Dr. Kristen Stuppy is a pediatrician who is passionate about sharing information to help others make informed decisions. She has a special interest in ADHD and has served on the board for ADHDKC.org since it began in 2012.
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?
It goes without saying that we all need sleep to focus. People with ADHD often struggle with sleep, but they need sleep.
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!
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!
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.
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.
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.
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
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!
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…
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
1. Choose the best time
There’s a time and a place for everything. We all know that. But choosing when you will do certain things is as important as choosing what you will do.
This is especially important for those with ADHD who have a limited time on medication.
If you plan to do your homework in the evening when your meds are out of your system, guess what? It will take longer. There will be more frustration. You’re more likely to make silly mistakes. Your handwriting may be less readable. You’re more likely to be tired and unable to recall things as easily.
It just isn’t the right time.
If you have a little extra time during class or between classes to get a few things done, use that time. Don’t waste it.
2. Choose a good location
Many people presume the best place to study is a quiet, secluded place, but that isn’t always the case. If you’re more likely to daydream when you’re secluded, choose an area with others around.
If you’re the type of person that gets distracted by every little sound or movement, you might do better secluded. Or if there are others around, use earplugs to help drown out the sound.
Don’t use your bed for studying. You’re more likely to fall asleep before finishing. And more likely to end up with neck and back problems.
If you like a tidy area and you have a cluttered desk, the clutter might be distracting. Take a few minutes to clear your space before you get to work.
3. Grab a study buddy
If you have a study buddy or are in a public location, these can help you stay on task. Keep each other accountable.
Of course the buddy can get you off track if they start joking around, so make a pact to keep each other on task. If you see your buddy checking their phone, tell them to put it down. If they see you staring off into space, they can bring you back to the books.
3. Sound control
Noises can be distracting.
Whether it’s a bird chirping outside that makes you look or if it’s a conversation at the next table in the library, there are distractions.
Use instrumental music to drown out these distractions. I don’t advise your favorite songs that will make you want to sing along… nothing that distracts you from whatever you’re doing.
Use earplugs if sounds in general drive you to distraction.
4. Find an aspect to like
We all have to do things we don’t like to do, but there can be at least one thing about it that you enjoy.
It might be hard to find, but look for it.
If you have to write a report on a book you hate, think of one aspect of the process that you like. Even if it’s the finished paper, there’s something good to focus on.
5. Break up big tasks
It’s easy to become overwhelmed with big projects, so break them up into tasks that are more manageable.
The secret to this is that you need to schedule time to do each task. Don’t just do one task and forget the rest of the project – people with ADHD are famous for starting many things but finishing nothing!
This technique doesn’t work for everyone. If it’s hard for you to get motivated to start, it might be better to do everything in one big block. Once you get started, if you’re in the zone, stay in the zone. As long as you still have time to do the other things that need to get done that day. If you need to move on, move on.
6. Fuel your body
Don’t forget to eat! Those with ADHD often don’t feel hungry due to medications, but it’s still important to eat at least small portions of nutritious foods.
There is a growing body of research that suggests a link between ADHD and vitamin and mineral deficiencies. Magnesium, B-Vitamins (this links to B12, but there are links to other B vitamin pages at the bottom), Iron, Zinc and Copper are all implicated in how our brains work. Not enough of them can lead to symptoms found in ADHD. Read about where you can get these vitamins and minerals naturally. Try to eat a variety of foods with these vitamins and minerals.
When your stimulant leaves your system and you start to feel hungry, don’t grab chips or cookies. Eat real food. More and more evidence is showing that what we eat affects not just our physical health, but also our mood, attention, and overall mental health.
7. If anxiety’s got you stuck…
For many of us, if we’re worried about an overwhelming project, it’s even harder to get started.
Just jump in.
You have to start somewhere. If you have to write a paper but are worrying about the final paper’s readability, content, and punctuation, you won’t be able to just start writing. Start by jotting down ideas. They don’t even have to be complete sentences. You can always go back and add to your comments to put them into coherent thoughts and make them grammatically correct.
For example, for this blog I first looked at my list of topics that I want to cover over time. After choosing productivity, I started by listing the headings/topics that I thought would help with productivity. I then added the explanations under each heading ~ many additions and changes were made along the way. I decided to make photos to go along with each section to make it easy for people who don’t like to read as a last minute thought. Along the way I changed things that needed to be improved. I finally proofread for what seems like the millionth time before posting.
If you’re stuck getting started because you’re worried about the final product, take time to break big tasks into smaller ones. It’s daunting to do big projects, regardless of the project. Even things you want to do can be overwhelming. Find small things that you can do to work toward a final goal. Plus, it’s fun to check off things as they’re done!
So often we get stuck because we want the finished product to be perfect.
You know what? It can’t be perfect if it’s not done.
You just need to start. You can always fine-tune as you go, but the trick is to just start.
10. Schedule everything
Taking a few minutes each day to plan ahead can save hours overall in mindless wandering.
Each morning review everything on your calendar for the day.
As you get new assignments or projects, add them into your planner. If it’s a big project that will need to be done over several days, schedule an appropriate amount of time between now and its due date. Waiting until the last minute increases anxiety, which can lead to problems focusing and getting started.
Don’t forget to schedule the little things and the things you want to do. Add in your activities and exercise time so you know what time’s not available for other things. Set your bedtime as a priority so you get the sleep you need.
Yet is such a little word, but it has huge potential. Learn how it can change your mindset and help you to be more reslilent.
We’ve all been frustrated when things get tough, but why do some people seem to trek on and succeed while others give up? They’re resilient. Many of them have learned the power of “yet.” Yet is a simple, but very powerful word. It gives people hope and a knowlege that they can. Even if they can’t do it now, they can one day. Understanding that you can will help you stay resilient.
Resilience and grit to succeed
Resilience and grit are traits some seem to come by naturally. These traits help people succeed when things don’t go their way.
In fact, resilience and grit are linked to success more than intelligence.
Think about that for a minute. Sticking to things is more important than intelligence when it comes to success.
I’m sure you know some really smart people who haven’t made it very far in life because they just don’t keep trying.
And you probably know some average intelligence people who have really gone far in life. They succeed beyond expectation. These people have grit. They keep going when things get tough and don’t quit.
The truth is, we can all learn to be more resilient. It can be hard, but possible.
We hear people say, “I can’t do this,” all the time. Maybe it sounds more like, “I’m not good at driving,” or “I don’t understand this math.” Whatever the actual words, the outcome is the same.
These people are stuck in a fixed mindset. They won’t ever be able to do whatever it is if they have that mindset.
Learn the power of “yet”
If you simply learn to say “yet” after you have the negative thinking above, it can help.
I can’t do this… yet.
I’m not good at driving… yet.
I don’t understand this math… yet.
A simple word changes it all, doesn’t it?
Learn to use “yet” in your daily life.
When you feel frustrated, try it.
If you feel overwhelmed, give it a shot.
When you’re challenged with new or difficult material, just say it.
Repeat it as necessary. Use it to give yourself momentum and an extra push.
People with ADHD tend to have something called rejection sensitivity or rejection sensitive dysphoria. Watch out for this!
What is rejection sensitivity?
It’s the tendency to perceive a situation negatively, when in reality it is not meant to be negative at all. It can lead to significant anxiety or low self esteem.
An example of this may be that you attempt to text a friend multiple times. There may be many reasons they don’t reply, but you automatically assume they’re mad at you or don’t value your friendship. Even after hearing that their phone died or they didn’t have it with them, you still may feel that their delayed response was somehow due to them not wanting to answer your text.
When you have ADHD, your nervous system overreacts to things from the outside world. Any sense of rejection can set off your stress response. This leads to an emotional reaction that is out of proportion to the situation. Sometimes whatever really occured was not a negative thing at all, but your reaction to it is negative.
Why does this happen?
It’s estimated that the typical 12 year old with ADHD has received 20,000 more negative messages than other kids their age.
They are constantly reminded that they’re not on task.
Chores are often forgotten.
Homework is lost.
They may interrupt others and speak without a filter.
Sitting quietly without constant movement is expected in certain situations, but very difficult for many kids with ADHD.
Each of these situations is due to all of the executive functioning shortcomings, not intentionally bad behavior. But the scoldings and reminders make kids feel like they were bad. All that criticism can take a real toll on their self-esteem.
Over time people who are chronically made to feel like they didn’t meet expectations grow more sensitive to all situations. They might attempt to be perfect in what they do to cover up real or perceived shortcomings. Since it’s impossible to always be perfect, they fail, which serves to further lower their self esteem.
What does low self esteem look like?
When people experience repeated failures to do things as expected, they may lose the drive to try. They often give up. This can look like laziness, which can lead to more shame.
Only when people who are affected in this way are guaranteed success will they even try. There aren’t many situations in life that we’re guaranteed anything, so this can be a big problem.
Many people are afraid to ask for help when needed, so they simply don’t do perceived difficult tasks. Some children fail to do homework because they’re ashamed to ask for help when they don’t understand it. Parents may mistake this for willfully not doing homework or being lazy, which isn’t the case. Often kids wish to do the work, but they’re overwhelmed and too embarassed to get help.
Some people try to overcompensate and show more confidence than they have. They might state that they are really good at something when they don’t really believe it. The overconfidence can backfire when it hurts someone else’s feelings or when they fail to live up to the set expectation. People can simply view their statements as bragging. No one wants to be around someone who thinks they’re better than others. The irony is that in this situation, the person really doesn’t think that. They have a low self esteem and are overcompensating or simply trying to hide their fears about themselves.
How does this affect relationships?
It’s not surprising that rejection sensitivity leads to a lot of problems within relationships.
Many people with very low self esteem attempt to blame others for all of their problems.
They are unable to accept responsibility for their shortcomings. This prevents them from learning from their mistakes.
It of course also affects how the other person feels – which isn’t good.
No one wants to stay around someone who makes them feel bad, so it can strain relationships.
Drive people away
With the texting example above, if you accuse your friend of not valuing your friendship, they will be annoyed. Maybe not at first. With the first occurance, they might simply blow it off and say you’re being silly. But if you consistently treat them like they need to be at your beck and call because you get angry or jealous when they’re not, they’re likely to get tired of it. They’d have every reason to ask for space and intentionally stop making plans to do things with you.
Dating relationships can be even more affected, since it’s a one on one situation. Many people with rejection senstivity easily get jealous. If their boyfriend/girlfriend talks to someone, they might misinterpret the situation and jump to the conclusion that they’re cheating with – or at least have a crush on – the other person. Relationships should be based on trust, but when there’s jealousy, all trust is lost.
When a person gets jealous easily, they often become very controlling. This can lead to emotional abuse of the partner. It brings forth negative emotions in both people in the relationship. It isn’t healthy to stay in relationships like this. Even if you really care for one another, it is important that everyone in a relationship is safe and respected.
It is not uncommon for people with ADHD to have more failed relationships (including marriages) than people without ADHD. This is not exclusively due to rejection sensitivity, but rejection sensitivity certainly plays a part. Recognizing this trait and working to improve self esteem and decrease the rejection sensitivity can help with maintaining strong relationships.
What can be done to treat rejection sensitivity?
The first step in treating this is recognizing what is going on when your extreme negative emotions are driving your thoughts and actions. If people tell you you’re being too sensitive, reflect on it with an open mind. Don’t just get angry, blame others, or avoid the issue.
Treat your ADHD
Treating the underlying ADHD can help some of the issues with rejection sensitivity, but not all of the symptoms.
Impulsive behaviors can exacerbate the emotional response to a perceived negative situation. Controlling the impulsivity appropriately can help with the response directly, as well as to help preserve your self esteem by allowing you to think before acting and speaking.
Improving your focus can help you be successful in completing tasks without rushing through them. Again, this helps to preserve your self esteem because you achieve success.
If you don’t think your ADHD symptoms are properly managed, talk to your parents and your doctor.
Talk to others
It’s important to not hide or cover up your negative thoughts and concerns. Doctors, therapists, and loved ones can help if they can be told what is going on in a way that helps them understand. Too many people are afraid to talk about why they stop trying, are negative or jealous, and about their overall low self esteem. Many might not even realize what is going on and why they feel like they do, but if the above list of symptoms reminds you of yourself, talk to someone you trust about it.
If the person you tell is not familiar with rejection sensitivity, they might not understand what you’re trying to tell them. Please don’t let that knock down your self esteem even more because they don’t understand. Show them this post and and other information about rejection sensitivity. Help them learn rather than accepting their ignorance and going further down in your own self esteem. Talk to your doctor, a school counselor, or a therapist. If they don’t know about the condition, show them the resources you have too.
Accept yourself for who you are
Learning to accept yourself for who you are – faults and all- can be difficult for anyone, but it’s possible.
Fighting sleep initially will make it harder to go to sleep when you finally go to bed.
If you miss the tired phase, you will hit a second wind and be up for much longer in a wired phase. You won’t necessarily feel tired past bedtime, but you body will suffer the effects of sleep deprivation if you miss out on needed sleep.
Attempt to follow a regular sleep schedule.
Going to bed and getting up at about the same time every day really helps you get better sleep overall.
While sleeping in on weekends can help repair a sleep deficit, it can make it harder to get to sleep Sunday night and getting sufficient sleep every night is better than just getting more sleep a few days/week.
Try to sleep in no more than 2 hours past your school day wake up time. Sleeping in too late makes it hard to get to bed on time that night.
Follow the same routine each night at bedtime.
Brush teeth, read a book, color, take a bath or shower — do whatever helps you wind down and relax.
Repeating this every night can help your brain get ready for bed. The routine itself helps. Your body anticipates sleep is coming.
Nap to help make up missed sleep.
A short 15-20 minute nap after school can help revitalize the brain to get homework done. Just don’t sleep too long or it can interfere with bedtime.
Turn off the screens an hour before bedtime.
All lighted screens keep your melatonin levels too low. A gland in our head makes melatonin in response to darkness. The melatonin helps us feel tired.
This means that television, computer games, computer/tablet use for homework, and smartphones for socializing all keep you awake. Turn them off at least an hour before bedtime. Don’t even check your social media accounts during that last hour of your day.
Try to get all your homework that requires a computer or tablet use completed earlier in the evening. Save the homework that only involves paper books and assignments for last if needed.
If you must be on a screen close to bedtime, use night mode screen lighting and apps that take the blue lights off of the screen. I personally use the f.lux app – it’s free and easy to set up. It works well!
What about melatonin supplements?
Melatonin is available as a supplement in many forms. It is commonly used in children to help with sleep. Since up to 70% of kids with ADHD have problems falling asleep, it is especially common to be used in this group.
It’s generally considered safe, but there are some cautions. It isn’t regulated by the FDA, so what the label says and what you get might be different. Studies in children are also lacking, so specific interactions, dosing, and best uses are not known.
In my experience, there are few side effects from melatonin. Some kids still don’t sleep well with it and others are still tired the following day. It can also interact with other medications, so if you take it, be sure to talk to your doctor about it.
The time it takes half of the caffeine to be removed from your body is 5-6 hours.
Ideally teens would sleep and never drink caffeine, but I know that isn’t reality. Any caffeine in the later afternoon can make it harder to fall to sleep.
Don’t forget “hidden” sources of caffeine, such as chocolate, energy bars, and workout supplements.
One interesting concept that has scientific backing (but goes against the “no caffeine after 3 pm” rule) is the coffee nap.
Basically, you drink coffee (or another caffeinated drink – but be careful of those loaded with sugar).
You then quickly nap for 15-20 minutes. Sodas and teas don’t work as well as plain coffee due to too much sugar and too little caffeine.
The coffee nap has been shown to be more effective than either a nap or caffeine alone. The basic premise is that your brain gets a nap before the caffeine kicks in, then you wake as the caffeine is taking effect to help you wake up.
Cautions for the coffee nap
Use the coffee nap only at times you really need it.
Don’t do this too late in the day or the caffeine will inhibit your regular night’s sleep.
Caffeine + stimulant medicines don’t mix
Be very careful using caffeine if you take a stimulant medication, such as methylphenidate or amphetamine.
When you add caffeine to this, it can cause an elevation in your heart rate and increase anxiety.
If you take a stimulant medicine most days but don’t take it other days, it would be acceptable to use caffeine for short term benefits when off your medicine. Caffeine is not a good substitute for medications long term though. The medications have a more consistent dose effect.
Talk to your doctor if you do drink caffeine so they can help you adjust your medicine if needed.
Skip the snooze button.
Set your alarm for the last possible moment you can, which allows your body to get those extra minutes of sleep.
If you need to get out of bed by 6:45, but set your alarm for 6:15 and hit snooze several times, you aren’t sleeping those 30 minutes. Set your alarm for 6:45!
Skip the late night studying.
Studying too late is ineffective.
When the brain’s tired it won’t learn as well and you will make mistakes more readily. It takes a lot longer to get anything done when you’re tired.
Go to bed and get up a little earlier to get the work finished if needed.
Of course you should also look at your time management if this happens too often. Are you involved in too many activities? Do you work or volunteer too many hours? Did you waste too much time on tv, games, or socializing? Do you put off big projects until the last minute?
Homework needs to take priority when you’re more alert in the afternoon and evening. If you have problems with this, talk to parents and teachers about what you can do.
Charge your phone in another room.
Friends who decide to text in the middle of the night keep you from sleeping. Even phones on silent have blinking lights that can spark your curiosity.
It’s too tempting to look at your social media apps one more time if you have your phone with you as you go to bed. Your brain gets a dopamine hit every time you play a game or interact on social media. This reinforces more and more phone use, which means one last check can turn into an hour or more of playing on the phone.
Don’t use the excuse that you need your phone as an alarm. Alarm clocks are cheap. Get one and put your phone elsewhere!
If you lay awake for hours or wake frequently, try these techniques to help fall asleep:
listen to Weightless – music that’s been shown to help initiate sleep
If these fail, talk to your parents and doctor to help find a solution.
Use your bed for sleep only.
Don’t do homework in bed.
Stop watching YouTube and Netflix in bed.
Train your brain that your bed is where you sleep.
Exercise helps our bodies sleep better, but it should ideally be earlier in the day.
Exercising too close to bedtime can wire us up, so if you can exercise earlier, that’s a better choice. I know some sports and dance require late practice and class, but if you can schedule exercise earlier, do it.
Get natural sunlight in the morning.
Natural sunlight helps to set your circadian rhythm. It’s a tried and true method to reset your internal clock when traveling out of your time zone and also helps when you need to adjust your sleep schedule at home.
Keep the bedroom cool and dark.
It’s harder to sleep if the room is too warm or too bright. A fan can be used to circulate air. (The fan also can double as background noise, which is often helpful.)
Use blackout shades if needed.
Keep pets out of the bedroom.
Your animals might love you and you love them, but if they keep you up, it’s just not worth having them around at night. They’ll still love you in the morning if you keep them away from your room.
Everyone should know that if they are using nicotine or alcohol, their quality of sleep will be affected.
Nicotine is a stimulant (like caffeine), which leads to more time sleeping lightly and less time in deep sleep. And yes, vaping and chewing lead to this problem too since it’s the nicotine that causes the problem. Don’t start these habits!
Alcohol reduces the time it takes to fall asleep but it increases sleep disturbances in the second half of the night, often leading to early wakening. Alcohol relaxes muscles, which can lead to sleep apnea (often noted as snoring). Sleep apnea does not allow the body to have restful sleep. Alcohol is also a diuretic, which might increase the need to wake to go to the bathroom during the night.
Get help if needed
If you are addicted to any substance, talk to your doctor for help stopping.
Your doctor must maintain confidentiality under most circumstances, so you can trust that they will help you and not cause more problems. The exception to confidentiality is if they think you are in immediate harm from a substance.
Problems from sleep deprivation are seen everywhere. I hear parents say they need more and that their kids need more. Even teens often admit that they don’t get enough. But why is it such a big deal? What problems are really caused by sleep deprivation? There are many! When we’re sleep deprived, it can lead to many problems that are often not attributed to poor sleep. This can include irritability, poor academic performance, accidents, obesity and more.
You’ll have to learn what your real sleep needs are. Too many people think they’re “used to” less than recommended amounts of sleep, so they’re okay. Once you know your needs, learn the problems with sleep deprivation so you can recognize symptoms in yourself.
Sleep experts recommend nine to ten hours for growing tweens and teens, with a minimum of eight and a half hours until the mid-twenties as our brains continue to mature.
Remember that when we’re sick or in a growth spurt, we need more than usual. Listen to your body!
Find your specific need.
You can estimate how much you need by experimenting over a school vacation time. Go to bed when you’re tired at night and wake on your own. Talk to your parents to let them know what you’re doing so they don’t try to wake you too soon.
Initially you will probably need a lot to catch up on sleep debt, but after a few nights of adequate sleep, see how much your body needs regularly. Don’t lay around all day watching tv or playing on your phone. Get moving! If you have too much down time, it can make your body feel tired, even when you’re not.
Count the hours you sleep naturally once your sleep debt is paid. When it’s time for school or other activities, adjust your bedtime to allow for that much sleep. If that’s impossible you’ll have to work with parents, coaches, and teachers to find solutions.
When you fall asleep within 20 minutes of going to bed and wake up without an alarm, you’re probably getting the right amount of sleep. If you fall asleep immediately upon hitting the pillow and always need an alarm to wake up, you’re probably sleep deprived.
Problems of sleep deprivation
Sleep deprivation can lead to increased levels of cortisol (a stress hormone), decreased activity of human growth hormone (which is active during tissue repair), and decreased glycogen synthesis (energy). Hormones that regulate appetite are affected by sleep duration. Sleep also influences the release of insulin, which is important in our sugar metabolism
These hormone changes are all implicated in the sleep problems we recognize, and we’re still learning more effects.
We all associate the teen years with angst, so we can easily attribute a teen’s moodiness to just being a teen. But being chronically tired can lead to emotional dysregulation. This will look like irritability, frustration and anger.
Chronic sleep deprivation is associated with developing depression. Depression affects our ability to sleep well and poor sleep can increase the risk of depression, so it can have a snowball effect.
Growth hormone is released as we sleep. Chronic sleep deprivation can affect your overall height if you don’t get enough sleep during your rapid growth tween and teen years.
Growth hormone isn’t just needed for growing. It also stimulates muscle growth, muscle repair, bone building and fat burning. Sleep loss may affect healing time and weight due to less growth hormone.
Obesity has been associated with sleep deprivation. Specific appetite hormones are altered by sleep. Our appetite can be increased when we fail to get enough sleep.
Sleep deprivation can lead to eating more calories than needed because of increased appetite. This increases the risk of obesity and all the health consequences of being overweight.
Sugar metabolism is directly affected by sleep. People who don’t get enough sleep are at increased risk of Type 2 diabetes from this direct effect as well as from carrying excess weight.
Getting proper amounts of sleep can help with focus and learning. When we fail to get enough sleep, problems with attention, memory, decision making, reaction time, and creativity start to show. As if ADHD wasn’t enough to cause these things – sleep deprivation compounds the issue!
Grades can easily fall, which leads to anxiety and depression, which in turn leads to more moodiness and trouble sleeping.
Sleep deprivation mimics ADHD. If you think the medicine to help your ADHD that’s worked for years suddenly isn’t working, think about your sleep needs and amounts. Increasing the medicine isn’t the answer!
Teens with chronic sleep deprivation are more likely to be accidentally injured due to poor focus and slowed reaction time. Sleep deprivation also slows healing after injury.
Drowsy driving is comparable to drunk driving. Tired teens are at high risk for falling asleep at the wheel. Drowsy driving is the most likely to occur in the middle of the night (2-4 am), but also in mid-afternoon (3- 4pm) as teens drive home from school.
Athletes are more likely to be injured while playing their sport, so it is in the best interest of the team to get enough sleep. And yes, I know with the busy practice schedule and homework it’s hard. But athletes need sleep.
It’s not just injuries that increase among sleep deprived athletes. Performance also falls when we fail to get sleep.
Less sleep increases fatigue, lowers energy, and leads to poor focus. It may also slow recovery as mentioned above.
Eve Van Cauter, Ph.D., from the University of Chicago Medical School, studied the effects of three different durations of sleep in eleven 18-27 year old men. For the first 3 nights of the study, the men slept 8 hours per night. Over the next 6 nights, they slept 4 hours per night. For the last 7 nights, they slept 12 hours per night.
After 4 hours of sleep per night, participants metabolized glucose least efficiently. Levels of cortisol were also higher during sleep deprivation periods. This can lead to memory impairment, insulin resistance, and impaired recovery.
After only 1 week of sleep restriction the previously young, healthy males had glucose levels that were no longer normal. They showed a reduced ability to manage glucose, similar to the way elderly people metabolize it.
Study of female university athletes
Cheri Mah of the Stanford Sleep Disorders Clinic and Research Laboratory has studied college level athletes for many years. Her research shows that getting more sleep leads to better sports performance for all types of athletes.
One study of the Stanford University women’s tennis team focused on increasing sleep to 10 hours per night. Those who increased their sleep time ran faster sprints and hit more accurate tennis shots than while getting their usual amount of sleep.
Too little sleep increases the risk of getting sick. Your immune system needs sleep to perform at its best.
Teens with chronic sleep deprivation have been shown to participate in more risk taking behaviors. These behaviors, such as driving without a seatbelt, drinking alcohol, skipping the bike helmet and tobacco use, add to the problems of sleep deprivation.
Now that you understand the many problems with sleep deprivation, come back next week to learn how to get more sleep.
Teens often do not get enough sleep. Most teens need 8.5-10 hours of sleep each night. Not 6 hours. Not even 8 hours. Most don’t get even close to meeting their needs and that’s a bigger deal than many realize. You don’t just “get used to” too little sleep. Sleep is very undervalued, but we need to prioritize it. Sleep deprived teens suffer from many physical and emotional problems. Add ADHD or anxiety into the mix, and it’s even worse!
This is part 1 of a 3 part sleep series. It will focus on what makes it hard to get enough sleep. Next up will be why it’s so important to get sleep, then the big topic of how to get more.
So… why don’t teens get enough sleep?
One of the most common reasons is that their biological clock (AKA circadian rhythm) makes it hard to fall asleep before 11 pm and school starts too early to allow them to sleep until 8 am, which would allow for a reasonable 9 hours. Nine hours are on the low end of sleep need for many adolescents. If teens are still growing, they will need even more!
Research shows that tween and teen sleep patterns are hormonally influenced. Your parents probably get frustrated with your late nights, thinking you’re in control of your bedtime, but you’re not. This isn’t an act of rebellion.
Research shows that the hormonal response to the 24-hour daily light/dark exposure that influences circadian rhythm is altered in the adolescent years. Adolescents physiologically stay awake later at night and therefore need to remain asleep later in the day.
It’s not your fault!
But sadly, it is your problem because you suffer the consequences.
Melatonin is a hormone that is released from our pineal gland. We need it to feel tired. During the day the pineal is inactive. When the sun goes down and it gets dark, the pineal gland starts to produce melatonin. It’s released into the blood and helps us feel tired and sleep. Melatonin levels in the blood stay elevated through the night until the light of a new day helps to lower the levels again.
The light from smart phones, tablets, and computers interferes with our natural melatonin rising. This keeps us from feeling tired and falling to sleep.
It’s best to limit screen use for at least an hour before bedtime. I know that for many teens this is difficult because they have to finish their homework at that time. Today’s teens need their computer or tablet to do homework.
If you have any time during the day to work on homework, do it. This is even more important for kids who take stimulant medicines for their ADHD. This medicine is out of your system close to bedtime, so it will be harder to sustain attention, making homework more frustrating and less efficient. Homework will take longer to do after medicine wears off, which decreases the time for sleep and fun activities.
If you can’t turn off the screen, at least use a program that limits the blue light that prevents the rise of melatonin. I personally use f.lux. It’s free and works on PC, Mac, ipad, android, and Linux. I find that it really helps. Try it!
Playing that one last game or checking Instagram one last time gives our brain a dopamine hit. Dopamine is a neurochemical known as the “reward molecule” that’s released after certain behaviors, such as eating, exercising or reaching a goal. While physical activity is most commonly linked to dopamine’s release, social media and online gaming are now shown to give a dopamine rush. This is why these behaviors are so addictive. It’s hard to stop the habit. One of the easiest ways is to just not use it except specific times of the day.
Take charge of your phone use ~
If you don’t want your parents restricting phone use, set your own reasonable limits.
Maybe check for messages before you leave for school after you’ve gotten ready. This can let you know of any needs or changes for the day.
Check messages again after school for the same reasons. Allow a 30 minute period to play a game or look at social media after homework is done. Then put it away and do something else.
It’s important to do things other than online games and social media. Find things to do that you enjoy. This article’s about sleep, but there are many negatives to spending too much time on screens. If you can’t limit yourself, talk to your parents or your doctor.
Indirect effects of phone use ~
It’s not just the direct issue of using our phone when it’s bedtime that interferes with sleep. There are indirect things as well.
It takes longer to finish homework when there are distractions from the phone. Putting your phone in another room when doing homework will help you finish more quickly, allowing you to get to other things more quickly.
Think of the extra time you can have to hang out with friends, getting exercise and getting to bed on time if you limit your screen time!
School districts that have started later start times have shown improved test scores, fewer absences and tardies, less depression, improved athletic performance, and better graduation rates.
Unfortunately, those schools are still in the minority.
Activities are too late.
It’s not uncommon to have regularly scheduled activities too late in the evening. Many activities in my area are scheduled to run until 9:30 or 10 on school nights for middle and high school aged kids.
When kids finally get home, they’re hungry, need a shower, and are ramped up so not ready for sleep. It can be well past 11 pm when they finally hit the pillow, so they need be able to sleep until at least 8 am to sleep 9 hours, but school’s already started by that time. It’s impossible for them to get sufficient sleep. After school naps might help, but not if there’s not enough time to fit it in between homework and the activity.
There’s no easy solution for this other than reviewing what’s really important and cutting back on whatever can be cut back. This might mean one less activity. Or maybe not taking every AP class or working fewer hours. All of these are important, but sleep is more important to your health and well being.
It will also take the adults in the community to recognize the benefits of sleep. Studies support later school start times, but there are many reasons schools haven’t adopted these. If you’re a real go-getter, get active in later start times movements.
Activities start too early.
I know many kids who must be at school before school actually starts. Whether it’s band practice, church study groups, sports, or taking a missed test before school, they all interfere with sleeping in, which is what teens need.
Again, this will take the adults in the community to recognize the importance of adolescents getting enough sleep. And for most teens, this means sleeping in because that’s when they’re physiologically able to sleep.
Medical causes of sleep deprivation.
If you suspect any of the following conditions are affecting your sleep, you should work with your doctor. Even if you aren’t sure why you’re always tired, talk to your doctor.
Anxiety – recurrent thoughts keep popping up
Restless leg syndrome – if your legs just need to move when you lay down
Sleep apnea – pausing of breath, often associated with snoring
Medications that affect sleep cycles – stimulants are commonly used for ADHD and can affect sleep
Heartburn or acid reflux
Hormone imbalances, such as thyroid problems – you might sleep a lot but still feel tired and have other symptoms
Anemia, or low red blood cell counts
Depression – every teen should have a depression screen yearly, but if you think you might be depressed, talk to your doctor now!
Nutrition – if you’re not eating enough, or eating foods that are not nutritious, you could feel more tired. If you eat foods that cause spikes in your blood sugar, as those sugars drop you feel fatigued.
Infections – we all need more sleep when sick!
Celiac disease – talk to your doctor if you have chronic abdominal issues, such as diarrhea, vomiting, pain, or weight loss
Chronic pain conditions – if it hurts, you can’t get comfortable enough to sleep
Chronic sleep deprivation – I know this is counter-intuitive, but being tired can make it harder to sleep.
ADHD – that race car brain just won’t wind down!
What difference does it make?
If you’ve read this far, you’re probably not surprised that so many teens (and adults) don’t get enough sleep.
What difference does it make if we’re sleep deprived? It turns out, there are a lot of consequences. Some you may know, some you may be unaware are related to sleep deprivation. Tune in next week to learn why we care so much about sleep deprivation!