on the test, surely your grade will drop. Bad grades won’t get you into the college you want, and then you won’t get the job you want. 

That line of thinking is what many people experience. Everything is a catastrophe.

What can you do to avoid catastrophizing?

Give it time.

First and foremost, give yourself some time. Whether you can only afford a few big breaths or you can sleep on it, a little time can help. 

If you impulsively react to anything negative, you’re more likely to overreact, cause more problems, or just not be able to find a solution.

Give yourself time to calm down because trying to think straight when you’re upset is not helpful.

In the example above, if you keep thinking along those lines, you won’t be able to focus on your test, which will negatively impact the outcome. Clear the negative thoughts to be able to focus.

Learn mindfulness.

I know it’s not easy. Trust me. My mind wanders horribly when I try to be mindful. But I’m still practicing.

Studies show mindfulness helps with anxiety, focus, and physical health. It’s worth learning. 

When you’re good at being in the moment, you can use mindfulness to help calm yourself before reacting. 

Learn how to get stuff done through mindfulness
November 6, 2018 come to our meeting about using mindfulness to get stuff done. See our Events page for details.

Look for facts.

I always say that feelings are louder than facts. When we’re sad, angry, scared, or feeling any strong emotion, it’s hard to think about the facts.

You need to find the facts.

Write down what’s going on. Sometimes it takes seeing things written out to see the facts. 

In the example above, do you really think you’ll fail to get a job because of one test you weren’t well prepared to take? 

No.

While it’s always a good idea to study, get a good night’s sleep, and be prepared for tests, the truth is many successful people have occasionally been unprepared.

They do their best and try harder next time. They use that as a learning opportunity and study differently the next time. Maybe they ask the teacher more questions or find a tutor. Or they simply make the time to study. They might try a new technique, such as taking notes while reading or standing to read.

Whatever it takes, they learn from their mistake. This is resilience.

Change your mindset.

There’s a whole post on changing mindset. Please read it. 

A growth mindset is correlated with success more than intelligence. So how do you get it? Did you know your brain can learn to change the way it works? It doesn't just learn the new information you study at school. Our brains are able to change and adapt. You can learn to use your brain to your benefit through developing a growth mindset.

Be realistic.

Let’s face it: we all have good days and bad days. Things happen. 

We don’t need to blame anyone or anything. Sometimes it’s no one’s fault. It just is.

A common example of a no fault solution is in sports. Someone has to win a game, which means someone loses. Losing isn’t the end of the world. Again, use it as a learning experience. Maybe there’s nothing you could have done to change the outcome, but you can change your mindset about the outcome. If you did your best and the other team was better, then that’s the way it is.

Think of other positives. Was it good just to spend time with friends? You got exercise and a break from studying. What good came from it?

Identify when you’re catastrophizing.

If you find yourself frequently frustrated at what is going on around you, look for triggers.

What sets you off?

If you can find certain things that always get your fire buring, watch out for those situations and tread extra cautiously.

Maybe things that work you up are frequently related to school. Smart students tend to worry excessively if they do poorly academically, even if it’s not worth many points.

Don’t fall for the slippery slope of one small setback leading to failure. Identify it as your hot topic area and work on changing your approach.

What is protective?

Do you realize that if you are tired or hungry you’re less able to handle stress? Does that mean that the oppoiste is true? Be sure to get enough sleep if you think it does. (Hint: This is true for most of us. Check out The Big 3.)

If you find that talking to someone helps, find people who can calm you down before you act inappropriately.

Exercise often helps people clear their mind. If you have the time to take a walk or hit the gym, do it. If you don’t have a lot of time, get your wiggles out in another way, such as a brisk walk around the room.

Change the pattern.

Learn to change the pattern of catastrophic thinking.

In catastrophic thinking, a negative experience is followed by unpleasant feelings. These unpleasant feelings make it seem like nothing good can follow in the situation.

If you learn to spot the pattern you can interrupt the thought process and choose to se the situation differently.

Play the rewind game.

A fun game to play that can help you learn how to change your mindset and behavior to get a better outcome is Rewind. In the game you roll play with a friend or just in your mind.

This game works a lot like those books that you can choose the ending. If you want to go in the house, you choose page 4, if you want to walk down the street, you go to page 12. The choice you make alters the outcome.

In this same manner, you can choose different things that could have been said or done, and role play what the response from the other people involved would have been.

Rewind a situation and play it out differently.

When you find yourself complaining about the outcome of an event, think it through again, starting with what you could do to try to get to a better ending.

The trick is you have to be the first to change what you say or do. In the real world we can’t just expect someone else to change a behavior. We can only change what we do. Others usually follow suit, depending upon what the situation is.

For example:

You forgot to turn in a homework assignment. This leads you to worry that your grade in the class will fall. A lower grade makes you worry that you’ll be kicked off the school team due to GPA requirements. Of course then you’ll lose your scholarship and won’t get to go to college. If you don’t go to college then you’ll end up in a minimum wage job or homeless.

The first step is to recognize this as catastrophizing. You won’t end up homeless due to one missed assignment.

Next you will need to not make missing homework assignments a habit, so use the rewind game to figure out what you can do to change the outcome in the first place.

What could you do differently?

Do you need to write your assignments in a planner and check them off when you do them? How do you remember to bring the homework and everything you need to complete it home? Did you choose the right location to do the homework without distractions? How do you remember to put the homework back in your backpack when copleted? What distracts you in class from turning it in? Can you come up with a routine that would help?

Sometimes the rewind game will allow you to play out a scenario in which your words or actions can change, which changes someone else’s response. This is good when you have a disagreement with a friend. You can’t expect them to change their response unless you first change yours. What can you do or say differently next time?

Playing rewind trains your brain to think about what you do and how others react. Each situation is different, but the game can help you play it out to get a better outcome and then use the techniques in real life.